What Medical Conditions Qualify For Long
Most medical conditions can qualify for long-term disability. However, some long-term disability plans will exclude certain medical conditions.
Assuming you dont have an excluded condition, then you can qualify for long-term disability benefits if your medical conditions prevents you from doing your regular work. You wont qualify to apply right away. Most long-term disability plans require you to be continuously disabled for a number of weeks before you are eligible to apply. This called the waiting period or elimination period.
The most common length of the waiting period is 17 weeks, but this can be different for each disability plan.
Most long-term disability plans have a two tier requirement for disability. For the first 2 years you can qualify for benefits if your medical condition prevents you from doing your regular work.
However, after 2 years, you can only qualify for long-term disability benefits if your medical conditions prevents you from doing any gainful work .
Following is an example of a long-term disability requirement fround in a group long-term disablity plan. This is only an example and these requirements and wording vary from plan to plan.
An employee is entitled to payment of a long term disability benefit if the employee presents proof of claim acceptable that:
- the employee became disabled while covered
- total disability has continued beyond the elimination period
- the employee has been folloing appropriate treatment for the disability condition
Impairments Of Alzheimers And Dementia
Many of those who have either Alzheimers, dementia, or a combination of the two, are over age 65. Earlier diagnosis means this fatal disease now touches a significant number of younger people. Many symptoms of these diseases affect the part of the brain that controls memory, reasoning, judgment, and behavior. This leaves those suffering with little capacity to function beyond the basic task of everyday life. Those who have more serious side effects or have had Alzheimers or dementia for longer may be completely dependent on a caretaker for even the most basic of tasks such as eating and going to the bathroom.
Determining Your Residual Functional Capacity
If your mental condition does not meet or equal a disability listing, the SSA will assess your “residual functional capacity” based on all of the evidence you have submitted. Your RFC is the limit of what you can physically and mentally do while working a 40-hour work week.
Physically, you might be limited to sedentary, light, or medium work. Mentally, you might be limited to simple, semi-skilled, or skilled positions. Dementia patients will likely have poor memory and attention skills, so your doctor might limit you to simple, unskilled work. If your cognitive skills have significantly declined, you might be unable to perform any work and be found disabled merely on this basis alone. Similarly, you might suffer from personality changes that affect your ability to work with others. In this scenario, you might be restricted from jobs requiring close contact with the public, co-workers, or supervisors.
In addition, if you are currently taking any medication for treatment of dementia, these drugs could cause side effects including drowsiness or fatigue. The SSA has explained in its Social Security Rulings that fatigue may limit your ability to perform physical demands. If you suffer from fatigue, you might be restricted to only sedentary or light work.
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The Cause Of Alzheimers Involves A Combination Of Genetic Lifestyle And Environmental Factors That Result In Changes In The Brain
Proteins in the brain that do not function properly disrupt the work of brain cells and the brain cells die. Damage usually begins in the part of the brain that controls memory years before the first signs of the disease appear loss of brain cells then spreads to other parts of the brain.
- A family history of Alzheimers. If a person has a parent or sibling with Alzheimers, their chances of developing the disease are greater.
- Down syndrome. This is likely related to people with Down syndrome having three copies of chromosome 21.
- Traumatic brain injury.
- Excessive alcohol consumption.
- Mild cognitive impairment . MCI is a decline in memory and thinking skills that doesnt prevent a person from functioning at work or in social situations.
- Poor sleep habits.
- Air pollution. Exposure to traffic exhaust and burning wood speeds degeneration of the nervous system.
- Gender. There is little difference between men and women developing Alzheimers, but women seem more likely to develop the disease because women live longer.
- Lifestyle. Smoking, obesity, lack of exercise, or another medical condition like high blood pressure, high cholesterol, or diabetes can increase a persons risk of developing Alzheimers disease.
Types Of Disability And Mobility Benefits
If youre living with dementia, you may be entitled to a disability benefit. These include:
- Attendance allowance
- Personal independence payment
- Disability living allowance .
However, people with dementia dont automatically qualify for these because tests are required to determine the level of need. If you do qualify, these benefits provide extra help to deal with the practical effects of a disability such as needing help with personal care or supervision to stay safe during the day or night.
These benefits are not means-tested and payment is not affected by your savings or income. They are tax free and do not depend on National insurance contributions. Disability benefits are paid at different rates, depending on your needs. They can be claimed whether or not you work, and whether you live alone or with other people. For some benefits a medical assessment may be required.
Up until November 2018, PIP was for people aged 1664 and AA was for those aged 65 or over. However, as pension age is now increasing in stages to 66 by the year 2020, the new cut-off point is each persons own pension age. For more information see the gov.uk website.
If your care needs started after you reached pension age, or you have not made a claim until then, you should claim AA. This is for help with personal care or need for supervision only.
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Qualifying For Disability With Early
The trouble is that, while it is an accepted disorder on the SSAs list of compassionate allowancesmeaning that it has a streamlined application processmental disorders like Alzheimers can be very difficult to prove, especially in their early stages.
