Can Autism qualify for disability benefits?
Can I get disability benefits if I am suffering from the effects of Autism?
Author: Attorney Greg Reed
The Centers for Disease Control and Prevention estimate that 2.2% of American adults have some form of autism spectrum disorder, or approximately 5.4 million people age 18 and older. Also known as ASD, autism is a complex disorder that is characterized by problems with communication and behavior, involving a wide range of symptoms and skills. If you are suffering from the effects of Autism you may qualify for disability benefits.
ASD can be a minor impairment or a disabling condition requiring full-time care in a special facility.
People with ASD may have trouble understanding what other people think and feel, making it difficult for them to express themselves with words, gestures, facial expressions and touch. Though learning disabilities may affect their ability to understand and use written and spoken language, a person with ASD may be very good at math, art, music or tasks involving memory.
Signs of autism usually appear before age 3 and include any of the following:
- Lack of eye contact;
- Not wanting to be held or cuddled;
- Doing something over and over, such as repeating words or phrases, or rocking back and forth;
- High sensitivity to sounds, sights, smells and touch;
- Problems understanding or using speech, gestures, and facial expressions;
- A narrow range of interests or an extreme interest in an activity;
- Not looking at or listening to other people;
- Not looking at things when another person points at them;
- Trouble adapting to changes in routine;
- Speaking in a flat, robotic or sing-song voice
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!
There are four different types of ASD which were once considered as separate conditions, but are actually different forms of autism spectrum disorder:
- Autistic disorder. When people think of autism, they are most often thinking of this type which is characterized by language delays, social communication challenges, and unusual behaviors and interests. Many people with classic autism also have an intellectual disability.
- Childhood disintegrative disorder. In this type, children develop normally for at least 2 years, then lose communication and social skills.
- Asperger’s syndrome. People with Asperger’s syndrome have milder symptoms. A person with Asperger’s Syndrome may be very intelligent and handle their daily life well, but experience difficulty in social situations and have a narrow range of interests. They do not have difficulty with language or have an intellectual disability.
- Pervasive development disorder. Also known as PDD or atypical autism. A doctor might use this term if a child displays autistic behavior, such as delays in social communication skills, but doesn’t fit into any other category of ASD.
The cause of ASD is not clear, but it’s believed that ASD may stem from problems in parts of the brain that process language and interpret sensory input.
Risk factors for ASD include:
- A family history of autism
- A child of an older parent
- Pregnant women who have been exposed to certain drugs or chemicals like alcohol, or anti-seizure medications. Diabetes, obesity, and German measles are also maternal risk factors.
Though there is no cure for autism, an early diagnosis can make a big difference in a child’s development.
Treatment of ASD is tailored 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. Medications can manage symptoms like attention problems, hyperactivity, or anxiety, while complimentary treatments like music, art, and animal therapy may also be helpful.
Qualifying for Disability for Autism
The Social Security Administration recognizes autism spectrum disorder in it’s Blue Book as both adult and childhood impairments, Section 12.10 (Adult) and Section 112.10 (Child), but the criteria for meeting each listing is the same:
- Medical documentation of both of the following:
- Qualitative deficits in verbal communication, nonverbal communication, and social interaction; and
- Significantly restricted, repetitive patterns of behavior, interests, or activities.
- Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning:
- Understanding, remembering, or applying for information.
- Interacting with others.
- Concentrating, persisting, or maintaining pace.
- Adapting or managing oneself.
To qualify for Social Security disability benefits with autism spectrum disorder, a child or adult must not only meet the above criteria, but Social Security’s financial requirements.
A child is eligible for Social Security Income (SSI) if their family income and assets aren’t above Social Security’s limits. An adult applying for Social Security Disability Income must meet all the following:
- You must meet Social Security’s definition of disability; that is, you cannot do any work (not just your previous job) because of your disability and your condition must last or be expected to last 12 months.
- You must have worked in a job that paid Social Security taxes long enough and recently enough.
- You must have enough work credits. Work credits are based on an individual’s total wages or self-employment income. The number of work credits needed depends on your age when the disability began; generally, this is 40 credits, 20 of which must be earned in the last 10 years.
