Obtaining Disability Insurance Benefits for Spina Bifida

Spina Bifida is a birth defect which occurs in early embryonic development at about twenty eight days into the pregnancy. The developmental defect causes brain disorders called neural tube defects and one defect manifestation is the Spina Bifida birth defect which usually involves incomplete development of the brain, the spinal cord, and/or the meninges or the protective covering around brain and spinal cord. There are four main types of Spina Bifida, occulta, closed neural tube defects, meningocele and  myelomeningocele. A spina bifida related medical impairment can range from no symptoms at all and no disability at all to a very severe disability involving paralysis of all body parts below the spinal opening and total dysfunction of the bladder and bowel.   

Social Security will consider a Spina Bifida related medical condition a recognized disability for approval of benefits if (1) the limitation on an adult applicant’s ability to engage in gainful employment is severely impaired, or if, (2) a child applicant’s ability to engage in fundamental daily activities is severely impaired.  The applicant must provide medical documentation of (1) the diagnosis of a Spina Bifida related medical condition and (2) medical documentation of (a) work related impairments if an adult or (b) daily functional impairments if a child.  In addition the applicant will need to meet the general Social Security program requirements such as Supplemental Security Income (SSI) financial and asset limitations or Social Security Disability Insurance (SSDI) minimum work credit amounts and earnings amounts paid into the Social Security system.

Rating Levels of Function Severity

When rating the degree of limitation in the first three function areas Social Security use a five-point scale: none, mild, moderate, marked, and extreme.  The "extreme" rating is a degree of limitation that in an adult will be found incompatible with the ability to do any gainful activity and benefits will be awarded.  If they rate the degree of an applicant’s Spina Bifida related disability within the first three functional areas as "none" or "mild" they will generally subsequently conclude that the applicant’s impairment(s) is not severe and deny the claim, unless the medical evidence in the file indicates that there are other more than a minimal limitations on an applicant’s ability to do basic work activities.

Getting Legal Help

If you or a member of your family has been diagnosed with a Spina Bifida related disability and would like to apply for benefits with a Social Security program it may be helpful to discuss the circumstances of the disability and the application with a disability attorney to obtain some valuable guidance concerning the application and disability medical evaluation process.