Getting Disability Benefits for Autism

Autism is a developmental disorder that impairs the ability to communicate and interact with other people. Also known as autism spectrum disorder, the symptoms can vary widely between individuals. People with milder symptoms may be considered "high-functioning," and are able to work full-time despite some difficulty connecting with others, while people with very severe symptoms may be unable to complete basic tasks independently. Many people with autism lie somewhere in between.

Doctors typically diagnose autism in childhood by performing neurological, cognitive, and language testing. Both children and adults may qualify for disability benefits, but the type of benefit differs depending on your age. Adults over age 18 who have autism can qualify for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), while children from low-income households can qualify for SSI only.

Is Autism a Disability?

Social Security acknowledges that autism symptoms may significantly interfere with quality of life for both children and adults. The agency can award disability benefits to people with autism who meet certain medical requirements. Recognizing the need for different medical standards of disability for adults and children, these requirements change somewhat based on whether the autistic person is over age 18.

When Is Autism Considered a Disability In Adults?

Adults with autism can qualify for disability in one of two ways—they can meet the criteria of Social Security's disability listing for autism, or they can get a medical-vocational allowance by showing that they can't work.

Getting Disability for Autism Using the Listing of Impairments

Social Security maintains a listing of impairments that can automatically qualify applicants for benefits, provided that they have specific evidence in their medical record. The agency evaluates disability claims for autism under listing 12.10, Autism spectrum disorders.

In order to get disability for autism by meeting listing 12.10, you need to have medical documentation of deficits in verbal communication, nonverbal communication, and social interaction. Your medical records must also contain evidence of significantly restricted, repetitive patterns of behavior, interests, or activities.

You must also show that the above symptoms result in significant functional limitations that affect your ability to work. (This is the requirement that can trip up people with "high-functioning" autism, who might not have too much difficulty in a work environment.) You'll need to prove that you have an "extreme" limitation in one, or a "marked" limitation in two, of the following areas:

• understanding, remembering, or using information (the ability to follow instructions, solve problems, and use reason to make decisions)
• interacting with others (the ability to maintain friendships, cooperate with coworkers, handle conflicts, initiate or sustain conversations, and understand social cues)
• focusing on activities (the ability to perform tasks at a consistent pace, avoid distractions, and complete job duties in timely manner), and
• adapting or managing oneself (the ability to regulate one's emotions, control behavior, recognize hazards to avoid, and maintain personal hygiene).

Social Security looks for evidence of the above limitations in medical records such as psychological testing, mental status examinations, and intelligence testing, including the Wechsler series (WAIS), the Test of Nonverbal Intelligence, the Leiter International Performance Scale, and the Peabody Picture Vocabulary Test.

Getting Disability for Autism Using Your Residual Functional Capacity

You can still qualify for disability even if your autism doesn't meet the disability listing if you can show that your residual functional capacity (RFC) rules out all jobs. Your RFC is a set of restrictions that reflect Social Security's assessment about the most you can do, mentally and physically, in a work setting.

People with autism are likely to have an RFC that contains restrictions on interacting with others, such as "no jobs involving the general public," "only occasional interaction with coworkers," and "superficial contact with supervisors." These restrictions can help eliminate most, if not all, retail or service industry jobs.

Depending on how severe your autism is, you may also have problems focusing on work tasks long enough to complete them on time, or may miss too many days of work to be a reliable employee. Social Security considers such restrictions in an RFC to be "incompatible with competitive employment," and can award disability on that basis because it means you're unable to perform any full-time jobs.

Social Security (SSI) for Autistic Minors

Autism in children is often diagnosed after they exhibit characteristic signs, including withdrawal from other people, avoidance of eye contact, delayed speech, repetitive actions (such as rocking), and excessive focus on certain objects. If you have an autistic child under age 18 and your household income and assets are below a certain eligibility threshold, your child might qualify for SSI benefits.

Like adults, children with autism can qualify for disability in two ways (although the methods differ slightly, as Social Security isn't concerned with how autism limits your child's ability to work). They can meet the childhood disability listing for autism spectrum disorders, or they can "functionally equal" the listing due to significant limitations in several developmental domains.

