Functional impairment in people with schizophrenia: Focus on employability and eligibility for disability compensation Schizophrenia Research, 05/02/2012

Harvey PD et al. – Research evidence suggests that disability applicants with a valid diagnosis of schizophrenia have significant impairment across multiple dimensions of functioning, and will typically remain impaired for the duration of normal working ages or until new interventions are developed.

• This is a selective literature review and synthesis, based on a work plan developed in a meeting of experts convened by the National Institute of Mental Health and the SSA.
• This review of the prevalence of disability is focused on the criteria for receipt of disability compensation for psychotic disorders currently employed by the SSA.

• Disability in multiple functional domains is detected in nearly every person with schizophrenia.
• Clinical remission is much more common than functional recovery, but most patients experience occasional relapses even with treatment adherence, and remissions do not predict functional recovery.
• Under SSA's current disability determination process, approximately 80% of SSDI/SSI applications in SSA's diagnostic category of “Schizophrenia/Paranoid Functional Disorders” are allowed, compared to around half of SSDI/SSI applications overall.
• Moreover, the allowance rate is even higher among applicants with schizophrenia.
• Many unsuccessful applicants are not denied, but rather simply are unable to manage the process of appeal after initial denials.