DISABILITY BENEFITS FOR AUTISM SPECTRUM DISORDER – LISTING 12.10
WHAT IS AUTISM SPECTRUM DISORDER?
Autism is a spectrum condition. This means that there is range to the condition and some people have greater symptoms than others. For example, some people with this condition do not use spoken language. However, others have excellent spoken language skills, but may have trouble understanding what other people mean or they may be unable to read social cues.
People with ASD may also have rigid thinking and repetitive behaviors. For example, they may spend a lot of time placing objects in a certain order. Or, they may say the same sentence over and over. These are a couple of simple examples of some symptoms.
Autism spectrum disorder is a neurological and developmental disorder that begins in childhood, but lasts throughout life. It includes what used to be known as Asperger syndrome and developmental disorders. Both males and females can have autism. But, studies show that more men have the disorder than women. According to the Centers for Disease Control and Prevention (CDC), 1 in 54 children in the United States has autism. Learn about childhood autism and SSI benefits.
SIGNS AND SYMPTOMS OF AUTISM SPECTRUM DISORDER
People with Autism Spectrum Disorder (ASD) often have problems with communication skills and dealing with other people. They might repeat certain behaviors and might not respond well to change in their daily activities. People with ASD often have different ways of learning, paying attention, or acting. Usually, the signs and symptoms of ASD begin during early childhood.
Examples of behaviors in children and adults with ASD might include:
- trouble dealing with others or not having an interest in other people at all
- avoids eye contact
- wanting to be alone
- having trouble understanding the feelings of other people
- being unable to talk
- being unable to express their own feelings
- does not like to be held or cuddled
- appearing to be unaware when people talk to them
- interest in people, but not knowing how to talk, play, or relate to them
- repeats words or phrases or does so in place of normal language
- having trouble stating their needs using typical words
- not looking at objects when another person points at them
- not being able to adapt to changes in routine
These are not all of the signs and symptoms of ASD. Additionally, severe symptoms differs between individuals. For example, some people with ASD are verbal and some are not. The spectrum ranges through a variety of mild to severe symptoms.
MORE FEATURES OF AUTISM SPECTRUM DISORDER
- Social and Communication Challenges: People with ASD often struggle with social relations and may have trouble understanding social cues. For example, they may not understand facial expressions, tone of voice, and body language. They may have trouble carrying out conversations, making eye contact, or sharing emotions and interests with others. Additionally, people with ASD may have repetitive speech patterns. They may also prefer routines and eating and doing the same thing.
- Restricted Behaviors: Another symptoms of ASD is the presence of patterns of behavior, interests, or activities. For example, a person with ASD may have repeated body movements. They may also do the same routines. Also, they focus their interest on specific topics. And they can be sensitive to certain sounds, sensations, or lights.
- Cognitive Abilities and Special Talents: Individuals with ASD can have a wide range of mental ability. For example, they may have an intellectual disorder or they have average or above average intelligence. Some people with ASD may have exceptional skills or talents in areas such as math, music, art, or memory. These people are often known to have “savant skills.”
- Causes and Risk Factors: The exact causes of ASD are still not fully understood. It is believed to be the result of a combination of genetic and environmental factors. Those with certain genetic conditions, such as Fragile X syndrome and Rett syndrome, have a higher risk of ASD. Other risk factors include advanced parental age and premature birth.
TREATMENT FOR AUTISM SPECTRUM DISORDER
Autism Spectrum Disorder (ASD) is a complex condition that affects communication, behavior, and social interaction. While there is no cure for this condition, there are treatments available to help people with ASD lead better lives. Treatment for ASD can include therapy and medications. These treatments focus on helping individuals with ASD develop better communication skills. The treatments also help those with ASD cope with anxiety or mood issues, which can improve their overall quality of life.
Medications can treat some of the symptoms of ASD, such as depression and anxiety. Additionally, therapy can be helpful in teaching people with ASD how to develop better communication skills. Also, therapy can help those with ASD cope with mental health issues. Examples of therapy can include applied behavior analysis (ABA), speech and language therapy, social skills training, and classes for parents. With the right treatment plan in place, people with ASD can lead happy lives.
