How a Child with Autism Can Qualify for SSD Benefits

Having a child be diagnosed with autism can be very challenging for parents. After the initial shock has worn off, there is a transition period where everyone in the household must make adjustments in order to make sure that the child is getting the care and support they need.

In some cases, part of the adjustment period is one parent leaving work in order to be the primary caretaker and point of contact for the child. It makes sense to have one parent organizing all the therapies and medical appointments and advocating for the child, but it can cause financial hardship to go from two incomes to one, or from one to none for a single parent.

The Social Security Administration has a program designed to financially help the parents of children experiencing a disabling condition while they care for their child. Supplemental Security Income, or SSI, payments are made to parents on behalf of the child. This money can be used for any of the child’s expenses either medical expenses or living expenses.

Parents will need to file a claim for SSI benefits on behalf of their child, and they will have to meet certain financial and medical requirements in order for the claim to be approved.

Medically Qualifying For SSI Benefits with Autism

The SSA maintains a listing of all the conditions that qualify for benefits called the Blue Book. In order for a child to be approved for SSI benefits the parents will have to submit documentation and medical records showing that the child meets the requirements that are listed for autism. Parents need to submit medical evidence showing that the child meets all three of these requirements:

  • Has deficits in social interaction
  • Has deficits in verbal and nonverbal communication, and
  • Has significantly restricted, repetitive patterns of behavior, interests, or activities.

On top of that the parents would need to show medical records, statements from a psychologist or statements from teachers, doctors, case workers, social workers, or experts that the child has an extreme limitation in one of these areas or a severe limitation in at least two of them:

  • understanding, remembering, or using information (ability to learn, remember, and use information, follow instructions, solve problems, use reason to make decisions)
  • interacting with others (ability to engage in interactive play, cooperate with others, maintain friendships, handle conflicts, initiate or sustain conversation, understand social cues)
  • focusing on activities (ability to engage in activities at a consistent pace, avoid distractions, complete tasks in timely manner), and
  • adapting or managing oneself (ability to regulate emotions, control behavior, protect oneself from harm, maintain personal hygiene).

Financial Requirements for SSI

In addition to the medical requirements, the parents will have qualify financially in order for the child’s claim for benefits to be approved. SSI is meant for families in need, so there are income limits that must be met based on household size. The parents will have to submit a W-2 or Federal tax return showing income for each adult in the household that works full time to show that the total household income falls below the cap set by the SSA.

Filing Your Child’s Claim

Parents will need to file a claim on behalf of their child in person at their local SSA office. Call and make an appointment and bring all of your child’s medical records and documentation to the appointment along with your financial documents. The SSA staff will help you file a claim for SSI benefits for your child.

-This post was authored by Rachel Gaffney

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