People with Down syndrome typically have some degree of intellectual disability (formerly called mental retardation) and certain physical characteristics, such as a flattened bridge of the nose, epicanthic folds (folds over the inner corner of the eyes), shorter arms and legs, and poor muscle tone. Over 96% of people diagnosed with Down syndrome have “non-mosaic” Down syndrome, where every cell has an extra 21st chromosome (called trisomy 21). A very small number of people are diagnosed with “mosaic” Down syndrome, where some of the cells have an extra 21st chromosome and some of the cells have a normal number of chromosomes. People with mosaic Down syndrome tend to have higher IQs than those with non-mosaic Down syndrome and may be less likely to be disabled.
Disability applicants with a diagnosis of non-mosaic Down syndrome can automatically qualify as disabled under the Social Security Administration's (SSA's) official disability listing for Down syndrome if they can prove they have a diagnosis of non-mosaic down syndrome (either trisomy or translocation).
The evidence required by Social Security's listing depends on whether the disability applicant with Down syndrome has had a certain type of chromosomal analysis done called a karyotype chromosomal analysis. In 2017, the evidence required by the listing, listing 10.06, was changed. Here are the various ways Social Security will now accept evidence of non-Mosaic Down syndrome:
While people with mosaic Down syndrome often suffer from many of the same additional physical impairments that people with non-mosaic Down syndrome suffer from, the SSA does not have a specific disability listing for mosaic Down syndrome. A diagnosis of mosaic Down syndrome alone is not enough to qualify for benefits.
Because the severity of impairments with mosaic Down syndrome can vary widely from person to person, the SSA requires the applicant to prove he or she has specific physical or mental limitations that are disabling. An applicant with mosaic Down syndrome will be evaluated by the SSA under the disability listing(s) that fit whatever physical or mental impairments he or she has. Some common physical and mental impairments that an applicant with mosaic Down syndrome might have that are "listed" impairments include:
For more information on SSA's disability criteria for these impairments, see our articles on disability for the specific impairment by visiting the links above. The above is true for children and adults with mosaic Down syndrome. In addition, for adults who don't meet a listing, Social Security will assess what their capabilities and limitations are.
If an applicant has non-mosaic Down syndrome, the SSA will not assess the applicant's ability to work, because a diagnosis of non-mosaic Down syndrome automatically meets SSA's criteria for disability. However, if an adult applicant has mosaic Down syndrome with other impairments but does not meet the criteria in the listing for those impairments (because the impairments aren't considered severe enough), the SSA will look at the applicant’s "functional capacity."
The SSA will create a residual functional capacity, or RFC, report to determine what limitations the applicant has and what kind of work the applicant is still capable of doing despite the limitations. For example, if an applicant suffers from congenital heart disease, his or her RFC assessment may limit the amount of physical exertion the applicant is able to perform in an employment situation. A person who is hard of hearing will have limitations on working in jobs that require good hearing. Depending on an applicant’s IQ, if he or she is severely intellectually disabled, the RFC assessment may limit the kinds of work that applicant can perform.
If the SSA finds that an applicant’s RFC is not sufficiently limiting, and that the applicant is capable of performing a simple and/or sedentary job, the SSA can deny the claim. But if the SSA determines that the symptoms associated with the impairment are so limiting that there is no job the applicant can perform, he or she will be awarded benefits under what is called a “medical-vocational allowance.” For more information, see our articles on RFCs and the medical-vocational allowance.
Since children can’t be assessed on how their disability limits their ability to work, the SSA does not assess a child's residual functional capacity if the child does not meet the requirements of a listing. Instead, the SSA will decide if the child's condition "functionally equals the listings."
A child (generally considered a person under the age of 18) can qualify for disability benefits in a few different ways.
SSI. A child can receive benefits through the Supplemental Security Income (SSI) program, just like an adult can. Under the SSI program, disabled people with limited resources and income receive monthly payments (keep in mind that some of the parents' income is deemed to the child). For more information, see our articles on eligibility for Supplemental Security Income.
SSDI. Social Security Disability Insurance (SSDI) is available only to disabled people who have worked a certain length of time in jobs that have paid Social Security taxes. A child cannot receive SSDI benefits based on their own earnings (a person isn’t able to work the required length of time before that person turns 18).
However, if a child’s parent collects Social Security retirement or is disabled and collects SSDI, the child may be able to receive what is called Social Security dependents’ benefits. The monthly amount of benefits the child receives is based on the record of the parent. (“On the record” just means that it is based on the amount of the parent’s earnings over the years.)
A child does not have to be disabled to receive dependents’ benefits. However, if the child is not disabled, the benefits will generally end when the child turns 18. If the child is disabled, the benefits will continue even after turning 18 if the following conditions are met:
For more information, see our article on disability benefits for disabled adult children.