Applying for Disability Benefits for someone with Alzheimer’s or Dementia
It’s difficult to watch a loved one suffer from Alzheimer’s or dementia. They may soon be unable to work and may struggle to take care of themselves. The costs of ongoing care and treatment can add up quickly and create financial difficulty for the whole family. Under such circumstances, it may be wise to apply for Social Security disability benefits on their behalf.
Provided by the Social Security Administration (SSA), these benefits can be used to pay for medical attention and for daily expenses. In order to qualify for these benefits, however, one must meet strict eligibility criteria and adhere to a very difficult application process. Here, we will cover the basics of the application process for Social Security disability benefits and how to qualify for them.
The Disability Programs
The SSA oversees two of the main public disability programs in the United States: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
Social Security Disability Income (SSDI) covers disabled workers and their families. SSDI is funded through Social Security payroll taxes and only to workers who have paid into the Social Security tax pool may qualify. In order to qualify, the applicant will need an employment history dating back around at least ten years, which demonstrates that the applicant was working and paying Social Security taxes for at least five of those years.
Applicants are assigned work credits yearly—up to four each year—and only those who have enough work credits will be approved for benefits. The required amount is subject to change, but the rule of thumb is that the applicant must have been working for at least five out of the previous ten years.
Another option is Supplemental Security Income (SSI), which is not funded through Social Security taxes. SSI is geared toward elderly and disabled individuals who meet certain financial parameters set by the SSA, but otherwise might not meet the SSDI requirements. Since SSI targets low income individuals, the applicant must meet the SSA’s strict limits on income and value of resources owned.
This information is available at their website and You can learn more about the different disability programs here: http://www.ssa.gov/disability/
Medical Qualification Criteria
In order to qualify for either program, you will also need to demonstrate that your loved one meets specific medical criteria that deem them disabled according to the SSA. This information is kept in a guidebook of all disabling conditions called the blue book. The blue book is divided into sections for adults and children. Anyone wishing to receive SSD benefits must meet the blue book listing for their condition, or if no listing exists, the condition must equal an existing listing in severity.
Alzheimer’s and dementia are evaluated under Section 12.02 Organic Mental Disorders. Conditions in this listing are associated with dysfunction of the brain. There are two primary pathways for meeting this listing.
The first requires a demonstrated loss of specific cognitive abilities and the medically documented persistence of at least one of the following:
• Disorientation to time and place
• Memory impairment
• Perceptual or thinking disturbances
• Change in personality
• Disturbance in mood
• Emotional liability and impairment in impulse control
• Loss of measured intellectual ability of at least 15 I.Q. Points
This pathway also requires two of the following:
• Marked restriction of activities of daily living
• Marked difficulties in maintaining social functioning
• Marked difficulties in maintaining concentration, persistence, or pace
• Repeated episodes of decompensation, each of extended duration
Applicants may also qualify under this listing with a documented history of a chronic mental disorder lasting for at least two years that has resulted in a severely reduced ability to perform basic work tasks. They must demonstrate one of the following:
• Repeated episodes of decompensation, each of extended duration
• A residual disease process resulting in such marginal adjustment that even a minimal increase in mental demands may cause decompensation.
• A history of one or more years’ inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.
The Compassionate Allowance Program
In some cases, the SSA can quickly pay benefits to an individual based on very minimal objective medical information, as long as the severity of their condition is clearly demonstrated. This is called a compassionate allowance.
The SSA maintains a list of medical conditions, which are eligible for compassionate allowances; included on this list are early-onset Alzheimer’s and several types of dementia. Compassionate allowances are not a separate program from Social Security disability benefits and the application process remains the same.
You can get a complete list of conditions that qualify for a compassionate allowance exception here: http://www.disability-benefits-help.org/compassionate-allowances
The Application Process
In order to begin the application process, schedule an interview with a representative from the nearest SSA office or begin filling out the application forms on the SSA website. You will need all of the necessary program information, including financial and employment documentation before beginning.
You will also need as much objective medical information about your loved one’s condition. This includes medical records, doctor’s notes, hospitalizations, and record of any treatments. It may also be helpful to seek statements from therapists or other professionals who can attest to how Alzheimer’s or dementia may impair your loved one’s ability to work and function.
It is important to remember that qualifying for Social Security disability benefits is less about the diagnosis and more about how the condition limits daily functions.
The SSA denies many first time applications for not completing the application correctly or because the applicant has not demonstrated that their condition is disabling. But if your application is denied, remember that you are allowed to appeal the decision, provided the appeals process is begun within 60 days of receiving the denial.
Otherwise, you will need to begin the application again. In fact, many of those who receive Social Security disability benefits only began doing so after filing an appeal.
The process is very demanding and requires lots of attention, but receiving the benefits can dramatically improve your loved one’s quality of life.
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