Autism is a developmental disorder that’s usually diagnosed in the early stages of development and impacts diagnosed individuals their entire lives. Autism is characterized by difficulties with social skills, focus, auditory processing, and motor coordination deficits, as well as physical health issues such as sleep and gastrointestinal issues.
Due to the potential severity of the condition, can you get disability for autism? The answer is yes. The Social Security Administration (SSA) has placed autism on its Blue Book impairments list because of its ability to prevent individuals from working, and individuals who meet the SSA criteria for how autism qualifies as a disability may be able to receive Social Security disability benefits.
What is Autism Spectrum Disorder (ASD)? Symptoms and Side Effects
Autism Spectrum Disorder (ASD) is a developmental condition that affects social intelligence, communication, and behavior. Formerly known as a type of Pervasive Developmental Disorder alongside Aspergers, these conditions are now grouped under the umbrella of Autism Spectrum Disorder. Symptoms typically appear in early childhood and can range from mild to severe.
Common symptoms include difficulties with communication, such as delayed speech or lack of eye contact, repetitive behaviors like hand-flapping or strict adherence to routines, and challenges in social interactions.
Individuals with autism may also exhibit intense interest in specific topics and have sensory sensitivities.
Is Autism a Disability According to the SSA Blue Book?
Yes, autism is listed in the SSA’s Blue Book under mental disorders. The Blue Book explains the criteria for disability benefits and identifies common debilitating disabilities and the prerequisites for whether those conditions qualify for disability benefits. While you can get disability benefits for a condition not listed in the Blue Book, being on the list typically makes proving your disability more straightforward.
To meet the criteria, you need to provide medical documentation showing severe limitations in social interaction, verbal and nonverbal communication, and behavior. These limitations must impact daily living and your ability to work.
Meeting the Blue Book criteria is key to getting disability benefits. This way, people with significant impairments from autism can get the support they need to manage daily living expenses and medical bills.
How Hard Is it to Get Disability for Autism?
Getting disability for autism can be tough due to the strict criteria and extensive documentation required. Applicants need to provide detailed medical evidence showing how autism affects their ability to work, documenting any limitations that hinder their work capabilities. It is crucial to have thorough medical documentation of the condition to meet the SSA criteria for a successful disability claim. The SSA reviews cases based on medical records, treatment history, and how symptoms impact daily living.
Conditions like anxiety, depression, or ADHD that often accompany autism can support a disability claim, and other commonly comorbid conditions like EDS and dysautonomia can also help. Working with a disability lawyer can increase approval chances by ensuring thorough documentation and correct completion of your application, navigating SSA requirements, and representing applicants in appeals if needed.
Getting Disability for Mental Health Issues
Autism often comes with mental health conditions like anxiety, depression, or ADHD. These conditions can further impact work ability and can support a disability claim. Detailed medical records documenting these coexisting conditions are key to showing the full extent of the disability. Presenting this information correctly can make a big difference in getting disability benefits.
SSA Disability Criteria
The SSA’s disability criteria require proving significant limitations in daily living activities. Applicants must show extreme limitations in one or marked limitations in two of the following: understanding information, interacting with others, concentrating, and adapting to changes. Providing complete medical documentation and treatment history is key to meeting these criteria.
Which Autism Symptoms Might Limit Your Ability to Work?
Symptoms of autism that can limit work ability include severe difficulties in verbal and nonverbal communication, social interaction challenges such as difficulty adapting to change or reading social cues, and sensory sensitivity. Autistic adults may struggle with tasks that require clear communication, such as following instructions or collaborating with colleagues. Social interactions can be particularly challenging, making it difficult to work in team settings or handle customer interactions. Repetitive behaviors and strict routines can interfere with the flexibility needed in many job environments.
Additionally, sensory sensitivities can make certain work environments overwhelming or unmanageable. Documenting these symptoms and their impact on work performance is crucial for a successful disability claim.
Other Medical Conditions & Comorbidities That May Help You Get Disability for Autism
Other medical conditions like epilepsy, Ehlers-Danlos Syndrome (EDS), and ADHD often come with autism and can support a disability claim, though many other possible comorbid conditions may also factor in. Providing detailed medical records that document these additional conditions is crucial to showing the full extent of the disability. This will make a bigger difference in getting benefits.
