Obtaining disability benefits for Schizophrenia
Author Attorney Greg Reed:
Updated: 12/18/2024
Can I get disability benefits if I am suffering from the effects of Schizophrenia?
First you must meet the SSA’s financial requirement:
You must have worked long enough, recently enough, and not made over a predetermined level of income.
Second you must meet the medical requirements:
The Social Security Administration (SSA) acknowledges schizophrenia as a qualifying impairment under Section 12.03 of its Blue Book. To qualify for disability benefits, individuals must provide medical documentation demonstrating specific symptoms, including delusions, hallucinations, and disorganized behavior.
Additionally, applicants must exhibit extreme limitations in areas of mental functioning including understanding information and interacting with others.
Alternatively, individuals may qualify if their schizophrenia has lasted at least two years, along with evidence of ongoing medical treatment and support.
Can I get Social Security disability benefits if I am suffering from the effects of Schizophrenia?
Schizophrenia is a mental illness that interferes with a person’s ability to think clearly, manage emotions, make decisions, and relate to others. About 3.7 million adults in the U.S. have been diagnosed with schizophrenia spectrum disorders, ranking this condition among the top 15 causes of disability globally. Of this population, 1.8% are aged 18 to 65
Schizophrenia Statistics
Each year around 100,000 new cases are identified in the U.S., but this number doesn’t include the many who remain undiagnosed.
Diagnosing schizophrenia can be tricky, especially at certain stages, and some people might not even realize they have a disorder. Typically, men are diagnosed in their late teens or early twenties while women usually receive their diagnosis in their early twenties to early thirties. On average, individuals with schizophrenia tend to have a life expectancy that’s about 25 years shorter than that of the general population.
Functional Challenges related to Schizophrenia
Schizophrenia can significantly impact an individual’s functional abilities, preventing them from maintaining employment.
Signs and symptoms of the condition vary, but some of the challenges an individual with schizophrenia may face include:
- Cognitive impairments, such as difficulties with attention, memory, and problem-solving that hinder the ability to learn new skills, maintain employment, and manage finances.
- Reduced motivation, social withdrawal, and blunted emotions, further limiting engagement in meaningful activities and relationships.
- Delusions and hallucinations that disrupt the perception of reality, leading to impulsive or disorganized behavior and hindering the ability to function independently.
People with schizophrenia often experience significant social and occupational difficulties.
Individuals may struggle to maintain stable housing, employment, and social connections. They may come up against stigma and discrimination, further isolating them and hampering their capability to fully participate in society. Disability benefits could potentially be a solution to ease the heavy financial burden associated with schizophrenia.
Can I get Social Security disability benefits if I am suffering from the effects of Schizophrenia?
Though many people respond well to medication and are able to hold a job, many cannot work.
The Social Security Administration recognizes schizophrenia as an impairment in its Blue Book under Section 12.03 and has strict criteria you must meet:
- Medical documentation of one or more of the following:
- Delusions or hallucinations;
- Disorganized thinking (speech); or
- Grossly disorganized behavior or catatonia.
AND
- Understanding, remembering, or applying information.
- Interacting with others.
- Concentrating, persisting, or maintaining pace.
- Adapting or managing oneself.
OR
- Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder; and
- 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.
What are the SSDI Financial Requirements?
In addition to satisfying the medical requirements for schizophrenia you must also satisfy some basic financial requirements. You must: 1) have a disability that has lasted or is expected to last 12 months; and 2) you must have worked in a job where you paid Social Security taxes long enough and recently enough; and 3) you must not earn more than Substantial Gainful Activity (SGA), which is $1,620 per month in 2025 for nonblind applicants and $2,700 per month for blind applicants.
The Social Security Administration realizes that some individuals may not be able to satisfy the requirements of the listing because they live in a regulated and monitored environment, such as a hospital or clinic.
These settings can create an illusion of enhanced functional capabilities compared to the challenges faced in everyday life, where stress and demands are significantly higher. The focus of Social Security is primarily on an individual’s functional limitations rather than on a particular psychotic diagnosis.
Many individuals with schizophrenia are reluctant to tell their healthcare providers the full severity of their symptoms.
They fear that they will be involuntarily admitted to a hospital if they disclose all of their symptoms to their doctors. Because of this, their doctors may believe that the patient is doing better than they really are and that their current treatment allows them to function normally. As a result, these patients don’t receive the proper dosages of medications and are often more likely to have a poorer outcome that, in the end, may lead to an involuntary hospitalization that the patient has been trying to avoid. Minimizing symptoms also harms their disability claim as Social Security is under the mistaken impression that they are doing well and can function in the work environment.
What if I have schizophrenia but don’t meet the criteria of the listing and still cannot maintain a full-time job.
