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Veterans (VA) Disability Benefits for Schizophrenia

August 19, 2019
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What is Schizophrenia?

Schizophrenia is a chronic and severe mental disorder that interferes with a person’s ability to think clearly, manage emotions, make decisions, and relate to others.  Research has shown that this condition affects men and women about equally, but may have an earlier onset in males.  For a diagnosis of schizophrenia, symptoms must be present in the context of reduced functioning for at least six months.  Symptoms generally fall into three categories:

  • Positive Symptoms. Positive symptoms are psychotic behaviors not typically seen in the general population.  Examples include hallucinations, delusions, thought disorders, and movement disorders (agitated body movements).
  • Negative Symptoms. Negative symptoms are associated with disruptions to normal emotions and behaviors.  Examples include flat affect (reduced expression of emotions via facial expression or voice tone), reduced feelings of pleasure in everyday life, difficulty beginning and sustaining activities, and reduced communication.
  • Cognitive Symptoms. Cognitive symptoms can include changes in memory or other aspects of thinking.  Examples include poor executive functioning (the ability to understand information and use it to make decisions), trouble focusing or paying attention, and problems with working memory (the ability to use information immediately after learning it).

The diagnostic process also involves ruling out other mental health disorders and determining that the above-mentioned symptoms are not due to substance abuse, medication, or a medical condition.  This is often done through physical examinations, tests and screenings, and psychiatric evaluations.  While there is currently no cure for schizophrenia, treatments focus on eliminating the symptoms of the condition.  The most popular treatments include antipsychotic medications, psychosocial therapies, and coordinated special care (an integration of medication, psychosocial therapies, case management, etc.).

How VA Rates Schizophrenia

Schizophrenia is one of the mental health conditions for which veterans can obtain service connection.  To establish service connection for schizophrenia, veterans must show that they have a current diagnosis of the condition and that it is the result of their time in service.  After service connection is granted, VA will assign a disability rating to reflect the severity of the veteran’s schizophrenia.  While VA has different diagnostic codes for different mental illnesses (e.g. schizophrenia is diagnostic code 9201 and PTSD is diagnostic code 9411), all mental health conditions are evaluated under the same rating criteria according to 38 CFR § 4.130.  Generally speaking, all of the criteria within the rating schedule for mental disorders address the following factors: treatment via medications; symptoms; and the ability to work, care for oneself, and maintain social relationships.  Based on the overall level of impairment across these factors, VA will assign a disability rating percentage of 0, 10, 30, 50, 70, or 100.

Secondary Conditions Associated with Schizophrenia

Secondary service connection is established when you can prove that a disability resulted from a condition that is already service-connected.  Here, providing a nexus opinion that links your secondary disability to your already service-connected disability is extremely important.  There are several conditions associated with schizophrenia that could either warrant secondary service connection or contribute to your overall disability rating.  Examples include the following:

Major Depressive Disorder

Since all mental health conditions are evaluated using the same rating criteria, veterans with multiple mental health conditions (e.g. schizophrenia and depression) will likely be assigned one combined rating.  However, many individuals with schizophrenia also experience depression as they tend to be socially isolated and lose feelings of pleasure in everyday life.  Therefore, while you might not receive secondary service connection for depression, the impairment caused by the condition should be taken into account when VA is assigning a rating.  Importantly, this may contribute to a higher percentage than you would have received if it was based on your schizophrenia alone.

Cardiovascular Disease

Research indicates that individuals with schizophrenia are two to three times more likely to suffer from cardiovascular disease due to the increased rates of obesity, depression, and anxiety.  If you are service-connected for schizophrenia and later develop cardiovascular disease, you may be able to establish secondary service connection and receive additional disability benefits.

Diabetes Mellitus

Studies also show that there is a three- to four-fold increase in diabetes amongst individuals with schizophrenia.  This increase is likely the result of a poor diet and lack of exercise, along with antipsychotic medications that may cause obesity.  Secondary service connection may be warranted in this case as well.

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