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SSDI and Congenital Disorders

Home  /  SSDI and Congenital Disorders

Congenital Disorders Affecting Multiple Body Systems


Every year in the United States, about 6,000 babies are born with Down syndrome – that’s one in every 691 babies. People with Down syndrome are at a greater risk for medical conditions such as congenital heart defects, respiratory and hearing problems, Alzheimer’s disease, childhood leukemia, and thyroid conditions. Although many with Down syndrome are able to get employment in a variety of positions, there are some who cannot participate fully in society or work or develop severe issues that stop them from working.


According to the Social Security Administration (SSA), Down syndrome and other chromosomal abnormalities, present from birth, are impairments involving multiple body systems. Social Security Disability Insurance (SSDI) benefits help provide critical financial support to those affected.


What Criteria Does the Social Security Administration (SSA) Use to Evaluate Down syndrome?


Down syndrome occurs when a cell has an extra chromosome 21. There are two kinds of Down’s syndrome:

  1. Mosaic Down syndrome: In this kind, not every cell has an extra chromosome21. This means that some cells have 46 chromosomes, which is the “typical” group, whereas others have an extra copy of the chromosome 21.
  2. Non-mosaic Down syndrome: Every cell in the body has an extra chromosome 21, and almost all cases of Down syndrome are non-mosaic.


Non-mosaic Down syndrome qualifies for disability benefits based solely on proof of diagnosis. On the other hand, a mosaic Down syndrome case needs to fulfill additional criteria to be considered. In addition to Down syndrome, other chromosomal abnormalities are also listed in this section.


What Kind of Documentation Is Required?


A karyotype test is the most definitive way Down syndrome is diagnosed, so the SSA requires a copy of the laboratory report of the karyotype analysis signed by a physician. Here are some things you need to keep in mind:

  • A fluorescence in situ hybridization (FISH) test is not accepted as it does not distinguish between mosaic and non-mosaic forms.
  • In case a physician has not signed the karyotype analysis, you also need a physician’s statement that you have Down syndrome.
  • In some cases, you may need a physician’s report stating that you have distinctive facial or other features of a Down syndrome, and that you are functioning at the level of a non-mosaic Down syndrome patient.


What Congenital Disorders Affecting Multiple Body Systems Are Listed?


Section 10 of the Blue Book lists Down syndrome and other chromosomal disorders. They are:


Non-mosaic Down syndrome: This is the most common form of Down syndrome. It affects many other systems of the body like the skeletal and neurological system, and is often accompanied by vision problems, heart disease, hearing impairment and other problems. With appropriate documentation, it is considered as a disability from birth.


Catastrophic congenital disorders: Under this listing, the following disorders appear, usually expected to result in early death: anencephaly, cyclopia, chromosome 13 trisomy, and chromosome 18 trisomy. To qualify for benefits, you need appropriate proof of diagnosis along with the additional criteria of expected death within the first few months of life, or serious limitations in functioning are required.


Mosaic Down syndrome: This differs in the extent of its severity, so there is no listing for it. However, in these cases, and the catastrophic congenital disorders, the SSA determines the effects of these impairments on the claimant on an individual case basis.


What Happens When Your Down Syndrome Does Not Meet a Blue Book Listing?


Mosaic Down syndrome has no listing in Section 10 of the Blue Book. However, the SSA evaluates each case in detail, and if your Down syndrome does not meet a listing, they will decide if your impairment medically or functionally equals a listing. They may even assess your Residual Functional Capacity (RFC) to see how much work you can do and to what extent. This is where mosaic Down syndrome cases can be considered for benefits if the severity equals that of non-mosaic Down syndrome. If it does, you may be approved for SSDI benefits through a medical vocational allowance.


Is There a Faster Way to Process SSDI Benefits?


Non-Mosaic Down syndrome claimants are considered as disabled from birth and become eligible automatically for Social Security disability benefits. While Down syndrome claims cannot be rejected on medical grounds if there is proper documentation, there might be other technical factors that could slow the process down. Unfortunately, Down syndrome cases are not listed under the Compassionate Allowance program, so it is best to fill out the forms and application carefully and wait for the claim to be approved in the standard amount of time.


Apply for SSDI Benefits Today


While a diagnosis of non-mosaic Down syndrome is more likely to get an approval than mosaic Down syndrome, it is important to remember that appropriate documentation and providing the SSA with accurate and detailed information is crucial to getting approval for SSDI benefits. Our disability advocates at Disability United can guide you through every stage of the application process.


Get the benefits you deserve. Start by filling out our form to receive a free disability evaluation.