A. Definition

Growth impairments are common in children. Growth impairments from a known source such as fetal alcohol syndrome, dwarfism, sick cell, and malnutrition have all been recognized as disabilities. However, just being smaller than average does not qualify as a disability, according to the Social Security Administration. Often an x-ray, magnetic resonance imaging (MRI), or computerized axial tomography (CAT scan) is required to examine children’s bone structure in regard to height and normal growth.

B. General Information

Impairment in growth may be disabling in itself or it may be an indicator of the severity of the impairment due to a specific disease process. Determinations of growth impairment should be based on the comparison of current height with at least three previous determinations, including length at birth, if available. Heights (or lengths) should be plotted on a standard growth chart, such as the National Center of Health Statistics (NCHS) Growth Charts. Height should be measured without shoes. Body weight corresponding to the ages represented by the heights should be furnished. The adult heights of the child’s natural parents and the heights and ages of siblings should also be furnished. This will provide a basis upon which to identify those children whose short stature represents familial characteristic rather than a result of disease.

Bone age determination should include a full descriptive report of medically acceptable imaging specifically obtained to determine bone age and must cite the method used. Medically acceptable imaging includes, but is not limited to, x-ray imaging, CAT scan, or MRI. Views of the left hand and wrist should be ordered. In addition, appropriate medically acceptable imaging of the knee and ankle should be obtained when cessation of growth is being evaluated in an older child at, or past, puberty.

C. Social Security Administration Medical Listing 100.00 –Category of Impairments, Growth

The Social Security Administration (SSA) recognizes growth impairment as a genuine disorder, as well as one that can be disabling. It is listed in Part B of the Social Security Administration’s List of Impairments. A doctor’s diagnosis of growth impairment alone, however, does not constitute a disability. For your child’s condition to be severe enough to meet the Social Security Administration’s medical listing, you must show:

• A fall of greater than 25 percentiles in height, which is sustained; and
• A bone age greater than two standard deviations below the mean for chronologicalage.

Slightly different criteria apply to children whose growth impairment is considered to be related to an additional medically determinable impairment. Your representative can help you determine whether your child’s growth impairment is severe enough to qualify for disability benefits under the guidelines of the Social Security Administration.