Social Security Disability benefits for children with autism

Molly Clarke

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If your child has been diagnosed with autism, it can place a significant financial toll on your family. According to the Harvard School of Public Health, it can cost between $67,000 per year and $72,000 per year in direct medical and nonmedical expenses to care for a child with autism. Parenting a child with autism can often mean footing the bill for doctor appointments, medications, therapy, special education, and child care. Unfortunately, families who earn very little income may not be able to provide these necessary supports for their child.

If you are the parent of a child with an Autism Spectrum Disorder and find that you are struggling financially, your child may qualify for Social Security Disability benefits. These benefits can help alleviate your financial strain and can ensure that your child is receiving the correct level of support.

Qualifying for Social Security Disability Benefits with Autism

According to the Social Security Administration, a child is considered to be disabled if he or she is under the age of 18 and:

• Is not working at a job that the SSA considers to be substantial work; and
• Has a physical or mental condition (or combination of both) that result 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.

Because autism is a spectrum disorder, it can affect children in a variety of ways. One child with autism may not require very much support while another child with the same diagnosis may face serious limitations. If your child’s autism makes it impossible for him or her to complete age-appropriate activities, they likely meet the SSA’s definition of disability.

Medical Criteria

When you apply for disability benefits on behalf of your child, the SSA will compare his or her condition to the guidelines listed in an official manual of disabling conditions. This manual is known as the SSA’s blue book. The blue book contains a list of potentially disabling conditions along with the criteria that must be met in order to qualify under each listing.

Autism is covered under Section 112.10 of the blue book. This specific section covers autistic disorder and other pervasive developmental disorders. According to the blue book you must be able to prove that your child has a disorder characterized by developmental deficits in the following areas:

• Age-appropriate social interaction;
• Verbal and nonverbal communication skills; and
• Imaginative activity.

In addition to these three criteria, the SSA will also look for evidence that you child has very limited interests and activities. View the entire blue book listing, here: http://www.ssa.gov/disability/professionals/bluebook/112.00-MentalDisord....
In order for your child to qualify for Social Security Disability benefits, you will need to provide medical records supporting the above-mentioned criteria. This may include clinical findings and test results. You should also provide detailed statements from professional adults that interact with your child on a regular basis and that understand the extent of his or her limitations. This can include medical professionals, caretakers, or even educators.

Technical Criteria

In addition to the blue book requirements, your child will also have to meet the technical eligibility requirements. The Social Security Administration operates two different disability benefit programs—Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Each of these programs has their own set of technical requirements. Because SSDI benefits require work history and tax contributions, children do not typically qualify for benefits from this program. As such, the following information will apply to the SSI program only.

SSI is a needs-based welfare program that offers financial benefits to blind, disabled, or elderly individuals who earn very little income. An applicant’s income and financial resources not only determine his or her eligibility, but also the amount of their monthly benefit—should they be approved. In the case of a child, his or her family’s income and resources will be determined. This is called deeming.
The SSA uses the deeming process if your child lives at home, is under 18 years of age, and is unmarried. The SSA will consider the following types of income as part of the deeming process:

• Parent and/or step-parent’s earned income
• Parent and/or step-parent’s unearned income
• Parent and/or step-parent’s financial resources

Income that is not counted includes a monthly living allowance for all members of a household as well as:

• Foster care payments
• Food stamps
• Disaster assistance payments
• Property tax refunds
• Produce grown for personal consumption
• Child support payments.

For more detailed information about applying for SSI, visit the following page: http://www.disability-benefits-help.org/ssi/qualify-for-ssi.

Applying for Social Security Disability Benefits for Your Child

The SSI application for a child under the age of 18 consists of the Child Disability Report, the Application for Supplemental Security Income, and a mandatory interview with an SSA representative. Both the disability report and the application can be filled out at the same time that the interview is conducted.

It is important that you call the SSA to schedule your child’s interview as soon as possible. This is because the next available interview appointment may not be for several months. It is also important that you complete the required forms with as much detail as possible. Any inconsistent or missing information may result in the denial of your child’s claim.

Appealing a Denial

Once you submit your child’s application, it may be months before you receive a decision. If, for some reason your child's application is denied, you have 60 days from the date of the denial notice to file an appeal. The first stage of appeals is called a request for reconsideration. Fewer than 20 percent of these appeals are approved. You will stand the greatest chance to overturn the SSA's decision during the second stage of appeals, known as the disability hearing.

Although this process may seem long and confusing, it is often a necessary step toward receiving the benefits that your child needs. For more information about Social Security Disability benefits and autism, visit this page: http://www.disability-benefits-help.org/disabling-conditions/autism-and-....