A Guide to Applying for SSI
Applying for SSI
There’s a lot out there on the eligibility criteria for SSI. And even more about how to apply. But there is so much, it’s almost like trying to drink out of a firehose. So I will help you by summarizing the main points here (and give you a little tip 😉).
Disclaimer:
· Rules, requirements, and procedures are ever changing. It’s the applicant’s responsibility to confirm application needs and procedures with the source at the time of their application.
· Note the date of the blog when interpreting this information.
· No one can guarantee any specific decision from any agency.
· The information below is a simplified summary and is not intended to be exhaustive.
· This information is offered as a guide, but it is the applicant’s responsibility to review official sources and decide about each step of the application process themselves.
SSI is for low-income people with disabilities that affect their ability to work (for adults over 18), and who have not worked enough in the past to have earned enough credits toward SSDI. Children are a different thing altogether. When a child is under 18 their parent’s income is taken into consideration so it’s really only low-income families who’s disabled child will qualify. But once a child turns 18 the parent’s income is no longer a factor. I will be mostly be talking about applications for adults in this blog, although a lot of this also applies to children under 18 also. One tip: if you are just now thinking of applying for SSI for your older teen, it may make sense to wait until just before their 18th birthday so their eligibility will be considered as an adult.
Also, while people qualify for SSI based on many disabling conditions, our crowd is mostly ASD and other neurodiversities, so I will be speaking to that demographic.
OK – here we go……..
Qualification summary
To qualify for SSI based on a condition like autism spectrum disorder (ASD), ADHD, intellectual disability, etc., the applicant must show that the condition meets these key criteria:
· Severely limits the client’s ability to work or function independently
· Is medically documented and expected to last at least 12 months (or be permanent)
And that they are of low income and have low assets.
Diagnostic requirements
There is a specific Social Security Administration (SSA) listing for Autism in the "Blue Book" (Listing of Impairments):
Listing 12.10 – Autism Spectrum Disorder
To qualify under this listing, a client will need:
A. Qualitative deficits in:
Verbal communication
Non-verbal communication
Social interaction
Development/maintenance of relationships
AND
B. Extreme limitation in 1 or marked limitation in at least 2 of the following:
Understanding or applying information
Interacting with others
Concentrating or maintaining pace
Adapting or managing oneself
**The applicant needs medical evidence, like evaluations from psychologists, neurologists, or developmental specialists.
Other Diagnoses: ADHD, Intellectual Disability, etc.
These may also qualify under different SSA listings, like:
12.11 – Neurodevelopmental disorders
12.05 – Intellectual disorder
**Same idea: The applicant needs medical documentation, functional limitations, and proof that it affects the applicant’s ability to work.
But….. SSA won’t approve based on a diagnosis alone. They focus on how much the condition impacts the applicant’s ability to function and earn income.
Functional limitations matter more than just the right diagnosis
What counts as a “disabling” level of autism or neurodivergence?
What kinds of functional limitations are looked at.
The applicant doesn’t have to be completely nonverbal or totally dependent — but SSI is for those whose condition significantly limits daily functioning, like (these are examples and are not exhaustive):
Can’t maintain a job due to challenges with communication, focus, or adapting to change
Needs supervision for daily tasks (even if this consist of regular quick checks and reminders)
Difficulty with self-care, organization, or social interaction
**Yup - the applicant needs medical documentation, functional limitations, and proof that it affects the applicant’s ability to work.
What the applicant will need to apply
Diagnosis documentation from qualified professionals
(I like to call these “the guys with fancy letters after their name”).
Detailed medical records (psych evals, school records if recent, therapy reports)
You should be entering information about impacted functional abilities into the medical record by talking to the applicant’s doctor, in preparation for the SSI application.
Statements from (these are examples):
Doctors or therapists
Social workers
Family or caregivers
School personnel (for transition aged youth – from high school or transition program)b
Others who work
These records and statements (and any other documentation) should include info about how the applicant’s condition affects their daily life (ADLs, or activities of daily living) and ability to work.
Financial situation
First: the SSA looks at countable income, not just the applicant’s paycheck.
Income
The applicant also needs limited income
What counts as income?
Earned income (wages, self-employment)
Unearned income (Social Security benefits, unemployment, gifts, support from others)*
In-kind support (free food, rent, utilities)*
*more on these below.
