Applying for Disability Benefits for Dementia

Applying for Disability Benefits for Someone with Dementia

Guest article by Ram Meyyappan

The recent 60 Minutes exposé on Social Security Disability (SSD) has many nervous about the idea of filing a new application for benefits. The report of the number of fraudulent claims filed in recent years may have you fearful of added scrutiny, especially when filing as a caregiver for one with dementia who is unable to file for him/herself.

The Social Security Disability program provides benefits for people with serious medical conditions including dementia.

As a caregiver for someone with dementia, you may apply for SSD benefits on behalf of that person without worrying about extra scrutiny. Dementia qualifies for disability benefits.

Medical Qualification for SSD with Dementia

Early onset dementia is covered by the SSD and is included in the Social Security Administration’s (SSA’s) Compassionate Allowances (CAL) program. The CAL program is designed to expedite the review and approval of certain medical conditions. This means the application you file on behalf of the person with dementia in your care will proceed through the initial review in a fraction of the time it takes the typical SSD application.

There are also several other forms of dementia covered by the CAL program, though all essentially have the same medical eligibility requirements. The SSA specifically needs to see medical records that document at least one of the following symptoms:

•  disorientation
•  impaired memory
•  thought or perception disturbances
•  personality changes
•  mood disturbances
•  emotional impairment
•  issues with impulse control
•  loss of intellectual ability, with a recorded drop in IQ of 15 points or greater

In addition, the medical documentation of your SSD applicant must also show the symptoms of dementia have resulted in functional impairments in the following areas:

•  normal, daily activities
•  social functioning
•  concentrating and/or persistence in completing tasks

Demonstrating through medical records that there are repeated periods when the applicant suffers even more pronounced symptoms, can also qualify as one of the two limitations in this requirement.

It is also possible to satisfy the SSA’s medical documentation requirements by proving the applicant’s dementia:

•  Results in recurrent episodes of decompensation (worsening of prior abilities) OR
•  Gets significantly worse when s/he encounters changes, stressors, or intellectual or emotional challenges OR
•  S/he requires constant monitoring even in a supportive care environment.

Click to learn more about the compassionate allowance program.

The Disability Benefit Programs

The SSA has two disability programs for which your charge may qualify:

•  Social Security Disability Insurance (SSDI)
•  Supplemental Security Income (SSI)

Qualification for either or both of these programs requires the applicant meets the medical requirements for SSD. Early-onset dementia due to any cause qualifies medically. The applicant’s medical records must show the proof mentioned above.

Both of these programs also have financial and technical eligibility criteria, and when you apply for benefits on behalf of your care recipient, you will need to provide the SSA with more than just medical records.

•  For SSDI, the SSA must see the applicant has a work history during which work credits were earned through the payment of Social Security taxes.
•  For SSI, the SSA needs to see the applicant has very limited income and other financial resources, including assets, with which to pay for his or her daily needs.

Click to learn more about SSDI and SSI.

Applying for Benefits

While the person in your care who suffers from dementia is technically the applicant for benefits, you can apply on his or her behalf. It is important to know that you can complete the application for benefits in two ways: online or in person. An online application can be started at any time on the SSA’s website and be electronically filed when complete. An in-person application requires that you schedule an appointment with the Social Security office by calling 1-800-772-1213.

Ram Meyyappan is the editor and manager of Social Security Disability Help, a website that contains information on how to apply for benefits with over 400 disabling conditions. Ram has written blog posts for various organizations on the process of applying for disability with different disabling conditions.

(Edited by The Caregiver’s Voice)