Disability Benefits for Schizophrenia

 
Schizophrenia is a mental disorder that affects how an individual thinks, feels, and behaves. Roughly one in a hundred people in the United States have a version of this disorder. Several of these individuals with schizophrenia experience symptoms that prevent them from being able to work and maintain employment in the workforce, and may qualify for Social Security Disability benefits from the Social Security Administration (SSA).

 

About Schizophrenia

Schizophrenia is a disorder of the brain that disrupts how a person manages thoughts, handles emotions and behaves on a daily basis. People with the disorder often interpret reality abnormally and have difficultly determining what is real and what is imaginary. They may hear voices and see things that don’t actually exist as well as speak in strange and incoherent ways. Many people with schizophrenia have been known to stay still for hours without moving and some individuals may even withdraw from society to prevent human interaction. The symptoms of schizophrenia are divided into one of the three categories; positive, negative, and cognitive symptoms.

Positive Symptoms

These symptoms are psychotic behaviors that are abnormal in healthy individuals.

  • Hallucinations – Anything a person sees, hears, feels, tastes, or smells that doesn’t actually exist in the real world.
  • Delusions – False beliefs a person has despite factual evidence that proves otherwise.
  • Thought disorders – Abnormal and dysfunctional thought processes. Also known as "disorganized thinking."
  • Movement disorders – Unusual or unnecessary body movements.

Negative Symptoms

These symptoms are disturbances in emotions and behavior.

  • Social withdraw – The individual avoids interactions with other people including close friends and family as much as possible.
  • Lack of motivation or initiative – There is a loss of drive and motivation to begin or complete activities and previous goals.
  • Lack of pleasure in everyday life – Everyday life and previous hobbies that were once enjoyable now seem unsatisfactory or pointless.
  • Emotional unresponsiveness – The individual shows a lack of emotion in most situations such as talking in a monotone voice.

Cognitive Symptoms

These symptoms are disruptions in normal cognitive functioning.

  • Issues with executive functioning – Inability to understand information and utilize it.
  • Problems focusing – Inability to maintain attention.
  • Poor working memory – Inability to use information immediately after learning it.

Although the cause of schizophrenia is unclear, medical professionals believe that the illness is pasted down through genetics and can also be the result of chemical imbalances within the brain. There are currently no cures for schizophrenia but the condition can be controlled with medication and/or psychotherapy in several instances.
 

Subtypes of Schizophrenia

Previously before 2013, there were 5 different subtypes of schizophrenia recognized by the American Psychiatric Association. The subtypes are listed below.

Paranoid Schizophrenia – Characterized by hallucinations (typically auditory) and delusional thoughts of persecution or conspiracy.
Disorganized Schizophrenia – Characterized by disorganized thought processes, incoherent communication and unstable emotions.
Catatonic Schizophrenia – Characterized by unusual movement, whether it’s a significant increase in sporadic activity or a sudden decrease in movement.
Undifferentiated Schizophrenia – Symptoms of Schizophrenia are present but don’t meet the requirements for the other subtypes.
Residual Schizophrenia – Only positive symptoms are present but at a low frequency and severity.

However, due to the fact that diagnosed subtypes could change over time and many symptoms of subtypes overlapped, doctors were having problems diagnosing and treating people correctly. Therefore the system of subtypes lost creditably and the American Psychiatric Association changed how schizophrenia is classified.
 

Qualifying for Disability with Schizophrenia

To qualify for Social Security Disability benefits with schizophrenia, one must prove how the symptoms of the condition prevent him or her from being able to work, even while taking the proper medication. Many people diagnosed with schizophrenia can control the symptoms with medication or psychotherapy and could return to work, disqualifying them for benefits.

The Social Security Administration (SSA) has a guide known as the Blue Book that lists the requirements necessary for certain disabilities to qualify for benefits. Chapter 12 is about mental disorders and section 12.03 Schizophrenia, paranoid and other psychotic disorders lists the requirements needed for a person to qualify with schizophrenia despite taking medication. An applicant must satisfy requirements A and B or must satisfy requirement C.

Requirement A

Continuous or intermittent of one or more of the following:

  • Hallucinations or delusions
  • Catatonic or disorganized behavior
  • Incoherence or illogical thinking with blunt, flat, or inappropriate affects
  • Emotional withdrawal or isolation

AND:
 
Requirement B

Condition causes at least two of the following:

  • Severe difficulties in maintaining social functioning
  • Severe difficulties with focusing or concentrating
  • Significant limitations in the ability to engage in activities of daily living
  • Repeated episodes of decompensation of extended length

OR:
 
Requirement C

Applicant has at least two years of medical evidence about their schizophrenia disorder that shows it severely limits his or her ability to work and perform basic tasks as well as one of the following:

  • Repeated episodes of decompensation of extended length
  • Any increase in mental demands or change in environment can cause decompensation
  • One or more years of inability to function outside a highly supportive living arrangement

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    Medical-vocational Allowance

    Should an applicant with schizophrenia not meet the requirements listed within the Blue Book, he or she may still qualify through medical-vocational allowance. This means an applicant needs to be able to prove that their disabling condition is severe enough to prevent them from performing unskilled work. Unskilled work involves any job that requires little to no education or training to successfully perform that job. If an applicant’s symptoms prevent them from performing unskilled work, he or she will have a good chance at being approved for disability benefits.

    However, as with all disability claims to the SSA, there needs to be plenty of medical evidence to validate the claim. One of the best ways to find out if an applicant can perform unskilled work is to have their treating doctor fill out a mental residual functional capacity form. Having this form completed before applying for benefits can make the difference between an approval or denial of a claim in the initial stages.
     

    Medication Compliance

    The Social Security Administration (SSA) has a strict rule that requires applicants to try and take all medications and treatments offered by their doctor to attempt to control their condition. If an applicant has not attempted to use all medications and treatments suggested by their doctor, the SSA will deny his or her claim for benefits. This is because the SSA will assume the applicant’s schizophrenia could be controlled if they used the proper medication and/or treatments.

    Although if the applicant takes all prescribed medication and treatment options possible but they cause bad side effects or have no effect at all and needed to stop taking them as a result, will still be consider medication compliant due to the fact that they tried all available options.