What doesn’t count?
These amounts are not counted when SSA figures the applicant’s income:
First $20/month of most unearned income
First $65/month of earned income, plus half of the rest
SNAP (food stamps)
Tax refunds
Small amounts of irregular or infrequent income
Resources:
Second: the applicant also needs to have limited assets or resources (the stuff the applicant owns, not what the applicant earns).
2024 SSI Resource Limits:
$2,000 or less for individuals
What Resources Count?
Cash
Bank accounts
Stocks, bonds
Property (other than the applicant’s primary home)
Extra vehicles (over just one)
What doesn’t count?
The applicant’s home
One vehicle (if used for transportation)
Personal belongings
Certain burial funds or life insurance
ABLE accounts (for people with disabilities)
Financial planning for the SSI application for an adult client
If the applicant is over these limits (especially if they have support from parents/family), SSA might deny the applicant’s claim — but planning is possible to avoid landmines.
There are lots of financial landmines in the application process. Keep these tips in mind.
· Your now adult disabled child doesn't live with the you, per se, they RENT a room from you at market rate (this is tricky as market rate, especially in many areas in California, may exceed the monthly SSI allowance, and then the overage, which presumable someone else helps the SSI recipient pay, is considered an in-kind resource. So, choose something that is doable and is in line with the area, rental space in question, comp rental rates, and household expenses). If they are in fact living in your household you will take their rent from their SSI check every month. This way they are not receiving in-kind resources in the form of rent.
· And you are LENDING them the money for their rent now and during the SSI process, which you are expecting to be paid back.
· The old rules also counted food as in-kind support. So, under the old law you didn’t feed them, they BOUGHT their own food that was separate from the households. However, effective September 30, 2024, the Social Security Administration (SSA) now no longer considers food received from others as countable income when determining SSI eligibility and benefit amounts. I mention it though because new rules sometimes have a “breaking in” period….so I would tread carefully around this topic.
*These positions might seem harsh. But think about neurotypical young adults. They are out there renting their housing, having jobs, and paying their own way to some degree. Your arrangement with the applicant needs to reflect this reality.
· Also make sure any assets they have, like money in bank accounts or investment accounts are transferred to CalABLE before the applicant applies for SSI, or are below $2000 (a figure set in the 70's and never updated).
*Keep in mind it is completely legal for you or anyone else to contribute to the SSI recipient’s CalABLE account any amount of money you choose, up to the annual gift amount of $19,000 per year and up to $100,000 in total to remain exempt as a resource for SSI. This gift may affect your taxes so check with your accountant.
Advantages of Hiring a Disability Attorney
It makes a lot of sense to hire a disability attorney. Hiring a disability attorney to help with the SSI application can seriously improve the chances of being approved — especially if the application for SSI is based on a condition like autism, ADHD, or other neurodivergence. Here’s why:
1. They know the system & the rules
The SSI process is notoriously confusing. A disability attorney:
· Knows exactly what the Social Security Administration (SSA) is looking for
· Understands how to build a case that meets their medical and functional criteria
· Can help avoid paperwork mistakes that lead to delays or denials
2. They guide you and/or help you gather the right evidence
Attorneys can:
Collect and organize medical records, evaluations, and treatment history
Get supporting statements from doctors, therapists, or caregivers
Make sure the applicant’s paperwork highlights how their condition affects their daily life and work ability
The SSA doesn’t just want a diagnosis — they want proof of how it limits the applicant. A disability attorney knows how to show that clearly.
3. Working with an attorney may speed up the process (and reduce stress)
Help the applicant avoid common mistakes
Track deadlines and respond to SSA notices
Reduce the emotional stress of navigating it alone
4. They represent the applicant if they’re denied
Most initial SSI claims get denied. Attorneys:
File appeals
Represent the applicant at a hearing before a judge
Present the applicant’s case professionally with expert legal arguments
5. The applicant doesn’t pay unless they win
By law, disability attorneys work on a contingency basis, meaning:
No upfront cost
They only get paid if the applicant is awarded benefits
The fee is usually capped at 25% of the applicant’s back pay, up to a max (currently $7,200)
(back due is calculated from the date of presumptive approval to the date of the first payment, which can be many, many months).
Ok – I think that will do it – a brief summary of an SSI application. Good Luck!