If you or a loved one has been diagnosed with early onset Alzheimer’s disease, there is a strong likelihood that you will be approved for Social Security disability. Because Alzheimer’s disease and related conditions associated with dementia are chronic, progressive medical problems that have no cure, Social Security decision makers are often sympathetic to claimants with these medical diagnoses.
When evaluating your case for disability, Social Security will look at those factors which make it difficult for you to perform work activities. Social Security defines disability in terms of how your medical problems impact your capacity to work. In most cases, however, you need to show more than an inability to perform the duties of your past work – instead you will need to prove that you cannot perform any type of work, even a simple, one or two step, sit down type of job.
In my experience with early onset Alzheimer’s and other dementia cases, my clients report symptoms that include:
- poor short term memory
- difficulty adjusting to changes in a (work) setting
- crying spells
- emotional instability
- outbursts of anger
- difficulty remembering and following simple instructions
- low stress tolerance
- difficulty interacting with the public, co-workers or supervisors
If you experience even a few of these symptoms you would find it difficult to perform the duties of even the easiest of jobs. At Social Security hearings, judges use “vocational witnesses” to answer questions about whether you could perform a simple, entry-level job. Judges ask these vocational witnesses detailed questions that can include limitations like those noted above. If the judge’s questions to the vocational witness describe a serious or severe level of several of these symptoms, vocational witnesses will respond that there are no jobs you could perform.
If the judge describes your symptoms as “mild” in his question to the vocational witness, there would be jobs that you could do. Our goal, therefore, is to convince the judge that your symptoms are severe so that his questions to the vocational witness will also describe a severe level of impairment.
Arguments That Apply in Early Onset Alzheimer’s Cases
I advise my clients that there are three arguments that can apply when you are trying to win a Social Security disability case. These three arguments are:
- meet a listing
- meet a grid rule
- prove that your functional capacity is so impaired that you would not be a reliable worker
Let’s consider each of these arguments in detail:
Meet a Grid rule
The grid rules reflect Social Security’s recognition that claimants over the age of 50 with minimal education and minimal work skills who have a physical impairment will have a very difficult time finding work even if they have some physical capacity to perform entry level jobs.
However, if you are over the ago of 50 and you do have physical medicine problems in addition to your Alzheimer’s symptoms, it would be worthwhile to look at the grid rules to see if you meet or equal one of the guidelines. You can read more about the grid rules by clicking on the link.
Meet a Listing
Social Security’s “listings” contain detailed descriptions of various medical conditions that are so serious that a listing level diagnosis will result in an automatic approval, without the need to carefully consider your work activity limitations that arise from your diagnosis. Currently there is no specific listing for Alzheimers disease, but it is possible to argue that your dementia diagnosis is equal to a listing.
The listing that I typically use when representing an early Alzheimer’s client is Listing 12.02, which describes “organic” mental disorders. An organic mental disorder arises from damage to the tissues of the brain and can result in disorientation, memory impairment, change in personality, mood disturbance, emotional instability, and loss of cognitive abilities.
Social Security intentionally sets the bar quite high to meet a listing, so if your dementia has not progressed to the point where you have a difficult time functioning on a day to day basis, your adjudicator or judge may be reluctant to award benefits based on the 12.02 listing. Further, disability adjudicators are the decision-makers that evaluate claims at the initial claim and reconsideration appeal level, and I find that adjudicators often do not have sufficient training to evaluate complex neurological records. Finally, I also find that physicians often do not arrive at a firm diagnosis of dementia without ruling out a variety of other potential problems, making these medical records more difficult to evaluate.
Nevertheless, the 12.02 listing argument is a good one and an argument that should be explored by every early onset Alzheimer’s/dementia claimant and their attorney.
Functional Capacity Argument
By far the most common argument for disability arising from dementia is the functional capacity argument. When I take this approach in a dementia case, I am saying to the judge that as a result of factors such as:
- cognitive decline
- emotional instability
- inability to maintain attention and concentration
- inability to adapt to changes in the work setting
- inability to interact appropriately with the public, co-workers, supervisors
- unscheduled breaks due to crying spells and other symptoms
- inability to remain on task
- inability to remember and perform simple tasks
- medication side effects
my client no longer has the capacity to function and perform the tasks required of even a simple, entry-level, one or two step job.
When I am arguing for disability based on functional capacity I am less concerned with the exact diagnosis and more concerned about how my client’s symptoms impact his capacity to perform the tasks of a very simple job.
This functional capacity argument allows me get creative when presenting my case. Depending on the facts, I may:present the testimony of witnesses (friends, relatives, former co-workers)
- submit affidavits of witnesses
- present a “functional capacity form” that I have created and asked a treating doctor to complete
Potential Problems in a Dementia case
Generally the early onset Alzheimer’s and dementia clients that I have represented are men and women in their 50’s and 60’s who have worked hard for many years and who have begun to experience disabling symptoms over the past few years.
It always helps when:you are 50 years old or older
- you have a long and consistent work history
- the evidence suggests that you are not the type of person who would stop working absent a very good reason
- you have been compliant with medical treatment
- you have obtained on-going medical treatment
- there is no evidence of malingering or dishonesty
- there is no evidence of drug seeking behavior
Generally, Social Security judges expect medical reports from neurologists or neuropsychologists to confirm a diagnosis of dementia or early onset Alzheimers. If you only submit medical reports from a family doctor or if the neurological test reports are inconclusive, the judge may not be as receptive to your claim of impairment.
Do Not Wait Too Long to Apply
Often, my early onset Alzheimer’s clients wait for months or even years before applying for disability. Often, my clients have a difficult time accepting the changes in their ability to remember or think clearly and that delay applying. As difficult as it may be to consider yourself “disabled” it is generally a very bad idea to wait to apply. In a disability case, your “insured status” only follows you for about 5 years after you stop working. If you last worked part time, your insured status may run out sooner. Occasionally I represent a client who clearly meets the medical requirements for disability but whose disability insurance coverage has run out.
Please feel free to call me if you need more information about what it means to be insured for purposes of Social Security disability. Please also let me know if you have any questions about how to apply or what to say when you apply.
If you have been diagnosed with dementia or early onset Alzheimers disease, I encourage you to apply for Social Security disability sooner rather than later. Do not be discouraged or surprised if your claim is denied and please do not hesitate to call my office if you have any questions about the disability process. I represent Social Security disability claimants on a “no fee unless we win” contract and I would be happy to offer you a no cost and no obligation evaluation of your claim.
Dementia Case Study #1 – 64 year old female with mild dementia and a variety of mild to moderate orthopedic symptoms. This case resulted in a favorable decision.