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Is schizophrenia a disability? How to claim benefits and more

Schizophrenia is a mental health disorder. It may result in a person having disruptions in their thought processes, perception of reality, emotions, and social interactions. They may qualify for disability benefits if they meet requirements set out by the Social Security Administration.

The symptoms of schizophrenia can vary between each person. However, the disorder can be severe and debilitating.

This article will explore how a person may qualify for benefits and what to expect from the disability application process. It will also discuss steps a person can take to improve their case for benefits.

According to the National Institute of Mental Health (NIMH), schizophrenia is one of the top 15 leading causes of disability globally. The disorder can affect all areas of a person’s life, including personal, social, educational, and occupational.

The Social Security Administration (SSA) assists people with disabilities through the Social Security Disability Insurance (SSDI) and the Supplemental Security Income (SSI) programs. However, the SSA has specific requirements that a person must meet to receive benefits.

The SSA produces a list of impairments that it considers severe enough to be a disability in a publication known as the Blue Book. This lists schizophrenia in the mental disorders section under listing 12.03.

A person is likely to meet the SSA’s definition of disability if they cannot engage in substantial gainful activity.

People with schizophrenia normally receive a diagnosis between the ages of 16 and 30. The symptoms of schizophrenia can vary between each person. However, symptoms generally fall into three categories: psychotic, negative, and cognitive.

These symptoms can severely impact a person’s ability to work. A 2021 studies notes that the employment rate is low among people with schizophrenia. It also says the employment rate of participants with schizophrenia decreased shortly after the first diagnosis.

Schizophrenia symptoms

Psychotic symptoms can affect how a person thinks, acts, and experiences reality. Psychotic symptoms of schizophrenia include:

  • hallucinations, which may include seeing, hearing, smelling, tasting, or feeling things that are not there
  • delusions, where a person has strong beliefs that are not true
  • ways of thinking that are unusual or not logical
  • abnormal body movements

Negative symptoms can impact a person’s daily activities and social life. Symptoms include:

  • difficulties planning and carrying out activities
  • trouble feeling pleasure
  • avoiding social interactions and activities
  • having low energy
  • being socially awkward

Cognitive symptoms can impact a person’s attention, memory, and concentration. Symptoms include difficulty:

  • processing information
  • making decisions
  • with focusing and attention
  • with using information directly after learning it

Learn more about the stages of schizophrenia here.

To qualify for disability benefits, a person must meet certain criteria outlined by the SSA in the Blue Book and provide information about their condition, medication, and work history.

SSA criteria

An applicant must have worked in jobs covered by social security and have a medical condition that meets the SSA’s definition of disability.

A person is eligible if they:

  • are unable to engage in a substantial gainful activity because of a medical condition
  • are unable to do work they did previously
  • have a medical condition that lasted or is expected to last for at least one year or will likely result in death

A person will also need to have worked long enough and recently enough to qualify for disability benefits under social security.

Blue Book criteria

The Blue Book outlines the criteria someone with schizophrenia must meet to be eligible for social security benefits. A person can find these criteria in the mental disorders section under listing 12.03. To qualify, they must satisfy either the criteria under A and B or A and C.

A requires that a person must have medical documentation of one or more of the following:

  • delusions or hallucinations
  • disorganized thinking (speech)
  • grossly disorganized behavior or catatonia

B requires an extreme limitation of one, or a marked limitation of two, of the following areas of mental functioning:

  • understanding, remembering, or applying information
  • interacting with others
  • concentrating, persisting, or maintaining pace
  • self-adapting or managing oneself

C requires that the mental disorder is serious and persistent and that there is a documented history from a medical professional regarding the condition over at least 2 years. Medical evidence that a person may use to support this includes:

  • medical treatment
  • mental health treatment
  • psychosocial support

A person will also need to show that they have minimal capacity to adapt to changes in their environment or demands that are not already part of their daily routine.

Applying for social security benefits

If a person believes that they meet the above criteria for schizophrenia, they may apply:

  • online using the SSA portal
  • at their local social security office
  • by calling 1-800-772-1213 between the hours of 8:00 am and 7:00 pm from Monday to Friday

A person can also appoint an advocate, attorney, or third-party representative to make an application on their behalf. The SSA provides information for people representing SSA claimants.

It is also important to check the SSA checklist of documents that a person will need to provide when making a disability application.

In addition to evidence regarding their medical condition, a person may also need to include information such as:

  • their doctor or healthcare professional
  • names and dates of medical tests
  • names of medication and reason for medication
  • job history, including dates of when their medical condition began to affect their ability to work

A person will also need to include identity documents such as a birth certificate and proof of US citizenship or lawful alien status.

Once a person submits their application, the SSA will review it and make sure that it meets the basic requirements for disability benefits. The SSA will also check whether the claimant has worked for enough years to qualify for SSA benefits and evaluate their current work activities.

The SSA then sends the application to the Disability Determination Services office in the state where the applicant lives. It will decide on the disability application and send a letter to notify the claimant.

If the application is approved, the claimant will receive a letter notifying them of the SSA’s decision, the amount they can expect to receive in monthly benefits, and the date from when payments will begin.

It is not uncommon for the SSA to deny a person’s first application. If this happens, the claimant has the right to appeal the decision. A person must request an appeal in writing within 60 days of receiving the original decision letter. There are four levels of appeal available.

Anyone applying for social security benefits needs to ensure their application is thorough and provides all the necessary evidence.

This includes ensuring that all necessary paperwork is present to prevent processing delays in their application. A person should follow the checklist provided by the SSA to ensure they meet the basic requirements.

Similarly, a person should ensure that their doctor evidences all treatment plans and provides extensive medical evidence to help strengthen the application for disability.

While the symptoms of schizophrenia can severely affect a person’s ability to work, various treatment pathways dog help people manage symptoms, prevent relapses and help a person lead a fulfilling life that involves work.

Potential treatment options include antipsychotic drugs, which can help make psychotic symptoms less intense and less frequent.

Learn more about treatment options for people with schizophrenia here.

Psychosocial treatments, such as supported employment, can help people with schizophrenia to find work as part of their recovery.

Individual Placement and Support (IPS) is a supported work model for people with serious mental illnesses, including schizophrenia. The IPS employment center works with 26 states in the United States to implement supported employment programs.

finding work

A person with schizophrenia can contact their state vocational rehabilitation agency, which will administer state-supported work programs. These agencies also offer training and educational opportunities to help people with mental health conditions start working.

Campaign for Disability Employment also offers job tips and resources for people living with disabilities trying to find employment.

People who have been out of work for some time may also benefit from volunteering. This can help people build confidence and social skills in a work environment. Volunteering also helps to build work experience and skills to add to a resume.

A person can find opportunities by contacting local voluntary organizations or searching national programs such as Volunteer.gov and AmeriCorps.

Schizophrenia is a mental health disorder that may disrupt a person’s perception of reality, emotions, social interactions with others, and thought processes.

The SSA can assist a person with schizophrenia as the administration considers it a disability.

To qualify for disability benefits, a person with schizophrenia will have to meet the SSA criteria and show that their condition is persistent and severe and prevents them from engaging in substantial gainful activity.

A person will need to provide medical evidence. The SSA will review their application before forwarding it to a local Disability Determination Services office.

If a person’s application is accepted, they will receive information regarding how much benefit they will receive. Alternatively, if the SSA denies a person’s application, they can appeal the decision within 60 days.

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