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How to Get Social Security Benefits for Autism Spectrum Disorder

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How To Get Social Security Benefits
For Autism Spectrum Disorder

By Tracy L. Kinney and Andrew W. Kinney
Attorneys at Hoglund & Mrozik P.L.L.C

Social Security pays benefits for children and adults who are disabled with limitations of Autism Spectrum Disorder.

How do you start a Social Security benefits application?

You first must apply for benefits either online or at a local Social Security office. A parent or legal guardian can do so for a child under 18. You can also assist on adult to apply.

Who can apply for Social Security Benefits for Autism Spectrum Disorder?

Both children and adults can get benefits for disability due to autism. Children who are under 18 years old may receive Supplemental Security Income (SSI) in households with financial need.

Adults with autism who are over 18 years old may receive SSI, Disability Insurance Benefits, or Disabled Adult Child Benefits. SSI benefits for these adults are possible with financial need. Disability Insurance Benefits are possible for those adults who have sufficient work histories of their own. Disabled Adult Child benefits are possible when disability is established before age 22 and a parent with a sufficient work history is disabled, retired, or deceased.

What makes a person with limitations from Autism Spectrum Disorder disabled enough to receive Social Security Benefits?

Social Security benefit programs pay benefits to those with Autism Spectrum Disorder when they prove how severe their day-to-day limitations are. There must first be a formal diagnosis of Autism Spectrum Disorder with appropriate testing from a qualified medical source. Qualified medical sources include physicians and licensed psychologists. Then, the limitations from Autism must be severe enough to be disabling.

How severe must Autism limitations be for Social Security to find them disabling?

This is the key question for those pursuing Social Security benefits for limitations from Autism. How Autism manifests from person to person can vary. Social Security looks for marked limitations when compared to those without these issues. Some marked limitations, when measured, are significant enough to be disabling. Social Security reviews testing scores, school records, and medical treatment notes to evaluate the following criteria to confirm the diagnosis of Autism Spectrum Disorder:

  1. Trouble with verbal communication, nonverbal communication, and social interaction; and
  2. Significantly restricted, repetitive patterns of behavior, interests, or activities.

Significantly restricted, repetitive patterns of behavior, interests, or activities.

  1. Understanding, remembering, or applying information.
  2. Interacting with others.
  3. Concentrating, persisting, or maintaining pace.
  4. Adapting or managing oneself.

How do you have the best chance of proving to Social Security that Autism Spectrum Disorder is disabling?

Key to autism claims is the initial testing. Without a valid diagnosis, trying to establish a claim for Autism is futile. With a valid diagnosis, however, it is very important to have ongoing therapy and treatment to establish functional limitations. Autism can be characterized by difficulties in social interactions. Proof of this can be documentation from a treating psychological or therapist and from special education teachers who know the diagnosis and track progress in this area. Autism can also be characterized by restricted interests. Proof of this can be information from parents or family offered to medical providers who know and track these patterns of behavior.

How does SSA err in evaluating those with Autism?

Children with Autism Spectrum Disorder may do well in school in certain subjects. Social Security most often errs when it assumes that proficiency in certain academic subjects translates to good functioning overall. Also, when children with Autism do not exhibit disruptive behaviors, teachers may determine they are well-behaved—leading both teachers (and, in turn, Social Security) to minimize the reality of these childrens’ inner lives. So, an IEP in school is the best way to offer students with Autism a better chance of success. An IEP focuses teachers on the signs and symptoms of Autism that are so critical to document—such as changes in cognitive skills, unusual responses to stimuli, and unusual behavior or mannerisms that interfere with day-to-day function. Also, get to know the special education teacher. The more this teacher understands about your child’s history and day-to-day life outside of school, the better he or she can document signs and symptoms in forms completed for SSA.

In adults with Autism, Social Security commonly errs by ignoring how other mental health disorders can impact a person with Autism differently. For example, a person with bipolar disorder and autism together may have uniquely difficult issues with impulsivity, mood swings, and interactions with others. Social Security also errs by relying on one-time evaluators rather than on longitudinal treatment records. In claims, Social Security sets up and pays psychological consultative examiners who likely unaware of the impact of autism early in life and how this history impact current mental health issues overall. Conclusions from a single visit does little justice. If Social Security determines a psychological consultative examination for an adult with Autism is necessary, make sure that that examiner has treatment records (and school age testing) from mental health providers who have been treating the Autism. Too often, a single diagnosis of Autism while a child is too remote to help effectively treat an adult. So, it is a good idea every few years for adults with Autism to have a full diagnostic evaluation by a licensed psychologist to assess how their unique combinations of mental issues may be impacting their adult lives.

Hoglund Law Offices represents children and adults with Autism Spectrum Disorder. Our attorneys and professional staff can help you navigate the Social Security Benefits process. You can get a free initial consultation by calling 612-564-1507.