Long-Term Disability for Dementia

According to the 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 those diagnosed with dementia?

Does dementia qualify a person to receive disability benefits? If so, what symptoms and test results must be documented in your medical records to get approved? Do you need a lawyer?

We prepared this article to help answer your questions and provide the information you need about getting Social Security Disability and long-term disability for dementia. If you still have questions, we are available to help. You can call us at (888) 321-8131 or contact us online.

Understanding Dementia

Dementia isn’t a specific disorder but rather a general term to describe a decline in cognitive functioning and memory. These conditions involve a gradual decline in daily functioning, affecting your language skills, memory, personality, or judgment.

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 the most common cause, accounting for over 60% of all dementia cases. Depression, excessive use of alcohol, and thyroid problems can also contribute to dementia.

Dementia is prevalent in people aged 65 and above. 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, such as those with early-onset Alzheimer’s disease, also start seeing signs of dementia at a younger age. Younger patients could lose the ability to work as a result.

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.
• Increasing communication difficulty.
• Repetitive questioning and wandering.
• Inability to care for yourself.

Since the condition is progressive, the symptoms may start mild but worsen over time. Many patients eventually require the care of others. You should discuss a long-term care plan with your loved ones.

Diagnosing Dementia

If you continuously experience signs of dementia, you must start exploring the possibility and seek out a diagnosis. The only way to confirm dementia is by consulting a health expert. The healthcare professional may perform specific tests on you to establish a diagnosis of dementia and the possible causes. Although there is no specific test to diagnose dementia, a doctor can perform many tests to evaluate a patient’s memory, problem-solving, attention, and cognitive abilities. 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.

Treatment for Dementia

Treating dementia depends on what’s causing it. For most progressive dementias like Alzheimer’s, there’s no cure yet. However, some medications can slow down the decline in cognitive abilities and daily functioning for those in the early stages of Alzheimer’s. Other drugs may temporarily ease dementia symptoms and improve the quality of life for Alzheimer’s patients and their caregivers. Doctors will sometimes prescribe the same meds used for Alzheimer’s to help with symptoms of other dementias, too. Non-drug therapies can also provide relief from specific dementia symptoms.

Can You Get Disability for Dementia?

Long-Term 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, you must meet specific requirements before you qualify. Each policy has certain requirements to meet to receive disability insurance benefits.

You will need medical evidence documenting the extent of your symptoms and how they affect your ability to work. 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.

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 one way to get benefits for dementia. You can still qualify for Social Security based on the GRID rules if you do not meet the listing or compassionate allowances requirements. If you are over the age of 50, it is more likely that your disability claim will be approved this way. Some forms of dementia qualify under the compassionate allowances initiative, which could help you receive benefits much quicker than usual.

If you’re unsure whether you qualify for disability benefits, speak with a disability attorney. Nick Ortiz has years of experience handling long-term disability and Social Security Disability claims. We offer a free, no-obligation case review so you can discuss your disability claim with an expert.

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 Social Security Disability Insurance (SSDI) or long-term disability (LTD) insurance. 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 family, friends, or coworkers. The requirements for each type of claim differ, so we will explain how to qualify for long-term disability insurance benefits and then move on to the SSDI process.

Long-Term Disability Insurance

Most long-term disability insurance policies have a definition of disability that changes over time. Here is an example of a typical definition of disability:

1. Own Occupation – Whereby you demonstrate that the condition precludes you from efficiently performing your 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 you have received benefits for 24 months. Once benefits have been payable for 24 months, the insurance company will consider the insured 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 ensure that your medical records include the results of any tests that confirm your diagnosis and a detailed history of any symptoms. Patients should work with their doctors to complete a residual functional capacity form clearly stating the limitations preventing them from performing work activities. A lawyer can often provide you with forms 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 or vocational expert. 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 doctor’s opinion. As a result, it’s easy for the insurance company to deny your claim. An experienced long-term disability lawyer can help you dispute the findings of a third-party expert.

Social Security Disability Benefits

Some types of dementia qualify under the SSA’s compassionate allowance initiative, which allows Social Security to identify the most obviously disabled applicants quickly. You can also be found eligible by meeting the requirements of one of the SSA’s impairment listings. 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
• Listening
• Physical coordination
• Social judgment
• Planning

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, including 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 get benefits based on your residual functional capacity (RFC). 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 that you can do.

How an Attorney Can Help You Get the Benefits You Deserve

If your claim has been denied or terminated, it is time to entrust it to an experienced long-term disability lawyer. It can be challenging for dementia patients to keep track of relevant information and medical evidence. You may need an expert to help you gather it all. Aside from helping you gather the appropriate information, long-term disability attorneys can also establish the legal merits of your claim and prevent you from missing any applicable deadlines. If you need a disability attorney to help you pursue disability benefits for dementia, Ortiz Law Firm is here to help. Call us at (888) 321-8131 for a free, no-obligation case evaluation, and let’s discuss your case.