Disability Benefits for Autism Spectrum Disorder

Autism, also known as Autism Spectrum Disorder (ASD), is a group of related brain disorders that are characterized by impairments in the ability to communicate, behave and interact. Several individuals who are diagnosed with autism may have symptoms severe enough to prevent them from engaging in activities of daily living as well as prevent them from working and maintaining employment in the work force. These individuals who are struggling may qualify for Social Security Disability benefits from the Social Security Administration (SSA).

 

About Autism Spectrum Disorder

Autism is considered a “spectrum” disorder meaning there is a wide range of symptoms and levels of severity individuals with autism can potentially have. Some people with autism experience mild symptoms while others experience severe symptoms.

The symptoms of autism spectrum disorder include but are not limited to:

  • Extreme difficulty with social communication and interaction
  • Repetitive, obsessive patterns of behavior, activities and/or interests
  • Continuous unusual posture and unnecessary movement
  • Inability to relate to other people
  • Learning or speech delay in children
  • Significant impairment in occupational or daily functioning
  • Sensitive to sounds, light, smells and textures

The first noticeable symptoms of autism in a child tend to surface before they turn 3 years old and involve the absence of normal behaviors for the given age. Many parents have mistaken the early signs of autism for good behavior because their child is quiet, self-contained and undemanding. The older a child becomes, the more apparent the autistic symptoms will be. It’s important to know the early signs of autism because early treatment can help potentially reverse some of the symptoms.

Early signs of autism in children:

  • Avoids eye contact
  • Won’t smile when smiled at
  • Won’t respond to his or her name or inflection of the voice
  • Doesn’t point or gesture for communication
  • Won’t play with others or share enjoyment
  • Doesn’t make basic requests or ask for help

Please note that just because your child has some autistic-like symptoms, doesn’t necessarily mean they have autism. However if your child is experiencing several of these symptoms, you should let your child’s treating doctor know and schedule an appointment. It is also recommended you ask your doctor for a referral to a child development specialist for a second opinion to make sure nothing is missed.

Types of Autism

Before May 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM) had 5 separate diagnoses of autism spectrum disorder. Autism spectrum disorder is often also called pervasive developmental disorder (PDD). These diagnoses were not clearly defined and didn’t always utilize the same symptoms with the same diagnosis. Because of this, when the DSM was updated to version 5 in May 2013, the way autism was diagnosed changed. Now there is only one diagnosis of autism spectrum disorder in which everyone is grouped under. However, the older terms are still widely used to specify where the individual is on the autism spectrum.

Autistic Disorder – This was the typical diagnosis for autism. It is characterized by difficulty with social communication and interactions as well as abnormal behavior and restricted, obsessive interests.
Asperger’s Syndrome – This category describes individuals who are at the high functioning end of the autism spectrum. These individuals developed language and speech skills like normal but have difficulty with social communications and interactions.
Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) – also known as atypical autism, this category is for individuals with some autistic symptoms but, they don’t fit into the other categories of autism.
Rett Syndrome – This category is for children with Rett syndrome. The DSM classified Rett syndrome as a pervasive developmental disorder with autism since the disorder has autistic features. Rett syndrome is a genetic disorder where children (mostly girls) begin developing correctly but then begin losing their communication and social abilities later on.
Childhood Disintegrative Disorder (CDD) – Also known as Heller’s syndrome, is a rare condition that was classified as a pervasive disorder due to its symptoms. CDD is characterized by a late onset of developmental delays in social, language and motor skills.

 

Qualifying for Disability Benefits with Autism

The Social Security Administration’s (SSA) Blue Book, also known as the Disability Evaluation Under Social Security, is a guide that explains the disability programs and lists the requirements necessary for certain disabling conditions to qualify for Social Security Disability benefits. Chapter 12 of the Blue Book deals with mental illnesses and section 12.10 Autistic Disorder and Other Pervasive Developmental Disorders lists the requirements for autism to qualify. An applicant must satisfy both requirements A and B.

Requirement A

1.) For autistic disorder, all of the following:

  • Deficits in social interaction
  • Deficits in verbal and nonverbal communication and in imaginative activity
  • Restricted list of activities and interests

OR

2.) For other pervasive developmental disorders, all of the following:

  • Deficits in social interaction
  • Deficits in verbal and nonverbal communication and in imaginative activity

Requirement B

At least two of the following:

  • Severe difficulties in maintaining social functioning
  • Severe difficulties with focusing or concentrating
  • Significant limitations in the ability to engage in activities of daily living
  • Repeated episodes of decompensation of extended length

 

The Six Domains of Functioning

When a child’s autism disorder doesn’t meet the requirements listed above, the child may still qualify if their disorder is equivalent to the listing through the domains of functioning. There are six domains of functioning the SSA evaluates when determining if a child’s condition is equal to the listings. For a child to be considered disabled, there must be medical evidence showing that the child has severe limitations in two domains or an extreme limitation in one domain.

The six domains include:

  • Ability to acquire and use information
  • Ability to attend and complete tasks
  • Ability to interact and relate to others
  • Ability to move around and manipulate objects
  • Ability to care for one’s self
  • Child’s health and physical well-being

The SSA will determine how a child functions in each domain by reviewing all medical evidence and opinions provided by medical professionals. A marked limitation means the child’s condition is severe enough to interfere with their ability to function properly within the given domain. An extreme limitation means the child’s condition is so severe that they have a complete loss of the ability to function within the given domain.

Medical-Vocational Allowance

When an adult with autism does meet the requirements listed in section 12.10 of the Blue Book, he or she can still qualify through medical-vocational allowance. In other words, an applicant needs to be able to show through medical evidence that their condition is serious enough to prevent them from working unskilled jobs. An unskilled job includes any work that requires little to no training or education to perform. If an applicant is successful at proving their inability to perform unskilled work, the Social Security Administration will award the individual disability benefits as long as they technically qualify.