Cognitive Impairment and Long Term Disability Insurance Claims

What is cognitive impairment?

Cognitive impairment is a difficulty in thinking, remembering, learning new things, understanding, and making decisions. Cognitive impairment ranges from mild cases, where a person may seem just forgetful, to severe cases where the person may not be able to communicate or take care of themselves.

Cognitive impairment is caused by a variety of things, such as disease or injury. Common causes include dementia such as Alzheimer’s disease, strokes, traumatic brain injuries, and congenital disabilities. While people of all ages can experience cognitive impairments, older people are more often affected by the condition. Other risk factors include family history, drug and alcohol abuse, physical inactivity, and conditions such as diabetes.

Exposure to hazardous chemicals such as pesticides can cause cognitive impairments, even decades after the original exposure. Certain professions are linked to higher rates of cognitive impairments. These include agricultural workers, emergency workers, and veterans of foreign wars.

Diagnosing cognitive impairment

Diagnosis of cognitive impairment includes both determining that there is an issue with cognitive function and finding the possible cause. Although a diagnosis can be made without knowing what is causing the impairment, successful treatment depends on knowing why the person is experiencing cognitive decline.

A doctor will take the individual and family medical history, including work history and possible exposure to hazardous chemicals. It is helpful if a friend or family member can confirm that the person has had a decline in mental functioning.

Diagnostic testing may include:

  • Neurological exams to test reflexes, coordination, and balance
  • Neuropsychological testing to see how well the person performs on tests of mental functioning compared to others in their age group
  • Bloodwork to look for vitamin deficiencies, uncontrolled diabetes, and thyroid functioning
  • Brain imaging tests such as MRIs and CT scans to look for physical signs of stroke, changes in brain size and structure, and for signs of diseases such as MS and Parkinson’s disease

Screening for mental illnesses such as depression and bipolar disorder are often included in diagnostic measures. If suspected, the doctor may also look for signs of sleep apnea or other sleep disorders. If a person has had repeated exposures to toxic chemicals, tests for heavy metals may be necessary.

Treating Cognitive Impairment

Before treating cognitive impairments, it is important to determine what is the cause. Causes such as thyroid functioning or sleep disorders may respond well to treatment. If the impairment is caused by medications, stopping the medication may cause an improvement in symptoms. Vitamin deficiencies can be treated by supplements. If the cause is a mental illness such as depression, treating the condition with a combination of medication and talk therapy can help with the impairment. Diseases such as Alzheimer’s or Parkinson’s may not respond as readily to treatment measures. For these disorders, supportive measures may be necessary.

In all cases, treatments that are started at the early signs of cognitive impairments are most successful. Keeping physically fit, mentally engaged, and managing chronic illness can help to slow symptoms or prevent the development of the condition. People who are active in their community and have the support of family and friends have better success at managing the symptoms and slower progression of the condition. Learning new skills, such as card games or exercise such as tai chi, can keep the brain active and elastic.

Lifestyle changes such as following a routine, using reminders such as lists and medication alarms, and simplifying the home setup to easily find things can help a person stay as independent as possible. People with severe cognitive impairments may need help performing daily tasks. They may not be able to live by themselves and may need live-in caretakers or to move to an assisted living facility.

Disability Evaluation of Cognitive Impairment

People with severe cognitive impairments may not be able to work. If a person is prevented from working because of their cognitive impairment, they may qualify for Long Term Disability (LTD) benefits. The insurance company will review their claim to see if they qualify under the conditions of that plan.

Definition of Disability

Most LTD plans consider a person disabled if they have a medical condition that causes them to 1) be unable to perform their work duties for the first two years of the policy and 2) be unable to complete the work duties of almost any occupation for the years following the initial 2-year period. It is important to understand how your specific plan defines disability.

Evaluating Disability for People with Cognitive Impairment

To qualify for disability benefits, the condition must prevent the person from working for a least one full year. They will need a Residual Functional Capacity (RFC) assessment that indicates how their symptoms affect and limit their life activities.

What the Insurance Company Needs From You and Your Medical Providers

The insurance company will need to get your medical records from any doctor that has treated you for your cognitive impairment. These records include office notes, clinical exams, diagnostic tests, and lab results. If for any reason they cannot get these records from your doctors, you should request them and provide them to the insurance company yourself.

You will need to provide proof of your diagnosis and your ongoing symptoms, as well as proof of how you are affected by your symptoms. Providing detailed documentation is key to a successful claim. Residual Functional Capacity (RFC) assessments determine how you are affected by the condition and what you can do despite your limitations. It is used to determine what jobs you may still be qualified to perform. Make sure that you are as honest as possible with your doctors so that they can complete an accurate RFC for you.

Working With an Experienced Disability Attorney

You do not have to fight the insurance companies alone. An experienced disability attorney will guide you through the process and give you the best chance at getting the benefits you deserve. Even if you have already applied and you have been denied, you are not out of luck. The experienced disability attorneys at the Ortiz law firm can help you through every step of the process, from initial application to potential appeals.

While the process can be daunting, your expert disability attorney will be able to guide you through the process. They do not get paid until you win your case. You can seek help without worrying about upfront costs or unexpected bills. Our law experts will focus on your case so you can focus on your illness.

The Ortiz law firm has successfully represented people in disability cases across the United States. If you would like to talk to one of our experienced disability lawyers about your cognitive impairment and how it affects your life, call us at (850) 308-7833.