September 27, 2012

Autism and Child Social Security Disability Benefits

One of the most rewarding parts of my job as a disability lawyer is helping disabled children and their families get the benefits they deserve.  After hearing about the daily struggles  families face when they have disabled children, it is hard not to take a personal interest in their cases.  I believe a larger percentage of my practice is made up of Supplemental Security Insurance (SSI) claims involving children than in the practices of many of my fellow Social Security disability attorneys.  In fact, sometimes other attorneys refer children’s cases to me because they simply do not handle children’s disability claims.  I have noticed that more and more of my child clients have been diagnosed on the autism spectrum, and I have found that many of these cases have unique issues that must be addressed in order to enhance the chances of a favorable outcome.

The Social Security Administration (SSA) uses six “domains” of functioning to determine how a child’s daily living is affected by the child’s disability.  These domains are:

  • Acquiring and using information
  • Attending and completing tasks
  • Interacting and relating with others
  • Moving about and manipulating objects
  • Caring for yourself
  • Health and physical well-being.

A child is considered disabled if the child either has “marked” limitations in two of these domains, or “extreme” limitations in one of them.

I have found that many autistic children have extreme limitations in interacting and relating with others.  Individuals with autism may have difficulty holding simple conversations with others, suffer from language difficulties, or repeat words or phrases (echolalia).  I have noticed many of these children do not have the ability to recognize the simple social cues most of us take for granted.  In my experience, most of these kids are smart, and I mean really smart, but their inability to interact and relate with others can interfere with their ability to function in a regular classroom setting.  Some of these children have Individual Education Programs (IEPs) to help structure classroom subjects in a more suitable way for them to learn.

Do I have a magic wand for helping all of these families win their Social Security disability claim?  No, but I do have experience in preparing cases to ensure that the Administrative Law Judge (ALJ) has all the information needed to understand how autism affects a child’s functioning.  This information includes:

  • Complete school records showing the kinds of accommodations and assistance the child receives during the school day, as well as grade reports, teacher comments, and progress reports.
  • Good medical records from doctors, therapists, and any other treating provider stating a clear diagnosis, including progress notes that reveal the provider’s professional observations and opinions.
  • Medical records related to any physical impairments for which the child receives treatment.
  • Medical source statements.  I strive to contact the medical professionals treating the child to obtain their written opinions, based on professional training and personal interaction with the child, about how the autistic child’s symptoms and behaviors fit under Social Security’s standards for disability.

Please keep in mind that even if your child suffers from severe autism, you may not qualify for SSI if your household income and resources rise above a certain level because SSI is a needs-based program.  To find out if you qualify for Supplemental Security Income (SSI) for your autistic child, you should contact the SSA and file an initial application.

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