For the purpose of receiving benefits through Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), the Social Security Administration must see evidence of a qualifying disability that prevents the recipient from working full-time. If parents apply on behalf of a child, the child must have a physical or mental condition that “very seriously limits the child’s activities.” It is natural to wonder whether individuals with autism spectrum disorder are considered disabled and eligible for benefits.
The answer, as is so often the case with disability questions, depends on the circumstances. Autism is recognized as a potentially disabling condition, but the severity of the symptoms and the impact on an individual’s life can fall anywhere along a wide spectrum. It is necessary to demonstrate that the symptoms resulting from autism are severe enough to prevent functioning at an appropriate level of autism in order to qualify for benefits.
Autism in the “Blue Book”
The Social Security Administration keeps a list of medical conditions and descriptions of impairments that are used to help determine when a condition will qualify someone for disability benefits. Although the list is online now, it is still referred to as the “Blue Book.” Autism spectrum disorder is described in this listing of impairments in two separate sections, one aimed at adults and the other for children.
For adults, autism spectrum disorder is listed at 12.10 and for children, the listing is found at 112.10. The guidelines are the same for both. An adult or child may be considered disabled when they can produce medical evidence demonstrating that the disorder causes both “qualitative deficits in verbal communication, nonverbal communication, and social interaction” and “significantly restricted, repetitive patterns of behavior, interests, or activities.” In addition, the disorder must limit the applicant’s ability to do one of the following:
- Understand, remember, or apply information
- Interact with others
- Concentrate, persist, or maintain pace
- Adapt or manage personal conduct
The limitation in these abilities must be “extreme” if it only affects one ability or “marked” if it affects two or more of these abilities.
How the Guidelines Are Evaluated in Practice for Children
The theoretical definition of impairment can be hard to apply to real-life situations. For children, SSA looks at the individual child and the severity of limitation in six domains of functioning:
- Acquiring and Using Information
- Attending and Completing Tasks
- Interacting and Relating with Others
Moving About and Manipulating ObjectsCaring for Himself or Herself
- Physical Health and Well-being
Autism as a Qualifying Disability for Adults
Generally, to be eligible on the basis of autism spectrum disorder as an adult, an applicant must be able to show that they experience symptoms which are severe enough to keep them from working full-time. Individuals with autism often experience symptoms such as: hey experience:
- Problems interacting socially
- Limitations in activities of daily living
- Difficulty with concentration, pace, or completing tasks
- Difficulties adapting or adjusting to any change in routine or schedule
Evidence of Disability
To satisfy requirements to receive benefits for any disability, an applicant must be prepared to submit significant amounts of evidence, and autism spectrum disorder is no different. The challenge is that because the condition is mental rather than physical, it can be much more difficult to obtain documentation of the condition and its impact. Medical records are critical, but evidence can also include statements from teachers, counselors, and vocational professionals. For instance, a teacher might explain the difficulty the applicant continually has in responding to everyday situations. A statement from a doctor can provide more specific information than that found in medical records.
Talk to Burgess & Christensen About Eligibility for Benefits for Autism Spectrum Disorder
The Social Security Administration makes it confusing to determine whether you qualify for disability benefits and difficult to gain approval for benefits even when you do qualify. But the team at Burgess & Christensen can help you succeed with the process. We focus our practice on obtaining disability benefits, so we have a thorough understanding of the evidence that is considered persuasive to examiners. We invite you to consult our team for a free consultation to learn more about whether you qualify for benefits and how we can assist.