Getting Disability Benefits for Schizophrenia

If you suffer from schizophrenia, you may be eligible for benefits if you are unable to work for 12 months and meet the disability requirements outlined by Social Security.

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Schizophrenia is a disorder of the brain that alters your perception of reality. If you have schizophrenia, you may suffer from hallucinations (experiencing events not linked to a clear source), delusions (giving abnormal meaning to regular events), social isolation, difficulty paying attention, and disrupted thinking and conduct. You may suffer from paranoia, speak with a flat or inappropriate affect, or have odd beliefs or mannerisms. The symptoms of this mental disorder usually surface during early adulthood. You can contact a psychiatrist to help diagnose schizophrenia.

Qualifying for Disability Benefits Based on Schizophrenia

To be eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits for schizophrenia, you will need to show that you have been diagnosed with this disorder and that you have been (or will be) unable to work for 12 months or more. In addition, you must either meet the requirements of Social Security's listing for schizophrenia or qualify for benefits because of "reduced functional capacity."

Meeting a Disability Listing for Schizophrenia

The Social Security Administration (SSA) will automatically approve you for disability benefits for schizophrenia if you meet the requirements of Listing 12.03, Schizophrenia spectrum and other psychotic disorders, in its Listing of Impairments. (This listing also covers schizoaffective disorder, schizophreniform disorder, schizotypal (personality) disorder, and substance/medication-induced psychotic disorder.)

To be eligible for benefits under this disability listing, you must have medical evidence showing that you have one or more of the following symptoms on a persistent basis, despite taking medication:

  • hallucinations or delusions
  • illogical thoughts and other disorganized thinking as evidenced by speech, or
  • a catatonic state (having rigid muscles or being nonresponsive) or grossly disorganized behavior.

In addition to these signs and symptoms, Social Security will need proof of how your disorder limits you. You don't need to prove specific limitations if your disorder has persisted for at least two years and you have either been receiving intensive medical treatment and mental health therapy or have been living in a highly structured setting that diminishes your symptoms. You will need to prove that you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life.

If this doesn't apply to you, you must show that you have an extreme limitation in at least one of the following areas, or a "marked" limitation in at least two of the following areas:

  • understanding, remembering, or using information (ability to understand instructions, learning new things, applying new knowledge to tasks)
  • interacting with others (using socially appropriate behaviors)
  • concentrating, persisting, or maintaining pace in performing tasks (ability to complete tasks), and/or
  • adapting to change and managing oneself (ability to maintain personal hygiene and appropriate attire, ability to cook and clean, ability to be aware of normal hazards and take appropriate precautions).

Note that Social Security defines "marked" as less than extreme, but worse than moderate.

Your medical record should include any instances of hospitalization, opinions of your ability to work from your doctor, psychologist, psychiatrist, or psychiatric nurse, medical notes from regular clinic visits, psychological testing, any evidence that you are living in a structured setting where others help you perform most daily tasks, and statements from family and friends regarding your ability to work.

Evaluating Your Residual Functional Capacity

If your medical evidence does not "meet" Listing 12.03, then the SSA will determine your "residual functional capacity" (RFC) to perform basic work tasks, which means how much you are still able to do in spite of your illness. To be found disabled, your RFC must show that you are able to do so little that you cannot perform any jobs you've done in the past or any other work in the U.S.

If you have schizophrenia, it is likely that your ability to perform mental skills will be greatly reduced. Therefore, your mental RFC might also include the following: an inability to concentrate on tasks on a long-term basis, an inability to work well with co-workers, and an inability to perform most basic work tasks quickly and under a deadline. If you have severe problems with basic mental skills such as concentration and understanding directions, then it is more probable that the SSA will find you unable to perform any work. But if the SSA finds you can do some type of simple unskilled job that doesn't require much contact with co-workers, it may find that you aren't disabled.

Medications and Schizophrenia

Schizophrenia is an illness that usually requires lifelong treatment. An important issue in disability cases involving schizophrenia can be the use of medications and whether they 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.

The SSA's federal regulations state that you must follow any treatment ordered by your doctor. If you are not taking your medications as prescribed, the SSA may deny you benefits unless you have a good reason for your failure to comply.

If your symptoms are well-controlled with medication, the SSA may use that information as a reason to find you not disabled. But while medication successfully treats hallucinations and delusions for most people with schizophrenia, there are not many people with schizophrenia who aren't left with some negative effects of the disease, such as poor social skills or poor motivation.

Additionally, the SSA must consider whether there are any side effects of the medication you are using and whether those side effects affect your ability to work. Common side effects resulting from the use of antipsychotic drugs include tremors, drowsiness, lightheadedness, fidgetiness, and sluggish movements.

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