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SSI - Can my child with sickle cell anemia qualify?

Many parents have a child with a severe health disorders and wonder if there is any help for them. If your child has sickle cell anemia they may qualify for Supplemental Security Income (SSI), but they will have to meet very specific requirements of the SSI program.

Supplemental Security Income (SSI) is provided by the Social Security Administration (SSA) to children who are disabled, under the age of 18 and have limited income and resources. For adults the SSA considers a disability a medical condition which is so severe it does not allow someone to perform substantial gainful activity. Because children do not work, the SSA will consider them disabled if they determine their condition is “marked and severe.” This means the child’s condition causes “marked limitations” in certain areas of functioning or “extreme limitations” in one area of functioning.

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How do I know if the sickle cell anemia is marked and severe?

For a child to be approved for SSI they must have a condition which is listed on the Social Security Administration’s Listing of Impairments. There is an adult guide and a children’s guide. If the child’s condition is on the listing or is as severe as a condition on the listing they will be determined disabled.

For Supplemental Security Income the family of the child must also have VERY limited income and resources. SSI is specifically for low income families, and if you have the income and resources to support your child the government does not provide any additional assistance through the SSI program. This can be confusing to some parents who think that their child should get SSI just because they are severely disabled. Unfortunately, even if your child is severely disabled they can be denied because their income and resources are too high. In fact, if you do not meet the income and resource limitations of the SSA program the SSA does not even evaluate your child’s medical condition.

SSA Listing of Impairments and Sickle Cell Anemia

The Social Security Administration does have a listing for sickle cell anemia but you will have to prove, through medical evidence, that your child’s condition either “meeting or equals the listing.” According to the SSA your child must be diagnosed with sickle cell anemia and have the following symptoms:

  1. Recent, recurrent severe vaso-occlusive crises (musculoskeletal, vertebral, abdominal); or

  2. A major visceral complication in the 12 months prior to application; or

  3. A hyperhemolytic or aplastic crisis within 12 months prior to application; or

  4.  Chronic, severe anemia with persistence of hermatocrit of 26 percent or less; or

  5. Congestive heart failure, cerebrovascular damage, or emotional disorder as described under the criteria in 104.02, 111.00ff, or 112.00ff.

Why was my child denied for sickle cell anemia?

As mentioned above, your child can be denied SSI for several reasons. If your income and resource level is too high they will be denied SSI, regardless of your health condition. If their condition does not meet or equal a listing, they will be denied.

Now, if the SSA states that their condition is not severe enough you can either gather more medical evidence and appeal the denial or you can talk to a disability lawyer.

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