- You must be unable to engage is Substantial Gainful Activity (SGA). A person who earns more than a certain monthly amount is considered to be engaging in SGA, which for 2022 is $1,350.
An adult with ASD can apply for SSI or SSDI, but most adults with ASD will not qualify for SSDI because they do not have the required work history.
The main difference between SSI and SSDI is that SSDI is available to individuals who have collected a sufficient number of work credits over the years to be considered “insured” for the program. Alternately, SSI disability benefits are available to low-income individuals who have never worked or who haven’t earned enough work credits to qualify for SSDI.
However, an adult may be approved for disability benefits even though they don’t satisfy Social Security’s listing requirements.
An “adult child” (meaning a child over the age of 18 who has had autism before age 22) whose parent is receiving Social Security disability benefits or retirement benefits may qualify financially for benefits based on the earning record of their parent.
Also, if you have ASD, but you don’t meet Social Security’s requirements, you may still be eligible for Social Security Disability benefits if you have an additional impairment.
Applicants often have more than one illness or injury that prevents them from working full time and people with autism frequently suffer from a variety of other mental and physical disorders, among them:
- Bipolar disorder;
- Gastrointestinal disorders;
- Heart problems;
- Allergies or asthma.
While one disorder alone may not meet the requirements of an impairment as stated in Social Security’s Blue Book, if you have multiple medical conditions, Social Security must consider how those health issues, combined together, limit an applicant’s ability to hold a job and perform necessary daily tasks.
Additionally, you may qualify for SSDI based on your limitations. Social Security will conduct a Residual Functional Capacity (RFC) assessment to evaluate how ASD affects your ability to work and if there is any job you are able to perform, taking into account whether or not you are able to drive, your age, and level of education.
In any case, you will need to collect as much medical evidence of your condition as possible to submit with your application.
Include statements from friends, family, doctors, teachers, and caregivers regarding your limitations and ability to care for yourself, perform tasks, work, and participate in everyday situations. Also provide financial records such as paystubs, statements from benefits received, bank account statements and other documents related to income and past wages.
One-third of autistic individuals do not develop the speech and communication skills necessary to meet their needs in daily life.
If you have been diagnosed with autism spectrum disorder and it has prevented you from maintaining full-time employment, you may be eligible for Social Security Disability benefits. An experienced Social Security disability attorney can review your case and help you apply.
In order to qualify for Social Security Disability, you will need to satisfy a few specific requirements in two categories as determined by the Social Security Administration.
The first category is the Work Requirements which has two tests.
- The Duration of Work test. Whether you have worked long enough to be covered under SSDI.
- The Current Work Test. Whether you worked recently enough for the work to actually count toward coverage.
The second category is the Medical Eligibility Requirement.
- Are you working? Your disability must be “total”.
- Is your medical condition severe? Your disability must be “severe” enough to interfere with your ability to perform basic work-related activities, such as walking, sitting, and remembering.
- Is your medical condition on the List of Impairments? The SSA has a “List of Impairments” that automatically qualify as “severe” disabilities. If your disease is not listed this does not mean you cannot get disability, it means you must prove you cannot maintain employment due to your limitations.
- Can you do the work you did before? SSDI rules look at whether your medical condition prevents you from doing the work you did prior to developing the condition.
- Can you do any other type of work? If you cannot do your prior work, an evaluation is made as to whether you can perform any other kind of work.
More details can be found on our Qualifying for Disability page.
Disability benefits are an important source of income for those who are unable to work. If you are 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 Greg Reed 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. Through his extensive litigation Mr. Reed obtained board certification from the Texas Board of Legal Specialization. Greg is admitted to practice in the United States District Court - all Texas Districts and the United States Court of Appeals-Fifth Circuit. Mr. Reed is a member of the Travis County Bar Association, Texas Trial Lawyers Association, past Director of the Capital Area Trial Lawyers Association, and an Associate member of the American Board of Trial Advocates. Mr. Reed and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.
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