Can You Get Disability Benefits For Autism?

Yes, it is possible to get disability for autism. However, eligibility for disability benefits for autism depends on various factors, including the severity of the condition, its impact on daily functioning, and the specific criteria set by the disability program you are applying for.

Children with autism may be eligible for Supplemental Security Income (SSI) if their condition meets specific criteria. Adults with autism may qualify for disability benefits through the Social Security Disability Insurance (SSDI) program if their condition significantly impairs their ability to work. An applicant may know the difference between SSI and SSDI before applying for disability benefits, which may prove to be beneficial. 

What is Autism?

Autism, also known as Autism Spectrum Disorder (ASD), is a complex neurodevelopmental condition that affects social interaction, communication, behavior, and sensory processing. 

It is characterized by a wide range of symptoms and challenges, which is why it is called a “spectrum” disorder. Individuals with autism may exhibit various strengths and difficulties.

Is Autism A Disability?   

Autism is recognized as a disability by various government agencies and organizations, including the Social Security Administration (SSA) in the United States.                                                                                                                                                                        

To qualify for disability benefits, an individual’s condition, including Autism, must prevent them from engaging in substantial gainful activity (SGA), which involves work that generates income exceeding a certain threshold. 

Common Types of Autism

Autism Spectrum Disorder (ASD) encompasses a range of conditions, and while it’s often referred to as a “spectrum,” there are no official “types” of autism. Instead, individuals with ASD may present with various characteristics and challenges. However, some terms are used to describe specific presentations or features within the autism spectrum:

• Classic Autism: This term is sometimes used to describe individuals with more severe symptoms and significant social communication and behavior challenges.
• High-Functioning Autism (HFA): HFA is a term used to describe individuals with ASD who have average or above-average intellectual abilities but still experience challenges with social communication and may exhibit repetitive behaviors.
• Asperger’s Syndrome: In the past, Asperger’s syndrome was considered a separate diagnosis from autism, often associated with individuals who had milder social and communication difficulties but significant challenges in other areas. 
• Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS): This term was previously used to describe individuals who displayed some autism-like characteristics but did not meet all the criteria for classic autism.

Symptoms of Autism

Autism Spectrum Disorder (ASD) is characterized by symptoms that typically affect social communication, behavior, and sensory processing. Common symptoms may include understanding and responding to social cues and difficulty forming and maintaining relationships.

Autism and disability can often lead to anxiety, depression, epilepsy, insomnia, immune system disorders, Crohn’s disease, diabetes, obsessive-compulsive disorder, and ADHD.

5 Questions To Ask Yourself Before Applying For Autism Disability Benefits

Before applying for autism disability benefits, here are five essential questions to ask yourself:

• Has the Autism Spectrum Disorder Been Professionally Diagnosed?
• How Does Autism Affect Daily Functioning?
• Are There Documented Medical Records and Evaluations?
• Have Other Interventions and Therapies Been Tried?
• Do You Meet the Eligibility Criteria for Disability Programs?

What If I Meet The Autism Disability Criteria Of The SSA?

Meeting the SSA’s criteria for Autism Spectrum Disorder (ASD) typically involves providing medical evidence and documentation that demonstrates the following:

• A Formal Diagnosis: You must have a formal diagnosis of ASD from a qualified medical professional.
• Functional Limitations: You must show that your ASD significantly impairs your ability to perform age-appropriate daily activities and work-related tasks.
• Duration: Your ASD must be expected to last for at least 12 continuous months or be expected to result in death.
• Compliance with Treatment: Compliance with prescribed treatments and therapies and evidence of limited improvement despite these interventions.
• Age Requirements: Specific age-related criteria may apply, especially if you are applying for a child with ASD.

If you meet these criteria, you can apply for disability benefits. 

Eligibility Criteria For Getting Disability with Autism

Eligibility for disability benefits with Autism Spectrum Disorder (ASD) often involves demonstrating medical documentation and marked limitations in various areas. 

• Medical Documentation: To qualify for disability benefits, you need a formal diagnosis of Autism Spectrum Disorder from a qualified medical professional, such as a psychiatrist, psychologist, or developmental pediatrician. The diagnosis should be based on recognized diagnostic criteria, such as those outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
• Marked Limitation in Social Communication: A crucial aspect of ASD is marked limitations in social communication. This may include difficulty understanding and responding to social cues, challenges in forming and maintaining relationships, limited eye contact, and delayed speech or communication difficulties.
• Marked Limitation in Behavior: Individuals with ASD may exhibit marked limitations in behavior, including repetitive behaviors or routines, intense focus on specific interests, resistance to changes in routines, and sensory sensitivities. These limitations can significantly impact daily functioning.

How Much Is The Average Autism Disability Check?

The average autism disability check is approximately $803.52. In the year 2023, the maximum social security benefit for autism spectrum disorder is $3,600 for SSDI and $914 for SSI. 

The amount may vary based on the severity of your condition or whether you are experiencing multiple disability conditions. Knowing about the Social Security Payment Schedule for 2023 may further give you clarity on the time within which you will receive your disability benefits.

What If You Do Not Meet The Autism Disability Benefits?

If you do not meet the eligibility criteria for autism-related disability benefits initially, you can appeal the decision. The appeals process typically involves several stages, including reconsideration, an administrative law judge (ALJ) hearing, review by the Appeals Council, and, if necessary, filing a lawsuit in federal court. 

During these stages, you can present additional medical evidence, gather supportive documentation, and, in the case of an ALJ hearing, provide testimony and witnesses to bolster your case. Many disability applicants are initially denied, but the appeals process allows you to give more evidence and make your case for disability benefits.

Need Legal Help? Contact A Disability Lawyer

A Social Security disability lawyer can assist by navigating complex regulations, gathering crucial medical evidence, and presenting a compelling case, increasing the likelihood of approval for disability benefits. Some applicants also try to apply for the benefits without a lawyer. However, having guidance may avoid your denying of benefits.

They also provide guidance, representation at hearings, and expertise in addressing the unique challenges of disability claims.

FAQs On Autism Disability