From medical and legal viewpoints, autism is considered a disability. If you meet certain criteria, you may qualify for government disability benefits.
Autism spectrum disorder (ASD) is a neurodevelopmental condition that’s caused by differences in the brain. If you are living with or caring for someone with autism, you know it encompasses a wide range of characteristics that affect each person and family differently.
But is autism considered a “disability?”
It depends on the point of view, and the individual’s experience with autism.
From medical, legal, and social standpoints, autism is defined a bit differently. Understanding when and how autism is considered a disability can help you navigate getting disability benefits for autism.
Autism can be viewed from a medical, social, and legal model of disability.
The medical perspective
According to the medical model of disability, autism is considered a disability because it’s an impairment, abnormality, or disorder to be treated, says Julie Landry, PsyD, ABPP, a clinical psychologist based in San Antonio, TX.
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The needs of autistic individuals exist on a spectrum from high to low. Due to this, autistic individuals will experience varying levels of disability.
The legal perspective
According to the Americans with Disabilities Act (ADA), “disability” is defined in legal, as opposed to medical, terms.
The ADA defines someone with a disability as “a person who has a physical or mental impairment that substantially limits one or more major life activity.” This includes people who:
- have a record of a physical or mental impairment, even if they do not currently have a disability
- do not have a disability but are regarded as having a disability
The ADA also makes it unlawful to discriminate against someone based on their association with a person with a disability.
Autistic people have a broad range of abilities. Some experience
For example, some autistic people may be non-verbal and have difficulty communicating or understanding behaviors expected at work or in social situations.
Some may have delayed movement and cognitive skills that affect their participation and learning in school. Others may have advanced conversation skills and need little to no support in their daily lives.
The social perspective
The social model of disability, explains Landry, views disability as a difference, which is neutral rather than negative.
“The idea is that an autistic person isn’t a problem but rather the barriers created by a society that fails to accommodate neurodiversity,” she notes. “The disability is created by society rather than an impairment.”
The experience of autism varies widely, adds Lila Low-Beinart, MA, LPCC, a psychotherapist who works with autistic people in Boulder, CO, and is autistic herself.
“So from a social perspective, it depends on the traits of an individual whether society views them as “disabled” or not,” Low-Beinart says.
Autistic people in the United States have access to the same government disability benefits that all disabled people do. Benefits vary from state to state, but common benefits include:
• Social Security Disability Insurance (SSDI): provides benefits to you and certain family members if you’re insured
• Supplemental Security Income (SSI): provides benefits based on financial need
Disability benefits may also include:
- Medicaid, which can include mental health support, depending on the state
- in-home care
- vocational care
- protection against discrimination
Only people with a disability who meet certain medical criteria may qualify for benefits under SSDI or SSI.
The SSA has a strict legal definition of “disability”, which differs from the ADA’s definition. According to the SSA, to be found disabled:
- you cannot do work and engage in substantial gainful activity (SGA) because of your medical condition
- you cannot do work you did previously or adjust to other work because of your medical condition
- your condition has lasted or is expected to last for at least 1 year or to result in death
The SSA maintains a list of medical conditions that may prevent a person from doing SGA. Autism spectrum disorder is located on this list under “mental disorders.”
Additional SSA disability requirements include:
- If you are working and your earnings average more than a certain amount per month, you may not qualify for disability benefits. If you aren’t working, or work but do not perform SGA, the Disability Determination Services (DDS) office may request additional information. They may also need periodic updates about your condition.
- Your condition must significantly limit your ability to do basic work-related activities for at least 12 months. Basic work-related activities are things like lifting, standing, walking, sitting, or remembering.
You can use the SSA Benefits Eligibility Screening Tool to find out which programs you may be eligible for.
There are some key differences in how disability benefits apply to children vs. adults, including eligibility requirements. Children may be eligible for SSI while adults are potentially eligible for SSI or SSDI.
“Since SSDI only covers people who have worked 5 of the past 10 years, only autistic adults can qualify,” explains Low-Beinart. “SSI covers disabled people in low-income homes, so an autistic child may qualify for this if their parents make less than a certain amount.”
Typically, a child stops receiving disability benefits once they turn 18 years of age unless they:
- have a qualifying disability
- are a full-time elementary or high school student until age 19
In some cases, conservatorship may be an option to maintain benefits, according to Low-Beinart.
“In the U.S., decisions about conservatorship are often made in conjunction with the team of mental and physical health supports for the child as part of their Individualized Education Program (IEP),” she explains. “You can submit a petition for conservatorship before the child’s 18th birthday in some states, however, they cannot be reviewed until after the child’s 18th birthday.”
If your application for disability benefits is denied, you can submit an appeal online. The appeal process can be difficult, and it may take some time to get approved, especially if you have a higher income.
If your application was denied for medical reasons, it can help to provide supporting documentation, such as:
- doctor visits
- therapy or neurology reports
If your application was denied for non-medical reasons, you can submit a non-medical appeal request. You can also contact your local Social Security Office or call the SSA toll-free at 1-800-772-1213 to request an appeal.
How do you discuss neurodivergence with an autistic child?
Talking with a child about being neurodivergent can be difficult. But you can help put them at ease by being open and understanding. Letting them know they are valued for being who they are is also helpful.
Low-Beinart recommends explaining that everyone has different neurotypes and that being neurotypical (i.e. fitting into the box of what society considers “normal”) doesn’t make one better than being neurodivergent.
“Encourage the child to share their feelings and experiences with others, as this discourages them from ‘masking‘ (hiding their autistic traits in order not to be bullied or discriminated against),” she says. “Masking in children is linked to worse mental health as an adult. Lastly, support them in exploring and obtaining accommodations they need in order to fully thrive.”
Autism is considered a disability from medical and legal standpoints, which may entitle you to certain government disability benefits.
Benefits differ for adults and children, and vary by state, so be sure to contact your local Social Security office, to understand what benefits you or your loved one may be entitled to.