Autism spectrum disorder can significantly impact daily functioning and financial independence—and Social Security offers programs that may provide crucial support for both children and adults on the spectrum.
In this article, we'll cover:
- The difference between SSI and SSDI for autism
- How children with autism qualify for SSI
- Adult disability criteria for autism spectrum disorder
- The critical age 18 redetermination and how to prepare
- Tips for strengthening your disability application
Two Programs, Two Sets of Rules
Social Security administers two disability programs: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). SSI is available to people of any age with limited income and resources, making it the primary program for children with autism. SSDI requires a work history, so it's generally only available to adults who have worked and paid Social Security taxes.
Many children with autism receive SSI during childhood. When they turn 18, their eligibility is reevaluated based on adult criteria, which can be a challenging transition for families.
SSI for Children With Autism
Children may qualify for SSI if they have a medically determinable impairment that results in "marked and severe functional limitations" and the impairment is expected to last at least 12 months. For autism, this means demonstrating significant deficits in social interaction, communication, and behavior that substantially limit the child's functioning.
Documentation is crucial. Medical records, educational assessments, therapy notes, and reports from teachers and caregivers all help establish the severity of the condition. The more comprehensive your documentation, the stronger the application.
Benefits for Adults With Autism
Adults with autism may qualify through SSI (if they have limited income and resources) or SSDI (if they have sufficient work history). The evaluation focuses on whether autism prevents the person from engaging in "substantial gainful activity."
Social Security considers limitations in areas like understanding and memory, social interaction, concentration and persistence, and self-management. Adults who have never worked may qualify for SSDI on a parent's record through the Disabled Adult Child (DAC) benefit if their disability began before age 22.
The Age 18 Redetermination
When a child receiving SSI turns 18, Social Security reevaluates their eligibility using adult disability criteria rather than the childhood standard. This review causes many young adults to lose benefits, even if their condition hasn't improved.
Preparing for this transition is essential. Continue documenting functional limitations, maintain medical treatment records, and consider consulting with a disability attorney or advocate before the review.
Getting Help With Your Application
Applying for disability benefits can be complex, and initial denials are common. Consider working with a disability attorney or advocate, especially if your application is denied. They work on contingency, meaning they only get paid if you win, and can significantly improve your chances of success.
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