Applying for Disability Benefits for Adults with Development Disability

Developmentally disabled adults may be able to receive disability benefits from the Social Security Administration (SSA), even if they have a limited work history or no work history at all. Additionally, those who have worked in the past, or who hold a part time or other job now, may also be able to receive Social Security Disability (SSD) benefits through two different disability programs:

  • Supplemental Security Income (SSI)
  • Social Security Disability Insurance (SSDI)

SSI and SSDI Benefits

When applying for benefits on behalf of a developmentally disabled adult, you can submit an application for SSDI and SSI simultaneously and the SSA will consider eligibility for both programs at the same time. To be eligible, the SSA must determine that the individual meets both the medical and the technical/financial rules for one or both programs.

  • SSI is a need-based program that requires the applicant has very limited financial resources, including income and assets, though only certain types of income and assets are “counted” when determining eligibility. Learn more about SSI benefits.
  • SSDI is a program which is designed to pay benefits to disabled workers (and in some cases, their dependents). In order to qualify for this program, an applicant must have a work history during which he or she has paid Social Security taxes (FICA).

It’s also important to understand that developmentally disabled “adult children” can, under some circumstances, qualify for SSDI benefits under the work record of a parent or legal guardian.

Medically Qualifying for Benefits

The SSA will need to see very specific medical records from you, including documentation that meets the requirements outlined in the Blue Book, which is a manual used for evaluating SSD applications.

There are several developmental disabilities (DDs) that can meet the SSA’s medical eligibility requirements. All DDs are evaluated under one of the following listings:

Intellectual Disabilities – Section 12.05Autistic disorder and other pervasive developmental disorders  – Section 12.10

Even if the condition of the individual for whom you are applying for benefits does not exactly match one of these listings, he or she can still potentially receive SSD benefits by closely matching a listing.

It is also possible to be approved for benefits after an evaluation of “residual functional capacity”, which essentially means the SSA looks at the applicant’s everyday abilities and determines whether or not his or her impairment prevents gainful employment due to the physical, mental, and emotional limitations it causes.

To qualify for disability benefits with an intellectual disability, the applicant’s medical records must show he or she has:

  • An IQ of 59 or lower

OR

  • An IQ of 70 or lower, accompanied by another physical or mental impairment that prevents gainful employment

OR

  • An IQ of 70 or lower, with marked restrictions in functioning socially, communicating, caring for oneself, or otherwise functioning on a daily basis.

Qualifying for benefits with autism or another pervasive developmental disability requires medical evidence that shows:

  • For autism, pronounced deficits with interacting socially, communicating, and participating in a normal, varied range of activities

AND

  • Marked difficulties with at least two of the following:
    •  activities of daily living
    • social functioning
    •  concentrating or completing tasks
    • episodes of decompensation, where functioning is even more severely impaired

OR

  • For other pervasive developmental disorders, medical records must document the same marked difficulties outlined above

AND

  • Pronounced deficits with interacting socially, communicating, and in participating in imaginative activities

Applying for Benefits

When you apply for disability on behalf of an adult with a developmental disability (DD), you must submit medical records and must also thoroughly complete the SSA’s application, which requires:

  • information on medical, education, and work history
  • financial details of the applicant’s income and other financial resources
  • details on the everyday living situation of the individual

AND

  • details regarding his or her activities of normal daily life.

Though you can complete an online application for SSDI benefits, you must complete a personal interview appointment at the local SSA office if you are applying for SSI benefits. For this reason, most people who are applying for benefits for an adult with a developmental disability choose to apply in person and complete both the SSDI and SSI application processes at the same time.

  • To schedule an appointment, call 1-800-772-1213

OR

Article by Ram Meyyappan
Social Security Disability Help