To qualify for disability with early-onset Alzheimers, you need to have clinical evidence/documentation of a progressive dementia condition. However, the initial symptoms of early-onset AD arent usually very obvious.
As noted by the SSA, the onset of AD is subtle because people with early-onset AD are often in the work force, it is not uncommon for the disease to first manifest as a decline or loss in their ability to perform work-related activities. This can lead to misdiagnosis of AD as a less severe condition.
Diagnosis Involves Reviewing The Medical History Of A Patient Over Time And Speaking With Relatives About Behavior Changes
A doctor will most likely order neuropsychological and cognitive tests, brain scans, lab tests and a psychiatric evaluation to confirm diagnosis. Treatment involves treating the cause of dementia, but, unfortunately, only 20% of cases are reversible. Those cases include dementia caused by drug and alcohol abuse, tumors and metabolic disorders, such as a vitamin B12 deficiency. Medications are prescribed to improve and manage symptoms such as depression, sleep disturbances, hallucinations and agitation. Occupational therapy can help a person manage their environment to make their home safer and prevent accidents.
If you have applied for Social Security benefits and been denied, be persistent. Two thirds of initial claims are denied. Most people currently receiving Social Security Disability Insurance or Long Term Disability benefits have had to appeal their case. If you are considering applying for benefits or appealing your denied application, it is recommended that you seek professional representation with ss disability lawyers. The process of appealing can be hard to understand. It makes sense to have someone work alongside you who has been through appeals before, and knows what the Social Security Administration and insurance companies are looking for in an application. The attorneys at Bemis, Roach and Reed have that knowledge and experience. Call today for a free consultation. Call 512-454-4000 and get help NOW.
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Qualifying For Disability If You Have Dementia
The Social Security Administration will find you disabled if you meet the requirements of an official disability “listing” in the SSA’s listing of impairments, or if your disability has reduced your functioning so much that you can’t do your past work or other work. Meeting the requirements of a disability listing is the simplest and quickest way to qualify for disability benefits.
The listing most commonly associated with dementia is disability listing 12.02, neurocognitive disorders. This listing was updated significantly in 2017 . To meet this listing today, you need medical evidence showing that your abilities have significantly declined in one or more of the following areas:
- learning and remembering
- planning and judgment
- using language
- paying attention to tasks or listening to others
- social judgment , or
- physical coordination.
If your records show that you have a significant decline in one of the above areas, the SSA will look to see whether your functioning is severely limited by this decline. Specifically, you must have either an extreme limitation in one of the following areas or a “marked” limitation in two of the following areas:
- understanding, remembering, or using information
- concentrating on tasks and being able to complete tasks
- adapting or managing oneself , and
- interacting with others.
If You Have Some Form Of Dementia It Is Likely You Have Poor Memory And Attention Skills And Are Unable To Perform Any Type Of Work
The Social Security Administration recognizes dementia as an impairment in two different sections of its Blue Book. Section 12. Mental Disorders evaluates dementia of the Alzheimer type, vascular dementia, and dementia due to a metabolic disease. Section 11. Neurological Disorders evaluates cases of early onset Alzheimers disease .
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Alzheimers Disease Symptoms And Complications
The symptoms of Alzheimers will change based on whether or not the patient has early onset Alzheimers, or if they are in later stages of the disease. Early dementia symptoms will attack mental function in a number of ways, such as abstract thinking, decision making, emotional behavior, forgetfulness, judgment, language, memory, perception or personality. Each person will be affected differently and at different speeds and severity.
Alzheimers will worsen over time. As such, the complications become more serious and dangerous as the disease progresses. In the early stages, people will begin to have difficulty with basic tasks, including balancing finances, playing games, remembering recent activities, losing interest in favorite activities, misplacing items and learning new information or tasks. Given time, these symptoms and complications will become worse and your ability to work will greatly diminish as the disease advances.
Expedited Processing For Early
Social Security has added early-onset Alzheimer’s disease to its list of Compassionate Allowance conditions, meaning that the agency will fast-track the processing of the disability application so that applicants with Alzheimer’s don’t needlessly have to go through the hassle of a denial and appeal as their symptoms get worse. Most applications that qualify for compassionate allowance treatment are approved within one month.
If you are helping someone apply for Social Security disability benefits, be sure to note on the application, or tell the Social Security field rep, that the applicant qualifies for Compassionate Allowance treatment and that the exact diagnosis is “early-onset Alzheimer’s disease.” Social Security will need to see medical records that include clinical notes documenting the applicant’s progressive dementia and an activities of daily living report filled out by a relative or caregiver. Results from standardized tests, such as the Clinical Dementia Rating scale or the MiniâMental State Examination , are also helpful.
