Facts about Autism and Filing for Disability
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1. Autism is a condition that occurs in early childhood development and inhibits social interaction and communication. It is part of a group of developmental disabilities called autism spectrum disorders (ASD), in which symptoms vary in range and severity.
2. The onset of autism starts in sometimes in infancy and sometimes in early childhood, in the toddler years of two - three.
3. Heightened awareness of autism among people in the United States is largely due to the rapid increase of diagnosis. The increase in numbers may be due to more knowledge, awareness and better detection, an unexplained increase in the condition, or possibly a combination of these factors.
4. Symptoms appear as problems in the three main areas of development, which are social, communication (language), and behavior. While autism varies in severity and each individual can exhibit very different skill levels, all autistic children experience difficulty in each of the three areas.
5. Social impairment may be seen in lack of eye contact, unawareness of others, not recognizing feelings, not responding and appearing not to hear when talked to directly, being withdrawn and not playing with others.
6. Communication and language impairment is exhibited through a delay in talking, abnormal or flat tone and rhythm in speech, inability to start and keep up with conversations, and repeating words and phrases without comprehension.
7. Behavior problems include repetitive movements, development of routines and rituals and difficulty with change in these habits, constant movement, fascination with specific parts of a machine like the wheels moving on a car, and over-sensitivity to sensory input such as light, sound and touch, while seeming to not feel pain.
8. The ability of those with autism can range from severely impaired with low levels of intelligence to high functioning and normal or high intelligence.
9. There are many differing views regarding autism in the United States due to lack of scientific knowledge about the causes of autism, and varying opinions of whether autism is a disability that needs a cure or a difference to be tolerated.
10. One popular belief is that early vaccinations, particularly those with the preservative thimerosal, cause autism. While extensive scientific research has failed to show this connection, many parents still resist vaccinations for their children.
Qualifying for disability benefits with this condition
Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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