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Blog

Long-Term Disability for Schizophrenia

May 8, 2020 By Rich Frankel

long-term disability schizophrenia

In popular culture, people with schizophrenia are often portrayed as violent, and beset by constant hallucinations (such as “hearing voices”). In reality, schizophrenia is a very treatable mental health condition — and people with this disorder are rarely aggressive towards others.

Approximately 51 million people across the world suffer from schizophrenia. Given the range of symptoms that a person with schizophrenia may experience, having this disorder may make it difficult to work — particularly in times when symptoms are more severe. In these situations, it may be necessary to apply for disability benefits to provide financial support while seeking treatment.

If you have been diagnosed with schizophrenia, you may qualify for long-term disability benefits through an individual or group insurance plan. A Philadelphia disability benefits attorney can work with you to put together a strong application for benefits. Read on to learn more about schizophrenia — and when you may be eligible for disability benefits if you have this disorder.

Understanding Schizophrenia

Schizophrenia is a chronic mental health condition that can cause delusions, hallucinations, difficulty with thinking and concentration, disordered thinking, and lack of motivation. It is often disabling, as it causes people to interpret reality in an abnormal way. While there is treatment available for this condition, there is no cure for schizophrenia.

There are a number of cognitive, behavioral, and emotional symptoms of schizophrenia. They may include:

  • Delusions, which are false beliefs that are not based in reality
  • Hallucinations, which involve seeing or hearing things that do not exist
  • Disorganized thinking, which can be inferred from disorganized speech; this impairs the ability to communicate effectively
  • Extreme disorganized or abnormal motor behavior, which may include unpredictable agitation, resistance to instructions, useless and excessive movement, or bizarre posture
  • Negative symptoms, which is the inability to function normally, such as neglecting personal hygiene, loss of interest in everyday activities, or lacking emotions.

Symptoms of schizophrenia can vary over time, with periods of severe symptoms and times of remission.

The exact cause of schizophrenia is unknown. However, it is believed that a combination of brain chemistry, genetics, and environment contribute to the disorder. People with a family history of schizophrenia, those who take mind-altering drugs in young adulthood, and those who suffered from prenatal or birth complications may be more susceptible to developing schizophrenia.

Schizophrenia becomes a disability when it prevents a person from functioning in their daily life. If this condition is not treated, it may either cause or be associated with complications such as:

  • Suicide, suicide attempts, and suicidal ideation
  • Depression
  • Anxiety disorders and obsessive-compulsive disorder
  • Abuse of alcohol and/or drugs
  • Inability to work or to attend school
  • Social isolation
  • Financial problems
  • Homelessness
  • Health and medical problems
  • Being victimized by others
  • In rare cases, aggressive behaviors

Schizophrenia is diagnosed through reference to the criteria in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5). This is typically done through a physical exam, psychiatric evaluation, and various tests to rule out other conditions that may cause the behaviors associated with schizophrenia.

Treatment for schizophrenia may include the use of oral antipsychotic medication, long-acting injectable antipsychotic medications, and therapies such as individual and family therapy. In addition, individuals with schizophrenia may undergo social skills training and vocational rehabilitation to help them find and keep jobs.

In times of crisis or severe symptoms, hospitalization may be necessary. If a person with schizophrenia does not respond to medication, electroconvulsive therapy (ECT) may be used.

Working with Schizophrenia

Schizophrenia affects less than 1 percent of the population in the United States. In most cases, medication and other therapies effectively treat schizophrenia — allowing you to live and work just as anyone without the condition would. However, there may be times when the symptoms of schizophrenia become so severe that you are unable to work.

For example, if your schizophrenia stops responding to your current medicine regime, you may start to experience delusions or hallucinations. In these situations, your ability to work may be compromised because your hallucinations or delusions make it difficult to concentrate. Alternatively, you may withdraw socially or be unable to take care of your personal hygiene — which may impact your ability to present yourself appropriately at work.

If you are experiencing symptoms of schizophrenia, it may affect your ability to understand, remember, or use information, which can prevent you from taking on job-related tasks. You may also find that you cannot interact with others appropriately, which can prevent you from interacting with clients, customers, colleagues, or supervisors. The ability to persist in performing tasks may also be impacted so that you cannot complete a particular job.

While schizophrenia is a treatable condition, if your symptoms have reached the point where your work is affected, then you may qualify for long-term disability benefits. The ability to qualify will depend on the terms of your policy and proof of your diagnosis and its impact on you.

Qualifying for Long-Term Disability with Schizophrenia 

Long-term disability (LTD) insurance provides monthly payments of a percentage of your salary if you are unable to work due to a disability. To be eligible, you must have a covered disability that prevents you from performing your job. These benefits are usually paid at a rate of 50 to 60% of your monthly salary and may last for anywhere from 24 months to retirement age.

Many LTD insurance policies — both individual and group — have specific exclusions for mental illnesses such as schizophrenia. Other policies provide coverage for mental illnesses but limit the benefit period to 24 months. In other words, if your insurance policy covers a condition such as schizophrenia, you may only be eligible for 2 years of payments.

If you plan to apply for LTD benefits for schizophrenia, you should first obtain a copy of your insurance policy. The way that the policy defines mental illnesses is important in determining whether your condition may be excluded from coverage. A Philadelphia disability benefits attorney can analyze your policy’s exclusions and limitations to help you determine if you may be eligible for LTD benefits, or if there is an exception in the policy that will allow you to qualify for benefits.

If your policy does cover mental illnesses, you will need proof of an objective diagnosis of your condition, including psychological testing. Using your job description, information from your personnel file, and other documents, a lawyer can ask your doctor to list your job limitations, based on your symptoms, in your medical file. This can then be used as part of your application, to demonstrate that you are unable to work because of your schizophrenia.

Qualifying for long-term disability benefits with schizophrenia can be challenging. However, there are many approaches that a skilled lawyer can take in order to increase the likelihood of coverage for your condition.

Questions? We Can Help.

If you have been diagnosed with schizophrenia, you may already be dealing with the stigma and bias against people with your condition. Although schizophrenia can be disabling, it is often treatable with appropriate medication. However,  if your symptoms become severe enough that you cannot work, you may be eligible for long-term disability benefits.

Bross & Frankel works with individuals with disabilities in Pennsylvania and New Jersey, helping them obtain the benefits that they need when they cannot work. With decades of combined experience, we understand how to best advocate for our clients. To learn more or to schedule a free claim review, contact our office today at 856-795-8880, or reach out online.

Posted in Long-term disability

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