Fragile X Syndrome Benefits in Indiana

To qualify for Social Security Disability Insurance (SSDI), you must have a disability that prevents you from working for at least 12 months, have worked enough years to qualify (paid Social Security taxes), and meet specific work credit rules[7]. For Supplemental Security Income (SSI), you must have a disability, limited income, and limited resources, regardless of your work history[6]. Both programs use the federal definition of disability: an inability to engage in substantial gainful activity due to a severe, long-term physical or mental impairment[3]. Children with Fragile X Syndrome may qualify for SSI based on the severity of their symptoms and family income[5]. The Social Security Administration (SSA) may request medical exams or school records as part of the process[5]. For 2025, SSDI and SSI benefits will increase by 2.5% due to a cost-of-living adjustment (COLA)[2], and the income limits for Substantial Gainful Activity (SGA) will also rise slightly[1].

Indiana follows federal guidelines for determining disability for SSI and SSDI, but you must apply through the state’s Disability Determination Bureau (DDB), which works with Indiana's 26 local Social Security field offices[3]. The DDB evaluates medical evidence to see if your condition meets the SSA’s definition of disability. State-specific Medicaid waivers, known as Home- and Community-Based Services (HCBS), may be available for people with Fragile X Syndrome who need extra support at home or in the community. While most programs are federally funded, Indiana administers its own Medicaid (Indiana Health Coverage Programs). To access these, your income and resources must meet Indiana’s Medicaid eligibility criteria. If you are a state employee, Indiana also offers Short-Term and Long-Term Disability benefits for non-work-related injuries or illnesses, but these are separate from SSI and SSDI[4]. For most people with Fragile X Syndrome, federal programs (SSI, SSDI, Medicaid) are the main sources of benefits. State-specific information is limited; start with the Indiana Disability Determination Bureau and the Indiana Medicaid program for details about local processes and waivers.

• Gather Documentation: Collect medical records, school reports, and proof of income for your child.
• Online or In-Person: Apply for SSI/SSDI online at ssa.gov, by phone, or at your local Social Security office.
• Medical Review: Indiana’s Disability Determination Bureau will review your medical evidence.
• Apply for Medicaid: Contact Indiana Medicaid if you qualify for SSI, or apply separately for other Medicaid programs.

• Step 1: Prepare Medical Evidence – Collect medical records, test results, and statements from doctors and therapists about how Fragile X Syndrome affects daily life. Include school records, especially if the condition affects learning.
• Step 2: Complete the Application – You can apply for SSI and SSDI online at ssa.gov, by calling 1-800-772-1213, or in person at your nearest Social Security office. For SSI, you’ll need to provide proof of income, resources, and household information.
• Step 3: Indiana DDB Review – After you apply, Indiana’s Disability Determination Bureau will review your case, contact your doctors, and may request an exam at no cost to you[3][5].
• Step 4: Decision Notification – Wait for a decision; the process can take several months. Some conditions may qualify for immediate payments for up to six months while waiting for a full decision[5].
• Step 5: Medicaid Enrollment – If approved for SSI, you may automatically qualify for Indiana Medicaid. For other Medicaid programs or waivers, apply directly through Indiana Medicaid with your SSI award letter.
• Step 6: Ongoing Reporting – Report any income or living arrangement changes to the SSA to keep your benefits current.
• Step 7: Appeal if Denied – If denied, you can appeal within 60 days. Consider getting help from a disability advocate or lawyer.

• SSI (Supplemental Security Income): Provides monthly cash payments to low-income individuals with disabilities, regardless of work history. Children with Fragile X Syndrome may qualify if their condition is severe enough and family income is within limits[5][6].
• SSDI (Social Security Disability Insurance): Pays benefits if you have worked long enough and paid Social Security taxes. Adult children with Fragile X Syndrome may qualify on a parent’s work record if the disability began before age 22[5][7].
• Medicaid: Offers health coverage for those with low income and resources. SSI recipients usually qualify automatically.
• Ticket to Work: Helps adults with disabilities return to work by offering job training and support[3].

