Child Support and Orthodontic Expenses

“Mommy I want braces!”  I think we all know the answer to this question: “They are just too expensive!”

Pretty straightforward, but what if the matter is complicated by legal issues such as child support payments?  And what if the child really needs them to straighten their teeth?

Not surprisingly, a common legal inquiry we get is whether a non-custodial parent must pay for orthodontic expenses in a child support arrangement.  The short answer is, it depends on if the child really needs them.

Generally speaking, parents who make child support payments are also responsible for covering any uninsured medical and dental expenses.  So the question becomes, “are braces medical expenses for the purposes of child support payments?”

Of course, this will vary by state, but most child support rules are codified in state statutes which require reasonable and necessary medical and dental expenses to be divided in proportion to the parents’ gross income.  So let’s say if one parent’s income is the equivalent of 70% of the parents’ combined income, then they will be responsible for 70% of the orthodontic bill.

Cases involving this issue are somewhat sparse, but fortunately they seem to be saying the same thing: parents are required to include payments for their child’s braces if they are a “reasonable and necessary” expense.

Braces: a Necessary Medical Expense or Cosmetic?

It helps to think of it as a sliding scale or a spectrum: the more the braces resemble a necessary medical expense, the more likely it is a non-custodial parent will have to render support payments for the bill.  However, the more the braces resemble a cosmetic expense, then the parent won’t likely be required to cover the expense.

This can be pretty clear cut, though- if the child’s case involves any sort of pain or discomfort, and not getting braces will mean injury to another body part such as the face or neck, then I’m quite sure that braces will be considered a necessary medical expense.  But if the child only wants them because they look cool, then I’m sorry: the laws just don’t enforce payments for purely cosmetic expenses.

Court cases involving these types of disputes are examined on a case-by-case basis, but courts will typically enforce the statutory “reasonable and necessary” requirements.  For example, a 2004 North Carolina case, Billings vs. Billings, required the non-custodial parent to cover their portion of orthodontic expenses because the braces were deemed a “necessary medical expense”.  In that case, the child’s dental condition was causing pain to her jaw and face.  Like most cases, the Billing’s judgment involved uninsured expenses that were over a certain amount (in this case, over $100).

Another case, Barret vs. Kantz, is a good example of how courts usually decide these disputes on a case-by-case basis.  In that matter, the mother of the children was seeking to enforce child support for two of their children’s braces.  However, the court found that the father had to pay for only one of the child’s braces, and not the other’s, because one child’s dental case was more “medically urgent” than the other’s.  So, even amongst children who are siblings, courts will not award a general payment but will tailor the support payments according to real medical and dental needs.

How to Handle the Future Cost of Braces with Your Ex?

So, what can be done if you are in this situation?  Here are some tips to avoid future conflicts:

• Ask your attorney to write such expenses specifically into the child support order if you think that orthodontic expenses are going to be an issue in the future.  For example, “the paying parent will pay ___ % for any orthodontic or dental expenses.”  Do this preferably at the outset.  Courts are likely to honor such tailored provisions because it shows that the parent is attentive to their child’s needs.
• Get insurance for your child, whether you are the paying spouse or the custodial spouse. Most child support statutes deal only with uninsured expenses, so if the child is insured, then orthodontic expenses won’t even become a legal issue.  Think dental or medical insurance is expensive?  It sure is, but is it more expensive than a lawsuit?  I think not!
• Make your support payments for medical and dental expenses if you are required to do so! Appealing a case is difficult to do in child support cases, because if a judge makes a ruling, the burden is on the appealing party to show that the court made an error in calculating payment amounts (this was true in the Barret v. Kantz case above).  Again, the additional payments may be expensive, but not more expensive than a lawsuit!

I think this last point is really the most salient.  After all, if the child truly needs medical or dental attention, then by all means they are entitled to treatment.  So even if it means some sacrifice on the paying parent’s part, it is in everyone’s interest to muster their best efforts to make the payments.  And, it will probably be the more cost-effective route in the long run.

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