Getting Disability Benefits for Schizophrenia

Schizophrenia is a mental health disorder that affects your ability to think and behave clearly. People with schizophrenia may experience hallucinations, delusions, social isolation, disorganized thoughts, and disrupted conduct. Paranoia, restricted emotional expression, and abnormal mannerisms are other common characteristics of schizophrenia.

Advancements in mental health treatment mean that many people with schizophrenia can manage their symptoms with proper medication. But others experience financial or social hurdles that can make it difficult to diagnose and treat schizophrenia. Some people may struggle with symptoms for years before finding the treatment that works best for them. During this time, they might not be able to work full-time—and may qualify for disability benefits.

Is Schizophrenia a Disability?

The Social Security Administration (SSA) recognizes that schizophrenia is a potentially disabling mental health condition. You can qualify for disability for schizophrenia if you're unable to work for 12 months or more due to symptoms from the disorder, you're legally eligible to receive disability benefits (SSI or SSDI), and your medical records establish significant mental limitations.

How Can You Get Disability for Schizophrenia?

The SSA can approve your application for benefits in one of two ways: the agency can find that you meet the requirements of a listed impairment ("medically disabled") or that you have a residual functional capacity that rules out all work ("vocationally disabled").

Qualifying for Schizophrenia by Meeting a Disability Listing

Social Security considers some medical conditions to be especially severe. If you've been diagnosed with one of these "listed impairments" and your medical records contain specific information mentioned in the listing requirements, you'll be automatically approved for disability benefits ("meet a listing").

Schizophrenia is a listed impairment. The SSA evaluates disability claims for schizophrenia—including related conditions such as schizoaffective, schizophreniform, schizotypal and psychotic disorders—under listing 12.03. To qualify for benefits under listing 12.03, you'll need medical documentation showing that you have one or more of the following symptoms on an ongoing basis, despite taking medication:

• hallucinations (experiencing events not linked to a clear source) or delusions (giving abnormal meaning to regular events)
• disorganized speech (verbalizing illogical or nonsensical thoughts), or
• catatonia (an unresponsive state characterized by an inability to move) or grossly disorganized behavior (actions that appear unpredictable or bizarre).

In addition to the above signs and symptoms, you must provide evidence of all the ways in which schizophrenia limits your mental functioning. Specifically, the SSA needs to see that you have an "extreme" limitation in one, or "marked" limitations in two, of the following areas:

• understanding, remembering, or using information (your ability to understand instructions, learn new things, and apply new knowledge to tasks)
• interacting with others using socially appropriate behaviors
• concentrating, persisting, or maintaining pace in performing tasks, and
• adapting to change and managing oneself (your ability to maintain personal hygiene, prepare meals independently, and take precautions to avoid danger).

The difference between "marked" and "extreme" isn't well-defined, but the SSA considers an extreme limitation to be worse than a marked one. For example, somebody who struggles to bathe and dress themselves daily—but ultimately is capable of maintaining hygiene—might be considered to have a marked limitation in managing oneself, while somebody who is frequently dirty and disheveled will likely have an extreme limitation in that same area.

Most people with schizophrenia who meet listing 12.03 are able to demonstrate marked or extreme mental limitations. But you can also meet the listing if:

• you've had symptoms of schizophrenia for at least two years
• you've either been receiving intensive medical treatment and mental health therapy or have been living in a highly structured setting that diminishes your symptoms, and
• you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life.

These criteria are meant to account for people with schizophrenia who might not have marked or extreme limitations within a controlled environment, but whose symptoms would worsen if removed from that environment. (In Social Security lingo, this is known as "marginal adjustment.")

Getting Disability for Schizophrenia By Having a Reduced Residual Functional Capacity

You can still qualify for disability even if you don't meet the requirements of listing 12.03. Social Security will review your medical records and daily activities to determine your residual functional capacity (RFC). Your RFC is an evaluation of your ability to perform basic work tasks despite symptoms of mental illness. In order to get disability with a reduced RFC, your limitations must rule out any jobs you've done in the past or any other work in the national economy.

