TN 18 (06-15)
DI 34005.100 Low Birth Weight and Failure to Thrive
100.00 Low Birth Weight and Failure to Thrive (Effective Date: 06/12/2015)
A. What conditions do we evaluate under these listings? We evaluate low birth weight (LBW) in infants from birth to attainment of age 1 and
failure to thrive (FTT) in infants and toddlers from birth to attainment of age 3.
B. How do we evaluate disability based on LBW under 100.04? In 100.04A and 100.04B, we use an infant’s birth weight as documented by an original
or certified copy of the infant’s birth certificate or by a medical record signed
by a physician. Birth weight means the first weight recorded after birth. In 100.04B, gestational age is the infant’s age based on the date of conception as recorded in the medical record.
If the infant’s impairment meets the requirements for listing 100.04A or 100.04B,
we will follow the rules in § 416.990(b)(11) of this chapter.
C. How do we evaluate disability under 100.05?
1. General. We establish FTT with or without a known cause when we have documentation of an infant’s
or toddler’s growth failure and developmental delay from an acceptable medical source(s)
as defined in § 416.913(a) of this chapter. We require documentation of growth measurements
in 100.05A and developmental delay in 100.05B or 100.05C within the same consecutive
12-month period. The dates of developmental testing and reports may be different from
the dates of the growth measurements. After the attainment of age 3, we evaluate growth
failure under the affected body system(s).
2. Growth failure. Under 100.05A, we use the appropriate table(s) under 105.08B in the digestive system
to determine whether a child’s growth is less than the third percentile. The child
does not need to have a digestive disorder for the purposes of 100.05.
a. For children from birth to attainment of age 2, we use the weight-for-length table
corresponding to the child’s gender (Table I or Table II).
b. For children age 2 to the attainment of age 3, we use the body mass index (BMI)-for-age
table corresponding to the child’s gender (Table III or Table IV).
c. BMI is the ratio of a child’s weight to the square of his or her height. We calculate
BMI using the formulas in 105.00G2c.
d. Growth measurements. The weight-for-length measurements for children from birth to attainment of age 2
and BMI-for-age measurements in children age 2 to attainment of age 3 that are required
for this listing must be obtained within a 12-month period and at least 60 days apart.
If a child attains 2 during the evaluation period, additional measurements are not
needed. Any measurements taken before the child attains age 2 can be used to evaluate
the impairment under the appropriate listing for the child’s age. If the child attains
age 3 during the evaluation period, the measurements can be used to evaluate the impairment
in the affected body system.
3. Developmental Delay.
a. Under 100.05B and C, we use reports from acceptable medical sources to establish
delay in a child’s development.
b. Under 100.05B, we document the severity of developmental delay with results from
a standardized developmental assessment, which compares a child’s level of development
to the level typically expected for his or her chronological age. If the child was
born prematurely, we may use the corrected chronological age (CCA) for comparison.
(See § 416.924b(b) of this chapter.) CCA is the chronological age adjusted by a period
of gestational prematurity. CCA= (chronological age) – (number of weeks premature).
Acceptable medical sources or early intervention specialists, physical or occupational
therapists, and other sources may conduct standardized developmental assessments and
developmental screenings. The results of these tests and screening must be accompanied
by a statement or records from an acceptable medical source who established the child
has a developmental delay.
c. Under 100.05C, when there are no results from a standardized developmental assessment
in the case record, we need narrative developmental reports from the child’s medical
sources in sufficient detail to assess the severity of his or her developmental delay.
A narrative developmental report is based on clinical observations, progress notes,
and well-baby check-ups. To meet the requirements for 100.05C, the report must include:
the child’s developmental history; examination findings (with abnormal findings noted
on repeated examinations); and an overall assessment of the child’s development (that
is, more than one or two isolated skills) by the medical source. Some narrative developmental
reports may include results from developmental screening tests, which can identify
a child who is not developing or achieving skills within expected timeframes. Although
medical sources may refer to screening test results as supporting evidence in the
narrative developmental report, screening test results alone cannot establish a diagnosis
or the severity of developmental delay.
D. How do we evaluate disorders that do not meet one of our listings?
1. We may find infants disabled due to other disorders when their birth weights are
greater than 1200 grams but less than 2000 grams and their weight and gestational
age do not meet listing 100.04. The most common disorders of prematurity and LBW include
retinopathy of prematurity (ROP), chronic lung disease of infancy (CLD, previously
known as bronchopulmonary dysplasia, or BPD), intraventricular hemorrhage (IVH), necrotizing
enterocolitis (NEC), and periventricular leukomalacia (PVL). Other disorders include
poor nutrition and growth failure, hearing disorders, seizure disorders, cerebral
palsy, and developmental disorders. We evaluate these disorders under the affected
2. We may evaluate infants and toddlers with growth failure that is associated with
a known medical disorder under the body system of that medical disorder, for example,
the respiratory or digestive body systems.
3. If an infant or toddler has a severe medical determinable impairment(s) that does
not meet the criteria of any listing, we must also consider whether the child has
an impairment(s) that medically equals a listing (see § 416.926 of this chapter).
If the child’s impairment(s) does not meet or medically equal a listing, we will determine
whether the child’s impairment(s) functionally equals the listings (see § 416.926a
of this chapter) considering the factors in § 416.924a of this chapter. We use the
rules in § 416.994a of this chapter when we decide whether a child continues to be
100.01 Category of Impairments, Low Birth Weight and Failure to Thrive
100.04 Low birth weight in infants from birth to attainment of age 1.
A. Birth weight (see 100.00B) of less than 1200 grams.
B. The following gestational age and birth weight:
Gestational Age (in weeks)
2000 grams or less
1875 grams or less
1700 grams or less
1500 grams or less
1325 grams or less
1250 grams or less
100.05 Failure to thrive in children from birth to attainment of age 3 (see 100.00C), documented by A and B, or A and C.
A. Growth failure as required in 1 or 2:
1. For children from birth to attainment of age 2, three weight-for-length measurements that are:
a. Within a consecutive 12-month period; and
b. At least 60 days apart; and
c. Less than the third percentile on the appropriate weight-for-length table under
2. For children age 2 to attainment of age 3, three BMI-for-age measurements that are:
a. Within a consecutive 12-month period; and
b. At least 60 days apart; and
c. Less than the third percentile on the appropriate BMI-for-age table under 105.08B2.
B. Developmental delay (see 100.00C1 and C3), established by an acceptable medical
source and documented by findings from one current report of a standardized developmental
assessment (see 100.00C3b) that:
1. Shows development not more than two-thirds of the level typically expected for
the child’s age; or
2. Results in a valid score that is at least two standard deviations below the mean.
C. Developmental delay (see 100.03C3), established by an acceptable medical source
and documented by findings from two narrative developmental reports (see 100.00C3c)
1. Are dated at least 120 days apart (see 100.00C1); and
2. Indicate current development not more than two-thirds of the level typically expected
for the child’s age.