DIFFERENCES IN FUNCTION ON THE AUTISM SPECTRUM
The terms “high functioning autism” and “low functioning autism” were previously used to describe the different levels of support and overall abilities of those with autism. However, it’s important to note that these terms are no longer officially used in manuals like the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
That being said, the terms may still be used by some to describe individuals with autism who have varying levels of needs. Here is an understanding of the differences:
- High functioning autism: This term usually refers to individuals with autism who have average or above average intelligence and language skills. They may have milder symptoms compared to those with low functioning autism. Therefore, their cognitive abilities might allow them to function in certain areas. However, they still face challenges with social interaction, communication, and sensory processing.
- Low functioning autism: This term was previously used to describe individuals with autism who had more significant symptoms and higher support needs. They often have an intellectual disorder, limited or no verbal communication skills, and challenges doing daily living skills. It is worth noting that the term “nonverbal autism” is sometimes used to describe those who have minimal or no functional speech.
The concept of different levels of function doesn’t really describe autism. The reason these terms are no longer used is because the autism spectrum is complex and covers a broad range of issues that can’t be captured by a single term. However, for SSA benefits, the law focuses on whether or not your autism symptoms prevent you from working.
SSA’S LISTING 12.10 FOR AUTISM IN SSA’S BLUE BOOK
The SSA has a specific listing to refer to win when looking at whether to pay you benefits for Autism. The listing for adults is listing 12.10. It is found in the SSA’s “blue book,” which is simply a list of medical conditions. In order to meet the listing, you must first be found to have Autism. Next, you must meet the elements under Part A and Part B :
12.10 Autism spectrum disorder, satisfied by A and B:
AND
In order to meet listing 12.10, you must have all of the elements in the listing. Additionally, your doctor must confirm you have the condition and that it will last for more than 12 months. The length of the condition is usually not a problem for those who seek benefits with ASD. However, a doctor must give you the diagnosis. Whether the SSA pays you benefits will depend on how severe your symptoms are and the results of testing.
HOW TO EQUAL LISTING 12.10 FOR AUTISM
If you do not meet listing 12.10, all is not lost. You can still win benefits if you “equal” the listing.
To equal Listing 12.10 for Autism, you do not need to meet every requirement from the listing. Instead, you must show that your condition is equal because it is as severe as the criteria. This means you must provide evidence to the SSA that your functional limits are as severe as those described in the listing, even if they do not match precisely.
For example, if your autism symptoms don’t meet the exact language in 12.10, you can equal the listing by showing marked limits. For example, you could have marked limits in three of the four functional areas (such as problems dealing with others, being able to concentrate, and managing oneself). If so, then your autism may equal the listing.
You can also equal the listing if you have a combination of other medical conditions that limit your ability to function in a way similar to the listing. Therefore, you will still need detailed medical opinions and medical records to prove your case. At the SSA hearing, your medical evidence and testimony will demonstrate the impact of your condition on your ability to perform basic work activities.
WHAT TO DO TO APPLY SSI FOR BENEFITS FOR AUTISM
Typically, it is a parent who files for Supplemental Security Income benefits for their child who is on the Autism Spectrum. If your child has no work experience and is under the age of 18, then you can file and application for SSI benefits for your child. However, the SSI program has two rules. First, the SSA must find that your child has a severe disability. Second, you must meet the income and asset limits of the program. Many families are over the income and asset limits set out by the SSI program.
WHY ARE RESOURCES IMPORTANT IN THE SSI PROGRAM?
The value of your resources is one of the factors that determines whether you can win SSI benefits. However, not all resources count under the SSI program. If the value of your resources is over the limit at the beginning of the month, then you cannot receive SSI for that month. Also, if you decide to sell the excess resources for what they are worth, then you may receive SSI beginning the month after you sell them. You may even be able to receive benefits while you try to sell the excess resources in certain situations.
WHAT IS THE RESOURCE LIMIT?
The limit for resources in the SSI program is $2,000 for an individual and $3,000 for a couple. This isn’t much money for most families to have in their bank account. Therefore, only families who are in the most critical financial need can obtain SSI benefits for their child.
WHAT RESOURCES DO NOT COUNT FOR SSI?
