Get Social Security & SSI Disability: Schizoaffective Disorder

Winning Benefits

Medical Evidence In A Social Security Disability & SSI Case

Schizoaffective disorder is an uncommon Social Security disability and SSI case compared to other types of disability cases. Less than one percent of the population is diagnosed with schizoaffective disorder. Schizoaffective disorder is a severe mental health disorder in which a person suffers psychotic symptoms and a mood disorder (manic or depressive). There are two types of schizoaffective disorder, 1) bipolar type (the disorder includes mania and depressive episodes), and 2) depressive type (the disorder includes only depressive episodes). Schizoaffective disorder shares many similarities to schizophrenia and is often simply considered to be a less extreme version of schizophrenia. The cause of schizoaffective disorder is unknown, and there is no cure.

For Social Security, your treatment is critical. First, your diagnosis will need to be done by a mental health specialist. Because of the severity and complexity of the diagnosis, it is best if the diagnosis is made by a psychiatrist or psychologist rather than a mental health counselor as they are regarded by Social Security to be much more qualified than a counselor. Second, you need regular psychotherapy treatment and medications. Treatment will address your symptoms and functional limitations. Medications for schizoaffective disorder generally include antipsychotics, antidepressants, and mood stabilizers.

In scrutinizing your medical evidence, Social Security generally expects to see the following symptoms for either type of schizoaffective disorder:

1. Mood disorder,
2. Mania,
3. Hallucinations,
4. Delusions,
5. Impaired concentration and cognition, and
6. Problematic social interactions.

Social Security & SSI Schizoaffective Disorder Listing

The listing for schizoaffective disorder is found Adult Listing 12.03 and Child Listing - 112.03.

Schizoaffective Disorder Resources

Schizoaffective Disorder Medical Information - National Alliance of Mental Illness (NAMI)

A Success Story - The Power Of Lay Testimony And An Independent Psychological Evaluation

Ms. Beals lived in Cincinnati, OH. Her mother called counsel and stated her daughter had just been denied at the reconsideration level and asked whether her daughter could obtain Social Security disability and SSI disability benefits. Ms. Beals was 19 years old. She suffered a mental health impairment, but it was unclear what the diagnosis was as she had not sought mental health treatment. Her only medical treatment was her primary doctor who diagnosed Ms. Beals with bipolar disorder and had prescribed medications. Ms. Beals did not find the medications helpful and stopped taking them.

Counsel requested a hearing and then worked with Ms. Beals and her mother to ready the case for the eventual hearing. Two very significant issues had to be addressed in her case: 1) she needed to obtain mental health treatment, and as we waited for her hearing, 2) it became clear we needed an additional medical opinion about her condition and disability.

Overall, we did five important things together. First, counsel convinced Ms. Beals of the need to obtain ongoing mental health treatment as this was the most important issue in her case. It is extremely difficult to win any disability case without ongoing medical treatment. She did so, but not for a number of months after she hired counsel. She ultimately sought mental health treatment about one year prior to her hearing. Her mental health counselor diagnosed her with schizoaffective disorder. Because she had limited insurance, she was unable to see a psychologist or psychiatrist. Despite treatment, her symptoms caused an unstable life. She frequently did not take her medications, and she had great difficulty getting along with others.

Second, Ms. Beals's mother was able to pay for an independent psychological evaluation of Ms. Beals. This was especially important for a number of reasons: 1) Ms. Beals had only received minimal mental health treatment, 2) Ms. Beals had only been treated by a counselor, 3) Ms. Beals's mental health counselor was unwilling to offer a statement about Ms. Beals, and 4) Social Security sent Ms. Beals out for a Social Security consultative examination (CE) wherein the examiner found Ms. Beals's symptoms moderate in severity and that Ms. Beals was capable of working.

The independent psychologist specifically addressed four points: 1) the accuracy of the diagnosis of schizoaffective disorder which he confirmed, 2) the nature of her impairment, and 3) Ms. Beals's mental residual functional capacity (MRFC) - how well she was able to function.

Third, counsel asked Ms. Beals and her mother to each maintain a diary summarizing Ms. Beals's behaviors weekly.

Fourth, counsel obtained two statements from Ms. Beals's friends and a statement from her father (who did not live in the home).

Fifth, counsel obtained her medical records from her counselor and primary care doctor.

At her hearing, Ms. Beals was a challenging witness since she frequently underplayed her symptoms or dismissed the consequences of her symptoms. Counsel called Ms. Beals's mother to testify for her daughter (layperson testimony) who did an outstanding job of enlightening the ALJ about the true nature of her daughter's symptoms. Her testimony was so good that the ALJ spent significant time talking with her, and to my surprise, he discussed the findings of the independent psychological examination with her.

The ALJ wrote a partially favorable decision wherein he found Ms. Beals disabled since the time she began receiving ongoing counseling (a fully favorable decision would have meant disability began on the date Ms. Beals alleged disability - about seven months early than she started treatment). The ALJ found Ms. Beals would miss more than two to three days of work per month, and therefore, she was unable to adhere to a regular full-time work schedule. She was therefore awarded Social Security disability and SSI disability benefits. The difference between winning and losing this case was the combination of the mother's testimony and the findings contained in the independent psychological evaluation.