I have been seeing more and more people contacting me who have been denied Social Security disability benefits even though they are schizophrenic. I have talked with other attorneys in North Carolina who tell me that they have seen the same thing. I have not seen disability claims based upon schizophrenia denied in a long time, more than 25 years. Social Security for many years that schizophrenia is such a devastating illness that any virtually every schizophrenic ought to be approved.
So what has changed? It's not been a change in the treatment of schizophrenia. There's no cure. Schizophrenia cannot be managed in the way that bipolar disorder can be managed for many people. The best that can be achieved with schizophrenia is to control the positive symptoms, the hallucinations and delusions, but treatment hardly touches the negative symptoms of schizophrenia, such as "inexpressive faces, blank looks, monotone and monosyllabic speech, few gestures, seeming lack of interest in the world and other people, inability to feel pleasure or act spontaneously." That may sound a little vague but it is very real and very disabling.
If something has changed in disability claims based upon schizophrenia, it is at Social Security. Social Security never announces these things. In fact, they always deny that they have made any change. They "announce" the change secretly using their quality assurance program. Disability Determination Services (DDS) tries to approve someone at the initial or reconsideration level, the case is subjected to quality assurance review and gets sent back because the quality assurance people did not like paying that person. Once DDS gets several returns on the same issue, they gets the picture and cut back on approving people who present that particular situation without Social Security every acknowledging that anything has changed.
If something has changed in disability claims based upon schizophrenia, it is at Social Security. Social Security never announces these things. In fact, they always deny that they have made any change. They "announce" the change secretly using their quality assurance program. Disability Determination Services (DDS) tries to approve someone at the initial or reconsideration level, the case is subjected to quality assurance review and gets sent back because the quality assurance people did not like paying that person. Once DDS gets several returns on the same issue, they gets the picture and cut back on approving people who present that particular situation without Social Security every acknowledging that anything has changed.
Take a look below at a quality assurance return that I have seen in a client's file recently. I have redacted the identifying information. Don't try to blame it on the diagnosis of "schizophreniform disorder" instead of schizophrenia? That's technical, because the young woman in question hadn't demonstrated her symptoms for six months. Since that time, predictably, her symptoms have continued unabated. DDS got the message from this return. They got updated clinic records which showed the continuation of the same problems and they turned her down. That's why her mother called me.
I find this depressing. What do you think?
Schizophrenia
I find this depressing. What do you think?
5 comments:
As a former agency employee at a state DDS, I used to handle these returns at the DDS level when they were returned from the Regional QA or Baltimore. Baltimore was noted for being off base the majority of the time. The Regional offices were more accurate in returns but still, largely out of touch. The DDS can rebut these, we did and won often. However, most DDSs don't - not enough staff, skills, time or will to mount a defense. Additionally, the regions were notoriously disparate in their reviews. For example, the Seattle Region was far more "liberal" with psychiatric allowances than the Dallas Region. So the program is inconsistently applied. Schizophrenics in Seattle fared better than those in Oklahoma. Moreover these "quality reviews" are often penned by star chambers of SSA policy wonks and medical consultants who've never seen a claimant and don’t have a current practice.
There is sufficient evidence in the above case to document a 12 month period of disability with a very poor prognosis. The allowance should not have been disturbed. Somebody wants to make a point. And the cost? Months to the claimant. And for the tax payer? Every time a SSA adjudicator or medical consultant weights in the salary clock ticks. Add support staff and the other requisite cost of handling a case. The entire post eligibility review of allowances (50% by law for SSDI) should be examined and revised in my opinion. These Post Eligibility and Federal Quality Assurance reviews have never been statistically justified and the methodology is not comprehensively reported and should be radically downsized. This would require a change in the law, but fewer schizophrenics and other claimants would face such expensive delays.
Some differences may be due to the advances made in medications that treat schizophrenia; however, given the evidence provided it does not appear that medication will result in this young woman being able to perform substantial gainful activity.
Jus sad that this is how our country treats our disabled citizans. My friend suffers from the same disorder and at a rather young age to boot and was only awarded 131.50 which is a sad allowance for her to live from.
I forgot to mention this was done in WV at age 16 and she is now 26 and has yet to have been approved for an increase.can any of you possibly offer any advise to help me help her?
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