According to World Health Organization (WHO), approximately 50 million citizens have dementia worldwide. Every year, there are nearly 10 million new cases. So what happens if you or your kin are among the patients? Does dementia qualify a person to receive disability benefits? If so, what symptoms and test results need to be documented in your medical records to get approved? Do you need a lawyer? We compiled this article to answer all your questions and give you all the information you need to know about getting long-term disability insurance and Social Security Disability payments for dementia. If you still have questions we are available to help. You can call us at (888) 321-8131 or contact us online.
Can You Get Disability Benefits for Dementia?
Disability Insurance Policies
If the effects of dementia preclude you from working and you have a disability insurance policy, you may be eligible for long-term disability (LTD). However, there are requirements that you have to meet before you qualify. Each policy has certain requirements that you must meet in order to receive disability insurance benefits. You will also need a doctor’s report showing the extent of the physical and mental damages that your symptoms have caused you. You can ask your doctor to complete a residual functional capacity (RFC) form that will detail the limit of what you can physically and mentally do while working. Most disability insurance companies will also require claimants to file for SSDI if they are receiving long-term disability benefits.
Social Security Disability Insurance
You may also be eligible to receive Social Security Disability Insurance (SSDI) benefits. Meeting the Social Security Administration (SSA) disability listing requirements (most commonly disability listing 12.02, neurocognitive disorders) is the easiest and most straightforward way to get benefits for dementia. Some forms of dementia qualify under the compassionate allowances initiative, which could help you receive benefits much quicker than usual. If you do not meet the listing or compassionate allowances requirements you can still qualify for Social Security based on your RFC. If you are over the age of 50, it is more likely that your disability claim will be approved this way.
If you’re unsure whether you qualify or not, you may consider consulting with a disability attorney. Nick Ortiz has years of experience handling long-term disability claims and he is also a Board-Certified Social Security Disability benefits lawyer. We offer a free, no-obligation case evaluation so you can discuss your disability claim with an expert.
What is Dementia?
Dementia isn’t a specific disorder, but rather a general term for different organic mental disorders that affect cognitive functioning and memory, making it difficult for patients to perform daily activities effectively. These conditions involve a gradual decline in daily functioning whereby your language skills, memory, personality, or judgment are affected. If you suffer from more than one cause of dementia simultaneously then it is called mixed dementia. Many researchers believe changes from mixed dementia may have a greater impact on the brain than changes from one type alone.
Dementia is prevalent in people age 65 and above and is often considered a normal part of aging. Although signs like memory loss, weakening bones and muscles, and other changes may result from normal aging, dementia also has many severe symptoms that are not normal. Some patients also start seeing signs of dementia at a younger age, such as those with early-onset Alzheimer’s disease. Younger patients could lose the ability to work as a result.
There is no specific cause of dementia. However, medical conditions such as a stroke, traumatic brain damage, and Alzheimer’s disease can increase the risk of dementia. According to statistics, Alzheimer’s disease is often the cause of this disease, accounting for over 60% of all dementia cases.
Symptoms of Dementia
Since dementia is a general term for several conditions, the symptoms can vary significantly from one person to another. Some of the most common signs of dementia include:
- Losing track of place and time
- Disorientation and confusion due to memory loss
- Getting lost in a familiar environment
- Speech and language disorientation
- Irritation and mood swings
- A decline in cognitive functioning and decision-making skills
- Hallucinations and delusions
- Social anxiety
- Diminished fine and gross movement skills
- Difficulty walking
- Aggression and irritation
- Difficulty recognizing friends and close relatives
- Inability to care for yourself
- Increasing communication difficulty
- Repetitive questioning and wandering
Since the condition is progressive, the symptoms may start as mild but worsen over time. Many patients will eventually require the care of other people. As a result, it’s essential that you seek help early on. You should discuss a long-term care plan with your loved ones.
Diagnosis of Dementia
If you continuously experience signs of dementia it’s essential that you start exploring the possibility and seek out a diagnosis. The only way to confirm whether it’s dementia is by consulting a health expert for a diagnosis. The healthcare professional may perform specific tests on you to establish a diagnosis of dementia and the possible causes. There are many tests that can be performed on a patient’s memory, problem-solving ability, attention, and various cognitive abilities.
Depending on the extent of your disease and symptoms, patients could also have to take blood tests and undergo a physical examination and brain scans like MRI or CT scan to determine the root cause (or, in the case of mixed dementia, root causes). If your medical records show that you have dementia and you are unable to work as a result of your disease then you may qualify for long-term disability benefits.
