Autism Spectrum Disorder Benefits in New York

• To qualify for federal Supplemental Security Income (SSI), you must have a disability that limits your ability to work, have limited income and resources, and meet citizenship requirements. Autism Spectrum Disorder is recognized as a qualifying disability for children and adults.
• For Social Security Disability Insurance (SSDI), you need a qualifying disability, a work history with enough Social Security credits, and meet the definition of disability. Adults with Autism Spectrum Disorder may qualify if their condition prevents substantial gainful activity.
• The Social Security Administration uses specific criteria to evaluate disability claims for Autism Spectrum Disorder, focusing on functional limitations in communication, social interaction, and behavior.
• Children with Autism Spectrum Disorder may qualify for SSI if their family meets income and resource limits and the child's condition meets the SSA's definition of disability.
• Adults with Autism Spectrum Disorder may qualify for SSDI if they have a qualifying work history and their condition prevents them from working.
• Both programs require medical documentation and may involve a review of school or medical records.

Source: Social Security Administration - Disability Qualifications (2024-11-06)

• In New York, individuals with Autism Spectrum Disorder may qualify for Medicaid waivers, which provide home and community-based services like therapy, respite care, and supported employment.
• Eligibility for Medicaid waivers requires a diagnosis of Autism Spectrum Disorder, functional limitations, and meeting financial criteria. The waiver programs are designed to help individuals live independently in the community.
• New York also offers special education services through the public school system for children with Autism Spectrum Disorder, including individualized education plans (IEPs) and related therapies.
• Families may qualify for additional state benefits, such as respite care, family support services, and vocational rehabilitation.
• The New York State Office for People With Developmental Disabilities (OPWDD) oversees many of these programs and can help families navigate eligibility and application processes.
• Eligibility for state benefits may depend on age, income, and the severity of functional limitations.

(2024-11-06)

• Gather medical records and documentation of your Autism Spectrum Disorder diagnosis.
• Review eligibility requirements for SSI, SSDI, and Medicaid waivers.
• Start your application online through the Social Security Administration or New York State Medicaid portals.
• Contact local agencies for help with the application process.
• Submit all required forms and documentation.
• Follow up on your application status and respond to any requests for additional information.

• Step 1: Collect all necessary documentation, including medical records, school records (for children), and proof of income and resources.
• Step 2: Review the eligibility requirements for SSI, SSDI, and Medicaid waivers. Make sure you meet the criteria for each program.
• Step 3: Start your application online through the Social Security Administration website for SSI and SSDI. For Medicaid waivers, apply through the New York State Medicaid portal or contact your local Department of Social Services.
• Step 4: Complete all required forms, including the disability application, medical release forms, and any additional state-specific forms.
• Step 5: Submit your application and all supporting documents. Keep copies of everything you submit.
• Step 6: Follow up on your application status. Respond promptly to any requests for additional information or documentation.
• Step 7: If your application is denied, you have the right to appeal. Contact the agency for information on the appeals process.
• Step 8: Once approved, you will receive information on how to access your benefits and any required reporting or renewal procedures.

Source: Social Security Administration - How to Apply (2024-11-06) Source: New York State Medicaid Application (2024-11-06)

• Supplemental Security Income (SSI): Provides monthly cash payments to individuals with disabilities who have limited income and resources. Children and adults with Autism Spectrum Disorder may qualify.
• Social Security Disability Insurance (SSDI): Provides monthly benefits to adults with disabilities who have a qualifying work history. Adults with Autism Spectrum Disorder may qualify if their condition prevents substantial gainful activity.
• Medicare: Available to individuals who receive SSDI after a 24-month waiting period. Provides health insurance coverage.
• Medicaid: Available to individuals who receive SSI or meet other eligibility criteria. Provides health insurance coverage and access to home and community-based services.

Source: Social Security Administration - Disability Programs (2024-11-06)

• Medicaid Waivers (HCBS): New York offers Medicaid waivers for individuals with Autism Spectrum Disorder, providing home and community-based services like therapy, respite care, and supported employment. These waivers help individuals live independently in the community.
• Special Education Services: Children with Autism Spectrum Disorder are entitled to special education services through the public school system, including individualized education plans (IEPs) and related therapies.
• Family Support Services: New York provides family support services, including respite care, counseling, and support groups for families of individuals with Autism Spectrum Disorder.
• Vocational Rehabilitation: Services to help adults with Autism Spectrum Disorder find and maintain employment, including job training and supported employment programs.
• Office for People With Developmental Disabilities (OPWDD): Oversees many of these programs and can help families navigate eligibility and application processes.

Source: New York State Office for People With Developmental Disabilities (2024-11-06) Source: New York State Education Department - Special Education (2024-11-06)

• ABLE accounts allow individuals with disabilities to save money for disability-related expenses without losing eligibility for SSI, Medicaid, and other benefits.
• In New York, the NY ABLE program offers tax-advantaged savings accounts for individuals with Autism Spectrum Disorder.
• Contributions to ABLE accounts do not count against SSI resource limits, making them a valuable tool for financial planning.
• Funds in ABLE accounts can be used for qualified disability expenses, including education, housing, transportation, and personal support services.

Source: NY ABLE Program (2024-11-06)

• SSI has strict income and resource limits. In 2025, the federal SSI payment is $943 per month for an individual and $1,415 for a couple. Income and resources above these limits may reduce or eliminate SSI benefits.
• SSDI does not have strict income limits, but recipients must not engage in substantial gainful activity (SGA). In 2025, SGA is defined as earning more than $1,620 per month ($2,700 if legally blind).
• Medicaid eligibility depends on income and resources, with different limits for children and adults.

Source: Social Security Administration - SSI Income Limits (2024-11-06)

• It is important to report any changes in income, resources, or living situation to the Social Security Administration and Medicaid to avoid overpayments.
• Overpayments can occur if you receive benefits you are not eligible for, and you may be required to repay the overpayment.
• Reporting changes promptly helps ensure you receive the correct amount of benefits and avoid penalties.

Source: Social Security Administration - Reporting Changes (2024-11-06)

• New York State Office for People With Developmental Disabilities
  Phone: 1-866-922-4669

  Website

  For questions about Medicaid waivers and other state disability programs.
• Social Security Administration
  Phone: 1-800-772-1213

  TTY: 1-800-325-0778

  Website

  For questions about SSI and SSDI benefits.

• What federal benefits are available for Autism Spectrum Disorder in New York?

  Federal benefits include SSI for those with limited income and resources, and SSDI for those with a qualifying work history. Both programs provide monthly cash payments and access to health insurance.

• How do I apply for Medicaid waivers in New York?

  Apply through the New York State Medicaid portal or contact your local Department of Social Services. You will need to provide documentation of your Autism Spectrum Disorder diagnosis and meet financial criteria.

• What is an ABLE account and how can it help?

  An ABLE account is a tax-advantaged savings account for individuals with disabilities. It allows you to save money for disability-related expenses without losing eligibility for SSI, Medicaid, and other benefits.

• Can children with Autism Spectrum Disorder receive SSI?

  Yes, children with Autism Spectrum Disorder may qualify for SSI if their family meets income and resource limits and the child's condition meets the SSA's definition of disability.

• What special education services are available in New York?

  Children with Autism Spectrum Disorder are entitled to special education services through the public school system, including individualized education plans (IEPs) and related therapies.

• How do I report changes in my situation to avoid overpayments?

  Report any changes in income, resources, or living situation to the Social Security Administration and Medicaid promptly. This helps ensure you receive the correct amount of benefits and avoid penalties.