4.2 Google RatedPekas Smith Disability Attorneys provide legal representation for adults and children who are disabled due to Down Syndrome. Our lawyers have extensive experience advocating for these individuals and ensuring their claims are approved. Call 602.833.1696 or send us a message for a consultation with a disability lawyer in Arizona about your case.
A specialized Down Syndrome SSDI lawyer will guide you from the initial application to final approval.
SSDI Benefits for Down Syndrome
Understanding Disability Benefits for Adults and Children with Down Syndrome
Most adults with Down Syndrome may receive Social Security Disability Insurance (SSDI) benefits and Supplemental Security Income (SSI) benefits. Medical documentation is necessary to show the individual meets claim requirements.
They can qualify for SSDI based on their own earnings record or a parent’s work history. SSI benefits are subject to household income and resource limitations. Parental income, including stepparents in the household, may factor into a child’s eligibility for benefits. However, parental income and resources are treated differently once a child turns 18. Even if your child is deemed ineligible while they are a minor, their qualification may change when they turn 18.
See SSA, Social Security Disability Insurance benefits for adults with disabilities since childhood. To qualify for child benefits, the parent must receive retirement or disability benefits or be deceased, having earned qualifying credits for Social Security benefits.
Qualifying for SSDI with Down Syndrome
To qualify for SSDI with Down syndrome, applicants must meet the Social Security Administration’s (SSA) medical criteria and demonstrate how their condition impacts their ability to work.
The documentation required will depend on whether the applicant has non-mosaic or mosaic Down Syndrome.
Non-Mosaic Down Syndrome and SSDI Eligibility
The Social Security Administration (SSA) considers individuals with non-mosaic Down Syndrome disabled from birth, as outlined in Section 10.00C of their Blue Book.
Because 98% of individuals with Down Syndrome have the non-mosaic form, most applicants qualify for Social Security Disability Insurance (SSDI) with appropriate medical documentation. To qualify for benefits, applicants must provide medical evidence, such as a karyotype analysis laboratory report or a physician’s diagnosis confirming the condition (chromosome 21 trisomy or chromosome 21 translocation). This form typically results in consistent characteristics, including developmental disabilities, muscle tone differences, brain function, and communication challenges.
People with non-mosaic Down Syndrome generally qualify for SSDI benefits with proof of their diagnosis without needing to prove the extent of their limitations. A Down Syndrome SSDI lawyer can help you understand eligibility requirements.
For children, non-mosaic Down Syndrome is evaluated under Section 110.06 of the childhood listings (Part B).
Mosaic Down Syndrome and SSDI Eligibility
Unlike non-mosaic Down Syndrome, mosaic Down Syndrome varies in severity and is much rarer. The effects of mosaic Down syndrome can vary widely. While some individuals may have minimal symptoms, others experience significant impairments similar to non-mosaic that affect daily functioning.
Those applying for disability benefits based on mosaic Down Syndrome must provide additional medical evidence showing how their condition limits their employment, daily functioning, and overall health. Evaluators will assess its impact on:
- Musculoskeletal function
- Neurological and mental health
- Special senses and speech
- Other functional limitations under Section 10.00E
Other Congenital Disorders That May Qualify for SSDI
In addition to Down Syndrome, other congenital conditions may qualify for disability benefits, including:
- Tay-Sachs disease
- Trisomy X syndrome (XXX syndrome)
- Fragile X syndrome
- Phenylketonuria (PKU)
- Caudal regression syndrome
- Fetal alcohol syndrome
Eligibility depends on the extent to which these disorders interfere with body systems and daily functioning.
Need assistance with your disability claim? Our Arizona Down Syndrome SSDI lawyers can guide you through the process of getting benefits for a number of conditions. They will help gather the necessary medical records and documentation to help you secure the benefits you deserve.
SSI for Down Syndrome
Supplemental Security Income benefits may be available for children or adults with Down Syndrome. For children, Parental income and household resources are considered when determining eligibility. In some cases, individuals with Down Syndrome may qualify for immediate payments while their application is still being processed.
