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Tips on Applying for Disability Benefits with Down Syndrome

Down syndrome is a common generic condition where children are born with an extra chromosome. Down syndrome typically results in developmental and physical disabilities, which can make it challenging for adults to work. There are three forms of Down syndrome: Trisomy 21, Translocation, and Mosaic. Most people with Down syndrome have non-mosaic Down syndrome, but a small amount of people (2%) have mosaic Down syndrome.

TIP #1: Collect all Available Medical Evidence

If your loved one has non-mosaic Down syndrome, he or she will automatically medically qualify for disability benefits through the Social Security Administration (SSA). To provide medical evidence of non-mosaic Down syndrome diagnosis, you will need to show that your loved one had a karyotype chromosomal analysis preformed in the past. You can provide a lab report from this test to the SSA to meet the criteria for receiving benefits, or you can list the hospital where the analysis was preformed in the application.

If you do not have the results of your karyotype chromosomal analysis, there are other forms of medical evidence you can provide to the SSA. One option is to ask your doctor to provide the SSA with a written statement that you have many of the physical and developmental features of Trisomy 21 or Translocation Down syndrome.

Your doctor will also need to give a statement that your child has received a chromosomal analysis in the past and that the test confirmed he or she has non-mosaic Down syndrome. If this information is provided, and no other information in your medical history goes against the fact that he or she has non-mosaic Down syndrome, he or she will most likely be approved for disability benefits.

If your child has mosaic Down syndrome, he or she will not automatically qualify for disability benefits through the SSA. This is because people with Mosaic Down syndrome often do not have the same physical or developmental delays of those with other forms of Down syndrome. One option to make a disability case with the SSA is to prove that your child has another medical condition caused by mosaic Down syndrome. Such conditions can include:

  • Heart disease
  • Breathing disorders
  • Hearing loss
  • Developmental disabilities
  • Thyroid issues

TIP #2: Provide as Much Non-Medical Evidence as Possible

If your child does not automatically qualify for disability benefits due to your mosaic Down syndrome along with any other medical conditions, there are still options available. The SSA will determine if your loved one is reasonably able to work by using a Residual Functional Capacity (RFC). This is an evaluation filled our by your doctor that shows what kind of work your loved one is still able to perform with his or her disability, if any.

For instance, if your child suffers from hearing loss due to Mosaic Down syndrome, he or she will not be able to work at a job that requires good hearing. If your child has heart disease caused by Mosaic Down syndrome, he or she will not be able to perform any job that requires a lot of physical effort. The SSA may also look the applicant's level of intelligence and level of developmental delays to see whether or not he or she is severely limited in the kind of work is possible.

If the SSA finds that the RFC does not limit your loved one from working certain jobs, he or she will most likely be denied disability benefits. But if you can prove that an applicant's mosaic Down syndrome and any associated conditions limits your loved one's ability to work, he or she could be approved.

TIP #3: Apply Meticulously and Leave no Sections Blank

If you are applying for a loved one with Down syndrome, you can start the application online at www.ssa.gov. When filling out the application, whether online or at your local SSA office, be as careful as possible. List everything and anything your child is unable to do, such as getting dressed alone, counting money, or handling large group settings. The more detailed you are, the higher your chances of approval.

Keep in mind that if your child with Down syndrome is under the age of 18, your income will be taken into account when evaluating your child's application. Children from moderate to high income households will not qualify for benefits. To learn more about asset deeming, visit our page on Supplemental Security Income.