Schizophrenia Social Security Disability SSI - Applying for Disability

There's a reason why most claimants will benefit from representation on a social security disability or SSI claim. And that reason is the simple fact that the criteria for disability can be fairly complex. In this post, I'll demonstrate how complex it can be for those individuals who are applying for disability on the basis of schizophrenia.

Schizophrenia is addressed in the social security administration's impairment listing manual (the blue book) in Listing 12.03, titled Schizophrenic, Paranoid, and Other Psychotic Disorders. The actual reading of the listing is fairly extended, but it can be summarized as follows.

To qualify for disability benefits by either meeting or equaling the specifications of listing 12.03, a disability applicant's records must show the existence of intermittent or continuous--

A) delusions or hallucinations

or

B) catatonic or other grossly disorganized behavior

or

C) A state of llogical thinking, incoherence, loosening of associations, or poverty of content of speech (associated with either a blunt, flat, or inappropriate display of mood or affect)

or

D) Emotional withdrawal and/or isolation

For a claimant to satisfy the requirements of listing 12.03, their records must also indicate that at least two of the following apply:

A) Markedly restricted daily activities;

B) Marked restrictions in maintaining concentration, persistence, or pace;

C) Marked restriction in the ability to maintain social functioning;

D) Extended and repeated episodes of decompensation;


Now, if a disability applicant does not qualify for disability on the basis of the aforementioned criteria, then listing 12.03 also sets forth the following criteria by which an individual may be approved if they have schizophrenia. In this second set of criteria, a claimant must be able to show ---

A) A medically documented history of a psychotic disorder (schizophrenia, paranoid, or other) that has lasted at least 2 years and has resulted in a limitation of the ability to do basic work activities.

B) The medical history must show the existence of repeated and extended episodes of decompensation or the existence of the inability to function outside a highly supportive living arrangement for at least one full year or the existence of a residual disease process whose effects are far-reaching enough that even a minimal increase in mental demands, or even a minimal change in environment, would be predicted to cause the individual to decompensate.

Listing 12.03 (Schizophrenic, Paranoid, and Other Psychotic Disorders) can seem fairly complicated. And it is. Even disability examiners who have handled hundreds of psychotic disorder cases need to refer to the impairment listing manual each time they evaluate a case involving schizophrenia. Because the listing is detailed enough to require it.

Because the listing approval requirements for many conditions are this complex (or more complex), claimants who go to disability hearings before federal administrative law judges without representation will generally be at a disadvantage versus represented claimants.

Of course, satisfying the requirements of a listing is not the only way to get approved for disability. Most applicants actually get approved via a Medical Vocational Allowance

What follows is basic information on schizophrenia itself:

Schizophrenia is a mental illness that affects how a person experiences reality. Schizophrenia must be diagnosed by a psychiatrist, clinical psychologist, social worker or other clinician, and is most often characterized by paranoia, hallucinations, bizarre delusions and perceptions, lack of emotions or motivations, and social and occupational dysfunction.

There are no biological tests that can be done to determine schizophrenia, therefore diagnosis depends upon the experiences reported by the patient in tandem with behaviors observed by the psychiatrist. To help determine schizophrenia, tests are usually ran to exclude other medical illnesses, such as delirium, epilepsy and a host of other illnesses.

The beginning stages of schizophrenia most often occur in early childhood, late adolescence or young adulthood, when behavior, emotion and cognition is affected. Less than one percent of the American population is affected by the disease and the ratio of male to female is fairly equal.

Symptoms of schizophrenia can be internal, such as auditory hallucinations, irritability and disorganized thinking, but later stages may render the person catatonic, mute and motionless. A common thought for schizophrenics is to think that someone or something is out to get them. To be diagnosed a patient must have experienced six months of troubled functioning, with at least a full month of symptoms.

The causes of schizophrenia are largely unknown, though neurobiology, psychological and social processes, early childhood, environmental stressors and genetics have all been contributed to the disease through clinical studies. A consistent finding in patients with schizophrenia is high dopamine activity in the mesolimbic pathway, a neural pathway in the brain.

Those with schizophrenia are usually diagnosed with other issues as well, from depression and anxiety to social issues and substance abuse. Life expectancy is decreased in those with schizophrenia due to physical health issues and a high rate of suicide.

Schizophrenia is most often treated with antipsychotic medications that suppress dopamine activity. In the 1950’s the drug chlorpromazine revolutionized schizophrenia treatment, though schizophrenia is more likely to be ‘managed’ than ‘cured’.

Social rehabilitation, vocational rehabilitation and psychotherapy are also very important in treatment. There are several sub-classifications for schizophrenia, including disorganized, paranoid, catatonic, residual, and undifferentiated. The success of schizophrenia treatment is often measured using consistent methods, one of the most common being the Positive and Negative Syndrome Scale (PANSS).

Those with schizophrenia are only hospitalized if they are posing a threat to themselves and/or others. If this is a threat, they are hospitalized with or without their own consent.



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