Qualifying for Disability Benefits with Mosaic / Non-Mosaic Down Syndrome
Down syndrome is a condition in which there are three copies of chromosome 21 within the cells of the body instead of two. The extra chromosomes result in delayed physical development and mental retardation. There are three types of Down syndrome: Trisomy 21, Translocation, and Mosaic Down syndrome. People with Non-Mosaic Down Syndrome have an extra chromosome in every cell of the body, while people with Mosaic Down Syndrome have some cells with an extra chromosome and others which are normal.
Ninety-eight percent of people with Down syndrome have Trisomy 21 or Translocation Down syndrome. The Social Security Administration (SSA) considers people with Non-Mosaic Down syndrome as being disabled from birth. Most cases of Non-Mosaic Down syndrome affect the mental, neurological, and skeletal systems, and the syndrome is often accompanied by heart disease, impaired vision, hearing problems, and other conditions.
Mosaic Down syndrome occurs in only one to two percent of people with Down syndrome, and there is a wide range in the level of severity of the impairment. Mosaic Down syndrome can be profound and disabling, but it can also be so slight as to be clinically undetected. To learn more about how the Social Security Administration (SSA) defines this disability, visit Section 10.00 of the Blue Book.
Does Mosaic / Non-Mosaic Down Syndrome Qualify for Disability?
The SSA considers those with Non-Mosaic Down syndrome disabled from birth and automatically eligible for Social Security disability benefits. For confirmation of a Non-Mosaic Down syndrome diagnosis, the SSA requires a definitive chromosomal analysis (meaning a karyotype analysis) from an acceptable medical source that indicates the existence of the impairment. The actual karyotype analysis showing the impairment should absolutely be included with a Social Security disability application. When furnished with the actual karyotype analysis, the SSA will not require the clinical description of the physical features of Down syndrome.
If you do not have the actual karyotype analysis, the SSA will ask for a report from an acceptable medical source that includes the clinical description of the physical features of Down syndrome. The report must state that the karyotype analysis was conducted and that the results confirmed the diagnosis. The report must be consistent with other evidence in the case record, such as evidence of limitations in adaptive functioning, signs of a mental disorder that can be associated with Non-Mosaic Down syndrome, educational history, or results of psychological testing.
Mosaic Down Syndrome
The symptoms of Mosaic Down syndrome must significantly impair the ability to achieve gainful employment in order to qualify for Social Security disability benefits. The SSA evaluates each applicant on a case by case basis. In addition, the particular body parts that are affected by Down syndrome must be impaired in certain ways that meet the SSA’s criteria in order to qualify a person for disability benefits. The impairments must be medically determinable, and found in SSA’s disability listings. Alternatively, an impairment will qualify a claimant for benefits if it “functionally equals a listing.” The SSA’s disability evaluation process focuses on the functional limitations caused by the condition, and therefore Social Security disability benefits can be awarded as long as the Mosaic Down syndrome condition is determined to be sufficiently limiting. The SSA considers the following in making its determination:
Related Disabling Conditions – for each major body system, SSA maintains a list of medical conditions so severe they automatically qualify a person for Social Security disability benefits. Certain bodily functions impaired by Mosaic Down syndrome may qualify you for disabilities based on this list, but if your condition and/or symptoms do not meet the requirements specifically listed, the SSA will decide if your impairment is of equal severity to a medical condition on the list.
Severity of Condition – the effects of Down syndrome must interfere with basic work-related activities for your claim to be considered.
Work – if you are able to work, your earnings cannot average more than $1000 a month. If you were previously working but were forced to stop because of a condition related to your Down syndrome, the SSA will determine whether or not you may be able to return to your previous employment in the future. If you cannot do the work you did in the past, the SSA will determine if you are able to adjust to other work. This determination will consider your medical conditions, along with your age, education, past work experience and any transferable skills you may have.
How Do I Apply for Disability Benefits?
To apply for disability benefits, it’s important to understand the disability application process. If you’ve been diagnosed with Mosaic or Non-mosaic Down syndrome and believe you may qualify, contact us today for a free disability case evaluation.
