Autism and autism spectrum disorders can make it challenging for children to function socially and reach certain developmental milestones. Even in their more mild forms, autism can prevent adults from working and earning a living.
Conditions like autism are recognized by the Social Security Administration (SSA) as potentially disabling and may be able to qualify you or your child for Social Security Disability (SSD) benefits through one of both of the SSA’s disability programs.
SSD Benefit Programs
The SSA administers two disability programs through which individuals who have been diagnosed with autism may qualify:
- Social Security Disability Insurance (SSDI) – this program is generally only available to adult, disabled workers who meet both the medical and technical eligibility requirements. To qualify, an applicant must have a severe mental, psychological, or physical impairment that prevents them from working and must also have sufficient work credits built up over the course of their previous employment. Most adults with autism will not qualify for SSDI benefits because they’ll need to have worked in the past, and because autism is congenital, it won’t “worsen” over time and render someone unable to work midlife.
- Supplemental Security Income (SSI) – this program is open to any individual with disabilities, of any age, regardless of work history, as long as they meet the medical eligibility and financial limitation threshold requirements. SSI is a need-based program and as such means that an applicant must have very limited income and financial resources available to pay for everyday needs and ongoing care. Children can apply for SSI, but may not be eligible if their family earns too much income.
Adults with disabilities can potentially qualify for both SSDI and SSI. Children with disabilities however, are only able to receive SSI benefits.
Medically Qualifying for Benefits
Every application for disability benefits is evaluated using the Blue Book, the SSA’s manual of impairments and the evidence required to prove disability with each listed condition. Autism is one of the hundreds of conditions listed in the Blue Book.
- Pronounced difficulty in interacting socially, especially in responding or reciprocating
- Impaired communication skills, verbal and/or non-verbal
- An inability to participate in imaginative or creative activities or thought
- Limited interest and participation in varying activities
To meet either of these listings, you or your child must also satisfy the following requirements:
- Children between one and three years of age must show one of the following signs, while kids age three to 18 must show at least two:
- Marked thinking and communication difficulties, documented through psychological and language/communication tests.
- Severe impairment in age-appropriate functioning, documented through extensive parental, teacher, and or doctor or other caregiver statements, and/or through standardized tests.
- Marked restrictions in personal functioning, including the ability to feed, bathe, dress, or otherwise care for him or herself, documented again through statements from others and/or through standardized testing methods.
- Pronounced difficulties with concentration, follow through, or the pace at which tasks are completed
- Any individual over the age of 18 must show two of the following signs in order to satisfy the Blue Book listing for Autism Spectrum Disorders in adults:
- Limitations in activities of daily living
- Difficulty interacting socially for any length of time
- Trouble concentrating, completing, or finishing tasks at a reasonable pace
- Repeated and lengthy episodes of decompensation, which are times when symptoms are more pronounced
Preparing and Applying for Benefits
Whether you are applying for yourself or on behalf of a child or adult with autism, you must collect as many medical records as possible. The more thorough the medical documentation that accompanies any claim, the more likely it is the argument for disability can be clearly made.
Additionally, statements from friends, family members, doctors, teachers, and caregivers can be instrumental in substantiating the argument that autism limits the child’s or the adult’s ability to care for him or herself or to participate in and appropriately respond to everyday situations, conversations, and activities.
Since there is a financial component to SSI, you will need financial records too. These may include paystubs, statements from any other benefits received, bank account statements, and any other documentation related to income and other financial assets or resources. You will also need information about past salaries or wages when applying for SSDI benefits, because the amount you earned while working will determine how much your monthly benefit will be.
When you are prepared to apply, you must schedule an appointment with your local SSA office for completing the SSI application, which are found in every state. To schedule an appointment, call the SSA toll-free at 1-800-772-1213.
The SSDI application can be filled out entirely online, or in person as well, whichever you prefer. Whether you apply in person or online, follow up with copies of all the pertinent documentation as successful applications are well supported with substantial medical and other records.
About the Author
Deanna Power is the Director of Outreach at Disability Benefits Help, an independent resource dedicated to helping people of all ages receive the Social Security disability benefits they need. She specializes in helping applicants determine if they’re medically eligible for benefits. If you have any questions on how to qualify with autism or about the Social Security disability process in general, she can be reached at firstname.lastname@example.org