SCHIZOPHRENIA AND DISABILITY

WHAT IS SCHIZOPHRENIA?

Schizophrenia is a mental illness with severe symptoms that cause a person to seem out of touch with reality. People with schizophrenia may also hear voices or sounds that are not there. Likewise, they may see things that other people cannot see. If someone is seeing things that aren’t really there, then they are hallucinating. For example, a person with schizophrenia may see the walls moving in a room. Or, they may hear voices constantly talking and telling them to act in a certain way. Some people with schizophrenia have catatonic behavior, a split personality, or antisocial behavior.

Likewise, the voices may tell them to do things that may not be healthy. Sometimes, they hear voices that tell them they are not a good person. Additionally, some people believe that they receive messages from the TV. Some hear voices coming from the radio or even traffic signs and license plates. These symptoms often make people feel paranoid. Or, the person may feel like others are out to get them or that other people are talking about them. These are false beliefs. But to the person with this mental condition, it seems very real.

Schizophrenia is a severe mental condition that can prevent you from working. If you cannot work due to your mental symptoms, then you should apply for SSDI and SSI benefits. There are two kinds of Social Security benefits you can apply for through the SSA. The first of these is Social Security Disability Insurance benefits or SSDI. It is also known as Title II benefits. The second of these is Supplemental Security Income or SSI benefits.

WHAT CAUSES SCHIZOPHRENIA?

The cause of schizophrenia is not known. However, a combination of genetics, environment, and altered brain chemistry may play a role in the mental illness. Schizophrenia symptoms include disorganized speech and odd behavior. Also, people with this mental condition don’t function well in their daily activities.

For example, if you have schizophrenia then you may have trouble with focus and being able to finish tasks. Also, you may have problems with your memory. Chances are good that you struggle with personal relationships. For example, you may struggle to get along with family members. You may also have problems making friends. Some people with the disease become aggressive when they are afraid or confused. These behaviors also impact their personal relationships.

The treatment for schizophrenia may go on throughout your life. Treatment often includes medication, therapy, and health care services given by mental health professionals. More information about these conditions can be found at the National Alliance on Mental Illness (NAMI).

IS SCHIZOPHRENIA A DISABILITY?

The short answer is “yes, it can be.” The symptoms of schizophrenia can be so severe that it stops you from working. Even if you take medication, it may not be enough to control your symptoms. If you cannot work due to your mental condition for longer than 12 months, then you should apply for SSD and SSI benefits.

Not only can schizophrenia prevent you from working, it can also result in homelessness. Studies show that schizophrenia and schizoaffective disorder affects about 1 out of every 100 people. Because of the serious nature of the symptoms, many people with this mental illness are unable to get the support they need to keep their housing, get treatment, and apply for SSD benefits. In fact, one of the main reasons that people with schizophrenia are denied benefits is that they are unable to manage the SSA appeal process. Learn about SSA’s five step review process.

HOW TO WIN SSD BENEFITS FOR SCHIZOPHRENIA 

If you are unable to work due to schizophrenia, then you may qualify for SSDI and SSI benefits.  The SSA states psychotic disorders should be looked at under listing 12.03. For example, the SSA considers mental conditions that include delusions, such as hearing voices or seeing things that other people don’t see. Visual hallucinations occur when you see things that aren’t really there. If you hear things that are not there, then you have aural hallucinations.

The SSA uses Listing 12.03 to define the symptoms of schizophrenia for which they will pay benefits. Below is listing 12.03. It reviews the symptoms you must document in your medical records. A full description of listing 12.03 can be found on the SSA website.

LISTING 12.03 FOR SCHIZOPHRENIA 

Below is SSA’s listing for schizophrenia. To meet a medical condition on SSA’s listing, you must have all of the elements under each of the listing sections. The symptoms under each section need to be written in your medical records and confirmed by your doctor. Preferably, you have a psychiatrist who is treating you for schizophrenia. If you do not have a treating doctor, then see our list of free and low cost doctors. Additionally, learn how to use the Part B rules to win your benefits.

12.03 Schizophrenia spectrum and other psychotic disorders satisfied by A and B, or A and C:

PART A

• Medical records of one or more of the following:
  1. Delusions or hallucinations;
  2. Disorganized thinking (speech); or
  3. Grossly disorganized behavior or catatonia.

