Can You Claim Social Security Disability Benefits For Alzheimer’s Disease?

by | Published on Oct 11, 2021 | Social Security Disability

Social security covers early-onset Alzheimer’s disease as a disability, and utilizes a medical chart review to determine eligibility. The patient can apply for a Compassionate Allowance, that speeds up the claim processing and the benefits are made available sooner. According to alz.org statistics, at present there are approximately 5.4 million Americans living with Alzheimer’s disease. These are not all old people either – 200,000 Americans under the age of 65 have the disease at present. It is a progressive, terminal illness which cannot be prevented, slowed, or cured. If the disease affects a person in his or her prime working years, and progresses, he/she cannot engage in gainful employment. Since the year 2010, the SSA (Social Security Administration) has added Alzheimer’s disease to their Compassionate Allowance Initiative, which allows faster payment of disability benefits to people with Alzheimer’s disease, mixed dementia, and Primary Progressive Aphasia.

Patients diagnosed with early onset Alzheimer’s disease, i.e. before age 65 may be able to collect disability benefits provided their symptoms and limitations are severe enough. Alzheimer’s disease and other forms of dementia are evaluated under SSA’s listing for neurocognitive disorders. To be eligible for disability benefits, Alzheimer’s patients must demonstrate that their abilities have severely declined in one or more of the following:

  • Using language – unable to remember words, or misuse of words
  • Learning and memorizing
  • Planning and judgment
  • Listening to others or focusing on tasks
  • Physical coordination
  • Social cognition or the capability to know proper social behavior in various circumstances

When filing a claim for SSDI due to a diagnosis of early-onset Alzheimer’s disease, the applicant must include as much medical documentation as possible because these records are subjected to a chart review to determine the validity of the claim. Medical records, documents, doctors’ statements supporting the diagnosis and other records will be crucial to the success of the SSDI claim.

Here is a look at the medical information required:

  • Names, addresses and phone numbers of the claimant’s healthcare providers including primary care physician, neurologist, neuropsychologist and/or psychiatrist.
  • Full list of medical condition(s), medications (also who prescribed them and why), names and dates of medical tests and the name of the requesting physician.
  • Names and dosage information for all medications the claimant is taking or has taken.
  • Medical records from all healthcare providers, including primary care physician, neurologist, neuropsychologist and/or psychiatrist.
  • The health records should ideally show that there is a progressive decline in function or test scores over time.
  • The records must state that the claimant has early-onset Alzheimer’s disease.
  • Clinical information including history of onset, description of functional and cognitive impairments at home and at work, neurological, cognitive, or neuropsychological examination results, and results from neuroimaging should be included.
  • It would be helpful to include documentation of dementia by standardized testing such as CDR (Clinical Dementia Rating) with a score of >1; Mini Mental State Exam (MMSE) of <24, or equivalent test.
  • Activities of daily living report or a similar report completed by caregiver or relative.

As a company providing medical review solutions to disability attorneys, we understand that even if a person suffering from Alzheimer’s disease doesn’t qualify for the compassionate allowance because their condition is not considered early-onset, he/she may still qualify for benefits. They will have to produce medical records that sufficiently prove that their condition makes them unable to perform any full-time job. The records should include a comprehensive explanation of the symptoms and the effect they have on the patient’s daily life.

It is important to understand that not all disability applications processed under the SSA’s Compassionate Allowances guidelines are approved. The claim could be denied if it is not accompanied by the necessary medical evidence, or if it isn’t properly submitted. Social security attorneys help claimants prepare their application, making sure that all necessary medical documentation is obtained with the support of a medical claims review company, and that the application is submitted properly to the Social Security Administration.

Discover our medical record review solutions and partner with us for your next case.

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