How to Apply for Social Security Benefits for a Child With Cancer

Receiving a diagnosis of cancer in your child can be devastating news for a parent. Supplemental Security Income (SSI), a program that provides disability benefits for low-income children, can provide crucial financial support. Medical insurance through Medicaid and other related services can also ease the burden on the family (in most states, Medicaid automatically comes with SSI).

Meeting the Financial Qualifications for SSI Benefits

The Social Security Administration (SSA) offers SSI for families whose income and total resources fall below certain financial thresholds. When children apply for SSI benefits, Social Security will consider ("deem") their parents' earnings and assets as their own.

The formula the agency uses to determine financial eligibility is complicated, but broadly speaking, the SSI resource limit is $2,000 for one parent or $3,000 for two parents. Keep in mind that the SSA doesn't count a lot of valuable resources—like your house and a car—towards the limit. For many applicants, the resource limit simply means how much cash they have in the bank.

Calculating how much income a family can have is even more complicated and depends on the number of children in your household as well as whether your income is "earned" or "unearned." Social Security has a deeming eligibility chart that shows the highest amount a parent can earn monthly (before taxes) and still have a child qualify for SSI. For 2022, the maximum countable income you could make and still qualify for SSI ranged from $1,722 per month (for a single parent with one child) to $4,622 (for two parents with six children).

For more information, see our article on how family income is deemed for child SSI applicants.

Eligibility for SSI Benefits for Children With Cancer

Despite the seriousness of a cancer diagnosis, even after your family meets the financial threshold for SSI, your child still must meet Social Security's basic disability requirements in order to qualify for benefits:

• your child can't be working (defined as earning more than $1,470 per month in 2023)
• your child isn't expected to recover for at least 12 months, and
• your child's activities are severely limited as a result of their symptoms or treatment.

The last two points can be challenging to prove in cases of childhood cancer where treatment was early and effective. But if your child's treatment was lengthy and involved, or caused long-lasting side effects, Social Security is more likely to find that the cancer is severe enough to qualify for benefits.

Can My Child Get an Expedited Decision for Cancer?

Social Security has a Compassionate Allowance (CAL) program that will fast-track applications with evidence of certain very serious, difficult-to-treat childhood cancers. When the SSA receives your child's application, if the medical records contain evidence of a CAL diagnosis, the agency will mark the file for expedited consideration.

Expedited consideration means that the agency might not ask you to submit any additional medical evidence and your child's claim will likely be processed in weeks instead of months. Childhood cancers that qualify for expedited approval include:

• neuroblastoma (adrenal gland cancer)
• lymphoma (lymph node cancer)
• Ewing's sarcoma (bone cancer)
• lymphoblastic lymphoma (blood cancer)
• rhabdomyosarcoma (soft tissue cancer)
• ependymoblastoma (brain cancer), and
• malignant brain stem gliomas (brain stem cancer).

Your child can also qualify for an expedited decision under the CAL program for cancers that are not specific to children, such as bladder, kidney, and intestinal cancers. You can find the full list of compassionate allowance conditions here.

What If My Child Has a Cancer That Isn't on the Compassionate Allowances List?

Social Security has three ways that children with a cancer diagnosis not on the CAL list can receive SSI disability benefits: their condition can meet, equal, or be functionally equivalent to the agency's "listings" for childhood cancer.

The listings provide guidance for medical professionals to help them determine how severe certain physical and mental conditions are. Reviewing the listings lets you know what medical evidence is required for the agency to find that your child is disabled.

Medically Meeting a Listing for Cancer

If your child's application contains the exact medical evidence described by a listing, the agency will find that your child is disabled. Social Security refers to this method of awarding benefits as "medically meeting a listing."

All types of childhood cancer are evaluated under the category of listing 113.00, but each type of cancer requires you to provide different medical evidence. Certain specific cancers have their own listings:

• malignant solid tumors (Listing 113.03)
• lymphoma (Listing 113.05)
• leukemia (Listing 113.06)
• thyroid cancer (Listing 113.09)
• retinal cancer (Listing 113.12)
• brain and spinal cord cancer (Listing 113.13)
• neuroblastoma (Listing 113.21), and
• skin cancer (Listing 113.29).

For malignant solid tumors, lymphoma, and leukemia, just having a diagnosis is enough for your child to receive disability for 24 months.

For other diagnoses, Social Security will find the cancer to be disabling only if the cancer has metastasized (spread to another part of the body) or if the cancer re-occurs after treatment. For these types of cancers, the SSA will also consider the intensity and duration of the cancer treatment. Your child's medical records should contain the following information:

• any records for medical procedures, such as a biopsy or surgery
• pathology reports
• treatment notes, including type, dosage, and frequency of drug administration
• hospital admissions
• Iab work
• imaging scans, such as X-ray or MRI, and
• schedule for radiation therapy.

Medically Equaling a Listing for Cancer

Even if your child's records don't contain exactly the right information to meet a cancer listing, the agency can still find your child disabled if your child's cancer is causing significant medical issues in the affected body part. Social Security refers to awarding benefits this way as "medically equaling a listing."

To determine if your child medically equals a listing, Social Security will review your child's condition under the listing for the affected body part. For example, if your child has retinal cancer, the agency will look to see if your child's vision has gotten bad enough to meet the low vision listing. Or, if your child has pain from chemotherapy-induced bone loss, the agency might award benefits due to abnormality of a major joint.

Examples of additional side effects that the agency will consider include stomach issues, ongoing weakness, heart complications, and mental health issues. Your child's oncologist (cancer doctor) should document these and any other side effects.

Functionally Equaling a Listing

Some children may not satisfy the medical criteria to meet or equal a childhood disability listing but are still severely restricted by cancer symptoms and treatment. Social Security can find these children disabled if they have a lot of difficulty in their day-to-day activities. The agency refers to this process as "functionally equaling" the listings.

Social Security will look at how well your child is capable of performing six "functional domains." In order for the agency to find your child disabled, you must show that your child has "marked" (very serious) limitations in two of the six "domains" (areas) of functioning, or an extreme limitation in one area of functioning. The areas of functioning are:

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

The agency will estimate whether your child's development in these areas is around the average for children that age. For example, your child might be too tired after a round of chemotherapy to think straight, and have trouble finishing homework. You'll likely need reports from your child's teachers, as well as doctors, who can help document your child's problems in these functional domains.

For more 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.

How Much SSI Can My Child Receive?

For 2023, the maximum benefit provided by SSI is $914 per month, but your child's exact amount might be lower depending on what state you live in and how much resources you have. According to the Social Security Administration, the average monthly benefit for children receiving SSI is $670.

How to Apply for SSI Benefits for Children

You'll need to contact the Social Security Administration to apply for benefits on behalf of your child. You can do this in two ways:

• Call 800-722-1213 Monday through Friday from 7 a.m. to 7 p.m. (If you're deaf or hard of hearing, call the TTY number at 800-325-0778.)
• Visit your nearest Social Security field office (you can locate your nearest office here).

Explain to the Social Security representative that you want to file an SSI application for your child. The agency provides a Child Disability Starter Kit that can help you prepare your child's application.

Your child's application will involve an interview with a Social Security representative. Review the agency's Checklist for Childhood Disability Interview before you attend. Additionally, you can file a Child Disability Report online by providing information about your child's cancer treatment so that the agency can obtain the medical records.

_{Updated February 3, 2023}