Step-by-Step Guide: Applying for SSI for a Child with Autism

Social Security Income is a federal assistance program that provides monthly cash benefits to individuals and families with qualifying disabilities. Children with Autism and other disabilities may be eligible for monthly Social Security Income (SSI) benefits. SSI benefits are not the same as Social Security Disability Insurance (SSDI) benefits: SSI eligibility is based on age, disability status, and income level. On the other hand, Social Security disability benefits are tied to a person's work history. 

It can be important to apply for SSI benefits for multiple reasons. Kids with Autism Spectrum Disorder (ASD) often need high-cost services. Similarly, many families are low-income and may not have the resources to obtain these services. Parents may find themselves unable to cover basic needs, let alone services for their child with ASD. It is also true that some parents may be unable to work full or part-time while caring for their child.

So, what are the steps to applying for SSI for a child with Autism? Follow this step-by-step guide to find out how to apply for SSI for a child with Autism Spectrum Disorder (ASD) and combat issues you may run into along the way.

Step 1: Determine eligibility for SSI

The first step to applying for SSI is to determine eligibility. There is a page on the Social Security Administration website that says "Who can get SSI." On this page, you'll find eligibility requirements and will be able to input information to get an idea of whether or not your child may qualify. This is not a formal application but is instead designed to help individuals and families understand the benefits they might get if they move forward with the application process and ultimately get approved. 

Criteria for qualifying for SSI

People with an Autism diagnosis may or may not meet the eligibility criteria for financial assistance in the form of SSI benefits. SSI eligibility criteria require that:

• The qualifying individual has a medical or mental condition causing severe impairments in daily life.
• Impairments affecting the individual are expected to last for at least one year or result in death.
• The individual or family does not have financial resources or income above stated limits.

Limits for financial resources are usually $2,000 for individuals and $3,000 for couples. However, as a parent applying for a child, this limit increases by $2,000. Family size, including whether or not your child has siblings, will determine the maximum amount of financial resources your family can have.

Documentation needed to prove eligibility

You will need to provide the Social Security Administration with a combination of necessary documents to complete your child's application. These documents must prove to the SSA that your child has a qualifying disability and that your family is in financial need.

Step 2: Gather necessary documents

On ssa.gov, you'll find what's called a child disability starter kit. The child disability starter kit is actually a checklist that will walk you through the documents you need, which include the following.

Birth certificate

The first thing you need is your child's birth certificate or proof of adoption. If your child was not born in the United States, you will need proof of their citizenship.

Medical records

You will need thorough medical documentation to apply for your child's SSI benefits. The child disability starter kit states that parents must provide the contact information (name, address, and phone number) of every doctor, therapist, hospital, and clinic that has treated or seen the child over the course of the last year at least. In some cases, they might want earlier medical records, too. You will also need to list prescription and non-prescription medications your child takes, as well as the name of the prescriber.

School records

In addition to medical documentation, school records can help illustrate your child's needs and are required for the SSI application process. Necessary school records include:

• Addresses and phone numbers of any school the child has attended in the past year.
• Names of and contact information for any teachers, school counselors, psychologists, speech therapists, or other applicable professionals the child has worked with in the past year.
• If applicable, the child's individualized education plan (IEP) or individualized family service plan (ISFP). 

There is no minimum age for SSI benefits, so not all of this will apply to every child.

Financial information

Although SSI and SSDI are different, both require your financial information. This includes your income status, which you can show by submitting pay stubs or other documents. You'll also have to provide information regarding resources for the child and any qualifying assets you may have. For example, child support payments,

Step 3: Complete the application process

There is more than one way to apply for SSI disability benefits. Here are the three possible routes and what to do. No matter how you apply for a child's social security benefits, the application process is 100% free.

Online application

You can fill out an online SSI application by going to https://www.ssa.gov/apply/ssi. The SSA will contact you within two weeks (14 days) if they need more information. Parents applying for a child will be directed to something called a Child Disability Report. You will have to fill out the Child Disability report and contact the Social Security Administration to complete your application.

