The Social Security Administration (SSA) does recognize autism as a potentially disabling condition; however, your child must be severely autistic in order to meet the SSA’s eligibility requirements. This is because many children who suffer from more mild forms of autism are able to function at a nearly “normal” level socially and academically.
Children with more severe forms however, do require significant supportive care, which can leave you financially strapped. Social Security Disability (SSD) benefits can give you the financial resources you need to ensure your child receives the consistent support and attention he or she needs and deserves.
Supplemental Security Income
Children who meet the SSA’s eligibility requirements receive benefits through the Supplemental Security Income (SSI) program. SSI is a need-based program, which means it has strict criteria regarding financial status for children to qualify. In other words, even if your child suffers from severe autism and meets the SSA’s definition of disability, he or she may not meet the financial eligibility requirements for getting SSI benefits.
The income and other financial resources you and your child have available will be thoroughly reviewed by the SSA, and must be very limited in order for your child to receive SSI benefits. The calculation of income and resources is fairly complex, with some sources counting and others not. To learn more about SSI financial criteria, visit: http://www.socialsecurity.gov/pgm/ssi.htm.
Medical Eligibility for SSI
For your child to be found medically eligible to receive SSI benefits, he or she must be severely impaired. To prove severe developmental impairment, you must have substantial medical records documenting specific information, including:
- Severe limitations in interacting socially
- Pronounced communication deficits
- Inability to engage in age appropriate activities that require imagination
- Very limited involvement in a broader range of interests and/or activities
You must also have the following information well documented in his or her medical records:
- For children between 1 and 3 years of age, a pronounced limitation in at least one of the following areas:
- Fine motor skills
- Communication and/or cognitive abilities
- Age appropriate social functioning
- For children between the ages of 3 and 18, severe limitation in at least two of the following areas is necessary:
- Communication and/or cognitive function
- Age appropriate social functioning
- Inability to provide age appropriate self care in everyday activities
- Pronounced difficulties with concentrating, remaining focused and on task, or in completing tasks at a reasonable/normal pace
Medical Evidence and SSI Eligibility
The documentation in your child’s medical records must meet certain standards in order to prove the criteria listed above. You must work closely with your child’s doctor to ensure the right tests have been completed to satisfy the SSA’s evidentiary requirements. You may also want to consider seeking assistance from a Social Security advocate or attorney who is familiar with handling autism disability claims.
The Application Process
You can begin the application process by contacting your local SSA office and obtaining a copy of the Child Disability Starter Kit. You can also get the kit from the SSA’s website.
The kit will tell you how the application and review processes work and what information you will need to complete the SSA’s application for benefits. Required information includes your child’s medical history and school records. Additionally, as SSI is a need-based program, you must present the SSA with financial records as well.
To finalize an application for SSI benefits on behalf of a child, you must participate in an interview with an SSA representative. If you have a caseworker from family and social services with whom you work, he or she can arrange the SSA interview appointment for you, or you can contact your local SSA office directly to make an appointment.
Article by Ram Meyyappan
Social Security Disability Help
For more information on Autism and Disability, please visit: http://www.disability-benefits-help.org/disabling-conditions/autism-and-social-security-disability