Can a Child Get SSI Disability for Fetal Alcohol Syndrome (FAS)?

Fetal alcohol syndrome (FAS) is not a single birth defect, but rather a cluster of related problems that occur due to a mother drinking alcohol while pregnant. The effects of a pregnant mother's substance abuse on a child vary greatly from child to child. Some children show no symptoms, while, in severe cases, FAS may cause death. The ability of the child to receive SSI (Supplemental Security Income) disability benefits depends on the severity of the symptoms.

Symptoms of Fetal Alcohol Syndrome

At birth, the following symptoms of fetal alcohol syndrome might be noted:

• low birth weight
• small head size and brain size
• facial abnormalities, including smaller eye openings, a lack of groove between the nose and upper lip, and a short upturned nose
• heart, kidney, or bone problems
• problems with vision or hearing, and
• deformities of the joints, limbs, or fingers.

During infancy, the following symptoms may be noted:

• sleeping problems
• problems with feeding due to difficulties with sucking
• slow physical growth, with regards to both height and weight, and
• failure to meet milestones, such as holding their head, sitting up without help, and crawling.

As children with FAS grow up, the following symptoms may be noted:

• development delays, including low height and weight for age
• epilepsy
• poor coordination, which may delay abilities such as riding a bike
• poor fine motor skills, including poor handwriting skills
• speech and language delays
• poor socialization skills, including difficulty making and keeping friends or feeling part of a group
• low IQ
• sensory problems, including overreaction or under reaction to stimulus
• learning disabilities, including memory problems, difficulty understanding concepts, poor problem-solving skills, poor language comprehension, and poor reasoning and judgment skills, and
• behavioral problems, including poor impulse control, poor awareness of personal boundaries, poor anger management, difficulty concentrating and hyperactivity (including attention deficit hyperactivity disorder), stubbornness, extreme nervousness, and anxiety.

FAS symptoms are often noted to become worse with age, especially behavioral symptoms. There is no cure for FAS, but treatment is based on individual symptoms.

Getting SSI Disability Benefits

For children to receive SSI disability benefits, first there are medical and monetary qualifications that must be met. Medically, there are two ways in which a child can qualify for disability benefits: by meeting the requirements of a listing from the Social Security "blue book," or by functionally equaling the listings.

Meeting or Equaling a Disability Listing

For those with FAS, multiple body systems are generally affected. Social Security does have a disability listing that addresses impairments that affect multiple body systems, but FAS is not included in this listing due to the variability of the impairments that those with FAS can have. Social Security does note in this listing that those with FAS should evaluate their symptoms under specific listings for the affected body systems. Below are some of the listings that may be met by a child with FAS:

• Listing 100.00 - Low Birth Weight and Failure to Thrive
• Listing 101.02 - Major Dysfunction of a Joint
• Listing 102.02/04 - Vision Loss
• Listing 102.10 - Hearing Loss
• Listing 104.00 - Cardiovascular Conditions, including chronic heart failure and congenital heart disease
• Listing 105.00 - Digestive System, including chronic liver disease, liver transplant, and malnutrition
• Listing 106.00 - Genitourinary Impairments, including impaired renal function and congenital impairments of the urinary system or genitals
• Listing 111.00 - Neurological, including seizures and motor dysfunction and communication impairments caused by neurological deficits, and
• Listing 112.00 - Mental disorders, including neurocognitive disorders, neurodevelopmental disorders, mood disorders, intellectual disorder (low IQ), anxiety disorder, ADHD, and developmental and emotional disorders in infants and toddlers.

For the child to meet one of the above listings, you must provide medical evidence that shows the child meets all of the requirements in the listing (visit the links above to see the requirements of the specific listing). For your child's condition to be considered medically equivalent to a listing, or "equal" a listing, you must show that the child has an impairment that is similar to one of the listings and is equal in severity and duration.

Children with FAS whose limitations are mainly cognitive or behavioral are likely to be evaluated under the neurocognitive disorder listing.

Functionally Equaling the Listings

If your child does not meet or equal one of the above listings, he or she may still be able to receive SSI disability benefits if you can show that your child's limitations "functionally equal" the listings. In order to functionally equal the listings, your child must show a marked limitation in two areas of functioning or an extreme limitation in one area. (Marked limitations seriously interfere with your child's ability to function, while extreme limitations very seriously interfere with your child's ability to function.) Social Security will look at your child's ability to function in the following six areas:

• acquiring and using information
• attending and completing tasks
• interacting and relating with others
• moving about and manipulating objects
• caring for himself or herself, and
• health and physical well-being.

Overall, Social Security wants to know how a child functions in these areas compared to other children who are the same age. Children with FAS can have physical, mental, and emotional symptoms that limit their ability to function properly in several areas. Physical symptoms, including heart, kidney, or bone problems, problems with vision or hearing, deformities of the joints, limbs, or fingers, epilepsy, poor coordination, poor fine motor skills, and sensory issues, can limit a child's ability to move about, manipulate objects, and care for himself or herself effectively and independently.

More importantly, mental problems, including speech and language delays, low IQ, learning disabilities, difficulty concentrating and hyperactivity (including attention deficit hyperactivity disorder, or ADHD), memory problems, difficulty understanding concepts, poor problem-solving skills, poor language comprehension, and poor reasoning and judgment skills, would all effect a child's ability to appropriately, effectively, and independently acquire information and complete tasks appropriate for their age.

Emotional problems, including poor socialization skills, poor impulse control, poor awareness of personal boundaries, poor anger management, stubbornness, extreme nervousness, and anxiety, would affect a child's ability to interact with others appropriately and to complete tasks that others their age could complete without assistance.

For more information, see our article on functionally equaling the listings to qualify for SSI disability.

Presumptive Disability (PD)

For certain disabilities, there is a presumption of disability that allows for Social Security to pay out benefits up to six months while a formal disability decision is being made. There are several impairments that are on the list for presumptive disability (PD) that those with FAS may qualify for. The PD impairments include:

• total blindness
• total deafness
• severe mental deficiencies of a child who is at least seven years old
• low birth weight, and
• terminal illness in which the child is not expected to live more than six months.

Continuing Disability Review (CDR)

After your child is approved for benefits, Social Security will periodically perform continuing disability reviews (CDRs) to confirm that your child is still disabled and eligible for disability benefits. Children with FAS can expect to have a CDR every three years if Social Security expects that the child's condition may improve.

Children who are receiving benefits based on low birth weight will have a CDR before they reach one year of age.

Once a child turns 18, Social Security will conduct a CDR to see if the child meets the requirements of adult disability. Keep in mind these timelines are guidelines; Social Security may actually review your child's case at an earlier date.

For more information, see our section on continuing disability reviews.

Other Fetal Alcohol Spectrum Disorders

Fetal alcohol syndrome falls on the more severe end of a spectrum called the fetal alcohol spectrum. Less involved types of alcohol-related disorders, sometimes called partial fetal alcohol syndrome (pFAS), include alcohol-related neurodevelopmental disorder (ARND) and alcohol-related birth defects (ARBD). ARND typically causes intellectual disability, learning disabilities, and problems with behavior, attention, and poor impulse control. ARBDs include problems with the heart, kidneys, vision or hearing. Social Security assesses these conditions in the same way as fetal alcohol syndrome.

Note that adults can also get disability benefits for the limitations caused by fetal alcohol syndrome if they last into adulthood.