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January 1, 2024

Benefits for Individuals with Autism (ASD)

Managing the challenges of an autism diagnosis while navigating daily life often comes with an emotional and financial toll for individuals with an autism spectrum disorder (ASD) and their families. Maintaining therapy, assisted living arrangements, and other necessary long-term support services for autistic individuals is often costly. Unfortunately, many individuals with autism face barriers to holding a stable job because of difficulties with communication, social interactions, and sensory sensitivities their condition brings. 

For many in these situations, disability benefits can provide crucial financial assistance to autistic individuals and their families struggling to make ends meet. In this blog post, we’ll  address common questions such as:

• When is autism a disability? 
• How do I apply for benefits for a child?

We’ll also outline the basic disability benefits available for individuals with autism through the Social Security Administration (SSA) and review the application process.

Is Autism a Disability?

As a neurological developmental disorder, autism and other autism spectrum disorder conditions affect individuals in different ways. While some people with ASD can maintain employment and live independently, others require substantial support. When autism significantly impairs daily functioning and the ability to work, individuals may qualify for disability benefits under both federal laws (e.g., the Americans with Disabilities Act) and SSA guidelines.

What Disability Benefits Are Available for Autism?

The Social Security Administration offers two avenues for getting autism disability benefits: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Which program applies depends on an individual’s age, work history, and financial resources.

Social Security Disability Insurance Benefits

SSDI is a form of financial support for adult, disabled workers who can no longer earn a living because of a physical or mental condition. Benefits come monthly and are based on your average earnings during your employment history. 

To qualify, you must have sufficient work credits compiled from years of prior employment and a history of paying Social Security taxes. Since autism is present from birth, many adults with ASD struggle to hold steady jobs and often lack the work history required for SSDI eligibility.

Supplemental Security Income Benefits

The SSI program offers financial assistance to individuals with disabilities who have limited income and resources. It can be a valuable lifeline for those who need help covering many of the costs that come with an autism diagnosis, including daily care, therapy, and essential living expenses.

SSI is different from SSDI in two significant ways:

• Benefits don’t require a work history, and
• Both children and adults can qualify for benefits.

Since SSI is a need-based program, only individuals or families with few financial resources are eligible. Parents of a child with autism can apply for SSI on behalf of their child, but they might not qualify if they earn too much income. 

What Do I Need to Qualify for Benefits with Autism?

The SSA evaluates benefits claims using the Blue Book, a guide that outlines impairments and the criteria required to qualify for SSDI or SSI. According to the Blue Book’s listing on autism-spectrum disorders, an adult or child must have medical documentation of all of the following to qualify for benefits:

• Significant difficulty with social interactions,
• Impaired verbal and non-verbal communication skills, and
• Restricted or repetitive patterns of behavior or interests.

Additionally, they must show marked impairments in at least two of the following areas:

• Understanding, remembering, or applying information;
• Interacting with others;
• Concentrating and performing tasks on time; and
• Managing emotions or behavior and adapting them to the environment. 

When applying for benefits for children with autism, you must also generally show that any communication and functional impairments are abnormal for their age group.

Gathering detailed medical evidence that illustrates each required point is essential for your chances of approval. However, this can be challenging for applicants and their parents to take on alone. 

Seeking guidance from an experienced disability attorney can help you clarify eligibility requirements and gather the medical documentation needed for a strong claim. An attorney can also help you with questions specific to your situation, such as how to apply for SSI for a child with autism, and ensure you present all medical and psychological evidence correctly.

How to Apply for Autism Disability Benefits

Applying for disability benefits can be a lengthy and complicated process. Understanding the potential steps involved ahead of time can be crucial for proper preparation that can improve your chances of a successful claim.

Gather Medical and Supporting Documentation

The SSA requires a lot of information as part of the disability benefits application process. Be prepared to provide:

• Personal information—Social Security number, birthplace, contact information;
• Official diagnosis—confirmation of autism diagnosis from a qualified medical professional;
• Medical records—psychological evaluations, notes from therapy sessions, hospitalization records, prescription history;
• Caregiver statements—letters from medical professionals, therapists, and caregivers who can speak to the impact of the condition on daily life; and
• Financial records—paystubs, tax returns, bank statements, rent or mortgage records, utility bills, and documentation of other financial assets.

Make copies of all documents you submit and keep them organized for future reference.

Complete the Application

You can apply for SSDI online, by phone, or in person at your local Social Security office.

The SSI application process is a little different. If you’re applying for a child, you can begin the process by completing the Child Disability Report online. However, you must call the SSA or go to your local office directly to complete the SSI application.

Attend an Interview or Evaluation

Applicants may be required to participate in an interview. During the interview, an SSA representative will examine their or their child’s medical history and functional limitations.

The SSA may also request an independent medical or psychological evaluation to assess the severity of the condition.

Wait for a Decision

Decisions from the SSA can take several months. If denied, you have the right to appeal.

Having legal representation can significantly improve the likelihood of a successful appeal.

An attorney can ensure all necessary documentation is submitted correctly, present a strong case, and guide families through each step of the process.

Personalized Guidance and Compassionate Advocacy 

Applying for disability benefits for autism can feel overwhelming, but having the right support can make all the difference. At the Law Offices of Jennifer R. Solomon, we help individuals with autism and their families secure the financial assistance they need. With extensive experience in disability law, Jennifer Solomon understands the complexities of the SSA system and is committed to guiding clients through every step of the application and appeals process. If you or a loved one needs help obtaining disability benefits for autism, contact our office today to schedule a consultation to learn more. 

Resources

• Social Security Administration, Child Disability Report, link.