Applying for Social Security Disability Benefits with Cerebral Palsy
Cerebral palsy (CP) is a group of neurological disorders that disrupts body movements, muscle coordination, balance, and posture. United Cerebral Palsy estimates that almost 800,000 adults and children are currently diagnosed with the disorder and about 10,000 babies are born with CP.
If you have CP or your child was born with it, the Social Security Administration (SSA) may be able to help you. The SSA has two financial assistance programs for individuals who can't work because of a disability.
The Financial Costs of Cerebral Palsy
CP can be a very debilitating condition, which can lead to high financial losses. The Centers for Disease Control (CDC) reports the disorder can cost families up to $921,000 over a child's lifetime. About 80 percent of these costs, or $742,000 are indirect costs due to missed work and more, while only 10 percent, or $93,000 is attributed to direct medical costs.
The CDC found that children with CP had medical costs that were ten times higher than children without CP or intellectual disabilities ($16,721 vs. $1,674). Additionally, medical costs for children with both CP and intellectual disabilities paid 26 times more in medical costs than children without ($43,338 vs. $1,674).
Another reason why CP can be so expensive is because many children with the disorder, as many as 60 percent, have another developmental disability as well, a study done by the Metropolitan Atlanta Developmental Disabilities Surveillance Program explained. They found that 40 percent of children had an intellectual disability, 41 percent had epilepsy, 15 percent had vision impairments, and 7 percent suffered from autism spectrum disorder.
Medically Qualifying for Benefits with the Blue Book
All applications for disability benefits are evaluated by the SSA based on medical, financial, and durational requirements. When you submit your claim, the SSA will use their official list of impairments, the Blue Book. If you meet or equal a Blue Book listing for CP, or any condition, you will automatically be approved for benefits.
Cerebral palsy can be found in section 11.00—Neurological Disorders for adults and section 111.00 for children .
In order to be approved with CP as an adult, you need medical evidence showing you have CP with at least one of the following:
- An IQ of 70 or less.
- Abnormal behavior patterns, such as destructiveness or emotional instability.
- Significant interference in communication due to speech, hearing, or visual defects.
- Significant and persistent interference with motor function in two extremities, resulting in sustained disturbance of large movements, fine motor skills, walking or standing. This can include paralysis, tremor, involuntary movements, ataxia (poor balance and coordination), loss of control of body movements, and sensory disturbances.
- In order to be approved with CP as a child, you need medical evidence showing you have CP with at least one of the following:
- Persistent interference or restriction of motor function for age involving two extremities, which (despite prescribed therapy) interferes with age-appropriate major daily activities and results in disruption of large and fine movements or ability to walk and stand.
- Less severe motor dysfunction and one either an IQ of 70 or less, a seizure disorder, with at least one major motor seizure in the year prior to application, a significant emotional disorder, or significant interference with communication due to a speech, hearing, or visual defect.
If CP is keeping you from working, talk to your doctor about applying for disability benefits, because they may be able to provide supporting documentation.
Qualifying Without Meeting a Medical Listing
If your CP is severe enough that you're unable to earn the SSA's minimum monthly livable salary, which is $1,130 in 2016, but you don't meet a Blue Book listing, you may still qualify for benefits. The SSA can also approve applicants with a medical-vocational allowance using their Residual Functioning Capacity (RFC).
The SSA measures an RFC by using grid rules that examine your physical and mental disabilities and limitations, as well as your education and work history. The SSA will put you in a category of work ability (sedentary, light, medium, heavy, very heavy) and try to find jobs that you could do with your education skill and work history.
There are three main kinds of CP which cause different kinds of symptoms, though it's possible to have a mixture. Spastic CP is the most common type, where individuals experience increased muscle tone and stiffness in different parts of the body, which makes their movements stiff or awkward. Dyskinetic CP causes motor patterns of slow and uncontrollable writhing or jerky movements of the hands, feet, arms, or legs. Ataxic CP affects balance and depth perception, which causes poor coordination and an unsteady or wide-based gait.
CP affects many different parts of your body and causes symptoms that could limit you from working, such as inability to walk or stand effectively or at all, muscle stiffness, balance and coordination problems, involuntary movements, pain, intellectual disabilities, seizures, issues with vision, speech, hearing, and communication, emotional instability, and more.
Many cases of CP are likely to be approved because of the nature of the disorder, however individuals with higher education are often less likely to be approved than those without higher education who worked in jobs like construction, retail, food service. However, even sedentary jobs often require fine motor skills as well, like typing, so it will ultimately depend on how your CP affects you.
How to Apply for Social Security Disability Benefits
If approved, your application can take months or years and go through a number of appeals before you see any money, which can put strain on you or your family, both mentally and financially. If your diagnosis of CP isn't severe enough that your doctor thinks SSA approval is likely, the application process may not be worth the time and effort it will take.
If you meet a Blue Book listing or you think an RFC approval is likely, the key to getting approved quickly is to include all of the medical information the SSA requires. 70 percent of applicants who are denied, and many of those are denied because they're missing important evidence about their condition.
Important medical evidence will include:
- Cranial ultrasound, MRI, CT scan, and other medical imaging tests
- Reports of seizures or other accompanying conditions
- Blood testing to check chemistry, plasma, and chromosome levels.
- Detailed clinical observations and report of limitations from your doctor(s).
- Analysis of motor skill development
- Visual, hearing, or speech testing
- Medical imaging tests, like MRI, X-ray, CT scans, or PET scans and blood testing to identify any accompanying conditions
- Neuropyschological I.Q. testing, such as the Luria-Nebraska or Halstead-Reitan.
- A list of treatments and outcomes.
- Records of hospitalizations or surgeries directly or indirectly related to CP.
- List of treatments and your body's response to each.
Make sure to check the SSA's website for a list of all documents needed for your application and double check your application. Any missing information, unanswered questions, or mistakes can cause the SSA to delay your answer while they try to figure out the correct material. The SSA has a convenient online application for benefits, so you don't have to make an appointment at an SSA office. However, all Supplementary Security Income applications must be done in person at your local SSA office.
If there are any changes in your condition or treatment plan, or new symptoms or hospitalizations, let the SSA know immediately. New evidence showing the limitations of your CP could help your case get approved.
If you’re approved for benefits, your spouse and children may also be eligible for benefits. To learn more about the different forms about disability benefits, visit our pages on Social Security Disability Insurance.
