Autism Disorders

Legal Guidance for Social Security Claimants in Massachusetts

Autism is a neurological development disorder that typically presents in children at a young age. Symptoms usually manifest when they are unable to interact in typical social fashion or do not respond to stimuli in the same way that their peers do. They may lack normal communication skills or exhibit restrictive or repetitive behaviors. Autism disorders fall along a spectrum from moderate to severe, and both children and adults may exhibit a wide range of characteristics and behaviors along this spectrum. When the effects of autism are particularly severe, a child or adult may be able to qualify for Social Security Disability Insurance (SSDI). At Kantrovitz & Associates, our Social Security attorneys can guide individuals in Massachusetts through the process of applying for benefits.

SSDI Applications and Autism

Since autism is typically diagnosed in children, it is included in the Social Security Administration’s Blue Book of Listings as a childhood disability. Section 112.10 addresses the type of impairments that qualify a child’s autism diagnosis as a disability for benefits purposes. If a child exhibits the requirement of the listing, he or she may qualify for benefits regardless of whether the child has been diagnosed with autism, Asperger’s Syndrome, or Pervasive Developmental Disorder, which is another disorder on the autism spectrum.

Under Section 112.10, a child must have medically documented deficits in the development of responsive social interaction, deficits in verbal and nonverbal communication, and a restricted ability to participate in activities or show interest in different tasks. Additionally, these restrictions and deficits must result in certain measurable severities, depending on the age of the child. If the child is three or younger, he or she must have limited functioning in gross or fine motor skills, cognitive function, or social function. If the child is between four and 18, he or she must have clear impairments of cognitive functions, social functions, personal functioning, or maintenance of concentration, persistence, or pace.

Many of the terms in the SSA’s autism listing are terms of art and have been carefully defined by the agency. For instance, “cognitive/cognition” is defined as “the mental process of knowing, such as awareness, perception, reasoning or judgment.” For this reason, it is very important to carefully consult the SSA’s listings when analyzing whether they might apply to your child.

The SSA has no specific listing for adult autism, Asperger’s Syndrome, or PDD. This is because the disorders are primarily diagnosed in children, and it is generally believed that adult diagnosis occurs in only mild forms of autism disorders. This means that it can be much harder for adults to establish disability on the basis of an autism diagnosis. In order to present a compelling application for disability benefits, an adult applicant will have to establish that the autism diagnosis prevents him or her from engaging in gainful employment. This is typically done through a residual functional capacity (RFC) assessment, as opposed to matching an SSA listing. To prevail in an RFC assessment, an applicant must produce extensive medical documentation to show how autism has limited his or her functioning and prevents the applicant from participating in common daily tasks required for employment, such as sitting or standing for long periods of time. Applications that proceed through an RFC assessment can be complicated and time-consuming, and you may wish to consult with a qualified disability attorney.

Consult a Massachusetts Attorney When Pursuing Government Benefits

Applying for disability benefits on the basis of an autism diagnosis can be difficult, but it is not impossible. At Kantrovitz & Associates, our government benefits lawyers have worked with people across Massachusetts to assert their eligibility for SSDI, whether in an initial claim, a request for reconsideration, or an appeal. You can contact our office for more information at (800) 367-0871 or online. Our clients have come from throughout the Boston region, as well as New Hampshire and Rhode Island.