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Autism and Social Security Disability

Autism - Condition

Autism Spectrum Disorder (ASD) is a neuro-developmental disorder that affects how the brain processes information.

There are three disorders in the “Autism spectrum”:

  • Autism
  • Asperger Syndrome (AS), and
  • Pervasive Developmental Disorder (PDD-NOS)

All three conditions are present from birth, although it is common for people with AS and PDD-NOS to be diagnosed until they reach their teen or adult years.

A diagnosis of Autism requires that the child exhibit at least two symptoms of impaired social interaction, one symptom of communication impairment, and one symptom of restricted or repetitive behavior.

  • Impaired social interaction is basically an inability to or marked difficulty in connecting with others either verbally or non-verbally. Examples include an inability to approach others or to imitate and respond to emotions in others.
  • Communication impairments can include difficulty in producing or responding to normal speech. Restricted and repetitive behaviors include purposeless movements, rearranging objects, preoccupation with a single activity, and a need for a highly structured, unchanging environment.

Autism that is not diagnosed until a person reaches teen or adult years is, by definition, a milder type than that diagnosed in a child.

Asperger Syndrome is included in the grouping of autistic disorders as well. While some symptoms of AS are quite similar to Autism, people with AS develop the ability to think and use language, often quite well. In many cases, they can learn to function independently at school, college, and work, provided they find the right sort of structured environment (limited social contact or a solitary working environment, and a quiet work area as people with AS are sensitive to light and noise).

While some medical professionals classify Pervasive Development Disorder as a subtype of AS, people with PDD-NOS generally fall into a separate category of those with Autism or Asperger symptoms who cannot be specifically diagnosed with Autism or AS.

To speak with a local disability attorney about your Autism case, fill out a free disability review today.

Symptoms

Symptoms of Autism vary in both type and degree and can develop gradually, but the condition is usually recognized by age three, and often sooner. An infant with autism does not react to social stimulation with healthy behavior such as babbling, laughing, smiling, or making eye contact. Instead, an infant with autism may show a marked inability to interact, and often begins to show signs of repetitive or limited behavior.

Early intervention can help children with autism cope with their condition to different degrees, but most are unable to live independently as adults. While some people with Autism are locked into continuous repetitive movements such as rocking and hand flapping and cannot interact at all socially, others have active, but odd, methods of social interactions, and sometimes exhibit highly focused interests.

Theories regarding the cause or causes of Autism range from the abnormal formation of brain synapses to genetic abnormality. Other possible causes may include external factors, such as exposure to heavy metals or pesticides.

Autism is not curable, but early diagnosis and treatment can help to manage the disorder.

Filing for Social Security Disability with an Autism Diagnosis


Childhood Autism

Childhood Autism is found as a listing under Section 112.10 of the Social Security Administration’s (SSA) Impairment Listing Manual, or “Blue Book.” The requirements of both Paragraph A and Paragraph B must be met in order to qualify a child for disability benefits.

Impairments that Qualify for Autism Disability Benefits

  1. Medically documented findings of all three of the following:
    1. Qualitative deficits in the development of reciprocal social interaction; and
    2. Qualitative deficits in verbal and nonverbal communication and in imaginative activity; and
    3. Markedly restricted repertoire of activities and interests.
  2. AND

  3. The findings in Paragraph A must result in the criteria listed in Paragraph B1 of Section 112.02 to demonstrate the severity of the impairment:
    1. For older infants and toddlers aged 1-3, having no more than one-half the age appropriate level of functioning in one of the areas set forth in subparagraphs a-c below, OR having no more than two-thirds the age appropriate level of functioning for two or more of the areas set forth in subparagraphs a-c below:
      1. Gross or fine motor development; or
      2. Cognitive/communicative function; or
      3. Social function.
    2. OR

    3. For children aged 3-18, marked age appropriate impairment in two of the areas set forth in subparagraphs a-d below:
      1. Cognitive/communicative function; and/or
      2. Social functioning; and/or
      3. Personal functioning; and/or
      4. Maintaining concentration, persistence, or pace.

Cognition is defined as the mental process of knowing, such as awareness, perception, reasoning, and judgment.

Communication is defined as a two way process of exchanging and understanding information. These abilities may be tested in a variety of ways, depending on age, with tests that can also be used to measure language and speech development.

Social functioning is defined by the Social Security Administration as the ability to form and keep relationships, cooperate with others, and respond appropriately to others.

Personal functioning is defined by SSA as the ability to perform self-case skills, such as feeding oneself, performing personal hygiene tasks, dressing, grooming, and toileting.

Maintaining concentration, persistence, and pace are defined by SSA as the ability to focus attention to a task, to persist at the task and to maintain an appropriate pace in working at the task.

Adulthood Autism

While the requirements for a disability claim under childhood Autism is found in Section 112, there is no specific listing for a diagnosis of adult Autism (AS or PDD-NOS) in the SSA’s guide to disabling conditions. Therefore, proving total disability and achieving disability benefits based on an AS or PDD-NOS diagnosis can be difficult because there are no specific criteria for approval.

In such cases, it is critical that a claimant (or claimant’s representation) be able to demonstrate that he or she is unable to function well enough to meet the SSA’s threshold for gainful employment due to the afflicting condition, in addition to presenting a medical diagnosis documenting the severity of the claimant’s Autism.

While meeting the requirements of the SSA’s Blue Book listings is the best way to qualify for disability benefits, it may be possible in some cases for an Autistic individual to qualify for a medical vocational allowance.

Your Autism Disability Case

If you are disabled because of Autism or a related autistic disability that prevents you from working, you may well be entitled to Social Security Disability (SSDI) benefits. Although total disability based on childhood Autism can be met by meeting the conditions of the SSA listing for that condition, total disability for adult-diagnosed Autism (AS or PDD) can be somewhat more difficult to prove.

It is therefore very important that you work closely with medical professionals and a qualified Social Security Disability attorney or advocate to collect to present the most appropriate and complete documentation possible in front of the Disability Determination Services (DDS) to help to ensure that your Autism disability case will have the highest possible chance of success.