Getting SSI Disability Payments for a Child With Juvenile Diabetes

Over 350,000 children under 20 in the United States are estimated to have juvenile diabetes today, a number that has increased substantially in the last decade. Depending on how much diabetes affects their lives, children with juvenile diabetes and low family income can sometimes qualify for Supplemental Security Income (SSI) disability benefits. But unless there are other complications or health problems present, a child's diabetes must generally require daily insulin or 24-hour-a-day adult supervision to qualify for disability benefits.

When Is Juvenile Diabetes Considered a Disability?

There are two ways children under 18 can qualify for SSI for a disability. One is by meeting the requirements of one of Social Security's official disability listings, and the other is by showing that the child's limitations are as severe as those mentioned in the listings.

The Social Security Administration (SSA) will automatically consider your child's type 1 or type 2 diabetes mellitus a disability if the child meets the requirements of the Blue Book listing for juvenile diabetes (listing 109.08). But the listing only applies to children younger than six. For children under six years old to qualify for SSI disability under the listing, they must simply require daily insulin. To learn how children older than age 6 can get disability benefits for diabetes, keep reading.

Getting SSI for Children Who Don't Meet the Juvenile Diabetes Listing

A child with type 1 or type 2 diabetes can qualify for SSI disability benefits without meeting the requirements of the listing. For children younger than six who don't need daily insulin, and for children older than age six, Social Security will look to see whether the child's diabetes "functionally equals the listings" because of the limitations it causes.

Functionally Equaling the Listings With Type 1 or Type 2 Diabetes

If your child's circumstances don't fit the diabetes listing, Social Security will consider how your child's diabetes affects several areas of day-to-day functioning. A child with severe limitations will functionally equal the listings.

Social Security will take into account how the child's daily life is affected by diabetes management, including:

• how many episodes of hypoglycemia the child has at school
• how much supervision the child needs in monitoring blood glucose levels, and
• how often the child has to miss school due to doctors' appointments or hospitalizations.

Social Security will also consider whether the child's studies, school performance, or social interactions are severely affected by hypoglycemia or other diabetes symptoms, such as:

• the need to monitor glucose levels
• the frequent need for urination, or
• extreme fatigue.

In addition, if your child suffers any complications from diabetes, such as blurred vision, Social Security should take this into account when determining the severity of your child's limitations.

It's important to keep records of your child's daily blood glucose levels and how often your child becomes hypoglycemic, both in school and out of school. You'll also want to record how many school days your child misses due to illness, treatment needs, or hospitalizations.

A Need for Adult Supervision Functionally Equals the Listings

If your child needs the same type of adult medical supervision as that required by daily insulin use, Social Security will consider the child's condition to functionally equaling the listings.

For example, suppose your child is eight years old and needs 24-hour-a-day adult supervision to take care of insulin injections and monitor food intake, blood glucose, and exercise levels. Social Security will consider your child's diabetes disabling. (See 20 C.F.R. § 416.926a(m)(2), which says that any time a child requires 24-hour-a-day supervision for medical reasons, that child will qualify for disability by functionally equaling the listings.)

When Does a Child Need Adult Supervision for Glucose Monitoring?

Some children are six years old or older but can't control their own diabetes by monitoring their own food intake and watching for hypoglycemia (low blood sugar). In deciding whether the child needs constant adult monitoring, Social Security will take the following into account:

• how long the child has had diabetes
• the maturity of the child
• whether the child has an intellectual disability or an attention deficit, and
• whether the child has "hypoglycemia unawareness."

Children and teens with hypoglycemia unawareness either don't have any symptoms when their blood sugar drops too low or can't recognize the symptoms. Uncontrolled or prolonged hypoglycemia can cause seizures, loss of consciousness, and even brain damage. So a child or teen with hypoglycemia unawareness will likely need round-the-clock adult supervision to prevent these potentially fatal complications.

Other children might be capable of monitoring their insulin and blood sugar levels but qualify as disabled because they need more monitoring due to more complex medical situations.

Diabetes Complications That Might Meet Additional Listings

If your child's diabetes has caused serious complications, Social Security might evaluate your child's impairments under a different listing. For example, a small child whose diabetes has caused a growth impairment might meet the requirements of listing 100.05 (failure to thrive).

Both type 1 and type 2 diabetes can cause severe complications. Some of the complications associated with diabetes mellitus can be severe enough to qualify a child for SSI disability benefits, such as:

• seizures/altered mental states due to hypoglycemia
• heart trouble, like cardiac arrhythmias
• intestinal necrosis
• neuropathy
• developmental delays and learning disabilities
• anxiety, and
• depression.

Children rarely have severe complications because issues like these usually take a while to develop. But some teenagers can develop early-onset complications, like serious eye problems or kidney trouble.

Applying for SSI for a Child With Diabetes

To file a child's application for disability benefits, you'll first need to notify Social Security that you want to apply for SSI for a child. Once you do, Social Security will make an appointment for you to work with an SSA representative to submit your child's disability application.

You can request an appointment to apply for SSI for your child in any of the following ways:

• request an appointment online
• complete an online child disability report
• contact your local Social Security office, or
• call the SSA's national office at 800-772-1213 (TTY 1-800-325-0778).

You'll need to provide Social Security with some basic information about your child, your family, and your child's medical condition. Social Security will also want to see certain documents, such as:

• your child's birth certificate or proof of adoption
• your income records (and those of your other household members)
• bank statements and other records that show your resources, and
• any medical records you have in your possession.

You'll also be asked to sign an information release form authorizing Social Security to gather the rest of your child's medical and school records.

Social Security reports that it takes an average of three to five months to make an initial determination in a child's SSI disability case. You can expect it to take much longer if you have to appeal. (Learn more about appealing a denied disability claim.)

How Much Will Your Child's SSI Payment Be?

The federal SSI benefit is currently $943 per month (in 2024), but few children actually receive that amount in SSI disability. If the child's parent or parents work, part of their income will be attributed to the child (read our article on how Social Security deems family income). That could mean the child might only get a couple hundred dollars a month in SSI payments.

On the other hand, some states add to the federal SSI benefits with a state supplementary payment. State supplements can add anywhere from $10 to $200 to the child's monthly SSI payment—providing additional financial help for children with Type 1 or Type 2 diabetes. (Learn more about state SSI supplements.)

How Can You Spend Your Child's SSI Payments?

You can use your child's SSI payment to pay for:

• medical treatment
• medical copays or uncovered costs of the child's daily insulin injections
• healthy food for the child, and
• rent and utilities for the family's home.

Some families have also racked up debts due to medical bills for doctors' visits, insulin delivery pumps, or other costs that weren't covered by insurance. SSI can be used to pay off these debts.

For more information, read our article on what you can pay for with your child's SSI.

_{Updated April 11, 2024}