Asthma is a chronic disorder that causes swelling of the airways, wheezing, coughing, and difficulty breathing. A child's asthma may be caused by genetic factors and by environmental factors like exposure to allergens, air pollution, and harmful chemicals. In reaching a diagnosis of asthma for your child, a doctor will talk to you about your child's history of symptoms and will also likely do testing with a spirometer, a machine that measures air flow. (For adults, see our article on disability for adult asthma.)
Children can get SSI if they meet Social Security’s definition of disability and if they have little income and few resources. Social Security will consider parental income and resources when deciding whether a child is eligible for SSI. (You can learn more about who qualifies by reading our article on Social Security benefits for children.)
If your child meets the financial criteria for SSI, Social Security will next determine whether your child's disability causes “marked and severe” functional limitations and has lasted or is expected to last at least a year. If your child’s condition satisfies these threshold requirements, Social Security will decide whether your child is considered disabled, either by meeting one of it's childhood disability listings or because of severe functional limitations.
Social Security’s childhood listing for asthma, updated in October of 2016, requires that your child has had three "exacerbations" or complications requiring hospitalization in the previous one-year period. The hospitalizations must have lasted at least 48 hours each and must have occurred at least 30 days apart.
The old listing, which applies to claims that were filed before October 7, 2016, required that a child have asthma attacks that were serious enough to require medical attention at least once every two months, or six times a year, despite taking asthma medications. The old listing also included other ways your child could qualify under the listing. For instance, your child could qualify if, due to asthma, he or she had abnormal growth relative to other children of the same age. Also, a child could qualify using results from a spirometer, if the child had the same level of forced expiatory volume (FEV1) as required to get disability for childhood COPD. The new asthma listing does not discuss forced expiatory volume, but a child can still qualify under the COPD listing for chronic asthmatic bronchitis if he or she has a low FEV1.
For children whose asthma doesn’t meet the requirements of the asthma listing, they may still be eligible for disability if Social Security finds that their condition “functionally equals” the listings -- in other words, causes limitations just as severe as those in the listings. For functional equivalence, asthma must cause your child to have a “marked” limitation in two areas of functioning or an “extreme” limitation in one area of functioning. The areas of functioning are:
You will need a lot of medical evidence about your child’s asthma to support an application for SSI. Social Security will look at your child's medical records for evidence that the asthma either meets a listing or functionally equals the listings. To qualify for SSI, you must show that your child’s asthma is not controlled with medications and continues to cause severe symptoms like those described in the listings.
Social Security will also review other records that may show your child’s limitations. In children's cases, school records are often helpful evidence of how the child's condition limits her daily activities.
If Social Security reviews your child's records and finds that more testing is needed, it may order a consultative exam and FEV1 test for your child. Social Security pays the cost of consultative exams. For more information, see our section on consultative exams.