Can I Get Social Security Disability Benefits for Schizophrenia?

Winning Social Security Disability Benefits for Schizophrenia by Meeting a Listing

To determine whether you are disabled at Step 3 of the Sequential Evaluation Process, the Social Security Administration will consider whether your schizophrenia is severe enough to meet or equal the schizophrenia listing. The Social Security Administration has developed rules called Listing of Impairments for most common impairments. The listing for a particular impairment describes a degree of severity that Social Security Administration presumes would prevent a person from performing substantial work. If your schizophrenia is severe enough to meet or equal the listing, you will be considered disabled.

The Listing for schizophrenia is 12.03. It has 3 parts: A, B, and C. To meet the listing, you must satisfy both parts A and B or just part C alone. You do not have to be in the active phase of psychosis to qualify under this listing.

Meeting Social Security Administration Listing 12.03A for Schizophrenia

To meet part A of the schizophrenia listing, you must have 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.

Part A requires persistent abnormalities. Persistent does not mean that the abnormality has to be present all the time. Intermittent presence of the abnormality is sufficient, as specific abnormalities may be present in greater or lesser degree depending on the phase of the illness (see Phases of Schizophrenia), partial suppression by medications (see Side Effects of Schizophrenia Medications), and the severity of psychosocial stressors.

Part A.1 Hallucinations or Delusions

Part A.1 requires hallucinations or delusions. A hallucination is a false sensory perception; it is a sensory experience generated within the brain itself, rather than as a result of input from the stimulation of a sensory organ. Hallucinations may be experienced as inside or outside of the body. Any of the senses may be involved, e.g., visual, auditory, gustatory (taste), olfactory (smell), tactile, or somatic (apparent sensations from inside the body). A person having a hallucination may or may not recognize its unreality. Auditory hallucinations (e.g., hearing voices) are most common in schizophrenia.

A hallucination is not the same thing as an illusion. An illusion, rather than a hallucination, occurs if a person misunderstands or misperceives an actual sensory stimulus. Perceptions experienced while falling asleep, dreaming, or in the process of awakening are not considered hallucinations. A hallucination alone does not mean the person has a mental disorder. A person may experience hallucinations without being mentally ill.

A delusion is an abnormality of thought content; it is a false belief that is maintained despite clear evidence to the contrary. The most common delusions in schizophrenia involve various beliefs that one’s thoughts are broadcast so that they can be heard by others; that one is being persecuted by others in some special personal way; that thoughts can be removed from one’s head by other people; or that one is controlled by some outside agency acting upon one’s mind directly and by force. However, the delusions may be of any type.

Part A.2 Catatonic or Other Grossly Disorganized Behavior

Part A.2 is fulfilled by “catatonic or other grossly disorganized behavior.” Catatonia is an extreme example of disorganized behavior, ranging from excited purposeless activity to a stuporous state. Catatonia may involve rigid or bizarre posturing of the body. Catatonia is not the only form of disorganized behavior that qualifies. If a person’s behavior is so disorganized that rational, goal-directed activity is missing, then that is also sufficient to fulfill part A.2.

Part A.3 Incoherence, Loosening of Associations, Illogical Thinking, or Poverty of Speech Content

Part A.3 describes a number of abnormalities. Any one of these in conjunction with one of the subparts (a) (blunt affect), (b) (flat affect), or (c) (inappropriate affect) is sufficient.

  • Incoherence is a defect in communication characterized by speech that cannot be understood in a rational way. The pattern of meaning found in rational speech is lacking, and even the rules of grammar may be distorted.
  • Loosening of associations is a thought defect, in which ideas shift inappropriately from one subject to another, showing a lack of rational connectedness of which the person is unaware. Incoherence represents an even more severe defect in the form of thought.
  • Illogical thinking is a defect in the content of thought in which clearly erroneous conclusions are reached from given presumptions or data, and can be closely linked to a delusional system.
  • Poverty of content of speech represents an abnormality in the content of thought, in that very little information with meaningful content can be gained from listening to such speech. (Poverty of the content and quality of speech is known as alogia.)

In blunt affect, emotional responsiveness is decreased. In flat affect, emotional responsiveness is absent. In inappropriate affect, emotional responsiveness is present but not rationally connected to a person’s speech or thoughts.

Part A.4 Emotional Withdrawal or Isolation

Part A.4 requires emotional withdrawal or isolation. Isolation and withdrawal are frequent features of schizophrenia. In the extreme condition, the person may become autistic with a seemingly complete lack of awareness of his or her environment. Many severe abnormalities of perception and thinking in schizophrenia produce confusion in self-identity and relationship to the outside world. Reality-testing breaks down, and di
sorganized behavior replaces purposeful activity and/or the purpose has an illogical or delusional basis.

Emotional withdrawal and isolation follow in response to an incomprehensible world and self. Or another way of looking at things is that the physiological processes of the brain are too disrupted to allow a normal level of interaction with the world. Suspiciousness and delusions tend to produce isolation and withdrawal also, as this may decrease the feeling of vulnerability the person feels.

Meeting Social Security Administration Listing 12.03B for Schizophrenia

To meet the schizophrenia listing, you must satisfy the requirements of part A and, as a result of those impairments have 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.

Information Needed to Assess Part B

Here is what Social Security Administration says about the information needed to assess whether part B of the listing is met:

Assessment of Severity: We measure severity according to the functional limitations imposed by your medically determinable mental impairment(s). We assess functional limitations using the four criteria in paragraph B of the listings: activities of daily living; social functioning; concentration, persistence, or pace; and episodes of decompensation. Where we use “marked” as a standard for measuring the degree of limitation, it means more than moderate but less than extreme. A marked limitation may arise when several activities or functions are impaired, or even when only one is impaired, as long as the degree of limitation is such as to interfere seriously with your ability to function independently, appropriately, effectively, and on a sustained basis. See §§404.1520a and 416.920a.

1. Activities of daily living include adaptive activities such as cleaning, shopping, cooking, taking public transportation, paying bills, maintaining a residence, caring appropriately for your grooming and hygiene, using telephones and directories,