April 17, 2015

Organ Transplants and Social Security Disability

Welcome to our very first experts advice article author Molly Clarke.  She runs an informational website that promotes disability awareness to those who need it most. Did you know that some of our transplant kids are eligible for Social Security benefits.  This informative article should provide many answers to anyone who has ever asked that question.


Written by Molly Clarke


Organ Transplants and Social Security Disability

According the Organ Procurement and Transportation Network, nearly 2,000 children under the age of 18 in the United States are on the waiting list for organ transplantation. Whether your child is waiting for an organ or is in the process of recovering from transplant surgery, there are certain obstacles that you—as a parent—must overcome.

Unfortunately, one of the most common obstacles that transplant families face is financial instability. Organ transplant expenses include the cost of pre-transplant testing, surgery, follow-up care, medicine, and rehabilitation. Because many parents require time away from work to care for their child during the transplant process, the resulting loss of income and the expensive medical bills can be financially devastating.

Whether your child is waiting for a transplant or has already had a transplant, your family may be eligible for financial assistance in the form of Social Security Disability (SSD) benefits. Continue reading for more information about applying for SSD benefits on behalf of your child.

Social Security Disability Benefit Programs

SSD benefits are governed and distributed by the Social Security Administration (SSA). The SSA operates two separate benefit programs that each has their own eligibility requirements.

The first program, Social Security Disability Insurance (SSDI), offers financial benefits to disabled workers and their families.  Eligibility for SSDI is based on the amount of taxes an applicant has paid into the system and his or her work history. For obvious reasons, children don’t typically qualify for SSDI on their own record. If one or both of a child’s parents already receives SSDI, the child may qualify for SSDI under a parent’s earnings record—these are called auxiliary benefits. If you think that your child may qualify for auxiliary benefits, contact the SSA representative who handles your claim.

The second program is called Supplemental Security Income, or SSI. SSI is offered to elderly or disabled individuals who earn very little income. Because SSI has no work requirements, children and young adults with little work history are often good candidates for this program. Because SSI is a needs-based program, applicants must meet the very strict income limits that are set by the SSA.

In the case of a child younger than 18 who is unmarried and still lives at home, a parent or guardian’s income will be evaluated. This process is called deeming. To see if your family meets the financial requirements, visit the following page from the SSA:

http://www.socialsecurity.gov/ssi/spotlights/spot-deeming.htm.

Medical Eligibility Requirements

In addition to the previously mentioned technical requirements, your child will also have to meet certain medical requirements to qualify for SSD benefits.

The most basic of these requirements are as follows:

  • Your child is not earning a substantial income.
  • Your child has a physical or mental condition that causes severe limitations.
  • Your child’s condition has lasted or is expected to last at least one year or result in death.

If your child meets these criteria, the SSA will then evaluate his or her specific condition using the guidelines listed in a manual of disabling conditions—known as the blue book. The blue book lists all potentially disabling conditions as well as specific symptoms necessary to qualify for disability benefits.

In the case of most organ transplants, the child will be considered disabled for a full 12 months following the transplant surgery. After these 12 months are complete, a child will be evaluated based on his or her residual impairments. You can read more about individual organs in the following blue book sections:

  • 103.05 Lung Transplant
  • 104.09 Heart Transplant
  • 105.09 Liver Transplant
  • 106.02B Kidney Transplant
  • 105.00 Digestive System (Although it does not have its own listing, intestinal transplant is mentioned in this section.)

If your child is waiting for transplant surgery, he or she may qualify for SSD benefits based on the condition that has caused them to need a transplant in the first place. You can browse all of the blue book conditions on the SSA’s website:

http://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm

The SSA recognizes that individuals with certain conditions may not be able to wait the standard processing times to receive disability benefits. For this reason, the SSA began the compassionate allowances program. Under the compassionate allowances program, applicants with severely debilitating conditions can be approved for benefits in as little as ten days. You can find a list of qualifying conditions, here:

http://www.disability-benefits-help.org/compassionate-allowances

The Application Process

To be approved for SSD benefits, your child’s application will need to include extensive medical documentation. This documentation should include records of your child’s diagnosis, diagnostic images, hospitalizations, treatments and his or her response to treatments. You should also include official statements from professional adults that interact with your child on a daily basis. This can include doctors, teachers, therapists, or coaches who can attest to your child’s limitations and how they affect his or her daily lives. You should also be prepared to present financial records as well.

Once you have the necessary medical documentation, you can begin the application process. To do so, you will be required to complete two separate forms—the “Application for Supplemental Security Income” and the “Child Disability Report”. Right now, only the Child Disability Report can be completed online. For this reason, many parents prefer to schedule an appointment with their local Social Security office to complete both documents at the same time.

Unfortunately the application process for disability benefits is not simple or straightforward. It can be overwhelming and, at times, discouraging. It is important that you remain persistent in your efforts. Once your child is approved you will be able to take care of his or her needs without worrying about your own finances.

For more information visit Social Security Disability Help or contact Molly Clarke at mac@ssd-help.org.