Supplemental Security Income (SSI, and formerly known as SSDI) is the name given to Title XVI of the Social Security Act of the United States of America. It is similar to Title II in that it is directed at individuals who are disabled and cannot work; however, qualifications differ significantly.
Title II, known as Disability Insurance Benefits, is a Social Security Insurance program workers pay into with each pay check. An individual earns points each year of working and earning substantial gainful activity (SGA). If that individual becomes disabled and can no longer work, and has enough points, then Title II can be collected.
Title XVI works differently. It is not an insurance program. In fact, it works similar to welfare. If an individual becomes disabled and can no longer work or meet SGA, but does not have enough points to qualify for Title II, then an application can be submitted for SSI.
In both cases, disability and the inability to work or meet SGA must be established. This is primarily met through official medical records; however, secondary evidence, such as witness testimony and portfolio assessments of SGA ability are also considered. If an individual has a monthly income of over $1,000/month or assets that can be turned to cash (i.e. vacation home, extra property, secondary vehicle), then a claim can be denied.
The process for getting approved can be lengthy and arduous. Currently, the national average for a claim to become approved and a check issued is about three-to-four years. Most individuals lack sufficient evidence to get approved from an initial application, which causes a bottle neck effect of individuals waiting for a judicial hearing with an extremely small amount of judges.
Autism and SSI
Individuals with autism spectrum disorder (ASD) can and do get approved for SSI. Yet, people debate whether individuals with ASD should get SSI or not. Is ASD a disability that can effect the workplace and social interactions with co-workers and customers? Yes, it is. Are individuals with ASD typically paid less then non-disabled peers preforming the same tasks? Yes, they are. However, that does not mean SSI is always the appropriate answer.
SSI limits a person’s growth and ability. For some, it is an accurate representation of the limits the disability has imposed on them. SSI works great for so many people, and in no way is it a waste or an insult. However, SSI can be a limitation in a negative way when it is used inappropriately. Research has shown that many individuals with ASD can be successful in the workforce. Many can preform tasks that can earn SGA that would disqualify them for SSI.
Why then do so many individuals with ASD choose to go on SSI?
First, and most importantly, SSI automatically qualifies individuals for Medicaid. The average cost of yearly medical expenses per individual with ASD is around $10,000, according to the Center for Disease Control (CDC). Since many insurance companies do not cover all of the needed medical attention that individuals with ASD require, Medicaid becomes vital in acquiring needed doctor visits and treatment.
Second, laws around the country exist that allow employers to pay individuals with ASD below minimum wage for their efforts. This acts as an incentive to hire individuals with disabilities, since many believe that people with ASD and developmental disabilities cannot complete the same amount and quality of work in the time in which a neurotypical person works. Many support agencies and schools contribute to this belief by matching individuals with ASD and developmental disabilities to jobs outside their skill set in order to keep SSI in place.
How do we help individuals with ASD succeed in the workforce and not need SSI?
To start, Medicaid and insurance reform is needed. I am not an expert in public policy; therefore, I have no proposed solutions for this problem. However, requiring an individual to live in poverty and earn below minimum wage in order to get health coverage can no longer be an appropriate answer.
Public perception can influence public policy when it comes to Medicaid access. Connecting individuals with ASD to jobs that match their skills and special interest areas (SIA) is the best thing professionals can do. Better skills and strengths assessments can lead to higher paying jobs. Take Dr. Sheldon Cooper (portrayed by Jim Parsons on The Big Bang Theory) as an example. While Dr. Cooper has the academic skills to succeed as a doctor, engineer, or lawyer, he lacks the social skills to excel in those fields. However, as a physicist he is not required to engage in the same type or amount of social skills as the previously mentioned professions, which allows him to excel in his current field.
Many individuals can excel in workforce if parents, professionals, and community members believe they can. SSI is great for so many reasons, including Medicaid. However, it should no longer be the first option for individuals with ASD. Perceptions need to change. Policies need to change. And professionals need to work to find better employment opportunities and employers for individuals with ASD so that SSI is not needed.