AND

PART B

• Extreme limit of one, or marked limitation of two, of the following areas of mental functioning:
  1. Understand, remember, or apply information.
  2. Interact with others.
  3. Concentrate, persist, or maintain pace
  4. Adapt or manage oneself.

OR

PART C

• Your mental condition in this listing category is “serious and persistent;” that is, you have a medical history of the existence of the condition over a period of at least 2 years, and there is evidence of both:
  1. Medical treatment, mental health therapy, psychosocial support, or a highly structured setting that is ongoing and that diminishes the symptoms and signs of your mental disorder; and
  2. Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life.

Your mental symptoms must be very severe in order to meet Listing 12.03. As you can see from the listing, a person with schizophrenia has usually spent time in the hospital getting mental health treatment. Treatment includes medication, as well as therapy. In order to win benefits, your symptoms must be severe enough to keep you from going to school and from work. Learn about the Part B criteria and the Part C criteria.

Also, with severe schizophrenia you are not able to go to social functions, like church, on a regular basis. Additionally, you may not be able to complete simple activities of daily living. Things like cooking, cleaning, or doing your own laundry are too difficult because of your mental symptoms.

RESIDUAL FUNCTIONAL CAPACITY FINDINGS COME FROM YOUR MEDICAL RECORDS

If you cannot win benefits by meeting a listing, then you can try to win benefits by proving your schizophrenia impairs your residual functional capacity (RFC). In other words, you need to prove that your mental symptoms limit you to the point that you cannot work 40 hours a week.

In order to define your mental RFC, the SSA will examine your medical records. They will take into account what your treating providers state in your medical records. The SSA will be looking for statements that prove you have severe mental symptoms. Also, the SSA will review any statements from other medical sources and statements from your past boss. If they need more information, then they may send you to one of their doctors for a mental health exam. Learn what to expect at SSA’s free doctor exam. It is free to you, because the SSA pays for it.

The SSA will also consider descriptions about your limits from your family, neighbors and friends. For example, your family or friends could write a statement about what they have seen you go through. They can talk about your mental symptoms and your behaviors. Find out how your RFC and age may prove that you cannot work. Also, find out more about SSA’s Medical Vocational Guidelines.

HOW DOES THE SSA FIGURE OUT YOUR RFC WHEN YOU HAVE SCHIZOPHRENIA?

In order to determine your RFC, the SSA first looks to the medical evidence in your case. That is why it is so important for the SSA to have all of your medical evidence. It is your “burden” or responsibility to provide all of your medical evidence to the SSA.

Usually, hiring a lawyer to help you do this is a wise choice. Learn how to obtain your medical evidence for free.  If you do not have enough medical evidence for them to make a decision, then they will arrange for your to have a doctor exam. Find out about SSA’s free doctor exam. See the next section for help if you do not have a doctor. We have free and low cost resources to help you find a doctor on our website.

FREE AND LOW COST MENTAL HEALTH SERVICES

If you have schizophrenia, then you are going to need to seek treatment from a psychiatrist, who is a doctor that can give you medication for mental issues. You should also see a counselor or psychologist. The evidence that you need to obtain for the SSA will be the medical opinion of your counselor, psychologist, or other type of doctor.

In addition, you will need to obtain your progress notes. Progress notes are the notes that your doctor or counselor writes when you visit them. That is the medical evidence that the SSA reviews to see if you they can pay you benefits. They will read through the progress notes and the medical opinion of your doctor to see if you meet  listing 12.03.

If you do not have a doctor or counselor, then call the resources that accept your health insurance. If you do not have mental health insurance, we have a list of free and low cost health resources. You can start with our list and if these doctors can’t help you, then ask them who can. If you live in Nevada, then go to Nevada’s Free and Low Cost Mental Health Providers.  If you live in Utah, then review Utah’s Free and Low Cost Mental Health Providers. In addition to ongoing treatment, if you need access to mental services, then these lists will help you too. Read if you need information about a payee to help you manage your benefits.

Learn about free or low cost mental health services in Colorado. Likewise, you can learn about free mental health resources in Idaho.

