Is dementia a disability?

Dementia refers to a debilitating set of diseases that impair a person’s thinking, memory, and everyday functioning. ^[1]

Over 55 million people have dementia worldwide, with the disease costing the global economy over 1.3 trillion US dollars. ^[1]

While extremely distressing, the question arises: is dementia a disability? The answer is that it depends – a person’s dementia has to satisfy the requirements of the USA’s Social Security Administration (SSA) to be eligible for disability benefits.

This article will explore the relationship between dementia and disability benefits, and the criteria required for a person to be eligible in the eyes of the SSA.

The SSA and disability benefits

To provide sufferers of dementia with some form of relief, the SSA offers them disability benefits. Federal law has a strict definition of the word ‘disability’, requiring a person to: ^[2]

• Not be able to do the work they did before.
• Not be able to adjust to other work because of their condition.
• Demonstrate that their disability has lasted, or is expected to last, for one year or longer – or to result in death before then.

In addition to meeting the above criteria, you must have worked recently enough and for a long enough period under Social Security to qualify for disability benefits. ^[2]

Two programs rolled out by the SSA provide monthly disability checks: ^[3]

• SSDI (Social Security Disability Insurance): This program provides benefits to individuals and eligible family members who have built up Social Security credits through their work history. To qualify, you must have worked for a certain period and paid Social Security taxes.
• SSI (Supplemental Security Income): SSI is a financial assistance program designed for individuals aged 65 or older, blind, or disabled, who meet specific income and resource requirements. It provides essential financial support to those in need, ensuring they can meet their basic living expenses.

What is the Compassionate Allowances (CAL) initiative?

The Compassionate Allowances (CAL) initiative is a program implemented by the Social Security Administration (SSA) in the United States. Its primary purpose is to expedite the processing of Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) claims for individuals who have certain severe medical conditions. Diseases relating to dementia include: ^[3]

• Early-onset Alzheimer’s disease
• Adult-onset Huntington disease
• Creutzfeldt-Jakob disease (CJD)
• Frontotemporal dementia (FTD), Pick’s disease – Type A
• Lewy body dementia
• Mixed dementia
• Primary Progressive Aphasia (PPA)
• Progressive Supranuclear Palsy (PSP)
• The ALS Parkinsonism Dementia Complex

When someone applies for SSDI or SSI and their condition falls within the list of CAL-eligible conditions, their claim is fast-tracked for approval. This means that individuals with these conditions can receive the financial assistance and support they need more quickly, without going through the lengthy and often complex disability determination process that other applicants may face.

It helps streamline the application and approval process for those who meet the criteria, offering a more compassionate and efficient approach to providing support to disabled individuals and their families.

How to apply for disability for a person with CAL

There is no special application for CAL. Individuals apply using the template SSA process for claiming either SSDI or SSI benefits. ^[2] In this process, you can specify that you have a CAL condition and the SSA will expedite your application. ^[2]

1. Gather required documents: Start by collecting all the necessary documents and information to support your application. This includes employment records, financial information,medical records, doctor’s reports, test results, and any other documentation that verifies your medical condition and its severity. ^[2]
2. Determine eligibility: Ensure that your dementia-related disease is on the list of CAL-eligible conditions (See above)
3. Choose the application method: You can apply for CAL through two primary methods: ^[2]

• Online Application: Visit the Social Security Administration’s website (www.ssa.gov) and navigate to the “Apply for Disability Benefits” section. Follow the instructions for completing the online application.
• In-Person Application: Schedule an appointment with your local Social Security office. You can find the nearest office by using the SSA’s office locator on their website. Alternatively, call 772.1213 (TTY: 800.325.0778) to find your local office. Do not walk in without scheduling an appointment. ^[2]

Important tips when applying

Here are some important tips to consider when applying for SSA benefits for dementia: ^[2]

• Apply for benefits if you have early-onset Alzheimer’s disease or any other dementia and you are unable to work.
• Do not hesitate to apply for SSDI benefits if you consider yourself, or a family member, eligibleas you may lose substantial benefits by delaying.
• Consider asking friends, family,or a suitable professional to help you with the application process.

What happens after you apply for disability benefits?

After you apply for disability benefits for dementia, the SSA initiates a comprehensive review process to determine your eligibility. Here is what typically happens after you submit your application:

1. The SSA reviews your application to ensure it is complete and accurate. They will assess the information you provided about your medical condition, work history, and other relevant details. This review is typically carried out by an examiner in your state working for the Disability Determination Service (DDS)
2. The SSA will gather medical evidence related to your dementia. This includes obtaining your medical records, test results, and reports from healthcare providers who have treated you.
3. The SSA will assess your eligibility based on their established criteria for disability benefits, which include the following factors: severity of impairment, duration of impairment, and listed impairment.
   
4. If your dementia does not meet or equal the criteria in the SSA’s listing of impairments, the SSA will assess your Residual Functional Capacity (RFC). This evaluation considers your ability to perform work-related activities despite your impairment. If the SSA determines that you cannot perform any substantial work, you can be deemed eligible for benefits.
5. Once the SSA has gathered all necessary information and completed their evaluations, they will decideregarding your disability claim. If the DDS finds you to be disabled, the SSA will notify you and begin paying benefits. ^[2] If the DDS does not find you to be disabled, you have the right to appeal the decision. ^[2]