Under the SSI rules, the SSA does not count:
- the home you live in and the land it is on;
- one vehicle, no matter the value, if you or a member of your household use it for transportation;
- household goods and personal effects (your wedding and engagement rings);
- life insurance policies with a combined face value of $1,500 or less;
- burial spaces for you or your immediate family;
- burial funds for you and your spouse, as long as the value is $1,500 or less (see the SSI Spotlight on Burial Funds);
- property you or your spouse use in a trade or business, or on your job if you work for someone else (see the SSI Spotlight on Property You Need for Self Support);
- if you have a disability or are blind, money or property you have set aside under a Plan to Achieve Self-Support (PASS) (see the Spotlight on PASS); and
- up to $100,000 of funds in an Achieving a Better Life Experience (ABLE) account through a State ABLE program (see the SSI Spotlight on ABLE).
WHAT OTHER RESOURCES DO NOT COUNT FOR SSI?
There are other resources that do not count in the SSI program. Many of the income or asset limits have a time limit. For example, tax refunds do not count, but only for 12 months. See the list below for more information:
- past due SSI or Social Security benefits for up to 9 months after you receive them (including payments paid over time);
- grants, scholarships, or gifts to pay for education costs for 9 months after receipt;
- money in an Individual Development Account (IDA) (See the SSI Spotlight on IDAs);
- maintenance and home energy assistance that the SSA does not count as income;
- cash for medical or social services that the SSA does not count as income is not a resource for 1 month;
- EXCEPTION: Cash reimbursements of expenses already paid for by the person are looked at under the regular income and resources rules.
- health flexible spending arrangements (FSAs);
- State or local moving assistance payments for 12 months;
- crime victim assistance, but only for 9 months;
- earned income tax credit payments, but only for 9 months;
- dedicated accounts for disabled or blind children (see Deeming Eligibility Chart for Children);
- disaster relief assistance which the SSA does not count as income;
- cash for the purpose of replacing a resource (for example, a house) that is lost, damaged, or stolen, but only for 9 months;
- All Federal tax refunds and advanced tax credits received on or after January 1, 2010, but only for 12 months;
- The first $2,000 of compensation per calendar year for taking part in certain medical trials; and
- Some trusts (See the SSI Spotlight on Trusts).
WHAT HAPPENS IF YOU GIVE AWAY OR SELL A RESOURCE?
If you or your spouse, or are an owner of a resource and you give it away or sell it for less than it is worth, then it may prevent your child from getting SSI benefits for up to 36 months. How long your child will be unable to receive SSI benefits depends on how much the transferred resource was worth. Before giving away a resource in the hope of getting SSI benefits, check the rules. Find out about SSI rules in our article, SSI benefits – what you need to know.
TIPS TO PROVE YOUR AUTISM DISORDER PREVENTS YOU FROM WORKING
MEDICAL RECORDS
We can’t stress enough how much the SSA relies on your medical history to pay you benefits for autism. Your medical records need to include the fact that you have autism. Additionally, your records should include records of treatment, medications, hospital visits, and a description of your symptoms. Specifically, your records should talk about how severe your symptoms are and if they keep you from working. Learn how to build medical record evidence.
PSYCHOLOGICAL EXAM
Autism can affect your ability to understand, remember, and apply information. You may not be able to speak or at least communicate in a way that is easy for others to understand. Likewise, autism may impact your ability to concentrate and sustain a steady work pace. If you need help getting treatment for your condition, then we have free medical sources for you. For example, you can find free medical resources in Utah. You can also find free mental health resources in Nevada.
Mental health testing can show your struggle to complete work activities. You can obtain testing by paying for it. Additionally, it is possible to have the SSA send you to a mental exam paid for by the SSA. The mental aspects of your disease, including your specific symptoms, are important to your case and must be part of the record.
TREATING DOCTOR STATEMENT
SSA will have specific questions for your doctors that will help them understand the your autism symptoms. It is important your doctor writes about how your autism effects your ability to work. We can give specific forms to your doctor to complete. These forms document your physical and mental symptoms for the SSA.
WHAT WE DO TO HELP YOU WITH YOUR AUTISM CASE
At our law firm, we can help you collect your medical records and apply for benefits. There are many forms to complete when you first apply for benefits. Our firm will make sure you complete the forms properly. We can help you submit your application. Or, if you prefer you can file your application online at the Social Security website.
If the SSA sent you a denial, then you have 60 days to appeal the denial. You will also need to submit your medical records to provide evidence of your mental condition. We can also help you appeal a denial from the SSA, whether it is an initial denial or a denial at later levels. Contact us to help you win your SSDI and SSI benefits. Put the legal experience of our team to work for you.
