Raising a child with severe autism can be an overwhelming emotional and financial responsibility. For families with limited income and resources, Supplemental Security Income (SSI) can provide vital support—but qualifying for benefits requires proving the extent of the child’s disability and need for care.
When a child with autism needs 24-hour supervision, Social Security may consider them eligible for SSI. Here’s what families need to know about qualifying for benefits and building a strong claim.
SSI Eligibility Requirements for Children
To qualify for SSI, a child must meet both medical and financial criteria:
Financial Requirements
- The household must have limited income and assets
- Parent income is counted in a process called “deeming”
- Income thresholds vary depending on household size
Medical Requirements
- The child must have a medically determinable physical or mental impairment expected to last at least 12 months or result in death
- The impairment must cause marked and severe functional limitations in multiple areas of life
How Autism Is Evaluated by Social Security
Autism spectrum disorder (ASD) is listed in Social Security’s “Blue Book” under Childhood Listing 112.10. To qualify under this listing, the child must have:
- Qualitative deficits in verbal and nonverbal communication
- Deficits in social interaction
- Restricted, repetitive behaviors and interests
In addition, the child must have extreme limitation in one or marked limitation in two of the following areas:
- Understanding or applying information
- Interacting with others
- Concentrating and completing tasks
- Adapting or managing oneself
What “24-Hour Supervision” Signals to SSA
When a child requires constant supervision, it often signals severe functional limitations. For example, a child may:
- Wander away without awareness of danger
- Engage in self-injurious behavior
- Have meltdowns that put themselves or others at risk
- Be nonverbal and unable to communicate basic needs
- Need assistance with all activities of daily living (eating, dressing, hygiene)
This level of dependency can support a finding of “marked” or “extreme” limitations required for SSI approval.
How to Build a Strong SSI Claim
1. Get a Detailed Medical Diagnosis
A formal ASD diagnosis from a developmental pediatrician, neurologist, or psychologist is crucial. Include:
- Results from ADOS (Autism Diagnostic Observation Schedule) or similar testing
- Speech, occupational, and behavioral therapy evaluations
- Notes on comorbid conditions like ADHD, intellectual disability, or seizures
2. Track Daily Functioning
Keep records of your child’s:
- Behavior patterns
- Supervision needs throughout the day and night
- Difficulty in social and school environments
- Developmental delays
Detailed observations help support your claim with real-life examples.
3. Gather Statements from Experts
Letters from your child’s therapists, special education teachers, or caregivers can reinforce how the child functions across settings.
4. Fill Out the SSA Forms Carefully
Be thorough and honest when completing the Function Report and other SSA forms. Don’t minimize your child’s needs—include specifics about meltdowns, communication barriers, and risks.
Denied? Don’t Give Up
Many claims are denied at first, especially when reviewers underestimate how autism impacts daily life. If you’ve been denied:
- File an appeal within 60 days
- Submit new evidence or clarifications
- Consider working with a disability attorney experienced in childhood SSI claims
Help Is Available for Families Navigating SSI
SSI benefits can be life-changing for families of children with severe autism, but proving eligibility isn’t easy—especially when 24-hour care is involved. You don’t have to go through the process alone.
Call PLBH at (800) 435-7542 for compassionate, experienced help with your SSI claim. We’ll fight to make sure your child receives the support they deserve.