Social Security Disability Benefits for Schizophrenia
Those suffering from schizophrenia must have medical records that show how they are limited in functioning socially, focusing on tasks, or in other ways.
Schizophrenia is a mental disorder that makes it difficult to think logically, interact socially in a normal way, pay attention, and distinguish between reality and delusions/hallucinations. People with schizophrenia usually have problems working or holding down a job. There are three main types of schizophrenia: paranoid, disorganized, and catatonic.
Can You Get Disability for Schizophrenia?
A simple diagnosis of schizophrenia is not enough to get disability benefits; an individual suffering from schizophrenia must be able to prove that the schizophrenic symptoms prevent him or her from working, despite taking anti-psychotic medication.
Schizophrenia Disability Listing
To help identify serious medical conditions, Social Security has a Listing of Impairments that list the criteria needed for each condition to qualify for disability. Schizophrenia is listed in the listing of impairments under heading 12.03, Schizophrenic, Paranoid, and Other Psychotic Disorders. In order to qualify for disability benefits based on schizophrenia, an individual must be able to demonstrate that he or she suffers from one of the following, on a constant or intermittent basis:
- delusions or hallucinations
- catatonic or grossly disorganized behavior (rigid muscles, unresponsiveness, or inappropriate actions)
- incoherent or illogical thinking (with inappropriate mood or flat speech), or
- emotional isolation and withdrawal from social interaction.
In addition, the individual must be able to prove, through medical records and/or work history, that the schizophrenic symptoms have resulted in a serious limitation on two of the following:
- ability to engage in activities of daily living
- ability to function socially (for example, maintain friendships)
- ability to focus on a task, and/or
- have recurring, lengthy episodes of worsening symptoms.
The disability criteria for schizophrenia are a reflection of the complexity of the medical condition itself. There are no biological tests that can be conducted to establish schizophrenia, although patients typically present high dopamine activity in the mesolimbic pathway, a neural pathway in the brain.
Alternatively, Social Security recognizes the broad range of symptoms associated with this disorder by setting forth a second set of criteria that can qualify those with schizophrenia for disability benefits. The individual must be able to show through medical records that he or she has a psychotic disorder that has lasted at least two years and has had a negative impact on his or her ability to work. In addition, the individual must show that the mental condition from which he or she suffers has impaired his or her ability to function in the world without a great deal of outside support; that is, living at home or in assisted living arrangements, and that either the individual suffers from episodes of decompensation or if the living arrangements were to change, the individual would suffer an episode of decompensation.
Those who have schizophrenia but are unable to meet the criteria of Social Security's listing for schizophrenia may still be able to win SSD/SSI on the basis of a "medical-vocational allowance." After all, there are plenty of people out there who suffer from schizophrenia who are not incoherent or completely disassociated from reality, but they still find themselves unable to hold a job. While many people who are schizophrenic exhibit stereotypical symptoms such as hearing voices, thinking everyone is out to get them (paranoia), or catatonia, there are also those who are simply unable to make normal associations, participate in normal social interaction, and maintain an organized thought pattern.
The medical-vocational allowance, or med-voc allowance, allows those who suffer from a schizophrenic condition that doesn't meet the requirements of a listing to get benefits if they can prove that their impairment is severe and ongoing (expected to last for a period of not less than twelve months) and that it prevents the person from doing even unskilled work. It often takes a qualified disability attorney to make this argument, particularly when it comes to appearing before an administrative law judge (ALJ) at a disability hearing. For more information, see our article on how Social Security decides if you can work with a mental condition.
What Are the Chances of Getting Benefits?
At first glance, it might appear that the criteria for schizophrenia are so broad it would be easy to meet them, but this is not the case. Medical records are often specific as to an individual's symptoms and the resulting limitations, but they seldom describe exactly how a condition prevents one from working, a concept that is key to being awarded disability benefits. Even disability examiners and judges who are well schooled in the criteria that must be met to qualify for SSD/SSI must refer to their manuals when it comes to conditions like schizophrenia -- the definition is so broad as to be open to quite a bit of individual interpretation. Interpreting the individual's medical records in a way that will persuade a disability examiner or judge that one is unable to work can be difficult.
Many schizophenrics actually get turned down after their initial disability application, but the overall allowance rate is over 80% for individuals with schizophrenia. Those who are able to manage the process of appealing and wait for a hearing date are usually successful in getting disability benefits.
Schizophrenics Should Get a Lawyer's Help
Disability applicants who have complex mental conditions like schizophrenia should consider hiring an experienced disability attorney to represent them; not only is schizophrenia a complicated disorder, but those who suffer from it are at a great disadvantage when they chose to represent themselves, particularly in light of the limitations this condition places on concentration, memory, and logical thinking. A disability lawyer can take over getting necessary medical records and doctors' opinions and can manage the hearing process for the applicant.