Social Security Decisions Are for Life!
On June 12, 2015, SSA final rule for evaluating growth disorders and weight loss in children became effective. Today SSA issued transmittal DI 24598 TN 02 for DI 24598.000 Evaluation of Specific Issues – Low Birth Weight (LBW) and Failure to Thrive (FTT) reflects the changes in the revised Low Birth Weight (LBW) and Failure to Thrive (FTT) medical listings. SSA revised this POMS section to provide updated guidance for evaluating the revised listings for FTT in children.
DI 24598.002 Failure to Thrive (FTT)
A. What is FTT?
FTT is the inability of an infant or young child to grow appropriately. Many children with FTT also show signs of delays in one or more developmental domains.B. When is FTT a medically determinable impairment (MDI)?
FTT is an MDI for children from birth to attainment of age 3, regardless of whether an underlying digestive disorder or other medical condition is present.C. When is FTT not an MDI?
FTT is not an MDI for children after the attainment of age 3. After age 3, evaluate growth failure under the affected body system(s).
D. When is it appropriate to establish FTT?
Establish FTT with or without a known cause when there is documentation of an infant or toddler’s growth failure and developmental delay from an acceptable medical source(s) (AMS) in DI 34005.100, Low Birth Weight and Failure to Thrive, listing section 100.05. Documentation of Growth measurements in listing section 100.05A and developmental delay in 100.05B or 100.05C must be within the same consecutive 12-month period and at least 60 days apart. The dates of developmental testing and reports may be different from the dates of the growth measurements.
1. Listing 100.05
Evaluate severe FTT in DI 34005.100, Low Birth Weight and Failure to Thrive, under listing section 100.05 using the appropriate table(s) under listing 105.08B in the digestive system. Establish FTT when there is documentation of growth failure and developmental delay from an AMS. For policy guidance regarding AMS and sources of evidence, see DI 22505.003B.1.
2. Growth failure
In DI 34005.100, Low Birth Weight and Failure to Thrive, under listing section100.05A, use the appropriate table(s) under listing section 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.
The following provides information regarding the weight-for-length and body mass index-for-age tables in 105.08B:
- For children from birth to attainment of age 2, use the weight-for-length table corresponding to the child’s gender (Table I or Table II) in 105.08B.1.
- For children age 2 to the attainment of age 3, use the body mass index (BMI)-for-age table corresponding to the child’s gender (Table III or Table IV) in 105.08B.2.