This information may help claimants with representation, as well as claimants who are not represented by an attorney or non attorney representative. Understanding how the Social Security Disability system works, of course, can make the difference between winning or not winning the benefits and backpay to which a person is entitled. More information may be found at the social security disability blog. |
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Schizophrenia is a medical condition listed in the official Social Security official list of impairments, or the blue book, as it is more commonly called. Schizophrenia falls under heading 12.03, Schizophrenic, Paranoid, and Other Psychotic Disorders, and the criteria that must be proven to meet this listing are complex, to say the least. In fact, the description of schizophrenia listed in the blue book is complicated enough to make this condition a perfect example of why so many who file for Social Security Disability (SSD) or SSI can benefit from legal representation. In order to qualify for disability benefits based on schizophrenia, an individual must be able to demonstrate that he or she suffers from delusions or hallucinations; or disorganized or catatonic behavior; or a pattern of incoherent or illogical thinking (as evidenced by inappropriate mood or flat speech, etc.; 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 symptoms associated with schizophrenia have resulted in a marked limitation on his or her ability to engage in activities of daily living or to hold a job. Thus, although schizophrenia is listed in the blue book, a claimant must be able to demonstrate, through his or her medical records, not only that he or she suffers from this condition, but that it prevents him or her from participating in substantial gainful activity (earning a minimum dollar amount each month, an amount that is determined annually by the Social Security Administration). Medical records are key to proving any claim for Social Security disability, but interpreting those records in a way that will persuade a disability examiner or judge that one is unable to work can be difficult, particularly when the severity of a condition’s limitations are up for interpretation. There are plenty of people out there who suffer from schizophrenia who are not incoherent or completely disassociated from reality, but still find themselves unable to hold a job or at least unable to hold a job at which they could earn the substantial gainful activity (SGA) amount. 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. These criteria are-- 1. 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. 2. 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; i.e., those who must live at home, those who are unable to leave their home environment to seek or sustain employment; those who are require assisted living arrangements, etc. At first glance it appears 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 symptoms and the resultant 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. Claimants who have complex physical or mental conditions like schizophrenia should really consider retaining 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. 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. They also tend to respond to treatment with medications that suppress dopamine activity, antipsychotics such as the drug cholorpromazine, which was discovered to be effective for treatment of schizophrenia in the 1950s. However, only about 1 percent of the population is diagnosed schizophrenic, and this diagnosis largely depends on the observations and opinion of the treating psychiatrists or psychologist. People who are schizophrenic may exhibit stereotypical symptoms such as “hearing voices,” thinking everyone is out to get them (paranoia), catatonia, or may be unable to make normal associations, participate in normal social interaction, or maintain an organized thought pattern. Any one of the latter symptoms, while less impressive than the image of someone talking to invisible voices alá Norman Bates in the movie Psycho, could prevent someone with schizophrenia from holding a job, and thus earning the minimum SGA amount. Those who have schizophrenia but are unable to meet the criteria of listing 12.03 may still be able to win SSD/SSI on the basis of a medical vocational allowance. The medical vocational allowance, of Med-Voc allowance, allows those who suffer from a condition not listed in the blue book to be compensated for their loss of wages, if they can prove that their impairment is severe, and ongoing (expected to last for a period of not less than twelve months). Again, 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. Disability Advocates Help with Claims Free Case Evaluation |
