SSDI Benefits for Autism

If you or a family member is living with autism, you may be curious about the rights afforded to autistic individuals under the Americans with Disabilities Act (ADA). You might also be wondering if autism qualifies for disability benefits from the Social Security Administration (SSA).

Children and adults over the age of 18 with autism could potentially be eligible for financial assistance through Social Security disability or Supplemental Security Income. Understanding how to navigate these potential options is crucial for accessing these services.

Is Autism a Permanent Disability?

Autism is considered a disability under the ADA, and some adults and children with autism may access Social Security benefits, including disability benefits and Supplemental Security Income (SSI). To delve deeper into autism and the available disability benefits, continue reading.

What Is Autism?

Autism spectrum disorder (ASD) is a complex developmental disorder typically appearing in early childhood, with males being four times more likely to develop the condition. It manifests differently among individuals, featuring difficulties in social interaction and communication, alongside unusual behavior patterns like repetitive activities and heightened sensitivity to stimuli.

Autism, Asperger Syndrome (AS), and Pervasive Developmental Disorder (PDD-NOS) fall within the autism spectrum. While there's no cure, early diagnosis and intervention have significant positive effects. Even children under two years old can receive an ASD diagnosis in certain cases.

What Disability Benefits Are Available for Autism?

The Social Security Administration (SSA) offers two benefits for individuals with disabilities that adults and children with autism may be eligible for:

1. Social Security Disability Income (SSDI)
- Supports individuals who previously worked but had to stop due to disability.
- Benefit calculation considers the individual's income before becoming disabled or, if the disability began before age 22, parental income may be considered.

2. Supplemental Security Income (SSI)
- Aids disabled individuals with low incomes.
- Families can apply for SSI for children with autism to cover additional resources.
- Family income is considered, and it must not exceed the SSI limit. Adults over 18 with autism may also qualify for SSI benefits.

Qualification for these benefits doesn't hinge on previous employment but rather on household income and resources. SSI recipients may also qualify for medical benefits like Medicaid. Monthly SSI amounts vary between states, with some states supplementing the amount for children with autism.

How Do I Know If I Qualify for ASD Benefits?

Qualifications for Children with Autism
Autism is a listed qualifying condition in the Childhood Blue Book, the SSA's medical guide for determining eligibility for Social Security benefits. Strict criteria outlined in Section 112.10 of the Blue Book must be met. To be eligible for SSI, a child with autism needs comprehensive medical documentation of qualitative deficits in verbal and non-verbal communication, social interaction, and restricted or repetitive behavior patterns.

Additionally, the child must have an "extreme" limitation in one or marked limitations in any two of the following areas:
- Understanding, remembering, or applying information
- Interacting with others
- Concentrating and completing tasks
- Adapting oneself (controlling emotions)

The SSA reviews the child's health every three years until age 18, after which adult rules apply, though SSI coverage may continue.

Qualifications for Adults with Autism
Autism is included in the SSA's Blue Book under Section 12.10, Mental Disorders. To qualify for SSI for autism if you are over 18, you must prove an inability to work a simple unskilled job, have limited income, and provide medical documentation showing difficulties in social interaction, verbal and nonverbal communication, imaginative activity, and restricted interests.

You must also demonstrate an extreme limitation in one or more areas of mental functioning, such as understanding, remembering, or applying information, interacting with others, concentrating, persisting, maintaining pace, or adapting or managing oneself.

Most adults with autism spectrum disorder won't qualify for Social Security Disability Insurance (SSDI) due to the employment history requirement. However, an exception exists: Adults with autism may apply for SSDI as an adult disabled child if a parent is deceased or receiving retirement or disability benefits.

Gathering the necessary documentation for an SSI or SSDI claim can be challenging, and explaining symptoms may pose a difficulty. As a result, many autistic applicants face rejection initially. Seeking assistance from an SSD attorney is crucial when pursuing Social Security benefits for a child or an adult with autism.