Fragile X Syndrome Benefits in Pennsylvania

To qualify for federal disability benefits in Pennsylvania, your Fragile X Syndrome must meet the Social Security Administration’s (SSA) definition of disability. This means your condition must be severe enough to prevent you from doing substantial gainful activity (SGA) and is expected to last at least one year or result in death. For SSDI, you need enough work credits based on your work history and Social Security taxes paid. For SSI, you must have limited income and resources, regardless of work history. Both programs require medical evidence showing how your Fragile X Syndrome affects your ability to work and live independently. 1, 2, 6

In Pennsylvania, eligibility for disability benefits is determined by the Bureau of Disability Determination Services (BDD) on behalf of the SSA. BDD reviews medical evidence and assesses how Fragile X Syndrome impacts your ability to work. SSI recipients automatically qualify for Medical Assistance (Medicaid), which provides healthcare coverage. SSDI recipients must wait 24 months for Medicare. Pennsylvania also offers the Medical Assistance for Workers with Disabilities (MAWD) program, which has higher income and resource limits for those who work but still need health coverage. State-specific eligibility may also include access to Medicaid waivers and other support services for people with developmental disabilities. 1, 2, 5

• Gather medical records and proof of income.
• Contact your local County Assistance Office or apply online at www.COMPASS.state.pa.us.
• Submit your application for SSI, SSDI, or both.
• Provide documentation of your Fragile X Syndrome diagnosis and how it affects your daily life.
• Follow up with BDD for any additional information requests.

• Step 1: Collect all necessary documents, including medical records, proof of income, and proof of disability (such as a diagnosis letter for Fragile X Syndrome).
• Step 2: Visit your local County Assistance Office, call (866) 550-4355, or apply online at www.COMPASS.state.pa.us.
• Step 3: Complete the application for SSI, SSDI, or both. You can apply for both programs at the same time if you meet the criteria.
• Step 4: Submit your application along with supporting documents. For MAWD, include proof of work (paystub or employer letter) and proof of disability (SSDI award letter or medical documentation).
• Step 5: The Bureau of Disability Determination Services (BDD) will review your application and may request additional information or schedule a medical exam.
• Step 6: Wait for a decision. If approved, you will receive benefits and information on how to report changes in your situation.
• Step 7: If denied, you can appeal the decision within 60 days.
• Step 8: Once approved, keep your information up to date and report any changes in income, work, or health status to avoid overpayments. 2, 5

• Social Security Disability Insurance (SSDI): For those with a qualifying work history. No income or asset limits. Average monthly benefit is $1,537 in 2025, with a maximum of $3,822. Family benefits may be available for dependents.
• Supplemental Security Income (SSI): For those with limited income and resources. Maximum monthly benefit is $943 for an individual in 2025. No work history required. SSI recipients automatically qualify for Medicaid in Pennsylvania.
• Medicare: Available to SSDI recipients after a 24-month waiting period.
• Medicaid: Available to SSI recipients and others who meet income and resource limits. 1, 2

• Medical Assistance for Workers with Disabilities (MAWD): Provides health coverage for people with disabilities who work. Has higher income and resource limits than regular Medicaid. Premium is 5% of countable income.
• Medicaid Waivers (HCBS): Offer home and community-based services for people with developmental disabilities, including Fragile X Syndrome. These waivers can provide support for daily living, respite care, and more.
• Special Education Funding: Pennsylvania has increased funding for special education to ensure students with disabilities have access to needed services.
• ABLE Accounts: Tax-advantaged savings accounts for people with disabilities. Funds can be used for qualified disability expenses without affecting SSI or Medicaid eligibility. 1, 4, 5

Pennsylvania residents with Fragile X Syndrome can open an ABLE account to save for disability-related expenses. These accounts allow you to save up to $18,000 per year (2025) without affecting SSI or Medicaid eligibility. Funds can be used for education, housing, transportation, and other qualified expenses. Learn more about opening an ABLE account in Pennsylvania. 4

• SSI: $943/month for an individual, $1,415/month for a couple in 2025. Asset limits are $2,000 for an individual, $3,000 for a couple.
• SSDI: No income or asset limits.
• MAWD: Higher income and resource limits than regular Medicaid, designed for workers with disabilities. 1, 5

It is important to report any changes in income, work, or health status to avoid overpayments. If you receive too much in benefits, you may have to pay it back. Report changes promptly to the SSA or your local County Assistance Office. Learn more about avoiding overpayments and reporting changes. 3

• Pennsylvania Bureau of Disability Determination Services
  Phone: 1-800-692-7469

  Hours: Monday-Friday, 8:00 AM - 4:30 PM

  Website

  For questions about disability determination and application process.
• Pennsylvania Department of Human Services
  Phone: 1-800-692-7462

  Hours: Monday-Friday, 8:00 AM - 4:30 PM

  Website

  For questions about Medicaid, MAWD, and other state benefits.

• Can Fragile X Syndrome qualify for SSI or SSDI in Pennsylvania?

  Yes, if your Fragile X Syndrome meets the Social Security Administration’s definition of disability, you may qualify for SSI or SSDI. SSI is for those with limited income and resources, while SSDI requires a qualifying work history. Medical evidence is required for both programs. [1](https://www.disabilityresources.org/pennsylvania-disability-benefits.html), [2](https://www.pa.gov/services/dli/apply-for-a-social-security-disability-determination)

• What is the difference between SSI and SSDI in Pennsylvania?

  SSI is a needs-based program for those with limited income and resources, regardless of work history. SSDI is an insurance program for those with a qualifying work history and Social Security tax contributions. Both provide monthly benefits and access to health coverage. [1](https://www.disabilityresources.org/pennsylvania-disability-benefits.html), [2](https://www.pa.gov/services/dli/apply-for-a-social-security-disability-determination)

• How do I apply for disability benefits in Pennsylvania?

  You can apply for SSI or SSDI at your local County Assistance Office, by phone, or online at www.COMPASS.state.pa.us. You will need to provide medical records, proof of income, and proof of disability. The Bureau of Disability Determination Services will review your application. [2](https://www.pa.gov/services/dli/apply-for-a-social-security-disability-determination), [5](https://www.phlp.org/uploads/attachments/cmevf5aioeas92fu89e5ckmqa-mawd-guide-2025.pdf)

• What health coverage is available for people with Fragile X Syndrome in Pennsylvania?

  SSI recipients automatically qualify for Medicaid. SSDI recipients get Medicare after 24 months. Pennsylvania also offers MAWD for workers with disabilities, which has higher income and resource limits. Medicaid waivers provide home and community-based services. [1](https://www.disabilityresources.org/pennsylvania-disability-benefits.html), [5](https://www.phlp.org/uploads/attachments/cmevf5aioeas92fu89e5ckmqa-mawd-guide-2025.pdf)