A congenital disorder is a medical condition which is present at birth, and, if severe enough, may qualify for disability benefits with the Social Security Administration.
Congenital disorders are covered by Section 10.00 of the Listing of Impairments (“Congenital Disorders That Affect Multiple Body Systems”). Section 10.00 consists of only one impairment, non-mosaic Down Syndrome (10.06).
Although Down syndrome exists in non-mosaic and mosaic forms, the SSA only evaluates non-mosaic Down syndrome under this body system.
Non-Mosaic Down Syndrome
Individuals with non-mosaic Down syndrome typically exhibit distinct facial or physical characteristics, experience a slower pace in physical development, and have intellectual disabilities. In addition to these traits, non-mosaic Down syndrome may also be associated with congenital heart disease, vision impairments, hearing difficulties, and other health issues. The evaluation of non-mosaic Down syndrome is conducted under the criteria found in section 10.06.
Under listing 10.06, Social Security sets forth the following requirements for Non-mosaic Down Syndrome:
“10.06 Non-mosaic Down syndrome, (chromosome 21 trisomy or chromosome 21 translocation), documented by:
A. A laboratory report of karyotype analysis signed by a physician, or both a laboratory report of karyotype analysis not signed by a physician and a statement by a physician that you have Down syndrome (see 10.00C1).
OR
B. A physician’s report stating that you have chromosome 21 trisomy or chromosome 21 translocation consistent with prior karyotype analysis with the distinctive facial or other physical features of Down syndrome (see 10.00C2a).
OR
C. A physician’s report stating that you have Down syndrome with the distinctive facial or other physical features and evidence demonstrating that you function at a level consistent with non-mosaic Down syndrome (see 10.00C2b).”
Other Congenital Disorders
There are many other impairments that can cause deviation from, or interruption of, the normal function of the body or interfere with development; for example, congenital anomalies, chromosomal disorders, dysmorphic syndromes, metabolic disorders, and perinatal infectious diseases. These conditions include, but are not limited to, the following:
- Trisomy X syndrome (XXX syndrome),
- Fragile X syndrome,
- Phenylketonuria (PKU),
- Caudal regression syndrome, and
- Fetal alcohol syndrome.
In these impairments, the degree of deviation or interruption may vary widely from individual to individual. Therefore, the resulting functional limitations and the progression of those limitations also vary widely. For this reason, Social Security evaluates the specific effects of these impairments on you under the listing criteria in any affected body system(s) on an individual case basis.
