Getting Disability for Growth Impairment or Growth Disorders

Some growth disorders and impairments can be seen at birth, while others are noticed when your child fails to keep pace with other children their age with regards to growth. Social Security distinguishes between height and weight when assessing growth impairments for disability benefits. Short heights are evaluated under the growth impairment listing, while weight deficiencies are assessed under other listings.

Causes of Growth Impairments

There are several different disorders and ailments that can cause short heights. Some of those impairments include:

• Human Growth Hormone (rhGH) Deficiency, which causes a noticeable slowing of growth. Hormone replacement therapies can often help a child to reach an average adult height.
• Cushing's Syndrome, which is caused by too much cortisol in the body and is characterized by weight gain without changes in height. This syndrome can also lead to weakening of the bones and overall weakness throughout the body.
• Hypothyroidism, which is caused by an underactive thyroid gland (which controls hormones in the body).
• Nutritional Short Stature, which is caused by improper nutrition that prevents the body from developing properly. Malnutrition can also lead to bone weakness and wasting. This can be reversed through proper nutrition.
• Fetal Alcohol Syndrome, which is caused by drinking during pregnancy and can cause short stature.
• Intrauterine Growth Retardation ("IUGR"), which occurs in the womb and causes an overall short stature.
• Russell Silver Syndrome, which usually begins in the womb and causes additional symptoms beyond short height, including hypoglycemia and kidney malformation.
• Disproportionate Short Stature (commonly referred to as dwarfism), which is caused by impaired growth of the bones and cartilage in the body.
• Achondroplasia, which is the most common of growth impairments, and is characterized by specific physical features.
• Diseases of the heart, lungs, and kidneys, which may prevent the body from absorbing the proper nutrition and thus lead to short stature.
• Diabetes, which may cause slow growth, especially in children whose blood sugar levels are not properly controlled.
• Bone disorders, including bone dysplasia.

Qualifying for Social Security Disability Benefits

Children can be eligible for Social Security disability benefits under the Supplemental Security Income (SSI) program. In order to qualify for these benefits, your child must meet both technical and medical requirements.

• Technical requirements: The household in which the child lives must meet certain income and asset requirements.
• Medical requirements: The child must meet or "equal" a listing in the Social Security "Blue Book" for growth impairments or must "functionally equal" the listings.

If your child was low weight and length at birth, see our article on getting disability for low birth weight.

Meeting a Listing

There are two listings for growth impairments.

Listing 100.04 is for children less than one year of age, and is satisfied by either:

• a birth weight of less than 2 pounds 10 ounces (1200 grams), or

• a birth weight in the following table:

The above gestational age is a correction for prematurity, since premature babies don't weigh as much and don't necessarily have any kind of growth problem. Along with birth weight, gestational age is routinely determined by a doctor at the time of birth using several possible means, such as Dubowitz criteria and the New Ballard Score.

Listing 100.05 is for children less than three years of age, and requires the following:

There must be at least three height and weight measurements in a year, at least 60 days part.

• For children less than two years of age, there must be a weight-for-length measurement less than the third percentile in a special table that can be found in listing 105.08 (Section B1, Tables I and II).

• For children at least two years of age, but less than three years of age, there must be body mass index (BMI) for age measurements that are less than the third percentile in a special table that can be found in listing 105.08 (Section B2, Tables III and IV).

In addition, the following evidence of a developmental delay is required:

• a test score that is at least two standard deviations below average, or

• a test score that shows development no more than two-thirds of that expected for age.

If there is no valid developmental test score as described above, then at least two narrative descriptions by a qualified doctor in child development (M.D. or PhD) can be used and must be done at least 120 days apart. These descriptions must indicate that the child has development no more than two-thirds that expected for age.

Medical Evidence Required

To satisfy growth impairment Listings 100.04 or 100.05, it is not necessary to show the reason such impairment exists though an adequate history and physical examination is needed. If either of these listings are not satisfied, a child might still have a chronic disease that qualifies under a different listing. For example, any serious chronic illness could be the basis of allowance without consideration of growth impairment—such as severe lung disease, heart disease, or kidney disease. It is also possible for a child to have a documented disorder that is severe enough in combination with a growth impairment to be an allowance even if neither separately would qualify.

Functionally Equal the Listings

If your child does not meet the listing for growth impairments, your child may be able to "functionally equal the listings" if they have significant functional impairments. To "functionally equal the listings," your child must have impairments that can be considered equal in severity to the listings in the Blue Book. There are six functional domains that Social Security assesses in determining this functional equivalency, including movement, self-care, and health and physical well-being. Your child must have two "marked" limitations or one "extreme" limitation within the six functional domains.

Those children with growth impairments may have physical difficulties due to their short height with regards to movement and self-care, especially if your child has shorter arms as a part of their growth impairment. Examples of difficulties may include difficulty climbing stairs or dressing themselves due to physical limitations. However, it is fairly rare for a child to functionally equal the listings for growth impairment. For more information, see our article on functionally equaling the listings.

Continuing Disability Review (CDR)

If your child is approved for benefits, Social Security will periodically review your child's medical records to insure that he or she is still disabled. For children with disabilities that have the possibility of improving, such as growth impairments, they may be reassessed every three years, or even more frequently. For more information, see our series of articles on continuing disability reviews.