Systemic lupus erythematosus (SLE), or lupus for short, is an auto-immune disease that affects multiple organs or body systems such as the joints, kidneys, lungs, and, intestines. Some children have mild symptoms of achiness, fever, and fatigue, while others can suffer progressive lung and kidney problems. In addition, some children experience emotional problems or developmental delays related to lupus.
Children with SLE may be eligible for SSI (Supplemental Security Income) if their parents’ income and assets are low enough. When a child with lupus turns 18, if a parent is collecting Social Security disability income (SSDI) benefits, the child will become eligible for SSDI as well (at that point, however, the child would apply for benefits under the adult listing for lupus). The SSA details what symptoms of lupus a child must have to qualify for SSI.
This article discusses disability benefits for children with lupus. The rules are different for adults (anyone over 18); see Nolo's article on SSDI or SSI for adults with lupus.
The SSA’s listing for lupus in children is listing 114.02. There are two ways your child can satisfy the listing: by fulfilling certain medical criteria or by fulfilling certain mental criteria.
Your child’s lupus must affect two or more body systems or organs, such as the kidneys, lungs, or heart. At least one of your child’s body systems or organs must be affected to a moderate degree of severity or more. Affected organs/body systems can be:
In addition, your child must have two of the four of the following constitutional problems:
The developmental/emotiona/mental requirements vary depending on your child’s age.
Age three to eighteen. Your child must have at least two of the following:
Your child’s developmental status must be documented according to SSA’s listing 112.02B2.
Age one to three. Your toddler must have one of the following:
Your toddler’s developmental status must be documented according to SSA’s listing 112.02B1.
Birth to age one. Your baby must have at least one of the following:
Your infant’s developmental status must be documented according to SSA’s listing 112.12.
To set up an appointment to submit an application for SSI through your local SSA office, call the SSA at 800-772-1213. It will likely take three to six months for the SSA to determine whether your child is eligible for disability benefits. If your child is denied SSI, contact a disability lawyer with experience with lupus cases. If the lawyer wins your appeal, he or she may take percentage of your child’s SSI back payments. If the lawyer loses the appeal, you won’t owe anything.