Schizophrenia

Social Security recognizes the mental disorder known as schizophrenia as a basis for a Social Security disability award. A detailed definition of schizophrenia may be found in the DSM IV (published by the American Psychiatric Association), and the Social Security Administration has adopted the DSM-IV definition in its listing for this mental disorder.

Basically a person is said to suffer from schizophrenia if he experiences abnormalities in the perception of reality. Examples of schizophrenic behavior include auditory or visual hallucinations, paranoia, disorganized speech and thinking and inability to manage basic needs such as hygiene. If you are a disability claimant, or a loved one who cares for a claimant who has been diagnosed with schizophrenia, there are two arguments you can use to recovery benefits.

The “12.03 Listing Argument”

First, you should argue that your condition is so severe that it meets the “listing” for bipolar disorder as defined by the Social Security Administration in Listing 12.03, which you can read by clicking on the link. In order to meet this listing, your treating psychiatrist will need to prepare a narrative report or, better, complete a checklist form that identifies specific elements of abnormal behavior described in the listing.

You should note that Listing 12.03 also contains an reference to function – to meet the listing a claimant must meet the “B” or “C” criteria of the listing, both of which describe activity limitations that would impact a person’s capacity for work.

You can enlist your doctor’s help by printing out the 12.03 listing, taking it to your psychiatrist and asking him to prepare a letter stating that you meet the listing. In my practice, I do not generally ask for narrative reports – instead, I create a checklist that tracks the listing, along with a few other questions that I know will be persuasive to Social Security judges.

You should be aware that Social Security is very demanding when it comes to approving a case based on the listing. All of the listings, including Listing 12.03, are designed to be difficult to meet and Social Security personnel are trained to look for very specific records and language in your doctor’s reports before they will approve a case based on the listing. However, my experience has been that most judges see schizophrenia as an organic mental health disorder in which a claimant’s brain chemistry is awry, and I have won a number of cases using a listing argument.

The Residual Functional Capacity Argument

Another method to win your schizophrenia case would be to argue that because of your symptoms, your capacity to perform even minimal work like activities has been compromised to the point where you would not be able to perform even a simple, unskilled job five days a week, eight hours a day. This is called a “functional capacity” argument and it can serve as the theory of your case if you experience some symptoms of schizophrenia but not enough to rise to listing level. I might also use an RFC argument if my client does not have regular treatment with a psychiatrist (medical doctor), but does have regular treatment with a therapist or psychologist.

Focus on Specific Activity Limitations

The RFC argument requires that you focus on the specific limitations you would have functioning at a simple, unskilled, low stress job. In most cases involving schizophrenia, the judge’s decision really boils down to his/her decision about whether you could hold down a simple, sit down type of job that requires no training, that allows you to sit, stand and adjust your position and is not production oriented and does not involve extensive interaction with others. Examples of these types of jobs include:

  • small parts assembler
  • ticket taker at a move theatre
  • surveillance system monitor
  • hand packer

In fact, in most hearings, the Judge will call a “vocational expert” to testify about work you have done in the past and about simple, minimally demanding jobs that exist in the national economy.

Examples of Winning Work Limitations

Your RFC argument will have the best chance of success if you can identify specific work limitations that arise from your condition – or your medications – that would prevent you from getting through a workday. Because you may find it difficult to recognize changes or limitations in your own behavior, you may find it helpful to ask a friend or relative to help you identify behaviors or activities that might impact your capacity for work.

  • your need to take frequent unscheduled breaks
  • you would likely miss three or more days of work per month
  • you would likely suffer “decompensation” at work (i.e. emotional breakdown)
  • you would likely have problems getting along with co-workers or supervisors
  • you would not be able to follow simple instructions
  • your concentration and attention are “severely” impaired
  • you experience audio or visual hallucinations
  • you experience feelings of paranoia or delusions

Note that this list of work limitations is just an example – you don’t need to show all of these work limitations to win your case.

An RFC argument is a legal argument and many of the terms that are used by Social Security have specific legal meanings. Examples of terms with special meaning include “marked limitation,” “substantial work,” “decompensation,” “frequent,” “often,” and “poor performance.” Because of the legal nature of this type of argument, you are well served by retaining the services of an experienced and capable Social Security disability lawyer.

Conclusion – You Will Need Your Doctor’s Support

Social Security recognizes that claimants suffering with schizophrenia may meet the requirements for disability because of the severity of symptoms and the impact of those symptoms on the claimant’s ability to perform even basic work activities. A treating doctor who understands the “big picture” about Social Security claims can be a big help to you in pursuing your claim. Recognize that many mental health professionals are reluctant to make a blanket statement that you are “disabled.” Instead, when you apply for disability ask your doctor to help you by using Social Security’s listing language and by identifying specific activity limitations that apply to you.

Schizophrenia Case Study #1: 28 year old male with high school education + 3 years of college

Schizophrenia Case Study #2: 28 year old female with high school education, who experiences on-going audio and video hallucinations