Can you get Social Security disability for Learning Disabilities?

Whether you are a child or an adult, Social Security recognizes learning disabilities as a condition that can support Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) payments. The severity of the condition, and its effect on how a person functions, are the key factors.

A significant portion of my practice is devoted to helping children and their families obtain benefits. Some other disability attorneys do not handle children’s cases, or are unfamiliar with what it takes to win them. Parts of a child’s claim work the same way as an adult’s, including the appeals process, but the way Social Security decides whether an impairment is severe enough is quite different.

Which listings apply to learning disabilities

This is worth setting out clearly, because a good deal of published guidance on this topic is out of date.

For many years, Social Security’s Listing of Impairments contained no entry that named learning disabilities, and claims had to be argued by analogy to other conditions. That changed when the mental disorder listings were rewritten in 2017.

Listing 12.11, neurodevelopmental disorders, now expressly covers specific learning disorder, along with borderline intellectual functioning and tic disorders such as Tourette syndrome. The childhood equivalent is listing 112.11. These listings cover conditions such as dyslexia and dyscalculia.

To meet listing 12.11 you need medical documentation of one or more of the following:

• Frequent distractibility, difficulty sustaining attention, and difficulty organizing tasks
• Hyperactive and impulsive behavior
• Significant difficulties learning and using academic skills
• Recurrent motor movement or vocalization

The third of those is the one most learning disability claims rest on.

You then need an extreme limitation in one, or a marked limitation in two, of four areas of mental functioning:

• Understand, remember, or apply information
• Interact with others
• Concentrate, persist, or maintain pace
• Adapt or manage oneself

Note that listing 12.11 has no alternative paragraph C route. The functional evidence has to carry the claim.

Learning disabilities that arise from another condition

Some learning difficulties are part of a broader diagnosis, and are evaluated under whichever listing fits that condition. Depending on the situation, that may be:

• Attention deficit hyperactivity disorder, also under 12.11 or 112.11
• Depressive, bipolar and related disorders, at 12.04 or 112.04
• Anxiety and obsessive-compulsive disorders, at 12.06 or 112.06
• Autism spectrum disorder, at 12.10 or 112.10
• Neurocognitive disorders, at 12.02 or 112.02, where there is a known organic cause such as a brain injury
• Intellectual disorder, at 12.05 or 112.05

When intellectual disorder applies instead

Many of the children I represent have received low IQ scores in testing performed by their schools or doctors, so this listing comes up often, and there is a common misunderstanding about it.

Listing 12.05 requires more than a test result. There are two routes, and the one that involves IQ testing requires all three of the following:

• A full scale IQ score of 70 or below, or a full scale score of 71 to 75 accompanied by a verbal or performance score of 70 or below, on an individually administered standardized test of general intelligence
• Significant deficits in adaptive functioning, shown by an extreme limitation in one, or marked limitation in two, of the four areas of mental functioning
• Evidence that the disorder began before age 22

The test has to be individually administered by a qualified specialist. Group testing carried out at school does not satisfy this part of the listing, even where the score itself is low enough, so it is worth checking how any existing score was obtained.

A low IQ score on its own does not meet this listing. A score in the borderline range above 70 does not rule a claim out either, because borderline intellectual functioning is evaluated under 12.11 instead.

The second route does not involve IQ testing at all. It applies where a cognitive impairment is severe enough that the person cannot participate in standardized testing and depends on others for personal needs such as bathing, dressing, and eating. The same requirement about onset before age 22 applies.

The requirement that the disorder began before age 22 is worth knowing for adult claimants. It does not mean you needed a diagnosis then. School records, special education placements, and repeated grades from childhood can establish it decades later, which is often the only evidence available.

Children’s claims

Most learning disability claims involve children applying for SSI. Children have two routes.

The first is meeting or medically equaling a listing, usually 112.11 or 112.05.

If that fails, Social Security goes on to assess whether the child’s combination of impairments functionally equals the listings, using six domains of functioning:

• 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 found disabled under this route with marked limitations in two domains, or an extreme limitation in one.