Medical Evidence You’ll Need for Your Autism Disability Claim
Strong medical evidence is key to a successful disability claim. This includes detailed records from healthcare providers showing the diagnosis, treatment, and how autism affects daily living.
Medical Records
Medical records should include complete documentation from doctors, therapists, and other healthcare providers. This includes psychological evaluations, therapy notes, and treatment history. These records should show the symptoms you experience, treatments provided, and how they both impact daily living and work ability.
Medical Evidence
Medical evidence must show how autism severely limits daily activities and your ability to work. This includes reports from healthcare providers and any relevant test results. Psychological assessments and therapy progress notes are key to the disability claim.
Evidence that Work Triggers Your Symptoms
Documenting how work triggers or worsens autism symptoms is important. This can include statements from employers, vocational therapists, or other professionals who have seen the impact of work on the individual. Detailed accounts of work-related difficulties and how they affect symptoms are crucial.
Proof of Other Conditions
Including documentation of coexisting conditions like anxiety, depression or ADHD can support the claim. These records should show how these additional conditions interact with autism to further impact daily living and work ability.
Do Autistic Children Qualify for Disability Benefits?
When it comes to applying for benefits, children and adults without a work history may qualify for Supplemental Security Income (SSI). For autistic children, there’s a certain level of severity that must be met in order to receive SSI. According to Section 12.10 in the SSA’s Blue Book, children must meet the requirements specified in both section A and B below.
1. Medically document findings of the following:
For autistic disorder, all of the following:
- Qualitative deficits in verbal
- Non-verbal communication and imaginative activity
- Markedly restricted repertoire of activities and interests
2. Must result in at least two of the following:
- Marked restriction of activities of daily living
- Serious difficulties in maintaining social functioning
- Marked difficulties in maintaining concentration, persistence or pace
- Repeated episodes of decompensation, each of extended duration
If your child can meet all the qualifications listed above, then you may potentially get SSI benefits for your child.
How to Apply for Autism Disability Benefits
Applying for autism disability benefits involves several steps. First, gather all medical evidence. Then complete the SSA forms and submit them with supporting documentation. It’s recommended to consult with a disability lawyer to make sure you meet all requirements and increase your chances of approval.
Applying for Social Security Disability Insurance (SSDI) with Autism
SSDI applications require a work history that shows sufficient work credits. These credits are earned through taxable work and are based on your total yearly wages or self-employment income. Generally, you need 40 credits, 20 of which were earned in the last 10 years ending with the year you became disabled. But younger workers may qualify with fewer credits.
For autistic individuals, showing that autism has severely impacted their ability to work is key. Medical documentation and possibly a lawyer’s help can increase approval chances. Applicants need to show how autism affects their ability to do substantial gainful activity (SGA). As of 2024, SGA is $1,550 per month for non-blind individuals and $2,590 for blind individuals.
Applying for Supplemental Security Income (SSI) with Autism
SSI is based on financial need, not work history, and applicants must meet strict income and asset limits to receive SSI benefits. As of 2024, the federal benefit rate is $943 per month for an individual and $1415 for a couple. The SSA considers income from various sources including wages, Social Security benefits, and pensions. Also, applicants must have limited resources, not more than $2,000 for an individual or $3,000 for a couple. Resources include cash, bank accounts, and other personal property.
For autism, you must provide medical evidence and show financial need to receive SSI benefits. The disability must last at least one year or result in death. Children under 18 may qualify if they have marked and severe functional limitations due to autism and their family’s income and resources are within the eligibility limits.
Work With a Disability Lawyer to Improve Your Odds of Approval
Working with a disability lawyer can increase your chances of getting disability benefits for autism. Lawyers can help gather and present medical evidence, complete forms accurately, and represent you in appeals if needed.
They can help you through the SSA’s requirements, make sure you provide all necessary documents, and prepare your application. They can also show you how to explain how autism affects your daily living and work capability. A disability lawyer can TRIPLE your chances of approval, so check your eligibility now!
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Megan Kelly is a former blogger and copywriter for LeadingResponse.
