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Mental Disability Benefits
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Social Security List of Conditions
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SSD SSI Definitions
SSDRC authored by Tim Moore
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Schizophrenia, Social Security Disability, and Applying for Benefits
Can you be approved for social security disability or SSI if you have a mental illness?
Yes. However, disability claims based on mental impairments seem to be treated by the social security administration even more arbitrarily than claims that are based solely on physical impairments.
If you file an application for disability on the basis of one or more mental impairments, prepare for the strong probability of being denied at the initial claim level, and prepare for the likelihood of having to file appeals. However, on the bright side, it should be noted that a large percentage of claims that are brought before administrative law judges at disability hearings are approved, and this is particularly true for represented claimants. The downside to this fact, however, is the fact that the appeals process leading to a hearing can take 1-2 years.
The difficulty of winning disability for Mental Illness (bipolar disorder, schizophrenia, depression)
As a disability examiner for social security disability and SSI disability cases, I was often amazed at the cases that were denied. For example, I've seen individuals with IQs in the fifties get denied and I've seen individuals with long and well documented histories of decompensation get denied. I've also seen fairly severe cases of bipolar disorder get denied on the basis of duration (a durational denial is a denial made on the basis of an assumption that a condition will not last the required twelve months needed to satisfy the social security administration's definition of disability), which is quite ridiculous when one considers the waxing and waning nature of bipolar disorder, and a number of other conditions as well.
Even well-documented and legitimate mental illness cases get denied by social security. However, that depressing fact only makes it more imperative that disability claimants who file on the basis of a mental impairment provide substantial documentation in the form of medical records.
Unfortunately, in our society at present, getting access to needed mental health treatment can be difficult. According to the National Mental Health Council, there are approximately three and a half million Americans who suffer from brain disorders, schizophrenia, and bipolar disorder. And forty percent of these individuals receive no treatment. In many instances, the lack of treatment may be due to an individual never having sought treatment. However, there are too many cases in which those who seek treatment find no avenue by which to continue receiving treatment. For instance, those who become disabled and have long term disability insurance often find that their LTD "coverage" for mental health treatment caps out at the two-year mark.
The schizophrenia listing
Schizophrenia is listed in SSA's disability listings. This means that a person filing for disability can potentially be approved for disability via a medial vocational allowance, a process by which it is shown that they cannot work and earn a substantial and gainful income, or by meeting the requirements, via their medical record documentation, of the listing. Here is the listing that addresses schizophrenia:
12.03 Schizophrenic, paranoid and other psychotic disorders: Characterized by the onset of psychotic features with deterioration from a previous level of functioning.
The required level of severity for these disorders is met when the requirements in both A and B are satisfied, or when the requirements in C are satisfied.
A. Medically documented persistence, either continuous or intermittent, of one or more of the following:
1. Delusions or hallucinations; or
2. Catatonic or other grossly disorganized behavior; or
3. Incoherence, loosening of associations, illogical thinking, or poverty of content of speech if associated with one of the following:
a. Blunt affect; or
b. Flat affect; or
c. Inappropriate affect; or
4. Emotional withdrawal and/or isolation;
B. Resulting in at least two of the following:
1. Marked restriction of activities of daily living; or
2. Marked difficulties in maintaining social functioning; or
3. Marked difficulties in maintaining concentration, persistence, or pace; or
4. Repeated episodes of decompensation, each of extended duration;
C. Medically documented history of a chronic schizophrenic, paranoid, or other psychotic disorder of at least 2 years' duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:
1. Repeated episodes of decompensation, each of extended duration; or
2. A residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate; or
3. Current history of 1 or more years' inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.
About the condition Schizophrenia
Schizophrenia is a severe brain disorder that affects about 1 percent of Americans. It is a complicated disorder that is commonly treated by antipsychotic drugs, which can alleviate symptoms in some patients, but not cure the disease. While the medical community has known about schizophrenia for a long time, no known cause has been found. Fortunately, new studies may hold the key.
Scientists from the studies believe the mental illness may be caused by mutations in various genes that interrupt biological pathways essential to normal brain development. This frees up the idea they are searching for one key gene that is responsible for schizophrenia. Now, they are considering the fact that there might be many different DNA deletions and duplications that disrupt genes linked to pathways crucial to brain development.
One team looked at a group of schizophrenics who developed the disease as children, finding genetic interruptions or glitches in 20 percent, while another study looked at DNA from 268 healthy people and 150 schizophrenics and found that 15 percent of the schizophrenics had these glitches, while only 5 percent of the healthy subjects showed a presence of disruptions. The second study was done by researchers at the University of Washington and Cold Spring Harbor Laboratory in Cold Spring Harbor, New York.
Finding the genes responsible for these glitches in brain development may inspire new drugs to treat schizophrenia and other neuro-developmental brain disorders. More studies are ongoing.
Return to: Social Security Disability Resource Center, or read answers to Questions
Related Body System Impairments:
MPD Multiple Personality Disorder and Filing for Disability
Personality Disorder and Filing for Disability
Schizoaffective Disorder and Filing for Disability
Schizophrenia, Social Security Disability, and Applying for Benefits
Antisocial Personality Disorder and Filing for Disability
Somatoform Disorders and Filing for Disability
Information on the following topics can be found here: Social Security Disability Questions and in these subsections:
Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI
These pages answer some of the most basic questions for individuals who are considering filing a claim.
Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria