Heart Issues in Children

Definition

The Social Security Administration defines a cardiovascular impairment as any disorder that affects the proper functioning of the heart or the circulatory system (arteries, veins, capillaries, and the lymphatic drainage). The disorder can be congenital (present at birth) or acquired (the result of a disease, accident, or medication).

General information

About one in every 100 children has a heart problem (also called a heart defect). Heart defects usually can be treated with medicine, procedures, or surgery. Common symptoms include a blue color of the skin and lips, shortness of breath, and difficulty feeding. However, many children have no symptoms and you, as the parent, may not even realize that your child has a heart defect. Most tests for heart problems are quick, simple, and painless. Many children with heart defects live normal lives. Some children are born with heart conditions that have a severe impact on their ability to function. Heart conditions can affect the long term health of your child and require a lot of expensive treatment. As a consequence, financial difficulties may result.

Social Security Administration Medical Listings 104.00 – Cardiovascular System

Children under the age of 18 who have a cardiovascular condition that results in marked and severe functional limitations may be eligible for Supplemental Security Income (SSI) benefits. The impairment must be disabling for 12 months or be expected to last for 12 months, or result in death. SSI is a needs based program so household income and assets is also considered when determining eligibility. This means that if you have too much income or too many assets, your child will not be eligible for SSI, even though he or she may be disabled.

The Social Security Administration will review medical evidence to help determine whether or not your child is disabled. Specifically, your child’s symptoms, signs, laboratory findings, response to prescribed treatment, and any functional limitations will be considered. The Social Security Administration has published medical listings on its website that outline what requirements a child with a cardiovascular impairment has to meet to be found disabled.

Cardiovascular impairments may fall into one of the following categories:

  1. Chronic heart failure or heart valve dysfunction.
  2. Discomfort or pain due to damage from a blockage in blood flow to a part of your heart.
  3. Syncope or fainting spells due to inadequate flow of oxygen to the brain from any cardiac cause.
  4. Abnormalities of the veins and arteries that may have debilitating effects on the legs, nervous system, kidneys or other organs.

If your child doesn’t meet a medical listing, it is possible to functionally equal a medical listing by having marked limitations in two domains of functioning or extreme limitations in one domain of functioning. (See Evaluating Childhood Disorders for Disability under SSA)

Your representative can help you determine whether your child’s cardiovascular disorder is severe enough to qualify for disability benefits under the Social Security Administration.