Asthma is a chronic disorder that causes swelling of the airways and 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.)
SSI for Children
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 by reading our article on Social Security benefits for children.
If your child meets the financial criteria for SSI, Social Security will next make sure that your child's disability causes “marked and severe” functional limitations and has lasted or is expected to last at least a year (or to result in death). If your child’s condition satisfies these threshold requirements, then Social Security will decide whether your child is disabled, either by meeting one of it's childhood disability listings or because of severe functional limitations.
Social Security’s Listing for Childhood Asthma
Social Security’s childhood listing for asthma describes four separate ways that a child's asthma can qualify for disability. Your child's condition only has to fit one of these situations to qualify for SSI.
- Spirometry test results. The child must have the level of forced expiatory volume (FEV1) equal to or less than the level required to show disability for childhood COPD. It may be difficult for a young child to follow directions for spirometry, so this will not be the way to qualify very young children for SSI.
- Severe asthma attacks that are not controllable with medication. The child must have asthma attacks that are serious enough to require medical attention at least once every two months or six times a year. The attacks must happen in spite of your child's taking asthma medications. If your child is hospitalized for more than 24 hours to stabilize her asthma, the hospitalization counts as two attacks for the purpose of meeting the listing. Qualifying for disability under this section requires an evaluation period of at least 12 months.
- Asthma that causes lung damage. Persistent difficulty breathing outward and persistent low-grade wheezing between attacks (or other absence of symptom-free periods) requiring your child to use asthma medications during the day and night and either pulmonary hyperinflation (abnormally large lung capacity, evidenced by imaging) or peribronchial disease (thickening of the bronchial walls).
- Asthma that causes frequent use of corticosteriods. Persistent low-grade wheezing between attacks (or other absence of symptom-free periods) requiring your child to use asthma medications during the day and night along with short courses of corticosteroids that average more than five days per month for at least three months during a 12-month period.
- Asthma that cases growth impairment. The child’s asthma is so severe that it is slowing the child’s growth relative to other children of the same age. To qualify under this section, a child’s doctor must compare the child’s growth over time to other children the same age, and the doctor must find that the child’s growth problem is caused by the asthma. Your child must appear under certain percentiles on standard growth charts.
Equivalence of Functional Limitations to Listings
If your child’s asthma doesn’t meet the requirements of any of these four sections of the asthma listing, she may still be eligible for disability if Social Security finds that her 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:
- Acquiring and using information
- Attending and completing tasks
- Interacting and relating with others
- Moving about and manipulating objects
- Caring for personal needs, and
- The child’s health and physical well-being.
You will need a lot 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 one. 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.