The prevalence of autism in America is significant. In fact, almost one out of every 59 young people will receive an autism or autistic spectrum disorder diagnosis during their developmental years. For family members looking to help their children lead fulfilling lives, this added uniqueness can create added financial burden.
Often, the parents of autistic children find it difficult to afford the various medical professionals needed to help their children thrive. The parents’ income is stretched to the limit which can cause stress, wondering where they might get added support.
For this reason, many parents look into filing for government aid on behalf of their disabled child. One of the main programs that provides monthly benefits to help defray costs associated with raising a special needs child is Supplemental Security Income (SSI).
Like all government benefits, there are several requirements your child must meet in order to qualify for these benefits. Read more about these requirements, and the application process, below.
It may be helpful to first evaluate how the Social Security Administration (SSA) views the diagnosis of autism in children and whether or not it is deemed a disability.
The SSA has a resource available called the “Blue Book.” This is a highly technical manual covering a wide range of social security and SSI topics pertinent to parents of special needs children. In this book, autism falls under Section 112.00, a section pertaining to childhood mental disorders.
This resource has qualifications that must be met for the SSA to consider your child disabled. For autistic children, the Blue Book states the following:
112.10 Autism spectrum disorder (see 112.00B8), for children age 3 to attainment of age 18), satisfied by A and B:
A. Medical documentation of both of the following:
- Qualitative deficits in verbal communication, nonverbal communication, and social interaction; and
- Significantly restricted, repetitive patterns of behavior, interests, or activities.
B. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 112.00F):
- Understand, remember, or apply information (see 112.00E1).
- Interact with others (see 112.00E2).
- Concentrate, persist, or maintain pace (see 112.00E3).
- Adapt or manage oneself (see 112.00E4).
To unpack what these qualifiers mean, you need to look at them in terms of how these impairments limit your child’s ability to function independently. As such, it’s important to take on the very uncomfortable task of articulating exactly how your child is being limited by their disability and, further, how the disability is extreme and measurable.
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, without meeting the minimum qualifications, you will not be able to receive SSI benefits for your 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 do the best they can to amass at least the following documentation, regarding their child from birth to age 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.
It bears repeating that this is the time to focus on your child’s weaknesses. This is contrary to what parents do, but it is essential if you want your child to qualify for SSI. Having those weaknesses well-documented by trustworthy sources such as physicians, therapists, and related professionals is so important. The documentation must show that the child has both qualitative deficits as well as behavioral restrictions (as outlined in the Blue Book) and that these impairments began before the child turns 18.
Best Practices for Applying
Normally, the SSA does not accept online applications. However, in light of the pandemic they have moved much of the application process online. While this allows us to abide by standards for social distancing, it has created its own set of persistent delays. As such, it is recommended you only call the SSA when absolutely necessary.
This being known, it is still important to know where all of your child’s documents are located. Ideally, they will all be kept in digital format in a single location to allow for easy access as needed.
While this step isn’t technically necessary, the easier you make your documents to review, the more likely your application process will go smoothly.
After filing, an interview will be scheduled. In the weeks following this interview, the SSA will determine whether or not to grant SSI coverage. If you receive and answer you disagree with, remember that you can always appeal the decision.
Pros and Cons of SSI
SSI provides monthly income for your young adult. This amount in 2020 is around $700 per month and could potentially afford your child many years of additional income. However, if you believe your child has the ability to thrive and support themselves through traditional employment, it may actually be wiser to forego SSI altogether.
The reason for this rests in the income threshold of SSI programs.
Unfortunately, in order to qualify, your child must be as poor as a church mouse. Earning above the threshold will cause your child to lose eligibility and, potentially, other government programs for which they would also qualify for such as medical insurance and SNAP.
Depending on the type and extent of your child’s disability, this could be a difficult determination to make.
An Attorney Who Understands Special Needs
I have helped many individuals over the years in addressing the legal needs of disabled family members. Many people are surprised to find that the processes they initially believed daunting are simpler than imagined when given the right help.
I am passionate about continuing to provide services to the special needs community as it allows me to use law in a way that creates a positive impact. If you have any questions or want to begin the process or make an estate plan that is right for your loved one, feel free to call or, preferably, email me at [email protected].