Some individuals might not display the typical symptoms associated with schizophrenia, such as hearing voices, yet struggle with maintaining coherent thought processes and may have difficulty interacting socially. If an individual can demonstrate that their condition is persistent and sufficiently severe to hinder their ability to engage in even unskilled work, they may be eligible for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) through a medical-vocational allowance. For example, if their schizophrenia causes them to be absent from work several days a month or causes them to be off-task at work, they may be unemployable and eligible for disability.
“Once Social Security determines the limitations caused by your condition, they will employ a vocational expert to assess whether a person with these limitations is employable. Most vocational experts will find a person to be unemployable if their condition or the treatment rendered for the condition causes the person to regularly be absent two or more days a month or be “off-task” 15% or more of the workday.”
While many applicants seeking Social Security Disability Income due to schizophrenia ultimately receive approval, the application process can be quite challenging.
Given the common problems with concentration, memory, and disordered thinking that individuals with schizophrenia often face, self-representation may not be reasonable. The assistance of a qualified disability attorney who has experience in obtaining medical documentation, physician statements, and managing appeals and hearings could make all the difference in a claimant’s case and is far more likely to secure a favorable outcome.
Citations:
FHEHealth
SSA 12.00 Mental Disorders
Singlecare Schizophrenia
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Disability Benefits FAQs
Social Security has some basic financial requirements.
Before you are eligible for Social Security disability benefits, you must satisfy some basic financial requirements. You must: 1) have a disability that has lasted or is expected to last 12 months; and 2) you must have worked in a job where you paid Social Security taxes long enough and recently enough; and 3) you must not earn more than Substantial Gainful Activity (SGA), which is $1,620 per month in 2025 for nonblind applicants and $2,700 per month for blind applicants.
Basic SSDI Requirements –>
You may also be eligible for Social Security Disability benefits if you have another medical condition.
One disorder alone may not meet the criteria of an impairment as stated in Social Security’s Blue Book, but if you have more than one medical condition, Social Security must consider how those health issues combined limit your ability to hold a job and perform necessary daily tasks.
Disability for Multiple Impairments –>
If you are 55 or older or have another medical condition you may get approval.
Applicants who are 55 or older often fall under a grid rule, which means they are not expected to learn a new job.
Disability for those over 55 –>
You may also be eligible for Social Security Disability benefits if you have another medical condition.
One disorder alone may not meet the criteria of an impairment as stated in Social Security’s Blue Book, but if you have more than one medical condition, Social Security must consider how those health issues combined limit your ability to hold a job and perform necessary daily tasks.
Disability for Multiple Impairments –>
Should you file a claim?
If you believe that you meet Social Security’s medical and financial requirements, you should apply for benefits. If you are still unsure or would like to talk to someone, please contact us at 512-454-4000. We are always ready to take your call and discuss your options with you free of charge. We are happy to help folks just like you find the best solution for their personal situation.
How do I file for Social Security Disability benefits?
Once you have decided to file a claim, you can take the first step and apply for Social Security Disability benefits in person at your local Social Security Administration office, online, or over the phone.
How to Apply for SSDI –>
Appealing denied benefits
Most who file are denied initially. That doesn’t mean you won’t qualify; you just need to file an appeal.
There are four steps to the Social Security appeal process.
SSDI Appeals Process –>
Do I need a disability attorney for SSDI?
You may certainly file a claim on your own, but evidence shows that your chances for approval are increased significantly if you have legal representation.
Do I need an SSDI attorney–>
What if I don’t qualify for SSDI?
If you haven’t worked long enough to earn enough work credits, or if you earn too much income, you may be eligible for disability benefits through another Social Security program, such as Supplemental Security Income (SSI), or from a long-term disability insurance plan through your employer or a privately purchased policy.
What is Supplemental Security Income or SSI?–>
I have long-term disability insurance – should I file a claim?
Absolutely – you should file a claim as soon as you become disabled.
LTD Disability Appeals Process–>
Disability benefits are an important source of income for those who are unable to work. If you are not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.
Try these links for further reading on this subject:
Appealing a Denied Claim with Texas Disability Lawyers
Prepare for your SSDI Hearing
Austin Social Security Disability Lawyers
Author: Attorney Greg Reed has been practicing law for 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Through his extensive litigation Mr. Reed obtained board certification from the Texas Board of Legal Specialization. Greg is admitted to practice in the United States District Court – all Texas Districts and the United States Court of Appeals-Fifth Circuit. Mr. Reed is a member of the Travis County Bar Association, Texas Trial Lawyers Association, past Director of the Capital Area Trial Lawyers Association, and an Associate member of the American Board of Trial Advocates. Mr. Reed and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.
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