Can a Child With Epilepsy Get SSI?

 

Having a child diagnosed with epilepsy can be difficult, especially if limited resources make it challenging to pay for the necessary care and medication. 

The good news is that social security for epilepsy is available for your child. If your child has frequent seizures and your family meets the financial requirements you can receive SSI (Supplemental Security Income) for your child with epilepsy.

What Is Epilepsy?

Epilepsy is a disorder of the brain marked by repeated seizures (unusual electrical patterns of activity in the brain.) Seizures cause sensory disturbances that can be manifested by:

  • Loss of consciousness.
  • Convulsions.
  • Staring spells, during which the sufferer is temporarily unaware of his or her surroundings.
  • Other unusual behavior.

Epilepsy can be caused by brain trauma, infections, tumors, cerebral palsy and in some cases the factors are unknown.

Medical Requirements

Epilepsy is one of the severe neurological disorders that qualify for benefits through the SSA (Social Security Administration) if seizures are frequent or if having the condition results in considerable limitations on your child’s ability to function.

The rule or “listing” that governs the medical requirement guidelines is found in the Neurological-Childhood section of SSA’s Disability Evaluation. 

Frequency of Seizures

To receive SSI benefits for epilepsy, you will need to confirm that your child has experienced one of the following:

  • Grand mal seizures (convulsions and total loss of consciousness) at least one time per month for three months in a row
  • Petit mal or partial seizures (temporary loss of awareness) at least one time per week for three months in a row

Functional Limitations

Even if your child’s seizures don’t occur often enough to meet these requirements, epilepsy may still impair his or her functioning enough to qualify for SSI. There are six areas of functioning that the SSA will consider:

    • Social — How your child relates and interacts with others
    • Motor — Ability to get from place to place and handle objects
  • Cognitive — Learning and reasoning skills
  • Focus — The degree to which your child can attend to tasks and see them through to completion
  • Self-care — Managing age-appropriate daily living activities like dressing and eating
  • General well-being — Your child’s overall physical health

If the SSA determines that your child has severe limitations in two of these domains or extreme limitations in one domain, he or she will be approved for SSI benefits. 

Financial Requirements

In addition to the medical requirements that need to be met to qualify for SSI, your family must also meet certain financial criteria. According to the SSA’s 2019 SSI Program Rates and Limits, you must have:

  • A monthly income under $771 for an individual, or $1,157 for a married couple
  • Assets of under $2,000 for an individual, or $3,000 for a married couple

Not all income is counted toward these monthly limits, so your child may qualify for SSI even if your family’s income level is higher.

Consult with a Disability Attorney

If you are unsure if your child with epilepsy qualifies for SSI, consult with a disability attorney. An experienced disability attorney can review your situation and guide you through the SSI application process. If your initial disability claim is denied, a lawyer can also represent you through the appeals process.

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