How does one qualify for autism disability in the USA?
June 20, 2023 6:39 PM Subscribe
I'm almost certainly autistic, according to the DSM V, professional level tests, and general life traits. If I get a documented diagnosis from professionals, what else would I need to get on Supplemental security income, and or Social security disability insurance?
I've been suffering massive burnout combined with deep grief, and am generally exhausted by the struggle to care for myself, heal, and try to find a job that I neither loathe, nor makes me want to, well, quit living. I think I have enough work qualification credits that SSI seems to need, but other than that, I'm not really understanding what the other qualifications mean, or who to ask to get help on that. How does it all work? What do I need to find out if it's even worth pursuing? What does the government legalese mean, and how strictly do they judge those criteria? I am running low on funds, spoons, and hope.
Thank you!
I've been suffering massive burnout combined with deep grief, and am generally exhausted by the struggle to care for myself, heal, and try to find a job that I neither loathe, nor makes me want to, well, quit living. I think I have enough work qualification credits that SSI seems to need, but other than that, I'm not really understanding what the other qualifications mean, or who to ask to get help on that. How does it all work? What do I need to find out if it's even worth pursuing? What does the government legalese mean, and how strictly do they judge those criteria? I am running low on funds, spoons, and hope.
Thank you!
Best answer: First, since you mention work history, you are likely thinking about SSDI, not SSI.
Autism is in the "medical listings," which means that it's a qualifying disorder. However, to be blunt, if you have worked in the past, that's evidence that your autism does not prevent you from working, so you are unlikely to qualify for benefits on that basis. You'd have to show that something has changed. For example, if you have developed depression, that could conceivably qualify on that basis, but it would be difficult. I'm sorry for your struggles, but based on my (informed but nonexpert) knowledge and your description, the application process would take a long time, a lot of effort, and not have great odds of success.
You certainly could consult with a lawyer that specializes in this area but quality varies widely and they have an incentive to take only cases with a high probability of success. You may get better advice from a local organization that supports people with autism. Good luck
posted by Mr.Know-it-some at 7:30 PM on June 20, 2023
Autism is in the "medical listings," which means that it's a qualifying disorder. However, to be blunt, if you have worked in the past, that's evidence that your autism does not prevent you from working, so you are unlikely to qualify for benefits on that basis. You'd have to show that something has changed. For example, if you have developed depression, that could conceivably qualify on that basis, but it would be difficult. I'm sorry for your struggles, but based on my (informed but nonexpert) knowledge and your description, the application process would take a long time, a lot of effort, and not have great odds of success.
You certainly could consult with a lawyer that specializes in this area but quality varies widely and they have an incentive to take only cases with a high probability of success. You may get better advice from a local organization that supports people with autism. Good luck
posted by Mr.Know-it-some at 7:30 PM on June 20, 2023
Best answer: Hi, Jacen. Sorry you're going through this. First thing is to make an account at Social Security (ssa.gov) if you haven't yet. I think your account page shows your work credits; page 1 of your current statement (available for download) calculates those credits and your potential disability benefit.
Page 2 has your earnings history: "Review your earnings history below to ensure it is accurate because we base your future benefits on our record of your earnings. There's a limit to the amount of earnings you pay Social Security taxes on each year. Earnings above the limit do not appear on your earnings record. We have combined your earlier years of earnings below, but you can view your complete earnings record online with 'my Social Security.' If you find an error, view your full earnings record online and call 1-800-772-1213."
"You can qualify for Disability Benefits if you become unable to work due to a medical condition that’s expected to last at least one year or result in death."
"If you become disabled before full retirement age, you can receive disability benefits after six months if you have: enough credits from earnings (depending on your age, you must have earned six to 20 of your credits in the three to 10 years before you became disabled); and a physical or mental impairment that's expected to prevent you from doing "substantial" work for a year or more or result in death. If you are filing for disability benefits, please let us know if you are on active military duty or are a recently discharged veteran, so that we can handle your claim more quickly."
The language in the Bluebook is reliably terrible and outdated; info on "autism spectrum disorder" here, which is listed in Chapter 12, "Mental Disorders." Take a look through all the disorders? You don't have that professional diagnosis yet, but many people have wound up being treated for (& thus have a documented history of) misdiagnosed or overlapping disorders before that formality. Documentation desired for autism:
12.10 Autism spectrum disorder (see 12.00B8), satisfied by A and B:
A. Medical documentation of both of the following:
1) Qualitative deficits in verbal communication, nonverbal communication, and social interaction; and
2) Significantly restricted, repetitive patterns of behavior, interests, or activities.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F):
1) Understand, remember, or apply information (see 12.00E1).
