Is High Functioning Autism Classified as a Disability?

High-functioning autism refers to individuals on the autism spectrum who possess average or above-average intelligence. Living with this condition presents unique challenges in the context of disability determination. The question of whether high-functioning autism is considered a disability is multifaceted, involving medical, legal, and social considerations. For potential Supplemental Security Income (SSI) applicants, understanding the nuances of this issue is essential for effectively pursuing disability benefits.

At Sackett & Associates, our entire legal practice concentrates only on disability law. Our extensive experience includes years of representing a total of thousands of clients with an expansive array of different impairments, including high-functioning autism. We understand the complexities and nuances of the law and all the Social Security Administration’s (SSA) regulations. If you need assistance or legal guidance preparing, filing, or arguing for SSI benefits for someone living with high-functioning autism, let us help you get the disability benefits to which you are entitled.

Medical and Diagnostic Criteria

High-functioning autism is not a formal diagnostic term in the medical community. Instead, it refers to individuals diagnosed with Autism Spectrum Disorder (ASD) who do not exhibit significant intellectual disabilities. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), ASD is characterized by persistent deficits in social communication and social interaction, alongside restricted, repetitive patterns of behavior, interests, or activities. The severity of these symptoms can vary widely, and individuals with high-functioning autism typically exhibit milder forms of these behaviors.

Despite possessing higher cognitive abilities, individuals with high-functioning autism often still face significant challenges. These can include difficulties in social interactions, maintaining employment, and managing daily life tasks independently. The presence of these challenges can play an important role in determining whether high-functioning autism is considered a disability for SSI purposes.

Legal Definition of Disability

Under the Social Security Act, disability is defined as

any medically determinable physical or mental impairment that lasts or is expected to last 12 months and prevents the person from performing substantial gainful activities (SGA).

This definition is crucial for determining eligibility for SSI benefits.

To qualify for SSI based on autism, an applicant must provide medical evidence demonstrating that their condition meets or equals the criteria listed in the Social Security Administration’s (SSA) Blue Book. Specifically, Section 12.10 of the Blue Book addresses Autism Spectrum Disorder. The criteria includes:

1. Deficits in social interaction and communication.
2. Restricted, repetitive patterns of behavior, interests, or activities.

In addition to those impairments, the applicant must show that these symptoms result in either:

1. Extreme limitation in one, or marked limitation in two, of the following areas of mental functioning:
   1. Understanding, remembering, or applying information.
   2. Interacting with others.
   3. Concentrating, persisting, or maintaining pace.
   4. Adapting or managing oneself.

As an alternative, the claimant must demonstrate a comprehensive inability to function independently outside the area of one’s home.

Challenges in Proving Disability

One of the significant challenges faced by individuals with high-functioning autism when applying for SSI is the requirement to provide sufficient evidence of their limitations. Despite their cognitive strengths, these individuals may still experience significant functional impairments that impact their ability to work and carry out daily activities.

1. Documentation and Medical Evidence: Comprehensive medical documentation is essential for a successful SSI claim. This includes detailed records from healthcare providers, psychological evaluations, and, if applicable, educational or occupational therapy reports. These documents should outline the applicant’s specific limitations and how these limitations affect their daily life and their ability to work.
2. Personal Statements and Third-Party Testimony: Personal statements from the applicant, as well as third-party testimony from family, friends, or employers, are sources of valuable insights into how high-functioning autism impacts the individual’s life. These statements should state specific examples of difficulties the claimant faced in social interactions, job performance, and managing their daily tasks.
3. Functional Assessments: Functional assessments conducted by professionals, like occupational therapists or vocational experts, can also provide powerful support to an SSI claim. These assessments should relate the results of evaluations of the individual’s ability to perform various tasks and identify specific areas where limitations exist.

Role of a Disability Law Attorney

Given the complexity of proving disability for individuals with high-functioning autism, Sackett & Associates welcomes contact from either the claimant with high-functioning autism themselves or from someone working on their behalf. As experienced disability law attorneys, our knowledge or the law and years of working on similar SSI claims can be highly beneficial. Our skilled disability attorneys and highly trained staff will gather the necessary documentation, prepare and file the claim complying with the SSA’s requirements, and present a compelling case for the SSA to approve the award of benefits.

Sackett & Associates helps applicants understand the specific criteria they need to meet and assist in compiling comprehensive evidence to support their claim. And we represent the applicant in hearings or appeals, always actively advocating on their behalf to ensure their case is effectively presented.

High-functioning autism presents unique challenges, and it is important to recognize that despite higher cognitive abilities, individuals may still face substantial difficulties in social, occupational, and daily functioning. Professional disability lawyers like Sackett & Associates work with the SSI claimants preparing and presenting well-documented and compelling cases to the SSA.