PROGRAM OPERATIONS MANUAL SYSTEMPart DI – Disability InsuranceChapter 252 – Title XVI Child Claims Based on DisabilitySubchapter 25 – Functional Equivalence for ChildrenTransmittal No. 2, 04/01/2021
Audience
Originating Component
ODP
Effective Date
Upon Receipt
Background
This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure.
Summary of Changes
DI 25225.060 Examples of Impairments That Functionally Equal The Listings (Section 416.926a(m))
We updated the examples based on new musculoskeletal listings.
The following are some examples of impairments and limitations that functionally equal the listings. Findings of equivalence based on the disabling functional limitations of a child's impairment(s) are not limited to the examples in this paragraph, because these examples do not describe all possible effects of impairments that might be found to functionally equal the listings. As with any disabling impairment, the duration requirement must also be met (see DI 25505.025 and DI 25201.001 ff.).
1. Any physical impairment(s) or combination of physical and mental impairments causing complete inability to function independently outside the area of one's home within age-appropriate norms.
2. Requirement for 24-hour-a-day supervision for medical (including psychological) reasons.
3. Major congenital organ dysfunction which could be expected to result in death within the first year of life without surgical correction, and the impairment is expected to be disabling (because of residual impairment following surgery, or the recovery time required, or both) until attainment of 1 year of age.