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 disability attorneys refer children’s autism cases to me because they simply don’t handle these types of disability claims.
Does My Child with Autism Qualify for SSI Benefits?
The Social Security Administration (SSA) uses six “domains” of functioning to determine how a child’s daily living is affected by their disability. I’ve found that understanding these domains is crucial for parents – they’re essentially the roadmap SSA uses to evaluate your child’s case.
We’ll assess your child’s case, help you understand your situation and explain your options.
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 they either have “marked” limitations in two of these domains, or “extreme” limitations in one of them. Let me break down what I typically see in my practice.
What I See in Child Autism Cases
I have found that many children with autism 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).
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, 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.
Common Challenges Parents with Disabled Children Face
In my years of practice, I frequently see parents struggling with several key challenges:
1. Understanding the Financial Requirements
I often meet families who assume they make too much money to qualify. Many families consider not applying because they think their income is too high.
However, it’s important to let Social Security evaluate your financial situation, as they use specific criteria to determine eligibility for this needs-based program.
2. Gathering the Right Documentation
When preparing to apply, you don’t need to gather all the actual documentation yourself.
What’s most important is having a list of:
- Names of all healthcare providers your child sees
- Schools your child attends
- Programs your child is enrolled in (such as ABA therapy, speech therapy, or occupational therapy)
- Any special education services or IEPs in place
- Social Security will be responsible for obtaining the actual records once you provide this information.
My Approach to Building a Strong Disability Case for Your Child
Do I have a magic wand for helping all 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.
Here’s what I focus on collecting:
- 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 – We work to obtain a doctor’s 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
We’ll assess your child’s case, help you understand your situation and explain your options.
Important Financial Considerations
SSI is a needs-based program, so the first step is determining if your family meets the financial requirements. The Social Security Administration will need to conduct a resource interview before they can evaluate your child’s medical condition.
It’s important to understand that this financial evaluation must be completed before they’ll consider the disability aspects of your case.
However, don’t let this discourage you – I’ve helped many families who initially thought they wouldn’t qualify.
Common Questions I Hear from Parents
Here are the questions I’m most often asked:
“How long will this take?” In my experience, initial decisions typically take 5-6 months. If we need to appeal (which is common), it can take longer. I always tell parents to prepare for the long haul but know that we’ll be there every step of the way.
“What if we’ve already been denied?” Unfortunately, many cases are initially denied. But we can appeal your initial denial and work to build your case. The appeals process gives us the opportunity to gather more detailed evidence and work towards a favorable outcome.
“Will my child lose benefits if they do well in school?” Good grades alone don’t disqualify a child from receiving benefits. Social Security evaluates children across six different domains of functioning. Academic performance is one area.
A child might excel in academics but still struggle in other crucial areas, such as social interactions or adapting to changes in routine.
We’ve successfully represented high-functioning children whose autism significantly impacts their ability to function in other important ways.
Taking the First Step Towards Your Child’s Disability Case
While many families contact us early in the process, we typically become involved after the initial application has been denied. This is when our experience can be most valuable in helping with the appeals process and ensuring your case is properly presented.
It’s important to know that if your initial application is denied, you shouldn’t give up or start over with a new application. Instead, you should appeal the decision within 60 days.
You can call our office at any time – no appointment necessary.
During our free consultation, we will:
- Discuss where you are in the application process
- Review whether we can help at your current stage
- Explain what Social Security looks for in evaluating autism cases
- Guide you on what steps to take next
If you’re at a point where we can’t help yet, we’ll explain why and let you know when would be the best time to contact us again.
Every case is different, and I’d like to hear about your child’s specific situation.
While I can’t guarantee any particular outcome, I can promise you’ll get straight answers and clear guidance based on my years of experience helping families just like yours.
Does My Child with Autism Qualify for SSI Benefits?
Children with autism may be eligible for SSI benefits. Learn if your child qualifies based on their condition and your family's resources.