• Indiana Disability Determination Bureau (DDB): Reviews disability claims for SSI and SSDI. Contact them for updates, appeal questions, or to check your claim status[3].
• Indiana Medicaid (Indiana Health Coverage Programs): Provides health coverage for eligible residents, including waivers for in-home supports and community-based care. SSI recipients are typically auto-enrolled. Apply separately for Medicaid waivers not linked to SSI.
• State Employee Disability: Indiana offers Short-Term and Long-Term Disability insurance for state employees unable to work due to illness or non-occupational injury[4].
• Indiana Medicaid Waivers (HCBS): While not program-specific to Fragile X Syndrome, these waivers support children and adults with qualifying disabilities (e.g., Developmental Disabilities Waiver, Autism Support Waiver). Waiver eligibility and availability vary; check with Medicaid for current options.

State-specific programs for rare/genetic conditions like Fragile X Syndrome are limited. Most support comes from federal benefits, Medicaid waivers, and local nonprofit services. For more, contact the Indiana Disability Determination Bureau and Indiana Medicaid.

Achieving a Better Life Experience (ABLE) accounts let people with disabilities save up to $100,000 without affecting SSI eligibility. ABLE accounts in Indiana follow federal rules, but you must set them up through a national ABLE provider. Use ABLE funds for qualified disability expenses like education, housing, health care, and assistive technology.

In 2025, the Substantial Gainful Activity (SGA) income limit for non-blind SSDI recipients is expected to be $1,530/month; for blind individuals, it’s $2,550/month[1]. SSI income and asset limits are strict: $2,000 for an individual, $3,000 for a couple, but some assets (like a home or one car) are excluded. Use our SSI Income Estimator to see what you might qualify for.

Always report changes in income, living situation, or medical condition to the SSA. Failing to report can result in overpayments, which you may have to pay back. For help avoiding overpayments and understanding your reporting duties, see our guide Avoiding Overpayments & Reporting Changes.

• Social Security Administration
  Phone: 1-800-772-1213

  TTY: 1-800-325-0778

  Hours: Mon–Fri, 8am–7pm

  Website

  Apply for SSI/SSDI by phone, online, or at a local office.
• Indiana Disability Determination Bureau
  Phone: 1-800-622-4968

  Website

  Call for updates on your disability claim or for help with the process[3].
• Indiana Medicaid (IHCP)
  Phone: 1-800-403-0864

  TTY: 711

  Website

  Apply for Medicaid or ask about waiver programs.

• Can my child with Fragile X Syndrome qualify for SSI in Indiana?

  Yes, if your child’s condition is severe and your family’s income and resources are within federal limits. The SSA may request medical exams and school records as part of the review process[5].

• Are there Indiana Medicaid waivers for Fragile X Syndrome?

  Indiana offers Medicaid waivers for home- and community-based services, but waivers are not condition-specific. Waiver eligibility is based on level of disability. Contact Indiana Medicaid for current waiver options.

• Can an adult with Fragile X Syndrome get SSDI in Indiana?

  Yes, if they have worked enough to earn Social Security credits and their disability meets the federal definition. Adult children may also qualify on a parent’s work record if the disability began before age 22[7].

• How much can I earn and still get SSDI in 2025?

  For 2025, the SGA limit for non-blind SSDI recipients is $1,530/month, and $2,550/month for blind individuals[1]. Earning above these amounts may affect eligibility.

• How does SSI differ from SSDI?

  SSI is needs-based for low-income individuals with disabilities; SSDI is based on work history and Social Security tax payments. See our **[SSI vs SSDI](/guides/ssi-ssdi)** guide for details.

• What are ABLE accounts, and can I have one in Indiana?

  ABLE accounts let people with disabilities save for disability-related expenses without losing SSI eligibility. Indiana follows federal rules, so you can open an ABLE account through any national provider.