Down Syndrome & Social Security Disability Benefits

Q: Is Down Syndrome a qualifying impairment for disability benefits?

The federal government offers two different disability benefits programs, both administered through the Social Security Administration “SSA”. The first program, Social Security Disability Insurance or “SSDI”, is available to disabled people who can satisfy the work history requirements, regardless of their financial status. The second program, Supplemental Security Income or “SSI” does not require a prior work history but rather is a means-based program for qualified disabled people who do not exceed the extremely limited income and assets threshold.

Qualifying for disability benefits for either program requires the applicant meet the federal government’s definition of “disabled” which is “suffering from a physical or mental impairment that prevents engaging in substantial gainful activities and that has lasted or is expected to last for 12 months or more or result in death”.

The SSA has a list of qualifying physical and mental conditions, called the Blue Book. While it would seem straightforward to qualify for benefits based on a diagnosis of one of these conditions, that isn’t always the case. When the impairment is mental in nature, symptoms can be difficult to evaluate which can open the door for a denial of benefits. The majority of initial applications for benefits are denied.

What are some reasons a disability claim based on mental illness might be denied?

Some reasons why disability claims for mental illness may be denied include but are not limited to:

• vague treatment notes by mental health professionals
• failure to take prescribed medication
• failure to follow doctor’s orders
• “lack of duration” –  if the condition hasn’t lasted or isn’t expected to last for at least a year.

How are Down Syndrome cases approached?

Generally, in 98%of cases, Down Syndrome applicants will qualify for disability benefits as far as the definition of being “disabled” goes, under the statute’s Blue Book section 10.00 Congenital disorders that affect multiple body systems and more specifically subsection 10.06 Non-mosaic down syndrome. For the 2% who have mosaic Down Syndrome, it’s harder to qualify for benefits, but qualifying may be possible using commonly accompanying conditions like cardiac issues, communication problems, vision or hearing loss, and more.

Parents of children with Down Syndrome may be able to apply for SSI benefits at a young age, depending on their income. If they exceed the income and assets threshold they may need to wait or reapply once the child reaches the age of 18. A disability benefits attorney can provide more specific guidance.

Interestingly, the new study shows that “three out of five people with Down Syndrome will be diagnosed with Alzheimer’s disease and other types of dementia by age 55”. Alzheimer’s is another impairment recognized as a qualifying disability by the SSA. So those with Down Syndrome who may be able to work in their youth despite their Down Syndrome symptoms may find they qualify for disability benefits if and when Alzheimer’s symptoms appear later in life.

Contact Our Social Security Disability Attorney Today to Learn More

If you have questions regarding applying for Social Security disability benefits for yourself or your child, or need assistance appealing the denial of benefits, the disability attorneys of Arizona at Roeschke Law can help you. Contact us today for a free consultation.

With offices in Tempe, Tucson, and Phoenix, we represent disabled people and their families throughout Arizona in all aspects of disability law.