TREATMENTS FOR SCHIZOPHRENIA

The treatment for schizophrenia usually requires a combination of medication, therapy, and support from mental health professionals. Below you will find some of the most common treatments for this mental illness:

SPECIALIZED MENTAL HEALTH TREATMENT 

Coordinated care:  This type of care is usually for people who are experiencing a psychotic episode for the first time. Treatment is a team approach that includes medication and talk therapy. Additionally, this kind of care includes your family whenever possible. The idea behind it is to catch and halt your disease in the early stages. Research shows that people with schizophrenia who get early treatment have the best results dealing with their disease over time.

Assertive community treatment: This type of treatment includes personal services to help people with mental illness. For example, you may need help taking your medications or dealing with other people in a work or home setting. ACT professionals help you handle problems on a daily basis.

Antipsychotic Medications: Antipsychotic medications are the main form of treatment for schizophrenia. Medications help manage symptoms such as psychosis and hallucinations. Your doctor will choose the right one for you. It may take some time for the medications to begin to work. If one medication doesn’t help, then your doctor will find another medication for you to take.

Supportive Services: People with mental illness often need support in multiple areas of their lives. This could involve assistance with finding housing, jobs, and getting mental treatment. Case management, which often includes an individual case manager, can make sure that all of your needs are met.

Hospitalization: In severe cases or during acute episodes of the disease, you may need to stay in the hospital. This may be necessary to control your symptoms and ensure your safety.

PROMISING TREATMENT PLANS FOR THE FUTURE

1. Genetic Research: Genetic studies are helping scientists understand the causes of schizophrenia. As a result, there is growing interest in a personal medicine approach. Treatment plans in this approach are specific to the patient and their genetic makeup. This could lead to more effective treatment.
2. Nutrition: Emerging research suggests that nutrition matters when treating mental health issues. For example, omega-3 fatty acids and certain vitamins may have a positive impact on brain health and symptom management.
3. Virtual Reality Therapy: Virtual reality therapy is being used as a way to create life situations in a controlled environment. This can help people with mental illness practice social behavior and coping skills in a safe, supportive setting.

WHAT OUR LAW FIRM DOES FOR YOU

You do not have to obtain SSD benefits on your own. If you have schizophrenia, then we can help file your SSD application. Also, we can help you through each of the appeal stages of the Social Security process.

When you leave that up to us, you can focus on your health. Our attorneys and staff can:

• Help you file your application for SSD and SSI benefits
• File an appeal if you receive an initial denial from DDS
• Collect your medical records
• Help you confirm your free SSA doctor exam
• Request a Hearing with an SSA judge
• Prepare you to testify at your ALJ hearing
• Represent you at your hearing and question the expert witnesses
• Read about job experts
• Learn about medical expert testimony
• Request review of an decision with the Appeals Council
• Request review of an Appeals Council denial in Federal Court

If you file your SSD application online at Social Security’s website, then you have six months to complete it. It is best to complete the application quickly. You don’t want to miss the six month time limit.

HIRE US TO HELP WITH YOUR SSD BENEFITS

If you need help proving you deserve SSD benefits, then contact our law firm. We will represent you without making you pay an up front attorney fee. Also, we offer a free review of your benefits. Additionally, we do not charge an attorney fee unless we win your case.

It is always our goal to win benefits for our clients. In order to win benefits, you will need mental health treatment. You need to attend therapy and try medications to help your mental symptoms. Additionally, you will need a mental health record. This means you must see a doctor or counselor on a weekly or monthly basis. Ongoing treatment records are crucial to winning your benefits. The medical opinion of your treating doctor is also important. To help you find a doctor, we have free and low cost mental health sources.

You will also need an attorney to help you win your SSD benefits. Our attorneys and staff will help you throughout the appeal process. We can help you fill out your forms or review them for you. Our staff can help you file your online application and appeal a denial from the SSA.

Likewise, we will also represent you at hearing before an SSA judge. Prior to your hearing, we will make sure the judge has your medical records. Then, we will meet with you to talk about your hearing. We will prepare you to answer the judge’s questions.

We represent clients in many states. Our main office is in Utah. But we can represent you no matter where you live. In the past 30 years, we have won 20,000 SSDI and SSI cases. Put our experience to work for you. Contact our legal team. Get a free review of your case today.