In 2022, the cost of raising a child in the U.S. to age 17 was roughly $17,000 per year. For families of children with disabilities, that estimate runs far higher.
The costs of such necessities as health interventions and behavioral therapies, assistive technology, medications, child care, and sensory-friendly items can mean parents raising a child with autism to adulthood will pay about $60,000 annually, according to nonprofit Autism Speaks. Depending on the severity of the child’s disability, those costs can easily escalate further.
Children with Autism Spectrum Disorder (ASD) who meet certain criteria outlined by the Social Security Administration (SSA) may be able to secure public benefits that can offset these costs to some degree.
What Is SSI?
Supplemental Security Income (SSI) is one such public benefits program. It is a federal assistance program that provides modest financial support in part to help families caring for children with disabilities. SSI is also a “means-based” program; to be eligible, the recipient’s resources cannot exceed extremely strict and specific limits. Note that the income and assets of the child’s parents can affect SSI eligibility.
Is Autism a Disability According to the SSA?
The Social Security Administration lists autism as a disability. Children with ASD could meet the SSA’s definition of disability, qualifying for SSI. Autism is a spectrum disorder affecting individuals differently. Eligibility depends on the severity of autism and how it affects a person’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 verbal and nonverbal communication and social interaction, 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 mental functioning domains:
Understanding, remembering, or applying information.
Interacting with others.
Concentrating, persisting, and maintaining pace.
Adapting or managing themselves.
When children with ASD receive SSI, they get a monthly payment that helps cover certain needs. In addition to using monthly payments to cover basic needs, families who may have limited resources can also use SSI to cover expenses related to autism, such as therapy, educational programs and summer camps, communication devices and sensory tools, and respite care.
Accessing Supplemental Security Income Benefits for Children With Autism
Children who meet the SSA’s disability criteria for autism must also have resources that fall under the SSA’s limits. The administration considers 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 factor into the decision.
To access SSI benefits for a child with ASD, families need records to show that their child’s autism significantly impairs them. These records typically come from health care providers as well as schools.
How Much Does a Child With Autism Get From SSI?
In 2023, the maximum monthly benefit for SSI is $914 per individual. However, the amount of Supplemental Security Income 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; additional sources of income offset monthly Supplemental Security Insurance payments.
The child’s state of residence; states have different rules determining how much assistance they provide. Some states supply 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 for Medicaid coverage.
How to Apply for SSI for a Child With Autism
Parents can apply for benefits for their children by taking the following steps.
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 Social Security Administration to complete the application. The state agency decides 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 an Attorney
If you are considering applying for SSI benefits for a child with autism, consider speaking with a special needs planning attorney. An attorney can guide you through the process, help you present a robust application, and address your unique needs.
Here at Sharek Law Office, we are qualified to help you and yours in special needs planning. Call us at 412-347-1731 or click here to schedule your free 15-minute introductory phone meeting to discuss tools like special needs trusts and ABLE accounts for you and yours.
This article is a service of Sharek Law Office, LLC. We don’t just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than you’ve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.