When a child reaches 18 years old, parental income and resources are no longer factored into their eligibility. This means that even if your child did not qualify for SSI before, they may become eligible once they turn 18.
Get Legal Help From a Disability Attorney
At Pekas Smith Disability Attorneys, we are dedicated to helping people secure and maintain the benefits that they deserve. If you need assistance filing a disability claim for someone with Down Syndrome, our law firm is here to guide you through the process.
How we can help with your claim:
- Determining eligibility for SSDI or SSI, whether for a child or an adult.
- Filing the initial claim and submitting the necessary supporting materials.
- Ensuring accurate benefit calculations to secure the appropriate payment amount.
- Identifying and addressing things potential barriers to approval.
- Verifying that all medical criteria are met and submitting complete medical records.
- Preparing a thorough application to reduce the risk of delays or complications.
- Assisting with the redetermination and reevaluation process when required.
Our law firm provides legal representation at every stage of the application process. We focus on maximizing the benefits available for individuals with Down Syndrome, ensuring that claims examiners receive all essential medical information for approval. Whether your case is straightforward or complex, you can rely on our knowledge and experience to help you navigate the system and secure the benefits you need.
Free Consultation
We invite you to learn more about how a Pekas Smith Down Syndrome SSDI lawyer helps people get and keep their Social Security Disability benefits. For a free consultation, call 602.833.1696 or message us now.
Frequently Asked Questions
What role does an administrative law judge play in a Down Syndrome disability appeal?
If an initial claim is denied, applicants can request a hearing before an administrative law judge (ALJ). The ALJ will review medical records, expert testimony, and other supporting data to determine eligibility. If the claim is still denied, further appeals can be made to the United States District Court with the help of an experienced Down Syndrome disability lawyer.
Does Down Syndrome qualify for Medicaid and health insurance coverage?
Yes. Many individuals with Down Syndrome qualify for Medicaid in addition to health insurance through Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Medicaid helps cover medical expenses related to conditions such as congenital heart defects, diabetes, and other health complications common in individuals with Down Syndrome.
How does Down Syndrome affect a person’s ability to work?
People with Down Syndrome may face challenges with communication, muscle tone, and cognitive development, making traditional employment difficult. However, some individuals can work in supportive environments. If Down Syndrome prevents someone from engaging in substantial gainful activity, they may qualify for disability benefits.
What medical records are needed to prove disability due to Down Syndrome?
Applicants should provide comprehensive medical records, including a karyotype analysis confirming the diagnosis. Additional documentation may include reports on muscle tone, brain function, and conditions like congenital heart defects or diabetes that may impact daily life. A Down Syndrome SSDI lawyer on our team can assist with this process.
Can families receive financial support for a child with Down Syndrome?
Yes. Parents of a child with Down Syndrome may qualify for Supplemental Security Income (SSI) if they meet income and resource limits. Additionally, children with disabilities may be eligible for education and therapy programs to support their development.
What should I do if my Down Syndrome disability claim is denied?
If your claim is denied, you can file an appeal and request a hearing. A social security lawyer can help navigate the process, gather additional medical evidence, and represent you before an administrative law judge or the United States District Court if necessary.
Are disability benefits for Down Syndrome taxable?
It depends on the recipient’s overall income. While SSI benefits are not subject to tax, SSDI benefits may be taxable if the recipient’s total income, including other sources, exceeds the IRS threshold. A disability attorney can explain how tax policy affects your specific situation.
How can social security attorneys help with my Down Syndrome disability claim?
A Down Syndrome disability lawyer can assist by:
- Reviewing your medical records to ensure all necessary data is included
- Preparing documentation related to pain, fatigue, and other disabling symptoms
- Guiding you through the application or appeal process
- Representing you before an administrative law judge or in United States District Court
If you need help filing a disability claim, contact our experienced Down Syndrome SSDI lawyer in Arizona today.
