Social Security Disability and SSI Benefits for Autism

A disability applicant with a diagnosis of autism and limitations in communication or social functioning may be eligible for benefits.

Autism is a neurodevelopmental disorder that affects communication and social interaction skills. Autism is thought to be present from birth and is usually recognized by three years of age. Not everyone with autism displays the same behaviors. There are many signs of autism and they may be experienced by varying degrees; severe autism is considered a disability.

Diagnosis of autism depends upon the patient showing symptoms of social interaction impairment, communication impairment, and a restricted, repetitive pattern of behavior.

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 autism, such as needing to do things the same way and at the same time every day 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.

Often included on the "autism spectrum" are Asperger's syndrome and pervasive development disorder—not otherwise specified (PDD-NOS).

Social Security Disability Claims on the Basis of Autism

Social Security updated its disability listing for autism in 2017. Listing 112.10, “Autistic disorder and other pervasive developmental disorders,” is now titled “Autism spectrum disorder.” The listing requires that all of the following are documented in a child’s medical records:

  • deficits in social interaction
  • deficits in verbal and nonverbal communication, and
  • significantly restricted, repetitive patterns of behavior, interests, or activities.

If all three items are documented (a deficit in imaginative activity is no longer required by the listing), Social Security will look to see whether the child’s functioning is severely limited by autism. The child must either have an extreme limitation in one of the following areas or a “marked” (severe) limitation in two of the following areas:

  • understanding, remembering, or using information (ability to learn, remember, and use information, follow instructions, solve problems, use reason to make decisions)
  • interacting with others (ability to engage in interactive play, cooperate with others, maintain friendships, handle conflicts, initiate or sustain conversation, understand social cues)
  • focusing on activities (ability to engage in activities at a consistent pace, avoid distractions, complete tasks in timely manner), and
  • adapting or managing oneself (ability to regulate emotions, control behavior, protect oneself from harm, maintain personal hygiene).

Cognitive and communicative functioning can 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.

Healthy social interacting 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 physically aggressive behavior, inappropriate response to authority figures, social isolation, and even mutism.

Focus is the ability to concentrate 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.

Managing oneself is measured by teachers’ and doctors’ observations of self-care skills (such as feeding oneself, personal hygiene, dressing, toileting) and the ability to manage one’s behavior in an age-appropriate way.

SSDI vs. SSI Disability for Adults and Children on the Autism Spectrum

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.) 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.

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.

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