Treatments and Therapies for Dementia
Most forms of dementia do not have a cure or any treatment to alter the progression of the disease. However, this does not mean that all hope is lost if you’re a patient that has been diagnosed with dementia. Several specific therapies and treatments have been proven to alleviate the symptoms. Depending on the condition’s root cause, these treatments may include routine occupational and physical therapy for the patient.
Additionally, you can take care of your health to avoid falling into the ditch of dementia. Here are some steps to take to avoid severe consequences of the condition, or lower the risks of being affected:
- Optimize physical health
- Detect and treat any mental disorders
- Be informed
- Provide information to carers
- Spot and treat accompanying physical diseases
- Early diagnosis and management
- Living a healthy lifestyle
- Maintain contact with loved ones and friends
How Do You Qualify for Disability with Dementia?
Qualifying for disability with dementia isn’t easy, but it’s possible. Statements from your doctors and regular medical care are essential in every claim for long-term disability insurance or SSDI. The insurance company and the SSA trust the doctors’ reports to establish the extent of your dementia symptoms and their impact on your life and job. It can also help to provide information from third parties such as your loved ones, neighbors, or workmates.
Many of the requirements for each type of claim are different, so we’ll cover the process to qualify for long-term disability insurance benefits then move on to the SSDI process.
Long Term Disability Insurance
Most long-term disability insurance policies have two different definitions of disability:
1. Own Occupation- Whereby you demonstrate that the condition precludes you from efficiently performing your actual job.
2. Any Occupation- Whereby you demonstrate that dementia prevents you from doing any job within the economy.
Under most policies, the “Any Occupation” definition does not kick in until after benefits have been paid for 2 years, or 24 months. Once benefits have been payable for 24 months, the insured is considered disabled only if the insured meets the “Any Occupation” definition.
The insurance companies use rigorous standards to determine if you qualify for benefits due to your condition. You must make sure that the results of any tests used to confirm your diagnosis and a detailed history of any symptoms are clearly documented in your medical records. Patients should work with their doctors to complete an RFC form that clearly states the limitations that prevent the patient from performing work activity. A lawyer can often provide you with forms that are specific to your conditions so that you do not have to use the general form provided by your insurance carrier.
Even after you provide evidence of your disability the insurance company may have your claim reviewed by an independent medical consultant. In many cases, the independent consultant hired by the insurance company will find that the patient is not disabled, and the insurance company will use this opinion to discredit your doctors’ opinion. As a result, it’s easy for your claim to be denied. An experienced long-term disability lawyer can help you appeal your case and get justice.
Social Security Disability Benefits
Some types of dementia qualify under the SSA’s compassionate allowance initiative which allows Social Security to quickly identify the most obviously disabled applicants. You can also be found eligible by meeting the requirements of SSA’s official disability listing. To do this, you will need medical evidence confirming that your abilities have significantly decreased. The impacts could be in one or more of these areas:
- Learning and remembering (as short-term memory affects the ability to learn)
- Language difficulty, including the ability to properly use words and recall words
- Paying attention
- Physical coordination
- Social judgment
If you have a severe limitation in one of the above areas then the SSA will determine if this limitation prevents you from performing work activity. Your records must specifically show an extreme decline in one of these areas or more than moderate restraint in two of the following areas:
- Social interactions
- Managing and adapting oneself, which may include awareness of typical hazards, adapting to changes, etc.
- Concentration on tasks and ability to complete them
- Remembering, understanding, or using information
The SSA may also need to see neuropsychological testing results, intelligence testing, clinical testing, psychological testing, and any evidence of hospitalization or repeated medical visits.
If you do not meet the listing you can receive benefits based on your residual functional capacity. The SSA will use your RFC to evaluate your ability to perform past work and may use your skills, education level, and age to determine if there are other jobs in the national economy which you can perform.
How Can Long Term Disability Attorney Help You Qualify for Benefits?
It can be difficult for people suffering from dementia to keep track of relevant information and track down medical evidence. You may need an expert to help you gather it all. Aside from helping you gather the relevant information, long-term disability attorneys can also establish the legal merits of your claim and prevent you from missing any applicable deadlines. Your attorney can help you follow the right process to achieve the benefits you deserve. If your claim has been denied or terminated, now is the time to entrust your claim with an experienced long-term disability lawyer.
Do you believe that information is power? We think that power is in applying the information you have the right way. We have highlighted the key factors in qualifying for disability due to dementia and other information that you need about the disease. Now it’s up to you to take the right steps if you’re already affected. If you need a long-term disability attorney to help you pursue disability benefits for dementia, Ortiz Law Firm is here to help. Contact us online or call us at (888) 321-8131 for a free, no-obligation case evaluation, and let’s discuss your case.