May 5, 2015

Asperger’s Syndrome and Obtaining Social Security Disability Benefits

Often, my blog topics reflect certain disabling conditions or Social Security disability issues that seem to be becoming more prevalent in my practice.  Asperger’s Syndrome is definitely one of these conditions; I represent many children and adults who have been given this diagnosis.

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Of course, the most recent DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, which was released in May of 2013) no longer contains a diagnosis of “Asperger’s Syndrome”; the disorder, along with other disorders such Pervasive Development Disorder NOS, is now included under the diagnosis of “Autism Spectrum Disorder.”  As people with Asperger’s and their families know, it doesn’t matter what it’s called; the symptoms and limitations remain.

People with a diagnosis of autism spectrum disorder typically have social communication and interaction deficits and restrictive, repetitive patterns of behavior.  These symptoms often interfere with an adult’s ability to work or with a child’s ability to function at an age-appropriate developmental level.  If you or your child have these symptoms, you could be eligible for benefits under Social Security’s Disability Insurance (SSDI) program or Supplemental Security Income (SSI) program.

Whether you are an adult or a child on the autism spectrum, the first way the Social Security Administration (SSA) assesses whether your impairment is disabling under its rules is by referring to the entry for “autistic disorder and other pervasive developmental disorders” in its Listing of Impairments.  The relevant listing for adults is Listing 12.10; the relevant listing for children is Listing 112.10.  First, Social Security will determine whether you meet the diagnostic criteria for an autism spectrum diagnosis.  Next, it will evaluate how severely your symptoms affect your ability to function.  For adults, this means an adjudicator will determine how markedly your symptoms impair your activities of daily living, your social functioning, and your ability to maintain your concentration.  The adjudicator will also review your record to determine whether you have repeated episodes of decompensation due to exacerbations in your symptoms.

For children, the adjudicator will evaluate functioning in six domains: acquiring and using information, attending and completing tasks, interacting and relating with others, moving about and manipulating objects, caring for yourself, and health and physical well-being.

Thorough medical records from a qualified professional can be key to a successful outcome in a Social Security disability appeal.  Observations from a psychiatrist or therapist can go a long way in proving this type of disability.  Children’s school records showing additional help they are receiving can also greatly enhance the chances of receiving a favorable decision from the SSA. Current treatments for patients on the autism spectrum can include, but are not limited to:

  • Training in social skills
  • Therapy, including cognitive, physical, occupational, and speech
  • Medications

With the ever-increasing number of these cases being brought before the SSA, it is important to have a well-documented medical record to help an Administrative Law Judge (ALJ) understand how disabling Asperger’s Syndrome can be.  Securing medical source statements from physicians can help an ALJ understand the restrictions an individual may have in a school or work setting.  If you have questions concerning Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) benefits for Asperger’s Syndrome or any other impairment, it may be in your best interest to talk to an attorney or qualified representative to discuss your options.

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