People with schizophrenia often have symptoms that affect their ability to perform certain mental functions at work. These symptoms can be reflected in your RFC as restrictions in your ability to concentrate on tasks, interact with others, maintain production pace, or keep up attendance.The more severe your symptoms are, the more likely you are to have limitations in your RFC that eliminate all available jobs.

Some of these highly restrictive limitations include being off-task 20% of the workday, missing more than one day of work per month, being unable to respond appropriately to stress on the job, requiring additional supervision to complete job duties, or needing to work in isolation. But if Social Security determines that you can do a simple job that doesn't require much contact with co-workers, you're unlikely to get disability (unless you have additional physical restrictions and are at least 50 years old).

What's the Schizophrenia Disability Approval Rate?

According to some survey results, applicants with schizophrenia were approved at a higher rate at a disability hearing than those with anxiety or mood disorders. This may be because it can often take years before a disability application reaches the hearing level—at which point the claimants with milder forms of schizophrenia may have returned to work, while the more severe cases (that aren't as responsive to treatment) remain.

Whether or not your disability claim is approved will likely depend on the quality and quantity of your medical evidence. Ideally, your medical records should include the following:

• clinical notes from your medical providers—especially those from your psychologist or psychiatrist—that document your mood, affect, and behavior at each visit
• psychological evaluations and mental status testing
• admission and discharge records from any hospitalizations you've had for a mental health crisis
• medical source statements from your doctors, counselors, or social workers
• evidence of a structured setting where others help you perform most daily tasks, and
• witness letters from family and friends who have firsthand knowledge of your struggles.

Because schizophrenia is a disorder that usually requires lifelong treatment, an important issue in disability cases involving schizophrenia is whether you're taking medications that are effective in controlling your symptoms. When you submit your claim, the SSA will ask you for a list of your current medications and dosage, the date first prescribed, and how much of the medication you take each day.

If your symptoms are well-controlled with medication, the SSA may use that as a reason to find that you're not disabled. While medications are often successfully used to treat hallucinations and delusions, the agency needs to consider what medication side effects have on your ability to work. Common side effects of antipsychotic drugs used to treat schizophrenia can include tremors, drowsiness, and slow movements. These side effects can affect your ability to do tasks involving fine motor skills or coordination—which can further reduce the amount of jobs you're able to perform (and increase your chances of approval).

What's the Disability Check Amount for Schizophrenia?

Social Security doesn't pay disability checks based on the type of disabling condition you have. Instead, the amount of your disability check depends on the type of benefit you'll be receiving.

Social Security Disability Insurance (SSDI) payments are awarded to people who've worked long enough to pay into the SSDI system by way of payroll or self-employment taxes. If you're receiving SSDI, therefore, the amount of your disability check will be calculated based on your past earnings record. SSDI can pay up to $3,822 per month, but the average amount is much lower—around $1,500.

Supplemental Security Income (SSI) is available to low-income and asset disabled applicants regardless of employment history. The amount of SSI that you'll receive depends on your living arrangements, whether you're currently working, and how much you're making. SSI can pay up to $943 per month in 2024, but that amount can decrease based on how much earned income you have or increase if you live in a state with an SSI supplement.

For more information to help you calculate the amount of your disability check, see our articles on how much you can get in SSDI benefits and how much you can receive in SSI.

Schizophrenia and Starting Your Disability Application

Once they've decided to file for disability benefits, people with schizophrenia don't need to do anything special when submitting their applications. When you're ready to apply, you can choose from the following methods:

• File online at the SSA.gov disability portal.
• Call 800-772-1213 (TTY 800-325-0778), Monday through Friday, from 8 a.m. to 7 p.m., to speak with a representative from the SSA.
• Go in person to your local Social Security field office.

While you don't need to hire an attorney, you may find it easier to have an experienced representative to guide you through the disability determination process. Your lawyer can help you effectively describe how symptoms from your schizophrenia limit your ability to function, whether on your initial application or at a hearing with an administrative law judge.

_{Updated April 2, 2024}