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 airflow. (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 the childhood disability listings or because of severe functional limitations.
Social Security's childhood listing for asthma 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.
For claims that were filed before October 7, 2016, the old listing applies. It 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 expiratory volume (FEV1) as required to get disability for childhood COPD. The new asthma listing does not discuss forced expiratory 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:
For children with asthma, the area that's most relevant is the last one, having good physical well-being. Social Security will look to see how your child's ability to function physically is affected by the asthma. For instance, your child may have lung damage or peribronchial disease (thickening of the bronchial walls) caused by asthma, causing persistent difficulty breathing outward and wheezing. Or your child may need to use asthma medications day and night along with corticosteroids. Some children have asthma so severe that it slows their growth relative to other children of the same age. These conditions all show marked or extreme limitations on the child's health. (For more information on qualifying for benefits this way, see our article on functional equivalence.)
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.
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