It’s vital to recognize the importance of not stigmatizing people struggling with their mental health. And it’s equally important to help support them in their quest to manage such a challenge. That’s why the Social Security Administration (SSA) recognizes that certain mental health disorders are absolutely disabilities. On that list is schizoaffective disorder — a severe psychological and mood disorder combination. Its symptoms and unpredictability make it difficult for those affected to function “normally.”
Often, it’s also impossible for those with schizoaffective disorder to work. And that’s when Social Security Disability Insurance (SSDI) comes into play, or Supplemental Security Income (SSI) for very low-income individuals. But qualifying for a SSA disability program is not as easy as just offering up a positive diagnosis.
The process of applying for medical disability can be confusing, so it’s important to know the steps to take.
What Exactly is Schizoaffective Disorder?
According to the National Alliance on Mental Illness (NAMI), schizoaffective disorder is a chronic mental health disorder. Its characteristics include symptoms of schizophrenia (like hallucinations and delusions) coupled with symptoms of a mood disorder (like manic-depression). Though symptoms vary individually, it may present as paranoia, illogical thought processes, OCD, sleeplessness, sadness, isolation, psychotic breaks and more.
This combination of multiple mental disorders can be very serious. Fortunately, NAMI considers this more severe schizophrenic condition rare with it occurring in only 0.3% of the population. Both men and woman may develop schizoaffective disorder at similar rates, though men tend to show symptoms earlier.
People with schizoaffective disorder will need treatment for both the psychotic symptoms and the mood condition. Concurrent substance abuse issues are a risk and may further complicate matters thus necessitating separate treatment protocols. The good news, however, is that barring any addictions, schizoaffective disorder typically responds well to medication and therapy.
How Does the SSA Determine If You’re Disabled by Schizoaffective Disorder?
If you are unable to work owing to this disorder, you may be able to qualify for Social Security disability. However, a positive diagnosis for schizoaffective disorder is not the only thing you need to qualify.
Like other disability claims, anyone applying for SSDI or SSI will have to satisfy requirements showing a previous work history. Non-medical eligibility requirements also include not being able to participate in substantial gainful activity (SGA) for 12 months. Remember, SSDI and SSI benefits are not for short-term or partial disabilities.
If those stipulations are met, then the SSA will next look to the severity of the applicant’s condition. In cases of mental disorders, the applicant will need to meet the SSA’s definition of the condition. The SSA outlines this in their annual “Blue Book” which includes a “listing of impairments” for qualified disabilities.
For individuals with schizoaffective disorder, there is no “listing” specifically for this condition. As such, they’ll have to show proof in one of two areas in the Blue Book. This includes either section 12.03 — “Schizophrenia spectrum and other psychotic disorders” or section 12.04 — “Depressive, bipolar and related disorders.”
What Proof of Schizoaffective Disorder Looks Like to the SSA
In order to qualify for disability, an applicant with schizoaffective disorder will have to prove schizophrenia or affective (mood) disorder. They can show they have both, to strengthen their case, but generally only one must be definitively proven for eligibility.
Individuals with schizophrenia must show at least one of the following, according to the SSA Blue Book listing:
- Hallucinations or delusions
- Illogical thinking or speech
- Disorganized behavior and emotional isolation
Individuals with affective (mood) disorder must show medical documentation of either of the following:
- Depressive disorder. The SSA requires evidence of five symptoms on their list including:
- Loss of interest in almost all activities
- Lack of energy (listlessness)
- Feeling of worthlessness or guilt
- Marked changes in appetite or weight
- Sleeplessness or sleep disturbances
- Difficulty with motor movement
- Trouble concentrating or thinking
- Suicidal thoughts or tendencies
- Manic/bipolar disorder. The SSA requires evidence of three symptoms on their list including:
- Hyperinflated sense of self
- Decreased need for sleep
- Rapid or pressured speech
- Hyperactivity or erratic physicality
- Easy distractibility
- Flights of fancy (improbable ideas)
- Participation in activities that may have painful consequences without realizing the potential for harm
Additionally, in proving schizoaffective disorder, the applicant must show one of the following is extremely limited, or two are markedly limited:
- Adapting or managing oneself (including regulating emotions, ability to handle change, and dressing appropriately/maintaining hygiene)
- Interacting with others
- Focusing, completing tasks, or maintaining a “normal” pace
- Understanding, learning, remembering, or applying information
Alternatively, the SSA will accept an applicant’s demonstration that their condition is “serious and persistent” occurring for over two years.
If You Don’t Meet the SSA Blue Book Listing Are You Out of Luck?
If you don’t immediately meet the SSA’s medical definition of schizophrenia or affective disorders, you may still qualify for benefits. How? You will need to show a serious impairment of your Residual Functional Capacity (RFC).
RFC indicates one’s ability to effectively handle their activities of daily living (ADLs). The SSA will look at an applicant through the lens of their RFC and how that would impact work ability. If the SSA determines that their symptoms preclude them from being able to work, then they will award disability benefits.
What Kinds of Medical Records Will I Need to Submit?
To qualify for schizoaffective disorder, you will need to have records of treatment for your condition. Working closely with a psychiatrist or other mental health expert is a vital component of this. If you’re only showing records from a general practitioner, the SSA may not find your condition serious enough for disability.
Be prepared to show the SSA your medical history plus records of your mental status examinations and psychological testing. You’ll also need to show evidence of any hospitalizations, treatments and medications.
The bottom line is that proving you deserve disability benefits for a mental illness can be challenging. It’s a good idea to hire a Social Security disability lawyer to help you navigate the process. Because when it comes to your mental health, you don’t need one more thing to worry about.
Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!
Kimberly Dawn Neumann is a multi-published NYC-based magazine and book writer whose work has appeared in a wide variety of publications ranging from Forbes to Cosmopolitan. She graduated summa cum laude from the University of Maryland, College of Journalism. For more, visit: www.KDNeumann.com, Instagram @dancerscribe, and Twitter/X @KimberlyNeumann.