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SSI Appeal help needed- just received denial letter for Autistic son with severe Anxiety and Sensory issues.

Rocklin, CA |

In the last year finally diagnosed with Autism Spectrum Disorder(high Functioning) and Severe anxiety. child is 5- attended pre-k where he had a 'modified day' only went a portion of the time of the others and now goes to a special outdoor school due to his struggles. We applied for SSI 3/2012 and were approved in 4/2012, 3 weeks ago we were asked to go to a medical eval. by a psychologist and i just gt a letter in the mail from ssi stating that hes not 'disabled under our rules' 'although (childs name) has been diagnosed with ASD, hes shown normal milestones. Also hes been diagnosed with Aspergers Disorder. He is imprving with prescribed treatment and Dr. Applebaum (whom is his general physician and met him only twice ever keep in mind) indicates he does well with do i appeal??

Basically, I strongly disagree with this decision, ive never been or have ever even known anyone whos received SSI or even been disabled for that matter- i need to be with my son constantly due to his Autistic Struggles leaving our annual income at less than 25,000 yr. Please help! i dont even know what to include in an Appeal letter or documents to fill out if there are any? all i know is that i have 60 days to figure it out and complete it- the letters dated 8/21/12 which i received today-8/24/12, any pertinent information would be deeply appreciated, thank you.

Attorney Answers 3

  1. An attorney who knows the disability criteria for SSI could help; most take cases on a contingency basis, which means no money to the attorney unless your son is awarded disability. Contact your local Bar Association or National Organization of Social Security Representatives for names of attorneys who do social security/SSI disability cases.

    Generally, SSI disabilty for children considers how well the child does in six areas of functioning:
    (i) Acquiring and using information;
    (ii) Attending and completing tasks;
    (iii) Interacting and relating with others;
    (iv) Moving about and manipulating objects;
    (v) Caring for self; and,
    (vi) Health and physical well-being.
    Functioning in at least two of these areas must be markedly or severely impaired.

    There are also income and resource limitations for the child and parent(s).

    This communication does not establish an attorney-client relationship. This communication offers general information based on the limited facts set out in the question, and does not constitute the giving of legal advice. For specific legal advice, consult an attorney in your state who is knowledgeable in this area of law.

  2. Based on the timeline you described (applied in March, approved in April, denied in August), it sounds like your son got a "presumptive disability" approval at first, and was then denied. Instead of going through the entire decision-making process, Social Security has a list of conditions, including certain ASD cases, where they will start paying benefits before they make a complete determination of disability. They will pay benefits for up to 6 months due to a "presumptive disability" while they're working on making their decision. You don't have to repay those benefits if they later deny you, and you have normal appeal rights.

    Ms. Hamilton has correctly stated the criteria for a child's disability case, and I agree with what she says about hiring an attorney. In practice, it's sometimes rather difficult to find a Social Security attorney who will work on a child's case. They are generally considered to be more difficult than adult cases.

    For now, the most important thing to remember is that 60-day appeal deadline. There is nothing special that you need to say on the appeal form to keep this moving forward - all you need to do is fill out the appeal form, and in the space provided for an explanation, just say "I disagree with the decision," or something like that. File that appeal as soon as possible, in my opinion, because it keeps things moving towards an eventual hearing with a Social Security judge, which is where you get a real chance to prove your son's case. You'll want to hire an attorney well before the hearing, so he or she has time to gather evidence and prepare. Most Social Security attorneys work on a contingency fee, so you shouldn't have to come up with any money up front to hire one.

    Good luck to you and your son.

    Jeremy Bordelon is a licensed attorney in the State of Tennessee only, and is authorized to practice in all Tennessee State and Federal courts, and before the Social Security Administration in any jurisdiction. Please call our firm at 1-866-959-5362 if you would like to discuss your case in more detail. The answers provided on are for information purposes only, and should not be relied on as legal advice. This answer does not create an attorney-client relationship between us. In some jurisdictions, this answer may be construed as attorney advertising.

  3. My colleagues are both correct. I also have some concerns about financial eligibility - but talking to a local attorney about this at the same time you talk about the medical eligibility would be smart too.

    You may want to talk to an attorney in your area so you can review the specific facts with counsel. You may contact your local city, county or state bar association to see if they have a lawyer referral program, or you may contact the National Organization of Social Security Claimants' Representatives (NOSSCR) for the name and email address or telephone number of attorneys in your area. Most attorneys who do any amount of Social Security work are members of NOSSCR and provide a free initial consultation. In any event, no attorney may charge a fee for work on a social security claim until it has been approved by Social Security. The fee limit is a maximum of 25% of past due or back due benefits you are owed, and many lawyers charge less than the full 25%, and the money is not paid until your claim has been approved.

    The telephone number for the lawyer referral service of NOSSCR is 1-800-431-2804. NOSSCR's website is

    In addition, you can find a Board certified specialist in Social Security by contacting the National Board of Trial Advocacy. They evaluate lawyers (independently) in many types of claims and require extensive experience and testing before a lawyer is certified. They have a section specifically for Social Security: The National Board of Social Security Disability Advocacy, Divisions of the National Board of Legal Specialty Certification.

    Their link is:

    You may also contact NADR (National Association of Disability Representatives) – automated Telephone Referral System at 1-800-747-6131

    I hope this information helps. Good luck to you!
    Please remember to designate a best answer to your question.

    The exact answers to questions like this require more information than presented. The answer(s) provided should be considered general information. The information provided by this is general advice, and is not legal advice. Viewing this information is not intended to create, and does not constitute, an attorney-client relationship. It is intended to educate the reader and a more definite answer should be based on a consultation with a lawyer. You should not take any action that might affect your claim without first seeking the professional opinion of an attorney. You should consult an attorney who can can ask all the appropriate questions and give legal advice based on the exact facts of your situation. The general information provided here does not create an attorney-client relationship.

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