Our Experienced Attorneys Can Help
According to the SSA, a child is found to be disabled if he or she is under the age of 18 and: does not have a job that the SSA considers to be substantial work; has a mental or physical condition that results in marked and severe functional limitations; and the condition has lasted, or is expected to last, at least 12 months or is likely to result in death. If your child has been diagnosed with autism and you are struggling with overwhelming expenses associated with the condition, contact our qualified Social Security Disability lawyers at Rechtman & Spevak for legal help. Your child may be entitled to disability benefits through the SSAs Supplemental Security Income program, which can help cover the cost of medical bills, child care and special education for your child. Dont hesitate to protect the rights of your child; contact our Atlanta-based law firm today.
Determining If Autism Qualifies You For Disability Benefits
The SSA has a very specific method in place for determining whether an SSDI or SSI applicant with autism should qualify for disability benefits. The SSA will pass the application on to the Pennsylvania Bureau of Disability Determination for a review by a physician and disability examiner team. The BDD will evaluate the claim to determine if autism spectrum disorder meets these requirements.
There is medical evidence that the applicant has measurable deficits affecting:
- Communication and social interaction; and
- Substantially limited, repetitive patterns of behavior, activities, or interests.
Severe limitation of one, or marked limitation of two, of the following:
- Understanding, remembering, or applying information;
- Interacting with others;
- Concentrating, persisting, or maintaining pace; and/or
- Adapting or managing oneself.
Appealing A Denied Disability Claim For Developmental
The rules for SSI are the same for every state, however the income limits may be different. Try applying for SSI instead of Social Security. You do have the right to appeal their denial, and it’s best that you do so. Also, you may want to find a lawyer who can help you 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 Hi I have Autism spectrum disorder, and ADHD, Short Memory Loss, Anxiety Disorder, Epilepsy, and I now am extremely Talented Musician/Songwriter and can cook food and grill food and can go fishing, can read, write, Speak perfectly good English Language as of the doctors from back then has told my parents that I will never be able to speak or walk or write or even graduate High School but I. You can visit or call the Social Security office and start the process. Unless your son has classic Autism you can expect a long, drawn out process. You would need ALL your doctors reports and school or Early Intervention reports/IEPs, Your income has to be below a certain level even if your son.
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How Does Ssa Measure Whether Or Not A Child Is Disabled
SSA has to find that your child has a physical and/or mental condition that either:
is so severe that your childs medical records & reports show that the condition is the same or almost the same as the requirements in the SSAs regulations for that particular condition; or
that the condition causes your child to have difficulty functioning like other children of the same age in a way that is marked in at least two or extreme in at least one of the following areas :
- Acquiring and Using Information;
Medical Evaluation At Steps 2 & 3 Of The Sequential Process
At step two of the process, the Social Security Administration determines if your childs condition can be considered severe. While impairments that are not severe will not cause functional limitations or cause only slight limitations, a severe disability will impose real limits and restrictions on your activities of daily living. If the SSA determines your condition to be of a sufficient level of seriousness, you will proceed to the third and final step of the evaluation process.
At the third step, the SSA determines if your condition is a listed condition. The childhood conditions are located in Part B of the Blue Book. However a simple diagnosis of a condition that is listen is not sufficient. The severity of your condition must also be of the minimum severity as described in the listing. Autism-related conditions include:
- 110.08 Catastophic Cogenital disorder
- 111.09 Communication impairment associated with documented neurological disorder
- 112.08 Personality Disorders
- 112.10 Autistic Disorder and other Pervasive Developmental Disorders
To be clear, individuals must inquire into the particular requirements for each listing and compare their childs condition. If the childs condition is at least as severe as the listed requirements, he or she is likely to receive benefits.
- Attending to and completing tasks
- Caring for self
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Your Childs Conditions And Impairments Are Assessed At Steps 2 &3
The second step of the sequential evaluation process determines if your childs condition is one that the SSA would consider to be severe.
At step two of the process, the Social Security Administration determines if your childs condition can be considered severe. A severe impairment is one that imposes marked or extreme limitations on your childs ability to function. An impairments that is not severe will not cause the individual to experience functional limitations or will cause only slight limitations in activities. If your childs autism condition is considered to be severe by the SSA, then the inquiry will proceed to the third and final step in the sequential process.
