Schizophrenia Case Study #2
28 Year Old SSI Claimant With Audio
and Video Hallucinations,
 and Anger Control Issues

In speaking with my client and her mother prior to the hearing, I evaluated my client as an above average witness.  I did not find her to be introspective with regard to her condition but she was very “matter of fact” in describing an imaginary friend that accompanied her everywhere.

In my experience, claimants with schizo-affective disorder experience a different reality than other people.  I think that at some level my client understands that only she can see and hear her imaginary friend but on a day to day basis, this hallucination is as real as her mother or me.  This different reality and an inability to distinguish between it and the reality that non-mentally ill individual experience is a reliable hallmark of schizophrenia.  In my experience, this “matter of factness” about her alternate reality indicates that she is speaking truthfully and not attempting to secure benefits wrongfully.

My client’s mother also impressed me as being honest and forthcoming.  Her daughter’s illness was obviously creating an emotional and financial strain.  There was nothing in either my client’s or her mother’s demeanor or behavior to suggest that the claimant was not legitimate.

Hearing Report:  the hearing opened with the judge greeting me and my client.  Before swearing the witnesses the judge turned to me and indicated that the record looked compelling to him and that he just wanted to hear from the claimant briefly.  As I suspected, the judge wanted to “eyeball” the claimant to convince himself that this 28 year old claimant was credible.

After proceeding through the preliminary matters, the judge asked me for a brief opening - which I provided by stating that the claimant’s primary problem arose from her on-going experience of hallucinations and side effects of medications (which put her to sleep).

I then turned to the claimant and asked her why she was terminated from her past work.  My client testified that she had become violent with one of her co-workers that she felt was following her and talking about her behind her back.  She spoke about another job that she lost when she wandered from the work site to confer with her “friend” (the hallucination).

I asked her about her friend and she testified that she understood that her friend was not real but that she did see her friend and regularly conversed with her.  The claimant testified that her “friend” sometimes told her how to deal with others, including instances where the “friend” told her to become violent.

My client testified that the psychotropic medications she took made her very sleepy and did lessen the presence of her “friend.”  I asked her why she could not return to a cleaning or packing job and she responded that if she was on medications she would fall asleep, and if not that she would be likely to wander off and lose focus.

The judge followed up with a few questions then turned to the vocational witness.  He asked the VE if the claimant could return to past work or any work if she had marked limitations in “attention and concentration,” “focus,” and “social interaction.”  The vocational witness testified that no jobs would exist for such a person.

I had no questions for the VE and the judge closed the hearing.

Observations:  there was no documentation or conflicting medical information in my client’s record.  I think that the only reason that the judge elected to proceed with a hearing was because of the claimant’s age.  It appeared to me that the judge wanted to see the claimant to resolve any nagging doubts he may have had about my client’s credibility.  In my view, her testimony was sufficient to resolve any such doubts.

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