For learning disabilities, acquiring and using information is usually the domain that matters most, but it is worth looking at all six. Children who struggle academically frequently also have difficulties with attending and completing tasks, and with interacting and relating to others, and two marked limitations are enough.

Evidence in a child’s claim

In my experience these documents matter most:

• Medical records from treating physicians, especially specialists who treat the child for any physical or mental impairment
• Written statements from treating physicians about the severity of the condition
• Individualized Education Programs (IEPs) and 504 plans
• Report cards and school grades
• IQ and standardized testing results
• Written statements from teachers about academic progress and behavior
• Behavior reports, progress reports, and other correspondence from the school
• Evaluations and treatment notes from occupational, physical, or speech therapy
• School or daycare discipline reports

Teacher comments are worth pursuing specifically. A teacher’s written observation about whether a child can work at grade level, complete assignments, work without supervision, and behave appropriately in a classroom describes exactly what Social Security’s domains measure, in a way a medical record often does not.

Records from specialists such as psychiatrists tend to be the most persuasive, because a specialist who has treated your child regularly can speak most knowledgeably about how symptoms affect learning and development. Social Security judges an opinion on how well it is supported and how consistent it is with the rest of the record, and specialization feeds into both.

For each of my clients I ask treating physicians to complete questionnaires designed to show Social Security’s adjudicators that the child fits the definition of disability, including one addressing the six domains directly.

Adult claims

Adults can also receive benefits for a learning disability, and these claims are decided differently. The children’s functional domains do not apply. Instead, if no listing is met, Social Security assesses residual functional capacity.

The past work problem

Proving an adult claim can be tricky, and there is one obstacle that comes up in nearly every case.

If you have worked in the past with your learning disability, an Administrative Law Judge may reasonably ask how it prevents you from working now, given that the condition has not worsened. It is a fair question and it needs a real answer.

Often the answer is accommodation. Employers sometimes make allowances they would not make for other workers: a job coach, repeated reminders of job duties, permission to leave early, or tolerance of being off task more than colleagues would be. Work performed under those conditions is not the same as competitive employment, and Social Security’s rules recognize that. If a previous employer was making allowances for you, that is not evidence you can work, it is evidence of the opposite, and it is worth documenting through statements from that employer.

Other answers include work that ended because the accommodations stopped, a job that was found through a family connection, or a role that no longer exists in the economy in the form you performed it.

What limits adults at work

Difficulty staying on task, difficulty responding appropriately to coworkers and supervisors, and difficulty remembering job tasks can each make full-time employment difficult or impossible without accommodations. Many people with learning disabilities need a job coach to function in a workplace, and where that is established it frequently supports a favorable decision.

Other factors that matter include the inability to read, to write, and to understand and follow simple instructions.

Evidence in an adult’s claim

• IQ testing
• School records, including any special education placement
• Vocational rehabilitation records
• Statements from employers, particularly about accommodations provided
• Medical source statements from treating physicians
• Progress notes from treating sources

Your testimony at a hearing matters too. Convincing a judge that your learning disability is severe enough to prevent full-time employment is often what decides these claims, since the documentary record from childhood may be thin.

Do not give up after a denial

Indiana residents frequently find their claims denied when they have a learning disability. Many claims are turned down in the early stages. If you have been denied and believe you are entitled to benefits, appeal rather than starting over, and do so promptly.

Remember also that Social Security must consider all of your severe conditions together. If a learning disability is accompanied by diabetes, asthma, back pain, or any other condition, the agency considers the combination in deciding whether you are disabled.

Talk with an Indiana disability attorney

My staff and I take pride in explaining the application and appeals process to parents of disabled children, and in making sure families are fully prepared for a hearing before an Administrative Law Judge.

You can file an initial claim online, by telephone, or at your local Social Security office. I generally tell clients to apply as soon as possible, because waiting can cost you benefits. The requirements for SSI and SSDI differ, and Social Security can tell you which program applies.