2) Interact with others (see 12.00E2).
3) Concentrate, persist, or maintain pace (see 12.00E3).
4) Adapt or manage oneself (see 12.00E4).
After reviewing your Social Security statement, you'd start pulling together your medical records. You may have to request them from former providers in previous towns -- there's usually a form linked on the physician's or healthcare system's website, or if you still have log-in credentials for online chart access, you may be able to get them there. Make an appointment for a professional evaluation, with a provider who works with adults; these records can aid in diagnosis. Applying for disability is difficult, and having a lawyer familiar with the process helps a lot. Maybe join an online support group, for local recommendations for medical and legal pros. Best wishes.
posted by Iris Gambol at 8:17 PM on June 20, 2023 [8 favorites]
Page 2 has your earnings history: "Review your earnings history below to ensure it is accurate because we base your future benefits on our record of your earnings. There's a limit to the amount of earnings you pay Social Security taxes on each year. Earnings above the limit do not appear on your earnings record. We have combined your earlier years of earnings below, but you can view your complete earnings record online with 'my Social Security.' If you find an error, view your full earnings record online and call 1-800-772-1213."
"You can qualify for Disability Benefits if you become unable to work due to a medical condition that’s expected to last at least one year or result in death."
"If you become disabled before full retirement age, you can receive disability benefits after six months if you have: enough credits from earnings (depending on your age, you must have earned six to 20 of your credits in the three to 10 years before you became disabled); and a physical or mental impairment that's expected to prevent you from doing "substantial" work for a year or more or result in death. If you are filing for disability benefits, please let us know if you are on active military duty or are a recently discharged veteran, so that we can handle your claim more quickly."
The language in the Bluebook is reliably terrible and outdated; info on "autism spectrum disorder" here, which is listed in Chapter 12, "Mental Disorders." Take a look through all the disorders? You don't have that professional diagnosis yet, but many people have wound up being treated for (& thus have a documented history of) misdiagnosed or overlapping disorders before that formality. Documentation desired for autism:
12.10 Autism spectrum disorder (see 12.00B8), satisfied by A and B:
A. Medical documentation of both of the following:
1) Qualitative deficits in verbal communication, nonverbal communication, and social interaction; and
2) Significantly restricted, repetitive patterns of behavior, interests, or activities.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F):
1) Understand, remember, or apply information (see 12.00E1).
2) Interact with others (see 12.00E2).
3) Concentrate, persist, or maintain pace (see 12.00E3).
4) Adapt or manage oneself (see 12.00E4).
After reviewing your Social Security statement, you'd start pulling together your medical records. You may have to request them from former providers in previous towns -- there's usually a form linked on the physician's or healthcare system's website, or if you still have log-in credentials for online chart access, you may be able to get them there. Make an appointment for a professional evaluation, with a provider who works with adults; these records can aid in diagnosis. Applying for disability is difficult, and having a lawyer familiar with the process helps a lot. Maybe join an online support group, for local recommendations for medical and legal pros. Best wishes.
posted by Iris Gambol at 8:17 PM on June 20, 2023 [8 favorites]
Best answer: The SSDI process takes years, during which time you cannot be working at the level of “substation gainful activity” as mentioned above. There are strict limits on any earnings in addition to your ssdi but not a limit on assets or household income.
SSDI took me 3 years and a lawyer and a federal court hearing to earn less than poverty level wages and I had left my job years prior and the back pay didn’t even cover all the time I hadn’t worked. AND it’s not permanent. I have to keep going back for the rest of my life.
And that was before an ongoing pandemic and mass disabling event. I don’t know how backed up the systems are.
The SSI process (which is SUPPLEMENTAL income) has strict limits on earnings, household income, and on assets (savings, cars, etc).
There are a few calculators that can tell you your estimated earnings. I think they are somewhere in your ssa.gov account.
This is not to say that autism won’t quality (it does) or that you won’t qualify (you might!) But it’s a system that is purposefully designed to essentially be broken on purpose and to only let the narrowest amount of people through then treat them to the lowest level of “income” that is often below survivable.
It’s hell. Honestly it’s hell. It’s the hardest thing I’ve ever done and I’ve had 4 surgeries. It’s dehumanizing beyond belief.
