The Ins and Outs of Supplemental Security Income (SSI) for Children With Autism
For families raising children with autism, the costs for care can really add up. Paying for health interventions and behavioral therapies, assistive technology, medications, child care, and sensory-friendly items can result in parents spending $60,000 annually to raise their child to adulthood, according to Autism Speaks. And depending on the severity of the child’s disability, those costs can easily escalate further.
To help offset some of these costs, many families turn to public benefits. Children with Autism Spectrum Disorder (ASD) who meet certain criteria outlined by the Social Security Administration (SSA) can qualify for programs like Supplemental Security Income (SSI).
What Is SSI?
SSI is a federal assistance program that provides modest financial support in part to help families caring for children with disabilities. It is also a “means-based” program; to be eligible, in most circumstances, the recipient’s resources – and the income and assets of the child’s parents – cannot exceed specific limits.
Is Autism a Disability According to the Social Security Administration?
The SSA lists autism as a disability. However, because autism is a spectrum disorder affecting individuals differently, SSI eligibility depends on the severity of the diagnosis and how it affects an individual’s abilities.
For children and adults, the SSA lays out the medical criteria for determining whether individuals with autism can receive benefits. The SSA recognizes youths with autism as disabled when they have medical documentation of deficits in social interaction and verbal and nonverbal communication, as well as significantly restricted, repetitive patterns of behavior, interests, or activities.
They must also have an extreme limitation in one, or marked limitation of two, of the following domains of mental function:
- Understanding, remembering, or applying information;
- Interacting with others;
- Concentrating, persisting, and maintaining pace; or
- Adapting or managing themselves.
SSI for Autism: How Can it Help?
When children with ASD receive SSI, they get a monthly payment that helps cover certain costs. In addition to using monthly payments to cover basic needs, families can use SSI to cover expenses related to autism, such as:
- Educational programs and summer camps;
- Communication devices and sensory tools; or
- Respite care
Accessing Supplemental Security Income Benefits for Children With Autism
Children who meet the SSA’s disability criteria for autism must also generally maintain financial resources below the SSA’s limits to receive SSI. This includes the income and resources of a child as well as family members. Even if a child spends time in a residential program, household members’ finances may factor into eligibility.
To demonstrate the severity of the disability and qualify for SSI, families will also need to provide records from health care providers and/or schools that show their child’s autism significantly impairs their abilities.
How Much Does a Child With Autism Receive From SSI?
In 2023, the maximum monthly benefit for SSI is $914 per individual. However, the amount of SSI that a child with autism can receive depends on numerous factors:
- The child’s financial status, including the income and resources of parents and guardians – having additional sources of income can offset monthly SSI payments.
- The child’s state of residence – different states have different rules regarding how much assistance they will provide. Some states make additional payments to SSI recipients to offset the cost of living.
In many states, children with ASD who receive SSI benefits are automatically eligible for Medicaid, a joint federal and state health insurance program for people with low incomes and limited resources. Other states have different eligibility rules for Medicaid, and SSI recipients may need to apply separately to receive Medicaid coverage.
How to Apply for SSI for a Child With Autism
Parents can apply for SSI benefits on behalf of their children.
- The first step is completing the Child Disability Report. This includes providing information about the child’s medical conditions, medical records, and education.
- After completing the Child Disability Report, you must contact the SSA to finish the application process. The state agency will decide whether the child is eligible for SSI.
- To make this decision, the agency reviews the information the applicant provides and conducts a disability interview. If needed, the agency can request additional evaluations at its expense. It can take three to five months to receive a decision. Applicants can appeal if they disagree with the outcome.
Consult With Your Attorney
If you are considering applying for SSI benefits for a child with autism, consider speaking with a special needs planning attorney about this and other estate planning questions. They can guide you through the process and help you present a robust application.