Paper application

If you prefer a paper application for SSI benefits, you can download a PDF version of the application online and print it out. Once your child's application is complete, you must mail it or take it to your local Social Security office.

Contacting the Social Security Administration for assistance

Sometimes, the SSI application process can be confusing. You can get in-person assistance filling out your child's application at your local Social Security office, or you can call the Social Security Administration with any questions you might have. Free interpreter services are available to those who need them.

Locate your local Social Security office here or call the Social Security Administration at 1-800-772-1213.

Step 4: Prepare for the evaluation process

Once you submit your Child Disability Report, a Social Security representative should call you within 3–5 business days. During that call, they'll review the report and discuss your household's income status or resources. If your state agency needs more information, they may arrange an evaluation for the child. Social Security Disability Determination Services will pay for the evaluation, so parents don't need to worry about the cost.

Scheduled interviews and evaluations

In-person evaluations and interviews are scheduled when a child's documentation is not enough to determine their SSI eligibility. For example, they may want to evaluate symptoms related to a child’s speech and language ability. 

Additionally, parents should generally expect that their child will get a repeated evaluation at least once every three years. You won't have to repay SSI benefits if you've received them, but kids might lose eligibility status for future payments at a later evaluation.

Providing additional information as requested

In addition to the possibility that your child might require an evaluation, the Social Security Administration may request additional information or documentation from parents. Send this information in as soon as you can to avoid any delays, keeping in mind that it often takes time to start receiving funds once a child's SSI disability claim is approved.

Understanding the decision-making process

The Social Security Administration will use information from documents and evaluations to determine a child's current disability status. For a disability to qualify, the Social Security Administration must determine that the disability severely impedes functioning in daily life activities. Parents must also demonstrate that their child is receiving medically necessary treatment for a medical condition. The logic behind this is that, even if a condition is lifelong, treatment could reduce symptoms and the need for SSI payments later on. This is also the reason for repeated evaluations throughout the years.

Step 5: Follow up on the application

Although the Social Security Administration will contact you sooner for additional information, such as additional medical documentation, it takes about 3-5 months for them to decide whether or not your child will receive SSI benefits. You can call the National Social Security number (1-800-772-1213) with any questions you might have.

Checking the status of the application

You can view the application status of your child's SSI disability claim online once it's submitted. To view the status of your child's SSI disability claim, go to the "check application or appeal status" page on the SSA website.

Appealing a denial

An overwhelming number of SSI applications are denied. In fact, about 67% are denied on average. If your child gets denied initially, it can be frustrating and stressful, but it may be worth it to appeal the denial. Neurodevelopmental and mental health conditions aren't the only concerns that could lead to denial of SSI benefits. Unfortunately, the process is largely unfair to people with nearly any type of medical condition or disability. 

You can appeal a denial by mail, online, or by fax. Call the Social Security Administration to request appeal forms or visit your local office. You will have 60 days to complete the appeal form once you receive a denial notice.

Understanding SSI benefits once approved

Once your child is approved for SSI payments, you'll receive a letter and booklet from the Social Security Administration. The letter will tell you when SSI payments will begin and the amount of monthly cash payments you will receive. Then, you'll start getting SSI payments, starting with the first full month your child became eligible for SSI or had an application completed in their name.

Conclusion

Social Security Income, or SSI, is a vital federal assistance program that provides monthly payments to individuals and families with qualifying disabilities. While both can help families and individuals cover basic needs and services, SSI is not the same as Social Security Disability Insurance or SSDI.

To apply for SSI for a child with Autism, parents must follow a number of steps. These steps include determining your child's eligibility, gathering necessary documents, completing and submitting an application, preparing for an evaluation, and following up. According to the SSA website, it takes about 3-5 months for the Social Security Administration to decide whether they'll approve or deny a child's disability claim. 

It is important to advocate for children with disabilities in the SSI application process. This could include appealing a denial. It is more common to get denied for SSI than it is for SSI to be approved, which is part of why advocacy matters. Parents deserve an adequate understanding of the SSI application process and support from people in their lives to help mitigate some of the stress that comes with navigating the system.