A child diagnosed with autism may qualify for benefits through the Social Security Administration’s (SSA’s) Supplemental Security Income (SSI) program. This need-based program has financial as well as medical eligibility rules. Even with these qualification standards however, many children receive benefits every month that can help cover everyday living expenses and special needs costs.
Medically Qualifying for SSI with Autism
While autism can range from mild to severe, a child’s medical records must meet the severity level of the SSA’s disability listing in order to get benefits. The autism listing appears in the SSA’s Blue Book in Section 112.10. This manual outlines standard definitions for disabilities, to ensure fairness in how the SSA approves and distributes disability benefits.
The autism listing specifically requires:
- Deficits in social abilities, including an inability to reciprocate or respond in social situations
- Pronounced deficits in verbal and nonverbal communication
- A lack of imaginative abilities or inability to participate in imaginative play or other activities
- Limited interests and activities, including a distinct increase in symptoms with any disruption of routines
Medical records are crucial when applying for disability benefits, and your pediatrician can provide records directly to the SSA for review. The DDS may seek input from others when reviewing your child’s claim too, including social workers, teachers, childcare providers, or family members that are familiar with your son or daughter’s daily challenges or limitations.
SSI Financial Eligibility and Deeming
When you apply for benefits on behalf of a child, the SSA reviews the financial situation of the entire family. A child is “deemed” a portion of any income or assets belonging to his or her parents. This deeming process means the SSA considers these financial resources available to pay for the child’s needs.
Although the financial eligibility rules for SSI are strict, many kids can qualify for benefits, because only some income and other financial resources are counted. Of these countable sources, only a percentage is “deemed” or assigned to the child as well. The SSA also takes other factors into consideration, like bills the family has, the size of the family, and the number of minor children that live in the household. You can view the SSA’s chart on income limits by a household’s size to determine if you or your spouse’s income will keep your child eligible for SSI benefits.
Preparing to Apply for SSI
Before applying for SSI, you’ll want to review the SSA’s Child Disability Starter Kit. This kit contains forms for you to complete in preparation for your disability application. It also helps you understand the other information and records you’ll need to gather before starting an SSI claim. Required records include bank statements and other information about your finances in addition to medical records; contact names, addresses, and phone number of your child’s healthcare providers; and school records, for school-age children.
Submitting an Application for Benefits
When you apply for SSI, an interview with an SSA representative is required. This representative will fill out your child’s application for you and submit it for review with the DDS. Interviews usually take place at the local SSA office, and no appointment is necessary. You can additionally call the SSA’s main helpline at 1-800-772-1213, to ask questions or make other interview arrangements.