Ask the Expert – How Your Child With Autism Can Qualify for Social Security Benefits

The Social Security Administration (SSA) oversees two disability programs, one of which is Supplemental Security Income (SSI).  This program provides monthly benefits to individuals with disabilities who exhibit financial need and meet the medical requirements, then he or she might be approved for disability benefits. If a child is on the spectrum and the disorder limits the child enough that he or she meets the medical qualifications, then you might want to help the child apply for disability benefits from the SSA. A child with autism requires special medical care, has special education needs, and requires therapy, all of which affect the family financially. Disability benefits can help with those extra costs.

Meeting the Medical Criteria
The first step in getting approved for Social Security Disability benefits is meeting the medical criteria that the SSA uses to determine disability. Children, who are younger than 18 years of age, have different criteria to meet than the adults do. The SSA uses the Blue Book, which is a medical guide that has separate listings for children. To meet the listing for children with autism, the child must have delayed social and communication skills for their specific age.

The child’s autism listing is found in the Blue Book under Section 112.10. To be approved for SSI benefits, the child must display:
-a symptom of a communication impairment, which might be difficulty responding to speech or producing normal speech.
-a symptom that shows impaired social interaction, which is the inability or difficulty of connecting with others in non-verbal or verbal ways. Examples include the inability to imitate others or respond to others’ emotions.
-a symptom of restricted and/or repetitive behaviors, which include preoccupation with a single activity, rearranging objects, and the need for a highly structured, unchanging environment to function properly.

In addition to those signs or symptoms of autism, the child must also exhibit symptoms or restrictions for his specific age group. Older infants or toddlers who range in age from one to three years of age should have no more than half the appropriate level of functioning for their age in the three areas below, or no more than two thirds of the appropriate level of functioning in all three of the criteria:
-communicative and cognitive functions OR
-fine motor development OR
-social functioning

Children from ages three to 18 years of age who have an age-appropriate level that is marked in two of these areas:
-social functioning
-personal functioning
-cognitive or communicative functioning
-maintaining persistence, concentration or pace

The Financial Requirements
SSI requires that the individual with the disability meets specific financial restraints, including low income and limited resources. When a child is involved, it is considered that the child would have access to a portion of the parents’ income. Using an approach called deeming, the SSA will determine if the disabled child meets the financial requirements to be approved.

Applying for Disability Benefits
If you have a child you think would qualify for SSI because of an autism-related disability, you should help him or her apply for disability benefits. Total disability based on childhood autism can garner approval by meeting the SSA-specified criteria for the condition. Documentation is the key to a successful claim. Consult with a Social Security Disability attorney today.

Frequently Asked Questions

Where do you advise parents to go should they have more questions or difficulty getting benefits?
If you are a parent of a child on the spectrum who is disabled and is seeking Social Security Disability benefits, you may need help getting the claim approved, or you might have questions about the disability claims process. You should consult with a Social Security Disability attorney. These attorneys help clients with the application process and walk them through the stages, ensuring the right documents are filed.

If my adult child has a job, how does that impact benefits?
Your child can still work and receive Supplemental Security Income (SSI) benefits. The adult child’s income cannot exceed the federal benefit rate, which is $771 for a single person per month. Countable income is money that can pay for shelter and food. The first $20 of any money is excluded from the count. Also, the first $65 of earned income is excluded. Any food stamps, any bills paid by a family member or friend, and any random small amounts of money received on occasion do not count toward those totals.

If I’ve been denied SSI, what should I do? What are the approval tips?
If you have been denied SSI benefits, you can file an appeal. Your denial letter details the process and gives you a deadline for filing the appeal. Most claims aren’t approved right away. If you are denied a second time, you will apeal and request a hearing before an administrative law judge. You should seek the help of a disability lawyer, who understands the process and who can help you prepare for the appeal.

How do I maximize the amount of SSI that my child or adult child gets?
Because of the deeming process, you will need to know how to maximize the amount your child can receive. If you child is a minor, your income is considered and the Social Security Administration (SSA) will consider that a portion of your income is available to your child for living expenses. If you adult child lives with you, you should charge rent. If the adult child lives rent-free in your home, their SSI payment will be reduced.

If the adult child lives rent-free, it will reduce the SSI benefit by one third of the Federal Benefit Rate, which is about $244 monthly. Calculate the adult child’s part of room and board, including all household expenses – rent or mortgage, utilities and food coasts. Take the total and divide it by the number of people in the household then charge the adult child’s portion of the room and board and report it to the SSA.

This article was written by the Outreach Team at Disability Benefits Help. They provide information about disability benefits and the application process. To learn more, please visit their website or email them at help@ssd-help.org.