By Melissa Kenney, Esq.
When you (or someone you love) have autism, attending school or working in a neurotypical world can be overwhelming. Attention deficits, sensory and muscle motion problems, and social/communication misunderstandings can prevent one from being able to independently adapt and perform work or school tasks in typical environments. The Social Security Administration (SSA) considers autism a complete disability in children and adults when certain criteria are met.
But how will you know if you should even apply?
If you have a young adult who is about to turn 18, you may be scared that he or she might not qualify for disability help even though your young adult does not have the skills to obtain or hold a job. And if you yourself have autism, you might wonder whether it is autism preventing you from succeeding in a job or whether you just need to find that perfect fit instead.
Here is what SSA looks for when evaluating children, young adults and adults on the spectrum. Let’s use Abe, a male with a spectrum disorder, as our example.
Children on the spectrum.
Families eligible to receive Medicaid and/or food stamps often fit SSA’s allowable income limit. Abe’s parents would first need to see if they qualify financially. Then, to decide if Abe is disabled under SSA regulations, SSA needs evidence from a doctor (Ph.D., Psy.D., or M.D.) and medical records with clinical findings and test results.
SSA also looks at detailed statements from family/friends, caretakers, therapists and teachers. The medical evidence from the doctor, based on teacher or treating therapy reports, parent reports and independent testing. Statements from others must identify that Abe has deficits in reciprocal social interaction (e.g., doesn’t know how to play with others, still engages in parallel play beyond typical age), deficits in communication (e.g., at least 1 ½ to 2 standard deviations below the mean for his age), deficits in age-appropriate imaginative play or concepts as well as restricted activities and interests.
Abe’s doctors must then provide an assessment opinion showing how these deficits cause serious limitations in at least two of the following areas of functioning: communication/cognitive functioning, social functioning, personal functioning, and/or sustaining concentration, persistence or pace.
Most parents think their child qualifies for disability only because she or he is diagnosed with autism or Asperger’s syndrome. This is not the case. Below is an example showing how Abe likely will NOT qualify for disability:
Abe’s parents applied for Abe’s SSI because they lost their home, assets and income due to Abe’s mother’s medical problems when Abe turned 11. As an 11-year-old, Abe’s attention problems in class caused poor grades except in his favorite class (math). Abe was diagnosed with Asperger’s syndrome when younger, but no longer met DSM-5 criteria for autism. In spite of occasional irritability caused by being around certain lighting or sounds, Abe can talk to others to share ideas and complete schoolwork with reminders to stay on task.
Abe has two friends from special education classes who also share similar interests. Although Abe gets anxious about changes, he doesn’t blow up or hit others when faced with a change in routine. Abe can’t make small talk and appears shy, but all his teachers say he is easygoing and polite in class, even when inattentive. Finally, Abe is fully toilet trained, doesn’t wet the bed and can bathe, feed and dress himself without help, although his parents have to give him reminders.
In the above example, SSI would deny Abe’s disability application because his spectrum disorder doesn’t cause serious problems in his functioning in school, having friends, communicating, or self care. Based on these facts alone, Abe would appear to have moderate problems at best.
Young adults on the spectrum.
SSA determines an adult is disabled if she or he either is severely impaired and meets SSA’s definition of autism impairment, OR if an adult with autism can’t do the work at his/her education level or training or work simple enough to learn within 30 days or less.
When Abe turned 18, different medical and non-medical rules determine if Abe qualifies for SSI disability. His parent’s income does not count; only his income and resources (which can include free room and board if he still lives with his family). Our Abe is intelligent, but needs a lot of supports and reminders to stay on task for a job, remain physically clean and to interact appropriately with others.
(SSA does NOT consider whether Abe could successfully interview to obtain a job, but SSA can look at evidence showing Abe’s lack of social skills prevent him from working well with coworkers, supervisors and the public).
SSA needs evidence to decide if Abe’s limitations prevent him from being successful at competitive employment—as opposed to a sheltered work environment where disabilities are accommodated by the employer, and performance is not measured against neurotypical people.
In general, Abe must prove he is too disabled to work with (1) medical records and testing results; (2) school IEPs and functional assessments; (3) his testimony describing his limitations (which should parallel with what he tells his doctors, therapists, or is demonstrated in assessments); and (4) witness descriptions of his problems and limitations in social interactions, self care, persistence and pace on tasks or hobbies.
Because Abe is so young, Abe should be enrolled in vocational rehabilitation, and, very importantly, should obtain a vocational assessment. Abe’s vocational assessment should contain a summary of his medical history, testing results and opinions, summary of his IEP goals that were achieved and not achieved, and what jobs, if any, Abe can perform with his limitation.
If his vocational assessment says Abe can only work part-time because of his limits, or requires sheltered work that permits constant redirection and a reduced work pace below normal, then Abe’s vocational assessment provides strong evidence that Abe is unable to work full-time in competitive employment. If Abe obtained disability, SSA likely would review his case every several years to see if Abe learned enough skills (whether educational or adaptive skills) to be able to work in spite of his disabling condition.
Older adults on the spectrum.
Imagine if Abe’s loving parents owned a small quiet corner market where Abe would help out by running a cash register, stocking shelves and answering phones. The store rarely had more than three to five customers at a time. Abe wasn’t really very good at the job because he needed a lot of reminders, was slow and couldn’t make eye contact with customers, but since everyone knew him, people were patient.
Abe tried living on his own, but was kicked out of his apartment because he never cleaned the place and it attracted vermin. Abe rarely bathed, too, and his brother always brought him clean laundry because Abe never remembered to do it himself. When Abe turned 40, his parents closed the store and retired. Abe tried to find work: with his high school education, some vocational training and experience at his parent’s store, no one hired him. He decided to apply for disability.
Under SSA regulations, the same proof that Abe needed at 18 still applies. In addition, Abe should also get witness statements from third parties that are not his family, such as former customers, neighbors, or family friends who can describe Abe’s limitations they personally observed. They should be able to describe limitations in concentration, pace and persistence at tasks, social interactions and self-care. If a medical professional or therapist observed these same limitations, they should be fully documented in Abe’s medical, therapy and/or vocational records as well.
Finally, if Abe was over the age of 18 and diagnosed with autism before age 22, he can get additional financial benefits through his retired or deceased parent’s SSDI, as long as he never married.
In our practice, the biggest hurdles for our clients with autism are that they possess exceptional gifts and intelligence, but also possess significant limitations in self-care, ability to work with others and ability to stay on task. Many of our clients succeeded in college only due to a sheltered parental home environment where others made sure basic hygiene standards, class registration and attendance take place.
Because of their parents’ well-intentioned supports, our clients with autism get an education, but are unable to transfer their education to an independent work environment. Most SSI analysts and administrative law judges see only high IQ scores, and conclude that a high IQ shows an ability to work. As such, parents and family need to be sure to provide SSA college attendance records, journals, receipts and other records. These should demonstrate that their adult children receive significant social, self-care and work supports from family and community.
Melissa Kenney, Esq. is a member of KP Law, PC, a social security and veteran’s disability law firm providing representation throughout the Pacific Northwest. In addition to pas work for people with disabilities and involvement in disability rights groups, Melissa is also a proud parent to her neurotypical step-daughter, her spectrum son and her neurotypical daughter.