Can My Child Get SSI for Kidney Disease?

Kidney diseases in children can range from mild, treatable disorders to acute and sometimes life-threatening and disabling conditions. The most common kidney diseases are present at birth and include:

• posterior urethral valve obstruction
• fetal hydronephrosis
• polycystic kidney disease
• multicystic kidney disease
• renal tubular acidosis
• wilms tumor
• glomerulonephritis, and
• nephrotic syndrome.

Getting SSI for Children's Kidney Disease

In order to be eligible for SSI (Supplemental Security Income), children must meet Social Security's definition of disability, and their parents must have limited income and resources. To learn more about the household income and resource limits, see our article on qualifying financially for SSI as a child.

Once the income and asset requirements are met, the child must meet Social Security's definition of disabled. There are two ways that Social Security can determine that your child is disabled. Your child's kidney disease can be severe enough that it meets the requirements set forth in Social Security's Listing of Impairments, which lays out the medical conditions that Social Security considers severe enough to be automatically disabling. If those medical requirements are not met, a child can still be found disabled if he or she has significant functional limitations arising from the kidney disease.

Meeting the Listing for Kidney Disease

The listing for kidney disease, found in Section 106 of the Listing of Impairments, sets forth a number of medical requirements that must be met in order for your child's condition to be disabling. If your child has any one of the following seven types of conditions due to kidney disease, Social Security will consider him or her automatically disabled.

• Chronic kidney disease with ongoing dialysis. Your child's dialysis treatment must have lasted or be expected to last for a continuous period of at least 12 months.
• Kidney transplant. Children who have received a kidney transplant will be considered disabled for one year from the date of the transplant. After a year, Social Security will evaluate whether your child is still disabled due to complications from the transplant.
• Impairment of kidney function with certain lab results.You must be able to demonstrate through lab reports one of the following, on at least two occasions at least 90 days apart during a 12-month period:
  • serum creatinine of 3mg/dl or greater
  • creatinine clearance of 30 ml/min 1.73m2 or less, or
  • estimated glomerular filtration rate (eGFR) of 30ml/min/1.73m2 or less.
• Nephrotic syndrome.Your child must have anascara (swelling of the body due to fluid build-up) plus either of the lab results set forth below, documented on at least two occasions at least 90 days apart during a consecutive 12-month period:
  • serum albumin of 3.0g/dl or less, or
  • proteinuria of 40 mg/m2/hr or greater.

• Congenital genitourinary disorder. This listing is met if your child has had urologic surgical procedures at least three times in the last year, with at least 30 days between procedures.
• Growth failure due to any chronic renal disease. To meet these requirements, there are very specific indicators of growth failure based on Body Mass Index (BMI). Look at the table contained in Section 105.08to find the measurements that apply to your child's age and gender.
• Complications of chronic kidney disease. This listing is met if your child has been hospitalized for at least 48 hours three times or more within a year, occurring at least 30 days apart.

Social Security will look at lab results, reports of doctors' examinations, and treatment records to determine whether your child meets the listings. Social Security may also send your child for a consultative examination with an independent doctor at no cost to you if there is not sufficient medical evidence to make a proper determination.

Showing Functional Limitations That "Equal" the Listing

As mentioned above, if the listing requirements are not met, Social Security may still find that your child is disabled if your child has significant functional limitations due the kidney disease. To be eligible for SSI by "functionally equaling" the listings, you must be able to show that your child has "marked" limitations in two out of six areas of functioning or an extreme limitation in one area of functioning. A marked limitation means that your child's ability to independently initiate, sustain, or complete activities is seriously limited. An extreme limitation means that your child's abilities are very seriously limited.

The areas ("domains" in Social Security jargon) of functioning are:

• acquiring and using information
• attending to and completing tasks
• interacting with and relating to others
• moving about and manipulating objects
• caring for personal needs, and
• health and physical wellbeing.

Because kidney disease can cause learning delays and concentration difficulties, you may be able to prove limitations in the first two domains of functioning: acquiring and using information and attending to and completing tasks. School records and teacher reports, in addition to medical records, would be helpful evidence to support these limitations.

In addition, because kidney disease can cause headaches and nausea and may result in repeat hospitalizations, your child's health and physical well-being may also be seriously compromised. Hospital records and school attendance records may be helpful in proving limitations in this domain of functioning.

Lastly, kidney disease can cause growth delays. This may limit your child's ability to move about and manipulate objects or engage in self-care as compared to peers of the same age. It is also possible for a combination of these conditions to impact your child's functioning in the various domains.

For further information on the domains of functioning and how to prove your child has marked or extreme limitations in these areas, see our article on how to get SSI for a child by functionally equaling the listings.