Fragile X Syndrome Benefits in Texas

To qualify for Social Security disability benefits (SSI or SSDI) in Texas, your Fragile X Syndrome must cause marked and severe functional limitations that prevent you from working or engaging in substantial gainful activity (SGA). The condition must last or be expected to last at least 12 months or result in death. For SSI, you must also meet strict income and resource limits. For SSDI, you need enough work credits from jobs covered by Social Security. Both programs use the Social Security Administration’s (SSA) definition of disability, which is stricter than other programs. The SSA evaluates each case using a 5-step process, including checking if your condition is listed in the Blue Book or if it severely limits your ability to work.

• SSI: For 2025, individual monthly income must be below $1,620; resources cannot exceed $2,000. For couples, income must be below $2,700; resources cannot exceed $3,000.
• SSDI: You generally need 40 work credits, with 20 earned in the last 10 years before your disability began. Younger workers may qualify with fewer credits.
• SGA Limit: In 2025, the SGA limit is $1,620 per month for non-blind individuals and $2,700 for blind individuals.

Children with Fragile X Syndrome may qualify for SSI if their condition causes marked and severe functional limitations and meets the income and resource rules.

[Sources: [1], [2], [4], [5], [7]]

In Texas, individuals with Fragile X Syndrome who qualify for SSI automatically receive Medicaid, which provides comprehensive health coverage. Texas does not have a separate state disability program, so federal SSI and SSDI rules apply. The Texas Disability Determination Services (DDS) handles the medical review for both programs. For children with Fragile X Syndrome, Texas follows federal SSI rules, including considering family income and resources if the child lives at home. Texas also offers Medicaid waivers for home and community-based services (HCBS), which may provide additional support for those with Fragile X Syndrome. These waivers can help with services like therapy, respite care, and supported living.

• Medicaid: Automatic for SSI recipients in Texas.
• Medicaid Waivers: Available for eligible individuals with disabilities, including Fragile X Syndrome.
• Presumptive Disability: In some cases, individuals with clearly defined severe conditions may receive SSI payments for up to six months while the SSA makes a final decision.

[Sources: [2], [4], [5]]

• Gather medical records and proof of income/resources.
• Check if you meet SSI or SSDI eligibility.
• Apply online at ssa.gov, by phone at 1-800-772-1213, or in person at a local SSA office.
• Consider working with a disability attorney for help.
• For children, apply for SSI if the family meets income and resource limits.
• Apply for Medicaid waivers if you need additional support services.

[Sources: [4], [6]]

• Step 1: Collect all medical records, including diagnosis, treatment history, and how Fragile X Syndrome affects daily life and work.
• Step 2: Determine if you qualify for SSI (based on income/resources) or SSDI (based on work history).
• Step 3: Apply online at ssa.gov, by phone at 1-800-772-1213, or in person at a local SSA office. The online application can be saved and returned later.
• Step 4: For children, apply for SSI if the family meets income and resource limits. The SSA will consider family income and resources if the child lives at home.
• Step 5: If approved for SSI, you will automatically qualify for Medicaid in Texas.
• Step 6: Apply for Medicaid waivers (HCBS) for additional support services like therapy, respite care, and supported living.
• Step 7: Consider working with a disability attorney to improve your chances of approval, especially if your application is complex or if you have been denied before.
• Step 8: Report any changes in income, resources, or medical condition to avoid overpayments.

[Sources: [4], [6], [7]]

• Social Security Disability Insurance (SSDI): Provides monthly payments to disabled workers who have a work history and paid Social Security taxes. Payment amounts are based on lifetime earnings.
• Supplemental Security Income (SSI): Provides monthly payments to people with limited income and resources who are disabled, blind, or age 65+. Payment amounts are based on financial need.
• Medicaid: Provides health coverage to SSI recipients. In Texas, SSI recipients automatically qualify for Medicaid.
• Medicare: Available to SSDI recipients after 24 months of receiving benefits.
• Medicaid Waivers (HCBS): Provide additional support services for eligible individuals with disabilities, including Fragile X Syndrome.

