Can Autism qualify for disability benefits?
Can I qualify for Social Security disability benefits if I am suffering from the effects of autism?
Author Attorney Greg Reed:
The Centers for Disease Control has reported that in 2018 autism occurred in one out of every 59 births. Autism Spectrum Disorder (ASD) is a developmental disorder that affects a person’s speech, nonverbal communication, and social skills. Autism is referred to as a spectrum disorder because it includes a wide range of linked conditions that are similar or may be caused by the same mechanism. It occurs in all ethnic, racial and economic groups.
Signs and symptoms of ASD usually appear by age two or three, but can be diagnosed as early as 18 months.
People with autism may have sensory issues and extreme sensitivity to light, sounds, smells and sensations.
A child with autism may not reach certain developmental milestones; for example:
- Not smiling and limited eye contact by 6 months
- Not responding to their name and little or no babbling by 12 months
- Not showing interest in objects or activities by pointing by 12 months
Children or adult with ASD may exhibit any of the following behaviors, but not all people with autism will show all of these behaviors:
- Getting upset by a slight change in routine
- Have trouble understanding other people’s feelings or talking about their own feelings
- Have little or inconsistent eye contact
- Repeat words or phrases over and over (this is known as “echolalia”)
- Talking at length about a subject without noticing that others are not interested
- Answering questions with unrelated answers
- Have an unusual tone of voice that might be sing-song or robot-like
- Have obsessive interests
- Flap their hands, rock their body, or spin in circles
- Have unusual reactions to the way things sound, smell, taste, look, or feel
- Have a preference for solitude
Each individual with autism experiences different challenges and has different strengths.
People with autism tend to be strong visual and auditory learners with the ability to learn and remember detailed information. They may excel in math, science or art. There are three types of autism spectrum disorder:
Contact a Social Security disability attorney at 512-454-4000 for a free consultation and see if you can get disability benefits while suffering from Autism. If you have been denied disability don’t give up!
Autistic Disorder or “Classic” Autism.
This type of autism is characterized by language delays, social communication challenges, and unusual behaviors and interests. Many people with classic autism also have an intellectual disability.
This type of ASD presents milder symptoms. A person with Asperger Syndrome may be very intelligent and handle their daily life well, but experience social challenges. They do not have difficulty with language or have an intellectual disability.
Pervasive Development Disorder or PDD.
Also known as “atypical autism” individuals with PDD have symptoms more severe than Asperger’s syndrome, but not as severe as autistic disorder and may only cause social and communication challenges.
The causes and risks for ASD include biological, environmental and genetic factors and there is some evidence that the period before birth is critical for developing ASD.
Children with a parent or sibling with ASD are more likely to develop autism as are people with certain chromosome disorders such as Down Syndrome or Fragile X syndrome. Also, some drugs taken during pregnancy such as thalidomide and valproic acid may cause ASD.
Though not curable, early diagnosis of ASD can make a big difference in outcome.
Treatment of ASD depends on an individual’s needs, but the goal is always to reduce symptoms and facilitate learning and development. A variety of treatments may be employed including speech therapy, occupational therapy, and behavior therapy. Often people with ASD have other medical conditions such as epilepsy, gastrointestinal problems, anxiety, depression and sleep disturbances which must be managed.
It is estimated that one-third of people with autism do not develop the speech and communication skills needed to perform daily life tasks.
The Social Security Administration recognizes autism spectrum disorder as an impairment in Section 12.10 of its Blue Book.
In order to qualify for SSDI under this listing a person must show:
- Qualitative deficits in verbal communication, nonverbal communication, and social interaction; and
- Significantly restricted, repetitive patterns of behavior, interests, or activities.
- Understand, remember, or apply information (see 12.00E1).
- Interact with others (see 12.00E2).
- Concentrate, persist, or maintain pace (see 12.00E3).
- Adapt or manage oneself (see 12.00E4).
Medical documentation of both of the following:
Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F):
Adults may apply for SSI or SSDI, but SSDI is available only to individuals whose work history includes jobs where taxes were paid.
An adult child between the ages of 18 and 22 can apply for SSDI based on their parents’ earning record. Adults who do not meet the requirements of the listing may be approved for SSDI based on their inability to work, known as a Medical Vocational Allowance.
If you have autism spectrum disorder and it has affected your ability to work, you may be eligible for Social Security Disability Income.
The Autism Society statistically reports that 1.5 million Americans are living with some degree of Autism.
This disability is now the fastest-growing developmental diagnosis experiencing an annual growth rate of up to 17 percent.
The U.S. Centers for Disease Control and Prevention (CDC) documents that one in 88 American children will now find their way onto the Autism Spectrum.
These children will experience varying degrees of serious developmental disorders with the most prevalent being their ability to communicate and interact with others. Only 56 percent will complete high school or enter into any type of post secondary education. Studies confirm that only 14 per- cent will become productive members of the U.S. workforce.
For parents raising an Autistic child the emotional and financial difficulties can be overwhelming.
According to the Autism Society, the cost of lifetime care can reach $3.2 million per child. For parents, this also raises the uncertainty of care options both physically and financially when they can no longer provide care.
There is hope.
In May 2013, the American Psychiatric Association (APA) released the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Autism is now defined as Social (Pragmatic) Communication Disorder. In conjunction with this new development, the Social Security Administration (SSA) provides two programs approved for individuals and families living with Autism:
Disability Insurance Program (SSDI)
Plan provides financial assistance to children under the age of 18 who are the dependent of a parent insured by Social Security.
Supplemental Social Security Income (SSI)
Plan provides financial assistance to individuals over the age of 18 who have limited income and resources.
If your child has been diagnosed with Autism, it may be in your best interest to explore these programs. These steps will assist with beginning your dialogue with SSA:
- Notify your physician that you will be applying for assistance. All medical documentation will be required by SSA at a later date.
- Review SSA’s Child Disability Starter Kit. This kit provides a worksheet detailing what is required by SSA.
- Contact your local SSA office to determine if your income is within financial range since both programs require income means-testing to determine eligibility.
- Complete the Child Disability Report. You can also schedule an appointment with your local SSA office or contact SSA directly at 1-800-772-1213. During this step, it is important to focus on your child’s disability and the extent of care required on a daily basis.
- A SSA Disability Evaluation Analyst will send an Activities of Daily Living Questionnaire to be completed. Promptly respond to all communications to keep the process moving forward.
- Await the SSA eligibility determination.
Each individual living with Autism is unique and so is their SSA benefits case.
If you reside in the Austin area and recently received a SSA denial of benefits for your child, contact the legal team of Bemis, Roach & Reed for a free consultation. Our experienced attorneys will construct the appeal process so you can concentrate on what is most important, caring for your child.
Disability benefits are an important source of income for those who are unable to work. If you not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.
Author: Attorney Lonnie Roach has been practicing law for 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Because of his extensive litigation experience Mr. Roach is board certified from the Texas Board of Legal Specialization. Lonnie is admitted to practice in the United States District Court - all Texas Districts and the U.S. Court of Appeals, Fifth Circuit. Mr. Roach is a member of the Texas trial lawyers association, has been active in the Austin Bar Association and is a past Director of the Capital Area Trial Lawyers Association. Mr. Roach and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.
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