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Why Did My Schizophrenia Disability Claim Get Denied?

Trying to obtain disability benefits through Social Security Administration (SSA) for a mental illness is notoriously difficult, especially for younger people, and many who apply are denied initially.  If you suffer from schizophrenia, your odds of getting approved increase substantially at the hearing stage of your claim.

There are a few common reasons why SSA might deny your schizophrenia disability claim, and we will discuss them here.  While the criteria for meeting SSA’s schizophrenia listing in the Blue Book are broad, medical records need to be precise and specific to you, and SSA employees will constantly be looking to see that your records support your claim completely and, therefore, make you a credible applicant.

Your first challenge might be a lack of a specific schizophrenia diagnosis.  Even if you see a psychiatrist regularly, if he or she does not explicitly state that you’ve been diagnosed with schizophrenia, your claim will not go any further.  Similarly, if your doctor’s medical notes are illegible or not detailed enough, SSA will deny your claim.

Another challenge could be a lack of treatment history.  SSA will look closely to see which treatments you have tried in the past and the effect that they had on managing your condition.  They will want to know whether these treatments impacted your ability to work.  Unfortunately, treatment can be expensive, and SSA does not care if you cannot afford tests or medications.  If you are not taking medications you were prescribed, for example, SSA might see you as non-compliant and deny your claim.  If you cannot pay for necessary treatment, seek out free or reduced-cost healthcare providers.  If that still doesn’t work, explain to the judge at your hearing that the reason why you cannot follow through on treatment is financial.

Additionally, SSA might consider you employable, even if you have demonstrated that you cannot perform the duties of your previous job.  The standard for Social Security disability is not whether you can work in the same capacity as you did before but, rather, whether you can work at all.  SSA may find that you retain the mental residual functional capacity to work and deny your claim.

Lastly, in order to qualify for benefits, you must show that your condition has persisted in severity for at least twelve consecutive months or is expected to result in your death.  With mental illness, however, symptoms usually come in cycles, and you might go through periods when you are capable of working, only to find months later that you cannot even get out of bed.

As a result of all of these reasons, people suffering from mental illness of any kind, including schizophrenia, are encouraged to seek the help of an experienced disability attorney.  He or she will know how to best present your claim and work with your health care providers to make sure your records reflect your ability to function on a daily basis.  And he or she will be able to guide you through the critical hearing stage to increase your chances of success.