[Sources: [2], [5], [7]]

Texas offers several programs to support individuals with Fragile X Syndrome:

• Medicaid: Automatic for SSI recipients. Covers medical, therapy, and some long-term care services.
• Medicaid Waivers (HCBS): Provide home and community-based services for eligible individuals with disabilities. These waivers can help with therapy, respite care, supported living, and other supports.
• Presumptive Disability (PD): Allows individuals with clearly defined severe conditions to receive SSI payments for up to six months while the SSA makes a final decision.
• Texas Health and Human Services Commission (HHSC): Administers Medicaid and waiver programs. They can help you apply and find local resources.
• Texas Workforce Commission (TWC): Offers vocational rehabilitation and employment support for people with disabilities.

[Sources: [2], [4], [5]]

ABLE accounts allow individuals with disabilities, including Fragile X Syndrome, to save money without losing eligibility for SSI and Medicaid. In Texas, ABLE accounts are available through the Texas ABLE Program. Contributions are tax-free, and funds can be used for qualified disability expenses like education, housing, and transportation. ABLE accounts do not count toward SSI resource limits, but withdrawals may affect SSI payments if used for certain expenses.

[Sources: [2], [4]]

For SSI in Texas in 2025:

• Individual monthly income must be below $1,620.
• Couple monthly income must be below $2,700.
• Individual resources cannot exceed $2,000.
• Couple resources cannot exceed $3,000.

For SSDI, there are no income or resource limits, but you must not earn more than the SGA limit ($1,620/month for non-blind, $2,700/month for blind).

[Sources: [2], [4], [5]]

It is important to report any changes in income, resources, or medical condition to the SSA to avoid overpayments. Overpayments can result in repayment demands and affect future benefits. Texas residents should report changes promptly to both the SSA and Texas Health and Human Services Commission if receiving Medicaid or waiver services. The SSA provides guidance on how to report changes and what to do if you receive an overpayment notice.

[Sources: [2], [4]]

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

  TTY: 1-800-325-0778

  Hours: 7 a.m. to 7 p.m., Monday through Friday

  Website

  For disability benefits questions and applications.
• Texas Health and Human Services Commission
  Phone: 2-1-1 or 1-877-541-7905

  Hours: 24/7

  Website

  For Medicaid and waiver program questions.
• Texas Workforce Commission
  Phone: 1-800-628-5115

  Hours: 8 a.m. to 5 p.m., Monday through Friday

  Website

  For vocational rehabilitation and employment support.

• Can Fragile X Syndrome qualify for disability benefits in Texas?

  Yes, Fragile X Syndrome can qualify for SSI or SSDI in Texas if it causes marked and severe functional limitations that prevent you from working or engaging in substantial gainful activity. The condition must last or be expected to last at least 12 months or result in death.

• What is the difference between SSI and SSDI for Fragile X Syndrome?

  SSI is for people with limited income and resources, while SSDI is for those with a work history and paid Social Security taxes. Both programs require that your condition severely limits your ability to work.

• How much can I get in disability benefits for Fragile X Syndrome in Texas?

  SSI payments in Texas are based on financial need, with a maximum of about $943/month in 2025. SSDI payments are based on your work history, with an average of about $1,580/month and a maximum of $4,018/month in 2025.

• Does Texas offer Medicaid to people with Fragile X Syndrome?

  Yes, individuals with Fragile X Syndrome who qualify for SSI automatically receive Medicaid in Texas. Medicaid provides comprehensive health coverage, including therapy and long-term care services.

• Can children with Fragile X Syndrome get SSI in Texas?

  Yes, children with Fragile X Syndrome may qualify for SSI if their condition causes marked and severe functional limitations and the family meets income and resource limits. The SSA considers family income and resources if the child lives at home.

• What are Medicaid waivers, and how can they help with Fragile X Syndrome?