SSI/Disability & Medi-waiver | Autism PDD

While some people are responding with answers specific to their state, I think it is important to understand the difference between the federal program and state programs.

SSI is a federal program. It does not change according to state.

Medicaid is administered by the state. It does have different benefits and qualifying factors according to the state you live in. It wouldn't hurt to apply for your state's Medicaid program at the same time you apply for SSI. But don't assume that you are applying for both just because you file an SSI application because they are completely seperate programs.

Medicare is a federal program. Once you or your dependent has been on SSI/SSDI for 2 years, he/she will automatically qualify for and receive Medicare.

If you decide to apply for SSI, it is important to know and list all of your child's diagnoses. I'm not sure if Asperger's is a qualifying condition, but the others may be. List them all out, whether or not you think they are qualifying conditions. Social Security will request your child's medical records and review them to determine what the diagnoses are. But if you don't list something, then disability benefits will not be considered for that condition. Your child may qualify based on one condition or a combination of conditions; that's why it's so important. It's also important that you know/state what your child's communication disorder is because that can weigh heavily in their decision.

I certainly understand the position you're in, as insurance has made it nearly impossible for me to get my son the help he needs. My out-of-pocket expenses are enormous, and private insurance doesn't cover most of the services my son's physicians say he needs. Be prepared however, that it will be more difficult to justify his case to Social Security if he hasn't been treated/evaluated in more than a year. They are looking for the most recent data to support his condition. If they can't find it, they will either order that more tests be performed or they will assume that your child has improved in the past year. The more professional documentation you have, the better your chances of getting approved.

CindyTN39175.5997800926

I've got my SSI intake this Friday. I'll let you know what I learn.

Wishing you all good luck and postive vibes in getting SSI.Just wanted to point out that Asperger's IS autism. Autism has a spectrum and aspergers certainly applies. It is a form of autism.

My son is diagnosed aspergers, and his forms clearly indicate that it is autism...

Hope that helps.

Hi! I am from Florida. Laws are different from state to state. Here children can apply for what is called the med-waver. That takes years to come through. However, I recently attended an ASA meeting that had members of the center for persons with disabilities and we were told the child had to have a diagnosis of Autism. Not pdd, aspergers or others, so start researching! It won't hurt!

ChrissyHi sabrys:

please call the social security administration at
1 800 772-1212 from 7 a.m.-7p.m. they'll able to answer your question if you qualify for SSI. It's based on your income until the child is 18 years old and then he/she can qualify on their own. It's worth a phone call to find out if you can qualify. It takes a while to get SSI once you qualify. Good luck.

The big bad woolf

I was recently told, by my son's school counselor, that we should apply for ssi/disability. I was under the impression that Aspergers did not qualify for ssi. He also has a communication disorder, ocd, anxiety, sensory issues, is in some special education and on some of his records he's classified as having autism on others it's classified as aspergers. Has anyone had any luck getting ssi for your children? Our main reason for even considering applying is for the disabled lable. While I don't like the lable, it will help out in the medical area. Right now our income is too high for medicaid, but we can't afford our company insurance (0 a week, yes weekly, not monthly!) So, right now, our son hasn't been able to get the necessary medical help he needs. He's not been to the doctor or counselor, except for a regular physical in over a year. However, if he were listed as disabled, we would qualify for medical assistance. Any suggestions and help is greatly appreciated.

Sabrys39156.539212963Oh, yes the glorious Indiana Medi-waiver. We went through the screening process two years ago, were denied and have been told to apply again. Of course given the states waiting time, 7-10 years, my son will be 18 by the time he gets it, if we would even be approved this time. I don't know about other states, but these are the requirements in Indiana

Meet Medicaid (also called the Medicaid “State Plan”) income eligibility requirements (Note: parental income and resources are disregarded for children under 18 years for all of Indiana’s Medicaid Waivers, although the assets and resources of the recipient are taken into consideration.); and
Meet the criteria required for admission to a long-term care facility (even though the person lives and will continue to live in their family home, his/her own home, or a licensed Foster Care Home in the community); and
The total cost to Medicaid for home-based services cannot exceed the average cost of serving an individual in a long-term care facility

Number two is where we fell short last time. Logan is just not severe enough to meet the requirements for a long term care facility.