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Schizophrenia and Disability: What to Know for SSDI

By August 15, 2024September 12th, 20245 min read

Schizophrenia is a psychotic mental disorder that alters your perception of reality, makes normal social interaction difficult, and causes challenges when thinking logically and controlling behavior. This condition is considered a spectrum disorder, which means it affects each individual who suffers from it differently. While it is possible for some people experiencing schizophrenia to work, not everyone responds to treatment the same, which can even make it difficult for those with high-functioning schizophrenia to hold down a job. Trying to obtain Social Security Disability Insurance (SSDI) for mental illness is notoriously difficult, especially for younger people. You may be denied initially even if your claim is valid.

Common Symptoms of Schizophrenia

Even though schizophrenia is a serious mental health condition, many people don’t automatically realize they have it or need treatment to manage their illness. Common symptoms impact how people think, feel, and behave, including:

  • Social isolation: Withdrawal from social interactions
  • Disorganized thinking and speech: Difficulty organizing thoughts and expressing them clearly. Thoughts may be verbalized in a flat or inappropriate tone
  • Odd mannerisms or beliefs: Unusual behaviors or beliefs, especially ones that are out of character for the person
  • Hallucinations: Perceiving things that aren’t actually there, such as hearing voices or seeing things
  • Paranoid delusions: Fixed and false beliefs, including the feelings that the person is being persecuted or controlled by others
  • Difficulty paying attention: Problems concentrating or focusing

Prior to the updated DSM-5, schizophrenia was categorized into five types: paranoid, disorganized, catatonic, undifferentiated, and residual. The features that define each of these types are still important for a diagnosis but are no longer viewed as separate subtypes.

Can You Get Disability for Schizophrenia?

If you are trying to qualify for disability benefits through the Social Security Administration (SSA), it’s not enough to simply be diagnosed with schizophrenia. You must prove to the SSA that your diagnosis makes it impossible for you to work, even with treatment. At present, schizophrenia must be diagnosed by a mental status examination and applicants must meet the following qualifications:

  • Medical documentation of at least one or more major symptoms, including delusions or hallucinations, disorganized thinking and speech, or catatonia, in addition to an extreme limitation of one or a mild limitation of two mental functioning symptoms, such as the ability to: understand, remember, and apply information; interact with others; concentrate, persist, or maintain pace; and adapt or manage oneself.
  • Your documented schizophrenia is considered both consistent and severe for at least two years. You must also have evidence of medical treatment, such as therapy or psychosocial support, that helps address your condition as well as demonstrate marginal ability to adapt to changes in your environment or daily life.

Why Was My Schizophrenia Disability Claim Denied?

There are a few common reasons why the SSA might deny your schizophrenia disability claim. Your first challenge could be a lack of a diagnosis. Even if you see a psychiatrist regularly, if your doctor has not explicitly diagnosed you with schizophrenia, your claim will not go any further. Similarly, if your doctor’s notes are illegible or lack enough details, the SSA will deny your claim.

Treatment history may pose another hurdle. SSA will look closely to see what treatments you have tried in the past and their effect on managing your condition. They’ll also want to know if these treatments impacted your ability to work. Unfortunately, schizophrenia treatment can be expensive and the SSA doesn’t care if you cannot afford tests or medications. If you do not follow the treatment as prescribed, the SSA might view your actions as non-compliant and deny your claim. If you are unable to afford your treatment, seek out free or reduced-cost healthcare providers. Otherwise, you’ll need to explain to the judge at your hearing the reason why you cannot follow through on treatment is financial.

It’s also possible SSA may still consider you employable even if you have demonstrated that you cannot perform the duties of your previous job. The standard for SSDI is not whether you can work in the same capacity as you did before your diagnosis, but rather whether you can work at all, even in a completely different job, as long as your current skills are applicable. The SSA may find you retain the mental residual functional capacity to work and deny your claim.

How to Improve Chance of Acceptance

To improve your chances of getting awarded SSDI or Supplemental Security Income (SSI) benefits, be sure your medical records include clearly stated opinions concerning your ability to work from your psychiatrist or psychologist. You’ll also want records from hospital visits, clinic visits, and psychological tests.

Since there is no current cure for schizophrenia, the disorder typically requires lifelong treatment. Keep a list of every treatment you’ve tried as well as how they affected your symptoms. This should include documentation of all your medications, when they were prescribed, and how often you take them.