Getting SSI for Your Child By Meeting the Autism Listing

Disability applications for children (ages 3 to 18) with autism are evaluated under listing 112.10. The requirements of this listing exactly mirror the requirements of the adult autism listing, so you'll need to show that your child has the same repetitive behaviors, communication deficits, and functional limitations as those found in listing 12.10. Social Security will, however, consider your child's limitations in light of whether they're age-appropriate—something the agency doesn't do for the adult autism listing.

Similar to the adult listing, Social Security looks for evidence of limitations in psychological evaluations, mental status examinations, and childhood intelligence testing, such as the Cattell Infant Intelligence Scale, the Revised Stanford-Binet test, and the Bayley Scales of Infant and Toddler Development.

For children ages 6 to 12, Social Security reviews school records, including Individualized Education Plans (IEPs). The agency will also review academic testing such as the Wide Range Achievement Test and the Peabody Individual Achievement Test. Test scores that are two or more standard deviations below the normal will likely be considered evidence of marked or extreme functional limitations.

Functionally Equaling the Listings

If your child doesn't exactly meet the requirements of the autism disability listing, Social Security will then need to decide whether your child's limitations are "functionally equivalent" to the listing. Determining functional equivalence is a similar method to meeting the listing, but the agency evaluates your child's abilities in a few additional areas ("domains").

In order to functionally equal the listings, you must provide medical evidence that your child has "marked" limitations in two, or an "extreme" limitation in one, of the following domains:

• acquiring and using information
• attending to and completing tasks
• interacting with and relating to others
• moving about and manipulating objects
• caring for oneself, and
• health and physical well-being.

Note that the above domains are very similar to the functional areas set forth in listing 112.10 for childhood autism spectrum disorders. One domain that's addressed in functional equivalence that isn't described in the listing is "moving about and manipulating objects." So a child who excessively rocks back and forth or rubs their fingers together ("stimming") may functionally equal the listings even if they wouldn't be found disabled by meeting the 112.10 criteria.

Social Security will consider medical opinions from a variety of sources, including pediatricians, nurses, teachers, and therapists to determine how well your child functions within each domain. When deciding if a limitation is marked or extreme, the agency will consider how important the activities are to the child's basic functioning, how often the limitations occur, and whether the limitation occurs in all settings.

Keep in mind that "extreme" limitations are more restrictive than "marked" ones. You can think of a marked limitation in a domain as something that your child can do by themselves (but with great difficulty), while an extreme limitation in an area signifies that your child can't do the activity independently most of the time.

How Much is a Disability Check for Autism?

Social Security doesn't calculate disability checks based on the type of disabling condition. The agency pays the same amount whether the recipient has autism, diabetes, or chronic heart failure. Instead, the size of your disability check will depend on several other factors—mainly, the kind of benefit you were approved for (SSDI or SSI). The two benefit programs have separate eligibility requirements and pay out different amounts according to those requirements.

SSDI Check Amounts for Adults With Autism

SSDI benefits are available to adults who've paid into the Social Security disability insurance program by working and having payroll taxes deducted from their wages. As a result, how much you'll receive in SSDI depends on how much you've earned before you became disabled. You can receive a maximum monthly SSDI payment of $3,822 (in 2024), but the average amount is much lower—about $1,537.

Calculating the exact amount that you'll receive in SSDI involves some complicated formulas. You can learn more about them in our article on how much you can get in SSDI benefits.

SSI Check Amounts for a Child With Autism

SSI is a needs-based benefit available to children from low-income and asset households. Because children typically aren't working, they can't qualify for SSDI benefits until after they've turned 18. So, Social Security will often act as if the parents' income is the child's income for purposes of determining how much the child will receive in SSI (a process called "deeming").

Calculating the exact amount of your child's SSI check is about as complicated as calculating an SSDI benefit, just in different ways. You can learn more about them in our article on how family income is deemed for child SSI applicants.

How to Apply for Disability Benefits for Autism

When you're ready to file for disability benefits, Social Security has several easy methods you can use to begin your application.

• For SSDI benefits, file online at the SSA.gov disability portal.
• For SSI benefits, call 800-772-1213 (TTY 800-325-0778), Monday through Friday, from 8 a.m. to 7 p.m., to speak with a Social Security representative.
• For both SSDI and SSI benefits, you can go in person to your local Social Security field office.

While you don't need an attorney at any stage of the disability determination process, having an experienced representative at your side can increase your chances of a successful disability claim for autism. Find out more in our article on when to talk to a disability lawyer.

_{Updated April 9, 2024}