My son was granted SSI within 4 months of the initial application without the need for any appeals. Based on the experiences of others this is quite an accomplishment.

Comprehensive Textbook on Psychiatry (p. 2765) has some interesting comments regarding the Social Security Administration's guidelines for disability claims:

Compensation rests on total disability (inability to do any job, not just one's former job) for a period of at least 12 months. APA guidelines aid in the determination. The critical factors to assess are:

1) diagnosis, using APA criteria; particular care should be taken with the determination, since only disorders consistant with total disability are compensated; and, 2) functional incapacity in four realms: a) activities of daily living; b) social functioning; c) concentration, persistence, and pace in job related activities or worklike settings; and, d) ability to resist deterioration or decompensation in work or worklike settings.

In the case of an adverse finding, cases may be appealed upward through several administrative layers.

Prior to completing the application, we fastidiously maintained records of my son's illness: it's progression, his hospitalizations, his encounters with police and the criminal justice system, etc. These records provided the framework for completing the applications and making sure that all the criteria for acceptance were met. After completing the application we reread it several times and satisfied ourselves that the criteria were unquestioningly satisfied. We also did the same thing with diagnosis criteria. Our neuropsychologist and psychiatrist provided a comprehensive assessment that corroberated the documentation. They knew SSA's requirements and their assessments clearly documented my son's disability in terms that a non-specialist could understand. Part of our records consisted of hospitalization records: admission records, psychiatric testing and assessments, and discharge summaries. Finally, we had the records from research programs in which he has participated. These records were extremely compelling. Both the VA and NIMH confirmed the diagnosis. The VA's testing was the most comprehensive and their conclusions discussed his ability to function. It's a little difficult for the SSA to disagree with the testing and assessments of the VA and NIMH!

In closing, I recommend that when applying for SSI:

o keep detailed records of all hospitalizations. These records should consist of the discharge summaries at a bare minimum. The more comprehensive the records, the easier it should be to establish the disability.

o participate in research. This will help establish the diagnosis and also help identify the causes of schizophrenia. If it is federally funded, so much the better. Much of this research will include testing that includes testing that probably are not part of the typical psychiatric evaluation: EEG, MRI, fMRI, PET, MMPI, WISC, etc.

o maintain copies of all educational acheivements. This can be used to show diminished capacity if the applicant went from A's and B's to D's and F's. Placement in an SED program in school also helps to document the disability. Even if the application does not ask about school performance--volunteer this information. It does ask about special education and accomodations.

o satisfy yourself that your application unequivocally meets SSA criteria for disability; for example, diagnosis can be derived from the symptoms and behavior documented in the application. Likewise, the functional incapacities that beset the applicant should be easily derived from the application.

o be thorough and concise. I used bulleted lists under the headings that needed additional information.

I was fearful that the approval process would be long and drawn out with multiple appeals. Many parents who I know have gone through this process and had their child granted SSI only after multiple appeals. We were pleasantly surprised by SSA's quick approval. We received several comments from SSA personel that the application for SSI was the most thorough they remembered seeing.

I hope that lessons from our experience translate to facilitating your applications for disability claims.

Bob