If you need to do it, I encourage anyone to speak with a disability lawyer. They work on commission only from your back owed earnings and there is a cap as to how much they can be paid. They only get paid if you win and are paid directly from the SSA. (They can charge for things like travel or expenses they incur like having to pay for medical records or something small. I paid nothing extra.)
But what I’m basically saying is if I could work my fucking god I would. It sounds like you need support and a change. Please seek the support you need. And also ANY supporting medical documentation is really needed if you are to go through the process. You need proof. So get support from physical and mental health professionals. If you can, get help in the household to ease your task load. And see if a change in jobs can help and be sustainable financially.
Honestly, my personal opinion is due to how broken the system is, disability programs are a last resort. They’re so so broken. And I’m so sorry about that. I just feel that people need to know how it goes before being dropped in the deep end of it. It’s complicated. But I want to give you hope that it’s doable. OR other types of support are out there and doable.
1) research the programs.
2) seek professional help and support
3) see a disability ssdi lawyer for a consult
posted by Crystalinne at 9:46 AM on June 21, 2023 [3 favorites]
SSDI took me 3 years and a lawyer and a federal court hearing to earn less than poverty level wages and I had left my job years prior and the back pay didn’t even cover all the time I hadn’t worked. AND it’s not permanent. I have to keep going back for the rest of my life.
And that was before an ongoing pandemic and mass disabling event. I don’t know how backed up the systems are.
The SSI process (which is SUPPLEMENTAL income) has strict limits on earnings, household income, and on assets (savings, cars, etc).
There are a few calculators that can tell you your estimated earnings. I think they are somewhere in your ssa.gov account.
This is not to say that autism won’t quality (it does) or that you won’t qualify (you might!) But it’s a system that is purposefully designed to essentially be broken on purpose and to only let the narrowest amount of people through then treat them to the lowest level of “income” that is often below survivable.
It’s hell. Honestly it’s hell. It’s the hardest thing I’ve ever done and I’ve had 4 surgeries. It’s dehumanizing beyond belief.
If you need to do it, I encourage anyone to speak with a disability lawyer. They work on commission only from your back owed earnings and there is a cap as to how much they can be paid. They only get paid if you win and are paid directly from the SSA. (They can charge for things like travel or expenses they incur like having to pay for medical records or something small. I paid nothing extra.)
But what I’m basically saying is if I could work my fucking god I would. It sounds like you need support and a change. Please seek the support you need. And also ANY supporting medical documentation is really needed if you are to go through the process. You need proof. So get support from physical and mental health professionals. If you can, get help in the household to ease your task load. And see if a change in jobs can help and be sustainable financially.
Honestly, my personal opinion is due to how broken the system is, disability programs are a last resort. They’re so so broken. And I’m so sorry about that. I just feel that people need to know how it goes before being dropped in the deep end of it. It’s complicated. But I want to give you hope that it’s doable. OR other types of support are out there and doable.
1) research the programs.
2) seek professional help and support
3) see a disability ssdi lawyer for a consult
posted by Crystalinne at 9:46 AM on June 21, 2023 [3 favorites]
Check out your state disability plan. For example, California offers short-term disability (up to a year). The criteria in California is "You have a disability not related to your job. SDI defines disability as “any mental or physical illness or injury which prevents you from performing your regular and customary work.” which is a lower standard than trying to get long-term disability from Social Security. If you are eligible, it might give you a little bit of a financial cushion while you deal with your health issues and then try to find a new job.
posted by metahawk at 6:02 PM on June 21, 2023 [2 favorites]
posted by metahawk at 6:02 PM on June 21, 2023 [2 favorites]
Nth-ing get-a-disability-lawyer. If money is an issue, look for "legal aid + [your city]" to at least be able to talk to someone about your individual situation and what the possibilities are.
posted by tivalasvegas at 6:44 PM on June 21, 2023 [1 favorite]
posted by tivalasvegas at 6:44 PM on June 21, 2023 [1 favorite]
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That said, SSI/SSDI for adults is for adults who are incapable of earning more than (this year) $1470/mo. due to their disability for at least 12 months. If you have been working and earning more than that up til now (what's called "substantial gainful activity"), you have something of an uphill climb. Just hating your job, even being burned out, while having a disability doesn't get you SSI/SSDI. Keep your expectations tempered.
posted by praemunire at 7:29 PM on June 20, 2023 [11 favorites]