Applying for Social Security Disability Benefits with Cerebral Palsy
Cerebral palsy is a neurological disorder that affects the brain and disrupts coordination and muscle movements. Most people who have cerebral palsy are diagnosed at birth, although some children are diagnosed after a matter of months. According to United Cerebral Palsy, almost 800,000 adults and children are currently diagnosed with the disorder.
If you have cerebral palsy or you are the parent of a child with cerebral palsy, the Social Security Administration (SSA) may be able to help you. The SSA gives financial aid to people who are unable to work due to a severe disability such as cerebral palsy.
The Financial Costs of Cerebral Palsy
Cerebral palsy can be a very debilitating condition, which can lead to high financial losses through an inability to work. The CDC reports the disorder can cost families over $900,000 throughout a child's lifetime. About 80 percent of these costs are indirect costs due to missed work and more. This is due to the fact that cerebral palsy is a lifelong disability. Because there is no cure, children who are diagnosed with cerebral palsy are often unable to work as adults.
Cerebral palsy is also expensive for families because children with cerebral palsy often have another disability, such as an intellectual disability, epilepsy, vision loss or difficulty seeing, or autism. These additional disabilities only add to a child’s medical care and inability to work as an adult.
Medically Qualifying for Benefits with the Blue Book
Whenever someone applies for disability benefits, his or her disorder will be compared to the SSA’s Blue Book. The Blue Book is a medical guide used to determine whether or not an applicant is ill enough to qualify for benefits.
Children and adults have separate Blue Book criteria. Cerebral palsy can be found in section 11.00—Neurological Disorders for adults and Section 111.00 for children.
In order to be approved with cerebral palsy as an adult, you need medical evidence showing you your cerebral palsy causes one of the following:
- An IQ of 70 or less.
- Abnormal behavior patterns, such as emotional illnesses
- Significant difficulty in spoken or visual communication
- Significant difficulty with motor function in two limbs, resulting in sustained disturbance of large movements, fine motor skills, walking or standing.
In order to be approved with cerebral palsy as a child, you need medical evidence showing you have cerebral palsy with at least one of the following:
- Difficulty with motor function for age involving two limbs, which (despite prescribed therapy) interferes with age-appropriate major daily activities and results in disruption of large and fine movements or ability to walk and stand.
- Less severe motor dysfunction and one of the following:
- An IQ of 70 or less
- A seizure disorder, with at least one seizure within the past year
- An emotional disorder
- Difficulty with vocal communication, vision, or hearing.
Children generally have an easier time medically qualifying for cerebral palsy than adults. If your child is approved for disability benefits, the SSA will revaluate your child at age 18. Although most children will keep their benefits into adulthood, around 30% of children are denied benefits after turning 18 because the medical eligibility is stricter.
Qualifying Without Meeting a Medical Listing
Not everyone with cerebral palsy, especially adults, will meet the SSA’s medical criteria. This does not mean that you cannot qualify for disability benefits with cerebral palsy.
If you can prove that your cerebral palsy is severe enough that you're unable to earn more than $1,130 in 2016 due to your cerebral palsy, you may still qualify for disability benefits. You can do this by having your doctor fill out a Residual Functional Capacity (RFC) evaluation.
The SSA measures an RFC by examining your physical and intellectual disabilities and limitations, as well as your education and work history. If you are older, and if you do not have a lot of education, you will be more likely to be approved for disability benefits. Young adults who went to college who have cerebral palsy are much more likely to be denied benefits than older adults who’ve never received an education and have been unable to work their entire lives.
Cerebral palsy affects many different parts of your body and causes symptoms that could limit you from working, such as inability to walk or stand effectively or at all, muscle stiffness, balance and coordination problems, involuntary movements, pain, intellectual disabilities, seizures, issues with vision, speech, hearing, and communication, emotional instability, and more.
Because of this, adults with cerebral palsy who have only worked in jobs like construction, retail, food service will also be more likely to be approved for disability benefits. However, even sedentary jobs often require fine motor skills as well, like typing, so it will ultimately depend on how your cerebral palsy affects you.
How to Apply for Social Security Disability Benefits
Before you apply for disability benefits, talk to your doctor. You doctor can speak with you about your medical records and determine whether or not starting the application process will be worthwhile. The application can take months or years and to be approved, especially if you need to appeal a denied claim. If cerebral palsy isn't severe enough to keep you from working, you could save yourself and your family a lot of emotional stress.
If you meet a Blue Book listing or you think an RFC approval is likely, the key to getting approved quickly is to include all of the medical information the SSA requires. Many of the 70 percent of applicants who are denied are denied because they're missing important evidence about their condition.
Important medical evidence for qualifying with cerebral palsy will include:
- Ultrasounds, MRI, CT scan, and other medical imaging tests
- Reports of seizures, hearing loss, blindness, or other related conditions
- Blood tests
- Detailed doctors, psychiatrists, and physical therapists reports
- Analysis of motor skill development from childhood into adulthood if applicable
- I.Q. testing
- Records of hospitalizations or surgeries related to cerebral palsy
Make sure to check the SSA's website for a list of all documents needed for your application and double check your application. The SSA has both Adult Disability Starter Kits and Child Disability Starter Kits. These guides will help families determine exactly what paperwork they will need to turn in to qualify for benefits.
When filling out the application, whether online or at your local SSA office, be sure to answer every question about your cerebral palsy or your child’s cerebral palsy as thoroughly as possible. Many applications are denied due to lack of medical evidence, or a mistake on the application.
If your application for cerebral palsy is denied, you can always appeal the decision in court. Keep in mind that when applying on behalf of a child, parents’ income will be taken into consideration. This means that if you are earning too high of an income, your child will not qualify for disability benefits until age 18, regardless of how severe his or her cerebral palsy is.
With medical evidence to support your claim, you will hopefully be approved for disability benefits in just a couple of months.