At Step 3, your condition is compare to a list of conditions that the SSA refers to as listed conditions. These listed conditions are contained within the appendix of the SSAs Blue Book under Part B for childhood conditions. A mere diagnosis of a listed condition, while useful, is not in itself sufficient to receive childhood disability benefits. Rather one must present longitudinal medical and clinical evidence along with reports of daily living from close associates and family members showing that the individual is affected by a listed impairment like:
- Catastrophic Congenital disorder
- Motor dysfunction
Visit Your Doctors And Therapists Regularly
SSA needs proof that you are still disabled when you turn 18. It is very important that you get treatment from your doctors regularly so that SSA will have the information it needs. If you have depression or anxiety be sure you are getting treatment for it and taking any medication your doctors prescribe.
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Overview Of The Appeals Process
Once you understand why your child was denied benefits, you must make a decision as to whether or not you are going to appeal the decision. Please be mindful that you need to give Social Security notice of your intention to appeal in writing. You have 60 days to do this from the day you received the denial notice, or you will lose the ability to appeal your decision. If you fail to appeal, you will need to reapply in order for your child to receive disability benefits.
When your child is denied SSI benefits, there are four steps that can be taken in order to get SSA’s decision reversed. Hopefully, the first step will be successful and you will not need to further appeal the benefits decision.
For more information on each level of appeal, see our article on the four levels of Social Security appeals.
Appendix: Digression On Parental Earnings Before And After Age 18
SSI’s parental-income deeming rules cease to apply when a potential recipient reaches age;18. At that milestone, the different treatment of parental income removes any incentives for parents to limit earnings. As a result, policy-aware parents may increase their earnings after a child turns 18. Although incentives to limit their income are eliminated, parents still may not be able to find a job while also providing or finding care that their children may need. In fact, mixed evidence suggests that parents with children receiving SSI payments have lower earnings and income than parents whose children do not receive SSI payments. For example, Kubik found that households with a likely child SSI recipient have lower parental labor force participation, yet Duggan and Kearney found no impact of SSI participation on household earnings. Deshpande , on the other hand, found that the loss of SSI eligibility increases parental earnings. For the change in income rules to affect earning behavior, it is also necessary for parents to understand those rules. Some parents surely do, but given the complexity of the SSI program, many others probably do not.
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Disability Determination For Children Under 18
Children with certain disabilities can be eligible for Social Security disability benefits beginning from birth. Because autism is a Spectrum Disorder, whether children qualify for assistance will depend on the severity of their symptoms. To qualify for a disability rating, the SSA uses different criteria for children than for adults.
Children with severe autism limitations will generally qualify. The SSA considers a child under 18 to be disabled if they have a permanent physical or mental condition that very seriously limits their activities.
The Social Security Administration clarifies that conditions must be established with medical evidence. This means doctors documentation of symptoms, along with lab results. A parents own listing of symptoms is not enough alone to show the disability, but a parent can help provide full details of the level of daily care and assistance that the child needs. Its also helpful to include written statements from any professionals who work with your child and can attest to their challenges. These can include health care provides, teachers, or caretakers.;
Applying For Ssi On Behalf Of A Child With Special Needs
Often times when a child has special needs, one of the parents decides to leave the workplace in order to tend to the needs of the child. When this happens, the family is left with only one income, which can make it very hard to get by financially. Between medical bills and the lack of two incomes, a financial situation can quickly become dire. Fortunately, in some cases, Social Security Disability benefits known as Supplemental Security Income can help offset some of this financial strain.
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Pennsylvania Social Security Disability For Autism Spectrum Disorder
Autism spectrum disorder , most often referred to as autism, is a common disorder that affects the nervous system. It can affect people in very different ways and cause a range of symptoms with widely varying degrees of severity. Some people can live relatively normal lives with autism, while others are unable to work or engage in most normal activities. There are about 200,000 cases of autism in the U.S. each year. Currently, there is no cure.
Autism is recognized as a disabling condition by the Social Security Administration and is included in its Listing of Impairments as amental disorder.
People with severe cases of autism may be entitled tobenefits under Social Security Disability Insurance or Supplemental Security Income , but it can be difficult to knowhow to apply, whatmedical evidence must be provided, and what to do if your application is denied.Our attorneys atHandler, Henning & Rosenberg LLC can help with all of this.