OUR LEGAL TEAM CAN WIN YOUR AUTISM BENEFITS
At our law firm, we can help you win benefits for Autism Spectrum Disorder. Our legal team are experts in helping you prove you or your child deserve benefits. Our goal is to develop your case so that your medical records show your severe medical condition. We need to prove to the SSA that your Autism Spectrum Disorder has the symptoms under Listing 12.10.
Our legal team works hard to prepare your case, because we know you need benefits to replace your income. Over the past 30 years, we have won over $100 million in ongoing and past due SSD benefits for our clients. When you are looking for a legal team with experience, hire a firm with a proven success record. If you need help with other mental issues, then find out about Utah mental health benefits. Contact us for a free review of your case.
WHAT WE DO TO HELP YOU WIN SSDI AND SSI BENEFITS
If you have Autism Spectrum Disorder, then you need help to apply for Social Security benefits. You can always call our law firm. We can help you file your application. Also, we can help you appeal every SSA denial. For example, our attorneys and staff can:
- Send you the paperwork you need to become our client
- Help you file your application for SSDI and SSI benefits
- Inform the SSA they should pay your benefits under the Compassionate Allowance Rules
- Appeal if you receive an initial denial
- Help you confirm your SSA doctor exam
- Request a Hearing with an Administrative Law Judge (ALJ)
- Prepare you to testify at your SSA hearing
- Represent you at your hearing and question the witnesses
- Read about job expert testimony
- Learn about medical expert testimony
- Request review of an SSA decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your application for benefits online at Social Security’s website, then you have 6 months to complete it. Once you submit your application online, the SSA sends you an application summary in the mail. You must sign the summary and mail it back. If you don’t send it back, the SSA will not process your application. Sign it and send it back as soon as you can.
IS HIRING OUR LAW FIRM EXPENSIVE?
No. We are not expensive, because we only charge you an attorney fee if we win your case for autism.
It also doesn’t cost you any money to hire us. Why? Because you only pay us an attorney fee if we win your case. This means if we win, then you pay us out of your back benefits. If you do not win, then you do not pay an attorney fee. How much is the fee? It is 25% of your back benefit.
However, there is a fee cap of $9200. You never pay more than the fee cap at the hearing stage of your case. And, 25% of your back benefit is usually less than the $9200 cap. You will pay the lesser amount between the fee cap and 25% of your back benefit.
If there are costs in your case, like getting medical records, then you pay for those costs. But the costs are usually less than $100. If your doctor charges for copies of your medical records, then that is your cost.
You will owe the costs in your case whether we win or lose your case. However, your attorney fees come from your back benefit. You only pay an attorney fee if we win your case.
We will use our skills to help you through the Social Security appeal process. It is our goal to make filing for SSD and SSI benefits easier for you. We offer a free review of your case for autism. There is no pressure to become a client if you call. Even if we don’t accept your case, we will still try to help you.
OUR LAWYERS OUR EXPERTS IN SOCIAL SECURITY LAW
At Cannon Disability Law we can help you apply for benefits. Also, we can help you appeal an SSA denial. Additionally, we will represent you in court at your Social Security hearing. We will help you be a witness in your case. If your child has Autism Spectrum Disorder, then we can help you testify on behalf of you child in court. If necessary, we can appeal your case to the Appeals Council. Likewise, we file appeals in Federal Court.
Finally, we can represent you where you live. For example, we can represent you if need the top SSDI attorney in Utah or Nevada. Additionally, we can help you if you live in Idaho, Colorado, or California. Learn about Idaho SSD benefits. Likewise, we have information on how to file for SSD benefits in California. If you need help filing for SSD benefits in Colorado, then we have information that can help you.
Your ability to receive Medicaid benefits and Medicare benefits depends upon whether or not you are successful with your claim. In order to fight the SSA’s denials, you need an attorney and legal staff with experience. Hire us. Dianna Cannon has been helping people win benefits for over thirty years. Brett Bunkall and Andria Summers also have many years of legal experience. Together, we have won over 20,000 SSDI and SSI hearings. You can trust us. We will do everything we can to win your SSDI and SSI benefits for Autism Spectrum Disorder.
