Babies born before 37 weeks gestation are considered premature, and some suffer many side effects—low birth weight being the most common (and some full-term infants also have low birth weights as well). Premature babies can also face other medical challenges.
If your baby was born prematurely or had a low birth weight, and the child has serious impairments, you might be able to get financial help from Social Security's Supplemental Security Income (SSI) program. This article will discuss how this program works, who's covered, and how your child can qualify for benefits.
Because low birth weight and premature birth generally go hand in hand, the symptoms of the two can't be separated. Below are the most common impairments in premature babies and children born with low birth weights. Depending on the severity of these impairments, premature babies can be considered disabled and entitled to SSI benefits.
The organs of babies born prematurely often haven't fully developed. Because these organs aren't developed enough to function fully, preemies can suffer from serious short-term or immediate medical issues, including the following:
Long-term medical problems caused by premature birth might not show up until later in childhood or even adulthood—especially cognitive delays and psychological issues. Social Security has included some of these latent medical conditions in the list of impairments, including the following:
Lung problems: Many preemies are born with underdeveloped lungs. These babies can develop respiratory distress syndrome (RDS), a condition that causes the lung tissue to collapse due to a lack of surfactant—a chemical babies born several weeks early can't yet produce. RDS can cause permanent damage to the lungs and lead to an obstructive lung disease called "bronchopulmonary dysplasia," which is found under listing 103.2, chronic respiratory disorders.
Vision problems: When a baby is born too early with a very low birth weight (less than three pounds), the development of the eyes is cut short, which can lead to a condition called retinopathy of prematurity (ROP). With ROP, abnormal blood vessels grow on the child's retinas. Over time, this can cause vision loss and blindness. Learn more about getting SSI for premature babies with vision loss.
Hearing problems: Preemies and low birth weight babies are more vulnerable to infections, including ear infections that can cause permanent hearing loss or deafness. Oxygen deprivation after birth (due to breathing or lung abnormalities) can also cause hearing loss in infants born prematurely and/or with a low birth weight. Learn more about how babies and children with hearing impairments can qualify for SSI.
Other long-term impairments: Other problems babies born prematurely or with a low birth weight commonly develop include the following:
Also, babies born prematurely and with low birth weights are more likely to develop type 2 diabetes and cardiovascular disease as adults.
Children who are disabled can often qualify for disability benefits through SSI. Your child must meet Social Security's medical and income requirements to qualify for SSI benefits.
For the Social Security Administration (SSA) to consider your baby disabled, both of the following must be true:
Premature and low birth weight babies can qualify medically for SSI by meeting the requirements of one of Social Security's impairment listings in its "Blue Book" or by showing Social Security that your child's condition "functionally equals the listings."
While Social Security doesn't have a specific impairment listing for premature birth or low birth weight, there's a listing that addresses developmental and emotional impairments in children up to three years of age. But since the effects of premature birth and low birth weight can vary greatly, depending on how premature and small a newborn is when born, an infant might meet other listings as well.
Developmental disorders: Social Security's listing for developmental disorders in children, listing 112.14, looks at the overall functioning of a baby or young child and how that level of functioning compares to others of the same age. The listing generally requires that the infant be significantly delayed (taking twice as long to reach milestones as others) in several areas, including:
To determine if your baby might meet the requirements of this impairment listing, you should go over Listing 112.14 with your child's pediatrician and/or a disability lawyer.
Other listed impairments: Premature babies and those born with a low birth weight might also meet the requirements of other listings, such as:
To meet a listing, your child's condition must meet all of the requirements of the listing, and you'll need medical evidence to back that up.
Meeting one of the listings above isn't the only way a premature baby or an infant with a low birth weight can qualify for SSI benefits. If Social Security agrees that your child's limitations are "functionally equal to the listings" (that is, your child's limitations are as severe as those caused by other conditions listed in the Blue Book), the child will qualify medically.
Domains of functioning: Social Security looks at six "domains of functioning" to determine whether your child's condition is severe enough to meet this standard. Social Security created these domains to cover all aspects of a child's daily functioning. The domains of functioning are:
To functionally equal a listing, your child must have a "marked" limitation (a serious limitation) in two domains of functioning or an extreme limitation in one.
Physical impairments that affect functioning: Children born prematurely or with a low birth weight can suffer from physical impairments that can limit the child's ability to complete tasks, move and manipulate objects, or care for themselves, such as vision and hearing problems, breathing problems (including asthma), or difficulty walking or decreased use of hands or fingers.
Mental impairments and functional limitations: Mental impairments caused by premature birth or low birth weight can include cognitive impairments (low I.Q.), learning disabilities, and ADHD.
These physical and mental impairments can limit your child's ability to function in the six domains. For more information, see our article on how a child can functionally equal a disability listing.
Social Security recognizes that some impairments are almost always found to be disabling. Because of this presumption of disability, for some conditions, Social Security will begin monthly payments immediately after you apply for SSI and continue them for up to six months while a decision is made on your application. Your child might qualify for presumptive disability payments with any of the following impairments:
To qualify for presumptive disability for low birth weight, your baby can't be older than six months and must have a birth weight below:
(Learn more about filing for presumptive SSI payments.)
If your baby was a preemie but doesn't meet the requirements for low birth weight or have a condition likely to qualify for presumptive payments, you'll have to wait for Social Security to make a disability determination. The initial decision process can take three to five months. If you have to file an appeal, you can expect to wait much longer. Learn more about your options if your baby's SSI claim was denied.
Because SSI is a needs-based program, the amount of disability benefits your preemie or low birth weight infant can get is based largely on your family income. Generally, an adult who gets SSI is eligible for up to $914 per month (for 2023). But the actual benefit payments your child would receive will depend on factors like:
If your baby is still in the hospital, your child's monthly SSI benefit might be limited to $30. Social Security limits the amount of SSI payments for hospitalized babies if the child is covered by health insurance or Medicaid.
Social Security also limits what your child's SSI payment can be used for. Learn more about how your child's SSI payment can be spent.
When Social Security grants SSI for premature babies and those with low birth weight, how long before those benefits expire will depend on several factors, such as:
When a child receives SSI benefits, the parents are required to report changes to their incomes. Your child's SSI benefits could be reduced or stopped if your countable income increases.
Social Security will conduct periodic "continuing disability reviews" (CDRs) to determine if your child is still disabled. Disability claims for premature babies and those with low birth weights are reviewed around age one. If, after that first year, your child is gaining weight and meeting developmental goals, the SSI benefits will expire.
But if the child isn't progressing adequately, the SSI benefits will continue until it's time for another review—generally once every three years. For more information on CDRs, see our section on Continuing Disability Reviews.
Updated May 30, 2023