Autistic adults and children may be entitled toSSDI or SSI benefits in Pennsylvania.Call to speak with a knowledgeable attorney about your unique situation.
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 , 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” limitation in two of the following areas:
- understanding, remembering, or using information
- interacting with others
- focusing on activities , and
- adapting or managing oneself .
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 of 70 or less.
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.
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Preparing For The Application Process
If you want to increase your childs chances of being approved for SSI benefits, you need to properly prepare for the application process. Prior to applying for benefits for your child, you need to gather copies of your childs medical records. Clinical histories, treatment histories, and lab results should all be provided to the SSA when applying for benefits so you should ensure that you have copies of these records ready prior to submitting your application. You should also try to obtain written statements from your childs treating physicians. In addition to medical records, you should also gather financial records such as bank statements and paycheck stubs to prove your childs financial eligibility for SSI benefits. Once you have all of the medical and financial records gathered and organized and you understand the Blue Book listing of the condition that your child qualifies under, you can move forward and apply for benefits for your child.
Other Disability Qualifications: Autism
In addition to meeting the above requirements that are specific to autism spectrum disorder, a person with this condition must also meet otherdisability requirements to qualify for SSDI.
SSDI is only available to people with permanent disabilities who cannot work.
- The condition must have lasted or be expected to last for at least 12 months.
- It must prevent you from working in your previous job.
- It must prevent you from learning a new trade or getting a new job.
- You must have earned enough work credits, by working long enough and recently enough, to be insured under SSDI.
It is important to note, however, that you may be able to work in limited circumstances even if youre receiving SSDI for autism. The general rule will be that you cannot take part in substantial gainful activity which is equivalent to earning more than $1,260 per month as of 2020. This number changes from year to year.
SSI may also be available to adults or children with autism, with the same disability requirements but without the work requirements. For SSI, you must not be earning more than a certain amount of money and cannot have more than $2,000 in resources to qualify. You may be able to receive both SSDI and SSI, depending on the circumstances.
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Should You Apply For Ssi Or Ssdi For Autism
Autism is one of those impairments which can be used to qualify for both the income-dependent SSI or the traditional Social Security benefits from working.
If you or your child has never worked and you are below a certain threshold of income and assets, you may qualify for SSI, or Supplemental Security Income. Adults without work history, children, and adult children are eligible for SSi but the process can be complex and you should consult with our lawyers to make sure you fit the criteria for SSI.
On the other hand, if you have work experience that has paid into Social Security, but the symptoms from autism have made you unable to work, you are eligible for SSDI, or Social Security Disability Insurance. These are benefits that are paid to you to replace your typical income.
Because of the complexity of the conditions and the criteria for disability, autism can be denied on the first attempt to apply. Dont give up! Nash Disability Law is here to help you appeal your denial and will help you every step of the way including in Federal Court.
Supplemental Security Income Program Entry At Age 18 And Entrants’ Subsequent Earnings
Latest information on benefits for a disabled child
In determining Supplemental Security Income eligibility and payment levels for child applicants and recipients, the Social Security Administration attributes part of parental income to the child using a process called deeming. Parental-income deeming ends at age;18, and many youths with severe disabilities who were income-ineligible for SSI as minors can become income-eligible as adults. This article provides evidence that substantial numbers of youths apply for SSI as soon as they turn 18. Additionally, the distribution by disability type of youths applying at or after age;18 differs from that of youths applying just before age;18. Further, applications filed at age;18 are more likely to be allowed than are those filed at age;17. Using denied applicants as a comparison group, I estimate a reduced likelihood of subsequent employment for allowed SSI applicants aged;1719 with an expected upper bound of about 25;percentage points.
Jeffrey Hemmeter is the deputy director of the Office of Program Development, Office of Research, Demonstration, and Employment Support, Office of Retirement and Disability Policy, Social Security Administration.
Acknowledgments: The author is grateful to Molly Costanzo, Jim Twist, Clark Pickett, Chelsea Shudtz, Ken Brown, Linda Mitchell, and other members of SSA’s Office of SSI and Program Integrity Policy staff for their comments on drafts of this article.
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