Mental health disorders are now the most common reason for Americans to be classified as disabled by the Social Security Administration (SSA). According to the most recent statistics, nearly 10 million Americans are receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. This includes disabled workers, disabled widowers and disabled adult children. Of the total in all three groups more than 3.5 million (35.5%) are classified as disabled due to a mental illness (including intellectual disabilities).
What Is Psychosis?
Psychosis is a collective term for any severe mental disorder that causes the sufferer to lose touch with reality, either consistently or at certain points in the day. A person afflicted by schizophrenia, schizoaffective disorder, paranoia and other psychotic disorders may win Social Security disability benefits if they are able to prove that their symptoms prevent them from working, despite taking anti-psychotic medication. They must demonstrate that their mental illness prevents them from performing even simple, routine, and repetitive work.
How to Qualify for Benefits
However, a diagnosis of a psychotic is not in itself sufficient to qualify for benefits. The Social Security Administration maintains a list of conditions with detailed requirements for when the SSA should judge a mental or physical condition to be disabling. If an individual matches the requirements in the listings (also called the “Blue Book”) they may qualify for disability payments. . Listings can be complicated. The listings for psychosis are in section 12.03 of the Blue Book.
In order to qualify for Social Security disability benefits under the schizophrenia spectrum and other psychotic disorders listing, psychosis sufferers must satisfy “A” and “B,” or “A” and “C”:
- Medical documentation of one or more of the following:
- Delusions or hallucinations;
- Disorganized thinking (speech); or
- Grossly disorganized behavior or catatonia.
AND
- Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning
- Understand, remember, or apply information
- Interact with others
- Concentrate, persist, or maintain pace
- Adapt or manage oneself
OR
- Your mental disorder in this listing category is “serious and persistent”; that is, you have a medically documented history of the existence of the disorder over a period of at least 2 years, and there is evidence of both:
- 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
- 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
Most individuals with mental health issues don’t match up exactly to the Social Security’s listings and therefore do not automatically qualify for benefits. Nevertheless, they can qualify for benefits by proving they are not able to sustain work activity due to the symptoms of their illness. Many individuals with schizophrenia are turned down on their initial disability application, but most of those who appeal, present their case at a hearing, and are supported by legal counsel are successful in earning disability benefits.
You Have a Team of Professionals in Your Corner
Our experience has shown that all mental illness disability cases can be complicated and difficult but they are winnable. For a free evaluation of your case call Cuddigan Law at 402.933.5405 or email us at [email protected].
For a more detailed look at mental health issues and Social Security disability benefits download our free book Mental Illness & Social Security Disability: A Practical Guidebook for Individuals, Families, and Mental Healthcare Providers from our website cuddiganlaw.com.
