Anorexia nervosa, commonly referred to as anorexia, is an eating disorder in which individuals starve themselves due to an unrealistic view of their bodies. Anorexia is becoming more and more common among children and teenagers. Bulimia nervosa, commonly referred to as bulimia, is another eating disorder, in which the individual binges and purges. Anorexia and bulimia often occur together. If your child suffers from anorexia or bulimia so severe that it affects their ability to function, it may be possible to receive disability benefits through Supplemental Security Income (SSI). (For those over 18, who can receive either SSI or Social Security disability benefits, see our article on disability for adults with eating disorders.
Symptoms of Eating Disorders
Some children are naturally slender, picky eaters, or show minimal interest in food. However, children and teenagers who suffer from anorexia go beyond normal childhood issues to a point where they can be harming themselves both in the short-term and long-term. Some of the signs of anorexia and eating disorders include:
- anxiety, depression, perfectionism, or being highly self-critical
- excessive or compulsive dieting
- dieting even when thin
- rapid weight loss that is covered up by loose clothing
- unusual interest in food, and
- strange eating habits.
Short-Term Effects of Eating Disorders
Short-term effects of anorexia can include:
- dry skin that stays pinched when pinched and released
- yellowing of the skin
- abdominal pain
- intolerance to cold temperatures
- growth of lanugo, which is a fine hair that grows on your body to keep you warm
- lowered blood pressure, pulse, body temperature, and breathing rates
- slowing of the intestinal track, and
- social withdrawal, irritability, moodiness, and/or depression.
Long-Term Effects of Eating Disorders
After your child begins to eat normally again, the short-term effects generally will go away. However, there are some long-term effects that can occur due to the stress placed on the body, including:
- damage to the major organs, including your brain, heart, or kidneys, and
- thinning of the bones.
It is important to remember that recovery from anorexia or bulimia is not as straightforward as treating other diseases. As it is a psychologically based disease, your child may relapse and will likely need ongoing treatment to maintain healthy eating habits.
When Eating Disorders Qualify for Disability Benefits
In order for your child to qualify for disability benefits through SSI, there are certain income requirements the household in which they live must meet. Once the technical requirements are met, your child must be medically eligible in one of the following ways:
- meeting or equaling an impairment listing from the Social Security “Blue Book,” or
- functionally equaling the listings.
Meeting the Listing for Eating Disorders
To meet a listing, your child must have all of the requirements in a particular listing, as well as the medical records to prove it. For children suffering from anorexia or bulimia, there is a listing in the Children Listings section of the “Blue Book,” called Somatoform, Eating, and Tic Disorders. To meet this listing, you must show that your child:
- Has an unrealistic fear of and perception that they are fat, despite being underweight
- Persistently maintains a body weight that is below the 15% mark for their height and weight, and
- Has marked impairments in at least two of the following areas:
- cognitive and/or communicative function
- social functioning
- personal functioning, and/or
- maintaining concentration, persistence, or pace with tasks.
For children ages one to three years, one of the following types of skills must be at the level of a child half the age of your child:
- gross or fine motor development
- cognitive function or communication skills, or
- social functioning.
(Or, if your infant or toddler has deficits in two or more of the above areas, your child’s general development or functioning needs to be only at a level of a child 2/3 of your child’s age (for example, your child is three but functions as a 18 month old).)
Medical Evidence Required to Meet This Listing
In order to prove that your child meets the requirements of the above listing, Social Security looks at the functional limitations that are caused by your child’s disorder and the severity and duration of your child’s impairments. Social Security compares your child's level of function to other children of the same age by looking at:
- psychiatric or developmental testing results
- standardized test results
- symptoms (complaints reported by your child)
- signs (medically demonstrable disorders according to a psychiatrist)
- lab results, and
- reports from individuals who are around the child, such as parents, teachers, babysitters, and so on.
If your child is on medication to deal with a mental disorder, such as medication to treat depression, the effects of the medication will be considered when looking at your child’s overall level of functioning.
In addition, you must show that the symptoms that your child is suffering from are not caused by a physical problem (that weight loss is not due to a physical problem which is causing them to lose weight).
Functionally Equaling the Listings
If your child does not meet the requirements of the above listing, but still suffers from significant difficulties, he or she may be able to "functionally equal the listings." To functionally equal the listings means that your child’s impairment has to be equal in severity to the impairments in the listings. Social Security assesses whether your child's condition can be considered equivalent to the listings by evaluating six domains of functioning, including learning, performing tasks, socializing, movement, self-care, and health and physical well-being. You must show that your child has two “marked” limitations or one “extreme” limitation within the six domains.
Those with anorexia would have significant difficulty in the domain of “health and physical well being,” as this domain includes the ability to have knowledge of and provide yourself with proper nutrition. The domain of “interacting and relating with others” will also likely be impaired, as this domain covers the ability to interact with others and maintain relationships with others. For those with anorexia, social withdrawal, depression, and strange eating habits may inhibit the ability to maintain relationships.
For more information on how to show that your child functionally equals the listings, see our article on how a child can functionally equaling the disability listings.
Continuing Disability Review (CDR)
If your child is awarded disability benefits based on his or her eating disorder, he or she will face periodic reviews of of the disability. For a disability that has a possibility of improving, like anorexia or bulimia, Social Security assesses your child’s disability every three years.
For more information, see our on CDRs.
When Social Security decides to grant or deny disability benefits based on a child's level of functioning, the medical and school records often don't contain enough information for an informed decision. So the decision often becomes a subjective one, based on the opinions of the claims examiner or administrative law judge who decides the case, rather than an objective one based on the records of doctors and psychiatrists or psychologists. To get help bringing as much evidence in your favor as possible to your hearing, and get your child the help he or she needs, you should consider hiring a lawyer who specializes in disability cases.