Down syndrome is a genetic disease caused from extra genetic material. This occurs when there is abnormal cell division resulting in an extra full or partial copy of chromosome 21. This extra genetic material causes the development and physical features of down syndrome. Individuals typically have 46 chromosomes. An individual with down syndrome will have 47 chromosomes. Again, resulting from an error in cell division. Down syndrome is typically diagnosed during pregnancy through blood testing. However, it does occur where an individual is not diagnosed until later in life due to a lack of knowledge in the medical field. The main risk factor for down syndrome is the mother’s age. At age 25 a woman has a 1 in 1,200 chance of having a baby with down syndrome. At age 35 the risk is increased to 1 in 350. By age 49 the risk is 1 in 10, according to the National Down Syndrome Society.
Every year approximately 3,000 to 5,000 children are born with this extra genetic material. Because this condition results from a genetic abnormality, there is no cure. Research is focused on addressing the health concerns associated with this condition, rather than finding a cure.
The typical symptoms of the down syndrome include decreased or poor muscle tone; short neck with excess skin at the back of the neck; flattened facial profile and nose; small head, ears and mouth; and upward slanting eyes. Individuals with a mild form of down syndrome typically have an IQ of 50-69. A moderate form has an IQ of 35-50 and severe cases having an IQ of 20-35.
Applying for Social Security Disability Benefits
Because Down Syndrome is more than likely diagnosed before birth, parents and medical providers are given time to plan on the care the child will need once they are born. One factor that should always be considered with a diagnosis of Down Syndrome is applying for Social Security Disability benefits. When discussing disability, it is often thought of as an adult benefit. However, children may qualify for disability as well, being eligible for the supplemental security income program. No matter the age, an individual who has been diagnosed with Down Syndrome should apply for socials security disability benefits.
In either circumstance, applying as an adult or as a child, the same analysis is performed to determine eligibility. SSA will first consider whether you are engaging in substantial gainful activity. You can still work while qualifying for disability benefits, however, the amount you are working for must be minimal. All this means is that SSA will evaluate if you are currently working. If you are, and you are earning over a certain amount of money per month, you will automatically be disqualified for the program. This program is meant to assist individuals who are either not working at all or earning very minimal every month due to their medical condition.
The second consideration is whether your condition is severe or not. The Social Security Administration (SSA) will determine whether your condition poses more than a minimal impact on your ability to work. This threshold tends to be very low, but still requires a showing of proof in terms of severity.
The third consideration is whether you meet one of Social Security’s listed impairments.
Meeting or Equaling the Listing for Down Syndrome
SSA has a list of medical conditions in which they have deemed to be so severe that if proven you will automatically be found disabled. Down Syndrome is evaluated using Listing 10.06. This listing requires a diagnosis of Down Syndrome documented by a laboratory report of karyotype analysis along with a statement by a physician that you have been diagnosed with down syndrome. OR, you can show a physician’s report stating that you have chromone 21 trisomy or chromosome 21 translocations consistent with prior karyotype with the distinctive facial or physical features of down syndrome. The third possible way to meet this listing is through a physicals report diagnosing down syndrome with distinctive facial features along with evidence demonstrating that you function at a level consistent with non-mosaic down syndrome.
In general, it is very difficult to meet or equal one of Social Security’s listings. This is because if you are found to meet a listing then you are automatically found disabled, without an analysis of your physical and/or mental capabilities. more often than not, individuals are not found to meet a listing. However, in this scenario, being diagnosed with down syndrome is a pretty good indicator that you would be found disabled based upon a listing, without the need for a physical and/or mental analysis.
In the rare case you are not found to meet a listing based on down syndrome, SSA will then consider your physical and mental capabilities. As mentioned in the beginning, individuals with Down syndrome generally have a diminished IQ level. Certainly, IQ testing will help discern the level of mental capability. A statement from your doctor regarding your physical capabilities would be helpful as well. Once your capabilities are determined, SSA will consider whether you can perform your past work, and if not if there is other work you could perform. In the case of a child, there would be no past work so the analysis would jump straight to whether there is work, in general, the person could perform.
If you have been diagnosed with Down Syndrome, you should apply for Social Security Disability benefits. If you apply as a child, you would be eligible for supplemental security income benefits along with potential state health insurance. If you are an adult, and you have been able to work for the past five out of 10 years, you would be eligible for the disability insurance program. No matter your age or your work background, SSA will analyze your claim using the same five-step process.
The application and analysis can be quite confusing. To have the best chance of your case being approved, you should enlist the assistance of an experienced disability attorney. At the LaBovick Law Group, we provide free consultations to determine if this program is right for you. Any attorney fee is on a contingency basis. Meaning, you do not pay for anything out of pocket. The only way we get paid is if you get paid.