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Qualifying for Disability Benefits (SSDI) with Autism in Pennsylvania

Statistics from the Centers for Disease Control (CDC) indicate that roughly one out of every five Americans lives with some sort of disability, including approximately 3.5 million Americans living with a form of autism. Autism belongs to a group of conditions classified as Autistic Spectrum Disorders (ASD), also referred to as Pervasive Developmental Disorders (PDD), and can sometimes interfere with a person’s ability to work and earn a regular income.

Unfortunately, life doesn’t stop for medical issues, and as bills and other financial obligations continue to pile up, the inability to work can become a major source of stress and anxiety. However, there may be relief in the form of monthly disability benefits. These benefits are overseen by the Social Security Administration (SSA) and can make a tremendous positive difference when it comes to financial management and covering the costs of daily living.

To schedule your private case evaluation with a Allentown disability attorney free of charge, call the law offices of Young, Marr, Mallis & Associates today at 215-639-5297, or contact us online.

Disability Benefits Process in Pennsylvania

While SSA benefits are a valuable resource for millions of Americans, actually qualifying to receive them is notoriously difficult. Unfortunately for SSI and SSDI applicants, the statistics point to far higher rates of rejection than acceptance.

The national average hovers around a dismal 36%, meaning well over half of all program hopefuls will be rejected after their first attempts at qualifying.

If your application is rejected, you have the option to go through the appeals process, which often includes a hearing before an ALJ or Administrative Law Judge. The experienced Philadelphia disability attorneys of Young, Marr, Mallis & Associates have decades of experience representing thousands of clients in these matters and will work with you to present the strongest application possible.

How to Qualify for Disability Benefits with Autism

The SSA looks at disability applicants on two basic levels: do they pass the general requirements? If so, do they also pass the requirements for their specific disability? There are specific requirements for an autistic child to qualify for Social Security Benefits.

The general requirements are that the applicant:

  1. Is not currently earning more than $721 per month. This is the 2014 FBR (Federal Benefit Rate).
  2. Has a disability severe enough to prohibit employment.
  3. Has a disability which has lasted (or is expected to last) at least 12 consecutive months, or to end in death.

Then, the applicant will be measured against the criteria for his or her condition supplied by the Listing of Impairments, or “Blue Book.” (However, even the applicant doesn’t exactly match the criteria supplied in the Listing, he or she might still be able to qualify based on something called a medical-vocational allowance, which weighs mental and physical abilities against factors like age and education.)

Eligibility information related to autism and ASD/PDD conditions can be found in the Listing under Section 12.10 of Section 12.00, Mental Disorders. Under Section 12.10, “The required level of severity for these disorders is met when the requirements in both A and B are satisfied.” So what are those requirements?

If you have autistic disorder, you will need to display all three of the following to the SSA:

  1. “Qualitative deficits in reciprocal social interaction.”
  2. “Qualitative deficits in verbal and nonverbal communication and in imaginative activity.”
  3. “Markedly restricted repertoire of activities and interests.”

If you have a different PDD condition, such as Rett Syndrome, you will need to display both of the first two qualities listed above (i.e. deficits in social interaction, as well as in communication and imaginative activity).

In either case, the “deficits” (and “restricted repertoire” for applicants citing autistic disorder) must result in at least two of the following:

  • “Marked restriction of activities of daily living.”
  • “Marked difficulties in maintaining” either social functioning or “concentration, persistence, or pace.”
  • “Repeated episodes of decompensation, each of extended duration.”

By the SSA’s definitions, examples of “activities of daily living” include but are not limited to “cleaning, shopping, cooking, [and] taking public transportation.” Likewise, “decompensation” refers to a temporary worsening or increase “in symptoms or signs accompanied by a loss of adaptive functioning.”

You can view the full text of Section 12.00 here, including autistic disorder information here.

Call a Pennsylvania Disability Lawyer Today

If you are living with autism or an ASD/PDD condition such as Rett Syndrome or Asperger Syndrome, you may be able to qualify for SSI (Supplemental Security Income) or SSDI (Social Security Disability Insurance). An experienced Pennsylvania disability benefits attorney can help. To schedule a free and confidential legal consultation, call the law offices of Young, Marr, Mallis & Associates at 215-639-5297.

Disability claims can take months or even years to be fully evaluated, so don’t delay: call us right away to start exploring the possibilities.

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