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Which Neurological Disorders Does The Ssa Evaluate Under These Listings
They evaluate epilepsy, amyotrophic lateral sclerosis, coma or persistent vegetative state , and neurological disorders that cause disorganization of motor function, bulbar and neuromuscular dysfunction, communication impairment, or a combination of limitations in physical and mental functioning such as early-onset Alzheimers disease.
Using Your Rfc To Determine If You Can Work
First the SSA will use your RFC assessment to determine whether you can perform your past work. If you cannot, the SSA will use your RFC plus your age, education level, and work skills to see if you can do any jobs in the national economy. The SSA will use its Medical-Vocational Guidelines, which are often illustrated as a grid showing what age, education, and skill groups are deemed disabled at each RFC level. The med-voc grid shows that if you are over age 50, it is more likely that the SSA will find you cannot perform any jobs and will be found disabled. For more information, see our article on getting disability through the medical-vocational guidelines.
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Alternative Ways To Qualify Outside The Blue Book
If your condition does not match the requirements listed in the Blue Book, you can still be eligible for disability benefits if Social Security deems aspects of your condition to be equal to a disability listing.
Additionally, if you do not meet the criteria listed in the Blue Book, you can still qualify if you can prove that your illness diminishes your ability to work.
If your condition is not yet in the Blue Book, you can still qualify if your illness is medically determinable, and that it either reduces your RFC or qualifies you for a medical-vocational allowance.
Those Who Have Dementia With Declines In Learning Memory Concentration Or Language Can Often Get Disability Benefits If They Meet The Requirements Outlined By The Ssa
Dementia usually involves a progressive decline in your everyday functioning, in which your memory, language skills, judgment, or personality are affected. A variety of medical conditions can cause dementia. The most common conditions are Alzheimer’s disease, head injuries, and having a stroke. Although dementia is more likely to occur in elderly patients, the onset of dementia symptoms can occur at any age. Your doctor can give you a neuropsychological evaluation to determine whether you have dementia.
If your symptoms of dementia will prevent you from working for 12 months or more, you may qualify for Social Security Disability or Supplemental Security Income benefits. You can apply for SSDI benefits if you are not currently receiving retirement benefits. Once you reach full retirement age , your SSDI benefits automatically change to retirement benefits.
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Disability For Alzheimer’s Disease
Often by the time people find out they are suffering from Alzheimer’s disease, they are over 65, which means they are too old to collect disability benefits through the Social Security disability insurance or SSI program.
Those who are diagnosed with early Alzheimer’s disease are able to collect disability benefits if their symptoms and limitations are severe enough. The disability listing that Social Security uses to evaluate the severity of Alzheimer’s disease is the listing for neurocognitive disorders. This listing was updated significantly in 2017 . To meet the requirements of this disability listing, applicants with Alzheimer’s disease must prove that their abilities have significantly declined in one or more of the following areas:
- learning and remembering
- using language
- paying attention to tasks or listening to others
- planning and judgment
- social cognition , or
- physical coordination.
After it’s established that an applicant has a significant decline in one of the above areas, Social Security will look to see how severely the applicant’s functioning is limited. Specifically, the applicant must either have an extreme limitation in one of the following areas or a “marked” limitation in two of the following areas:
- understanding, remembering, or using information
- concentrating on tasks and completing tasks at a reasonable speed
- adapting or managing oneself , and
- interacting with others .
What Medical Conditions Qualify For Disability Benefits
Any medical condition can qualify for disability benefits. Generally speaking, most disability benefits programs in Canada do not give benefits based on a medical diagnosis. Rather, they provide benefits based on the level of disability caused by the medical condition. So the focus will always be on the level of disability caused by your medical condition, rather than only the name of your medical condition or diagnosis. To qualify for benefits, you must show that the level of disability from your medical condition meets the eligibility criteria of the disability benefits plan in question.
Following is a list of common medical conditions that qualify for disability benefits. For each of these conditions we discuss the unique challenges you will face.
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Work History And Alzheimers
To qualify for SSDI for Alzheimers, like with any disabling condition, youll need to meet the work history requirement. This can be problematic for some.
You see, normally, the SSA will use a set date at which you became disabled to assess whether or not you meet the recent work history test. But, with a mental condition like Alzheimers, establishing an exact date or even month in which you became disabled is harder.
This could complicate the calculation for your recent work test.
For example, say that your early-onset AD became severe enough to render you disabled under SSA guidelines at age 55. To pass the recent work test, you need to have worked at least 5 years out of the 10-year period ending with the quarter your disability began.
In this example, lets say you worked pretty consistently from age 48 to age 52 for four years of work. After 52, your condition began to compromise your ability to workcosting you your jobbut it wasnt enough for a clinical diagnosis, and you only had one year of work from age 45 to age 46.
If the SSA puts your date of disability later in the year at age 55, you might not meet the recent work test because youd be missing out on some of the work history from the first half of the year when you were 45, leaving you with less than 5 full years of work history.
Doing so can help you prove the date of disability so you have an easier time meeting work history testsnot to mention helping you prove the disabling condition.