The prevalence of autism diagnoses among children in Arizona and the rest of the country has reached significant proportions. In fact, almost one out of every 59 young people will receive an autism or autistic spectrum disorder diagnosis during their developmental years.
Parents of autistic children face many challenges, including how to cover needed medical and caregiving costs. For this reason, many mothers and fathers have explored submitting a claim for supplemental security income (SSI) on behalf of their autistic child when that child is close to or has attained the age of eighteen (18). These types of SSI claims have become more common, but they still require a deep understanding of the SSI application, interview, and, if needed, appeals process.
How SSA Views Autism in Children
It may be helpful to first evaluate how the Social Security Administration (SSA) views the diagnosis of autism in children, as well as whether or not autism is deemed a disability.
The SSA has released a “Blue Book.” The massive online Blue Book covers a wide range of social security and SSI topics pertinent to parents of autistic children. Autism diagnosis falls under Section 112.00, which pertains to childhood mental disorders. Specifically, the Blue Book says that children from ages 3 to 18 who have been diagnosed with autism spectrum disorders must meet two qualifications in order to make a viable claim for SSI compensation.
The first qualifier is that the child’s medical condition be well-documented by trustworthy sources such as physicians, therapists, and related professionals. The documentation must show that the child has both qualitative deficits as well as behavioral restrictions and that these impairments began while the child was under the age of eighteen (18).
The second qualifier necessitates extreme or marked limitation of a number of abilities, including how the child functions and interacts with other people and whether or not the child is capable of managing himself or herself related to the functions of typical children of the same age. For instance, many children on the spectrum find social interactions and communications skills challenging. Again, these impairments needed to begin while the child was under the age of eighteen (18).
The impairments and designations as noted by SSA paint a broad stroke, particularly because two children with autism can exhibit very different reactions, needs, and behaviors. However, Section 112.00 does help parents prepare for the first step in applying for SSI benefits for an autistic child.
Preparing for an Autistic Child SSI Claim
Typically, parents begin thinking about a SSI claim as their child nears the age of eighteen (18). Obtaining guardianship through the court for the soon to be adult child is often the best step to do first and then apply for SSI. As the court-appointed guardian, you may have an easier time of maneuvering through the SSI process.
Before applying for SSI, parents should amass at least the following documentation, as best as they can, from birth to 18
- Medical documentation
- Reports from service providers
- IEPs or 504 Plans
- Any other documentation that thoroughly discusses all aspects of your child’s autism, development, and disabling conditions.
I tell my clients that this is not the time to brag about all of their child’s accomplishments. It is the time to articulate all of the weaknesses that they try not to focus on usually. Once all of the paperwork is in one place, make a copy of everything and buy a huge 3 ring binder and dividers. At the front of the binder, put the key pieces of information you want the SSA worker to know, along with page numbers where more information can be found.
SSA workers have a lot of things to do and so the easier you make it for them, the better your chances are that the process will go smoothly.
After you file the paperwork, an interview will be scheduled. The decision whether to grant SSI will come a matter of weeks after the interview. If you are not pleased with the decision, you can always appeal.
Pros and Cons of SSI
SSI provides monthly income for your young adult. This amount in 2019 is around $700 per month. Your young adult, however, has to be poor as a church mouse to qualify for SSI. Your income and finances is irrelevant once your child turns eighteen.
The good news is that SSI has been a reliable income source for many years. It helps defray costs. The bad news is that if you want your child to be employed, which means your child will earn income, that income must stay low enough to still allow your child to financially qualify for SSI as a poor church mouse.