Getting Disability Benefits for Autism

Disability applicants who have serious difficulty communicating to others, impaired social conduct, and repetitive behavior patterns may qualify for benefits.

By , Attorney

Autism is a developmental disorder that results in impaired social behavior, difficulty communicating to others, and repetitive behavior patterns. The severity of the disorder can vary from one individual to the next. Children who have autism may exhibit the following signs: withdrawing from other people, limited eye contact, a delay in speaking and forming words, repetitive actions such as rocking, and an excessive focus on certain objects. Medical experts diagnose autism by performing neurological, cognitive, and language testing.

Adult vs. Child Disability Benefits

Autism can affect both children and adults. If your child is under age 18 and has autism, and you have low income and assets, your child may be eligible for Supplemental Security Income (SSI) benefits under the Social Security Act. If you are over age 18 and have autism, you may qualify for either Social Security Disability Insurance (SSDI) benefits or SSI benefits.

Autistic Children

There are two ways in which a child with autism can be found disabled. First, the child's autism could meet the requirements of the childhood disability listing for autism spectrum disorders (listing 112.10), found in the SSA's Listing of Impairments (discussed below). Second, the child's autism could "functionally equal" the autism disability listing because the autism causes severe or extreme limitations in functioning (see below).

The SSA accepts tests using the Cattell Infant Intelligence Scale, the Revised Standford-Binet test, and the Bayley Scales of Infant Development. For older children age 6 to age 12, the SSA will review school records. It will also review academic testing such as the Wide Range Achievement Test-Revised and the Peabody Individual Achievement Test. The SSA considers a score that is two standard deviations below the normal as evidence of a severe limitation.

Autistic Adults

There are also two ways in which an adult with autism can be found disabled. The adult could meet the requirements of the adult autism listing (listing 12.10), which has the same requirements as the children's listing. If not, an adult with autism can get a "medical-vocational allowance," described below.

The SSA will consider medical evidence such as psychological testing, mental status examinations, and intelligence testing, including the Wechsler series, the Test of Nonverbal Intelligence, the Leiter International Performance Scale-Revised, and the Peabody Picture Vocabulary Test-Third Edition.

Meeting the Autism Listing From the Listing of Impairments

The SSA's Listing of Impairments contains categories of medical conditions along with specific requirements that must be met before an applicant can be found disabled. The requirements for autistic spectrum disorders are the same for the adult listing and childhood listing. Both listings require medical evidence showing all of the following factors:

  • deficits in social interaction
  • deficits in verbal and nonverbal communication, and
  • significantly restricted, repetitive patterns of behavior, interests, or activities.

In addition, Social Security will look to see how much autism limits the applicant's ability to function at school or in the workplace. The applicant must either have an extreme limitation in one of the following areas or a "marked" (severe) limitation in two of the following areas:

  • understanding, remembering, or using information (ability to learn, remember, and use information, follow instructions, solve problems, use reason to make decisions)
  • interacting with others (ability to cooperate with others, maintain friendships or work relationships, handle conflicts, initiate or sustain conversation, understand social cues)
  • focusing on activities (ability to perform tasks at a consistent pace, avoid distractions, complete tasks in timely manner), and
  • adapting or managing oneself (ability to regulate emotions, control behavior, protect oneself from harm, maintain personal hygiene).

Children's Alternate Method: Functionally Equaling the Listings

If your child's autism does not meet the disability listing for autistic spectrum disorders, the SSA will consider all of the child's limitations. This method is similar to meeting the listing, but there are a few additional areas of functioning that are evaluated. To be found disabled, your child must show medical evidence of marked (severe) limitations in two the following areas of functioning or an extreme limitation in one area of functioning:

  • how well a child moves about and manipulates objects
  • how well a child cares for himself or herself
  • whether a child has good health and physical well-being
  • how well a child acquires and uses information
  • how well a child attends to and completes tasks, and
  • how well a child interacts and relates with others.

To determine how well your child functions within each "domain," the SSA will consider medical opinions from a variety of sources, including pediatricians, nurses, and occupational therapists. When determining whether a limitation is marked or extreme, the SSA will consider how important the restricted activities are to the child's basic functioning, how often the limitations occur, and whether the limitation occurs in all settings. For more information, read our article on how children qualify for disability benefits.

Adults' Alternate Method: Residual Functional Capacity

If your condition doesn't to meet the disability listing for autistic disorders, the SSA will evaluate your residual functional capacity (RFC). Your RFC is the most you can perform in a work setting. The SSA will consider various skills, including your ability to sit, stand, and walk, your ability to work with others, and your ability to concentrate on tasks. To be found disabled, you must be unable to perform any jobs given your RFC.

If your autism is severe, then you will likely have problems interacting with the public and with supervisors, and these limitations should show up in your RFC. This will reduce the number of jobs that you can perform. Due to your autism, you may also have problems focusing on work tasks for an extended length of time. If you are unable to perform work at a competitive pace, then the SSA could consider you disabled because you are prevented from performing almost all jobs.

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