Can Schizophrenia Qualify You for Disability Benefits?

About 3.5 million Americans live with schizophrenia, according to reports by SARDAA (Schizophrenia and Related Disorders Alliance of America).  Some people have very mild and manageable cases, but for others, their condition is so severe that they are unable to work.  This can lead to stressful financial problems as bills continue to pile up, but fortunately, there may be a solution: if you or someone you love lives with severe schizophrenia, you may be a good candidate for monthly social security disability benefits. Our disability lawyers explain how to qualify.

SSA Disability Eligibility Requirements

Before we can address the medical requirements which apply to schizophrenia disability claims, it’s important to make sure you meet the general requirements that apply to all applicants.

First, your disability must be severe.  Remember, the purpose of SSI (Supplemental Security Income) and SSDI (Social Security Disability Insurance) is to help provide financial assistance to people who cannot work, or who can only work in very limited amounts, because of a medical problem.  If you can manage and suppress your condition with prescriptions, therapy, or other treatments, then the Social Security Administration or SSA will decide that you can go to work and are therefore not severely disabled.

Second, your disability must be long-term.  This means your condition must either:

  • Have already lasted for at least one year.
  • Be expected to last for at least one year.
  • Be expected to end in death.

If you have a disabling but short-term injury which will heal in a matter of weeks or months, such as a broken leg, you will probably be more successful seeking out worker’s compensation or other temporary benefits.

Finally, you cannot be earning too much money.  The income limits change every year, and vary depending on factors like whether or not you are legally blind, whether you are single or married, and whether you are applying for SSI or SSDI.  For 2015, most SSDI applicants have an income limit — expressed as “SGA,” or “Substantial Gainful Activity” — of $1,090 per month.  The 2015 SSI limit is $733, but you can earn more and still qualify because the SSA will not count all of your income.  You can”>work while receiving disability, as long as your earnings do not exceed the limit.

Applying for Benefits with Schizophrenia

A little earlier, we talked about how being severely disabled was one of the key eligibility requirements.  But how does the SSA decide whether an applicant’s medical condition is severe?

To make this determination, the SSA’s medical examiners refer to a document called the “Blue Book” or Listing of Impairments.  In order to be deemed eligible, claimants need to either match or equal the Listing’s description for severe schizophrenia symptoms. Many people can’t precisely match the descriptions in the Listing, which tend to be very technical and specific, but are still able to qualify through other means.  Our disability attorneys can help walk you through the application process.

The Listing addresses schizophrenia in Section 12.00 (Mental Disorders) under Section 12.03 (Schizophrenic, Paranoid, and Other Psychotic Disorders).  In order to qualify under Section 12.03, claimants must exhibit a “medically documented persistence” of either emotional isolation and withdrawal, or at least one of the following symptoms:

  • Hallucinations or delusions.
  • Catatonic states, or other disorganized thinking and behavior.
  • Incoherent or illogical thoughts or speech.

Additionally, claimants must also have severe difficulties with daily life, social interaction, staying focused, or “repeated episodes of decompensation, each of extended duration.” This means you have episodes of “temporary increases in symptoms.”  These episodes must each last for at least two weeks, and you must have at least three episodes per year or about one every four months.

If you don’t have the “severe difficulties” described in the previous paragraph, then instead, you must have a “medically documented history of a chronic schizophrenic, paranoid, or other psychotic disorder,” which must have lasted for at least two years. In addition, you must have either:

  • Repeated episodes of decompensation.
  • Symptoms which are so severe that even a minor change to your environment or responsibilities would probably trigger decompensation.
  • A history, dating back at least one year, of being unable to live outside of a “highly supportive living arrangement,” which will never go away.

These requirements are very demanding, but remember: don’t be discouraged if you can’t match the Listing exactly.  As long as your symptoms render you unable to perform work, there’s a chance you may still be eligible through something called a medical-vocational allowance.

Pennsylvania Social Security Lawyers Offering Free Consultations

If your claim was rejected and you want to appeal an SSA disability denial, or if you simply have questions about getting started, the disability attorneys of Young, Marr & Associates can help. To start talking about your goals in a free and private consultation, call our law offices at (215) 701-6519 in Pennsylvania. We serve residents of Pennsylvania.