Social Security Disability and SSI Benefits for Autism
A disability applicant with a diagnosis of autism and limitations in communication, social functioning, self-care, and/or concentration may be eligible for benefits.
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This article begins with a brief informational write-up regarding autism, followed by a discussion of the SSA's disability listing on childhood autism.
For adults, keep in mind that satisfying the requirements of a disability listing (referred to as meeting a listing) is not the only way to be approved for disability benefits. Individuals whose claims are not approved on the basis of meeting a listing may still be approved on the basis of what is known as a medical-vocational allowance.
Diagnosis of Autism
Autism is a neurodevelopment disorder that affects communication and social interaction skills. Autism is thought to be present from birth and is usually recognized by at least three years of age, if not sooner. Infants with the disorder may not be as attentive to social interaction and may not smile, laugh, babble or focus on social stimuli as much as infants without the disorder. As infants turn into toddlers, they exhibit less eye contact and show a lack of communication skills, as well as showing repetitive or limited behavior. Not everyone with autism displays the same behaviors. There are many signs of autism and they may be experienced by varying degrees.
Diagnosis of autism currently depends upon the patient showing at least six symptoms. Two of the symptoms must be linked to social interaction impairment, while one must be a communication impairment, and another one must be a restricted or repetitive behavior impairment.
Communication symptoms can include a lack of responsiveness or unusual gestures. It has been reported that at least one-third of autistic individuals do not develop speech and communication enough to meet the needs of daily life.
Restrictive behavior can include purposeless movement such as rocking, head rolling, hand flapping, and other movements. It can also include compulsive behavior such as rearranging objects and needing to control the physical environment. Ritual behavior is also a common symptom of austism, such as needing to do things the same way and at the same time everyday and resisting change in the environment. Limited activity, focus, and interest is also a symptom of autism, as well as self-injury, such as biting oneself, pulling hair, and other self-injury activities. None of these symptoms are specific to autism, but these behaviors are often present, severe, and reoccurring.
Social Security Disability Claims on the Basis of Autism
The required level of severity for autistic disorders is met when the following requirements are satisfied. A doctor must have found the child has:
- deficits in reciprocal social interaction
- deficits in communication and imagination, and
- a restricted repertoire of activities and interests (not needed for Asperger's syndrome).
And these deficiencies must cause serious limitations in at least two of the following:
- communicative/cognitive functioning
- social functioning
- personal functioning, and/or
- sustaining concentration, persistence, or pace.
Cognitive and communicative functioning may be measured through the use of standardized testing that is appropriate for a claimant's age and special tests for language development or speech pattern development. Regarding the measurement of cognition itself, a primary sign of limited function is a valid IQ score (either full scale, verbal, or performance) of 70 or less.
Social functioning is defined by Social Security as a child's capacity to form and keep relationships. This includes relationships with peers, parents, and other adults. Impairments in social functioning may result in a number of expressions, including physically aggressive behavior, becoming socially isolated, and even mutism, while healthy and strong social functioning may be indicated by a child's ability to form and maintain social relationships, participate and cooperate with other individuals and groups, and respond appropriately to authority figures (parents and teachers).
Personal functioning refers to the development of self-care skills (such as feeding oneself, personal hygiene, dressing, grooming, and toileting).
Concentration, persistence, and pace is the ability to focus attention on a task, to stick with it, and to maintain a pace at the task that would be considered an age-appropriate level. This is measured both by observing the child and also measured by results obtained from standardized testing.
SSDI vs. SSI Disability
Children with autism may be eligible for SSI disability benefits if their family's income and assets aren't above the SSI limits. For more information, see our section on financial eligibility for SSI.
An adult with autism syndrome can apply for SSI or SSDI. However, SSDI is available only to those with a work history from jobs that paid Social Security taxes. For more information, see our section on SSDI requirements.
An "adult child" of a parent receiving Social Security retirement or disability benefits, meaning a child over the age of 18 who has had autism before turning age 22, can get SSDI benefits on the earning record of the parent. For more information, see our article on disability benefits for adult children.