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Facing the challenges of Alzheimer’s disease can be overwhelming, especially when faced with a long-term disability claim denial. A disability attorney at Ortiz Law Firm can help you understand the evidence needed to get long-term disability for Alzheimer’s disease and guide you through the appeal process.
What Is Alzheimer’s Disease?
Alzheimer’s disease, often referred to as Alzheimer’s by itself, is the most common form of dementia. It involves the parts of the brain controlling thought, memory, and language, causing progressive memory loss and impaired mental functioning. While common, it is a devastating diagnosis that can seriously disrupt a person’s life, eventually leading to their death.
Alzheimer’s disease is strongly correlated with aging, with most patients over the age of 65, though it can appear in younger patients as well. Patients who are under the age of 65 when diagnosed are said to have early-onset Alzheimer’s. Scientists are still researching the disease to understand how it develops, but there seems to be a link between genetic, environmental, and lifestyle factors.
In its more progressed state, patients depend on others for all their basic needs. Impaired mental functioning can leave a person unable to complete sentences, dress, feed themselves, or respond to their environment. Changes in the brain can leave a person unable to swallow or move normally. Alzheimer’s patients often require assisted living arrangements.
Symptoms of Alzheimer’s Disease
Symptoms may appear gradually and worsen over time. Once symptoms appear, they do not disappear without treatment. Often, people with the condition do not realize that they are experiencing symptoms due to impaired mental functioning and may resist suggestions to seek treatment.
One of the early signs is difficulty remembering new information, as Alzheimer’s first affects the regions of the brain responsible for learning. Other symptoms include disorientation, confusion, memory loss, mood and behavior changes, suspicion and paranoia, and difficulty speaking, swallowing, and walking. Severe loss of brain function can cause life-threatening dehydration or malnutrition or leave the body vulnerable to infections.
While some symptoms of Alzheimer’s can first appear to be a regular part of the aging process, Alzheimer’s is a severe disease. To best treat this condition, see a doctor as soon as Alzheimer’s is suspected.
Diagnosing Alzheimer’s Disease
Diagnosing Alzheimer’s disease starts with a thorough medical history and physical exam. Doctors often use a combination of memory tests, cognitive assessments, and brain imaging to get a clear picture. Blood tests may rule out other causes of memory problems, like vitamin deficiencies or thyroid issues. In some cases, brain scans such as MRI or CT scans can show if there’s shrinkage in areas of the brain tied to memory. It’s also crucial to talk about changes in behavior or abilities to complete daily tasks. Since there’s no single test for Alzheimer’s, this mix of methods helps doctors make an accurate diagnosis.
Treating Alzheimer’s Disease
Alzheimer’s disease cannot be cured, but treatment can help reduce the severity of symptoms and slow down the progression of the disease. Often, treatment success depends on starting treatment as soon as possible. Certain medications can help slow the progression of symptoms and preserve some brain function. Antidepressants or antipsychotic drugs may be used to help treat behavioral changes.
A healthy diet and exercise can support both brain health and physical coordination. Lifestyle changes, such as keeping a routine and using memory aids, can make day-to-day activities more comfortable. Caregivers and medical aids may be necessary for more advanced cases. Eventually, people with Alzheimer’s require intensive care and help with daily activities. Living at home may not be an option. Long-term care facilities and memory units may be necessary for patients and their families.
How Are Long-Term Disability Claims for Alzheimer’s Disease Evaluated?
Patients diagnosed with Alzheimer’s disease may not be considered disabled when they are first diagnosed, but as the disease progresses, they may be considered disabled. Evaluating Alzheimer’s disease for disability involves assessing how much the condition affects daily living and cognitive abilities. It’s not just about your diagnosis but your ability to work. Patients seeking disability payments for their Alzheimer’s disease will have to prove that they are impacted in a way that they cannot perform their old job or any job that they could be trained to work.
How Is Disability Defined In Your Policy?
Most LTD plans consider a person disabled if they have a medical condition that causes them to 1) be unable to perform their work duties for the first two years of the policy and 2) be unable to complete the work duties of almost any occupation for the years following the initial 2-year period. Each LTD plan defines disability slightly differently, so look over your plan policy to see how your plan defines “disabled” and whether the definition changes from own occupation to any occupation.
Documentation Needed to Support Payment of Long-Term Disability for Alzheimer’s
The long-term disability insurance claims adjuster reviewing the claim will evaluate medical records and physician statements to determine whether the claimant qualifies for LTD benefits. They are typically looking for impairments in one or more of the following categories:
- Memory, especially short-term memory;
- Learning new things;
- Communicating;
- Listening or paying attention;
- Physical coordination; and
- Social skills.
Thorough documentation is essential. This means you need to show evidence of your diagnosis and how you’re still dealing with symptoms. For example, if you’re experiencing memory lapses, trouble with tasks you used to do easily, or shifts in mood or behavior, these should be documented. The insurance company will want to see all your medical records to fully understand your health situation.
These records should cover visits to your doctor, clinical exams, tests you’ve undergone, lab results, and neurological assessments. The claimant will also want to provide the LTD insurance adjuster with evidence, such as a residual functional capacity (RFC) form, which indicates how the condition affects you and what jobs you may still be qualified to perform.
You Can Get a Free Case Review with a Long-Term Disability Attorney
Hiring a skilled disability lawyer like Nick Ortiz increases your chances of securing the benefits you deserve for Alzheimer’s disease. If your initial application for benefits was denied, it’s not the end of the road. It’s common for many to face denial on their first try. You’re entitled to appeal and gather more supporting information for your case.
Seeking professional assistance could be the deciding factor in whether you’re denied or approved for benefits. Navigating the process might seem overwhelming, but a qualified disability attorney can lead you through it step by step. They only get paid if you win, so you can get help without worrying about upfront fees or surprise charges.
The Ortiz Law Firm has a track record of winning disability cases nationwide. If you’re dealing with Alzheimer’s and your long-term disability claim has been denied, give us a call at (888) 321-8131. We’re ready to review your denial letter and discuss how we can support you during the appeal process.
Sources
- Centers for Disease Control and Prevention. “Alzheimer’s Disease and Dementia.” Retrieved from: (https://www.cdc.gov/alzheimers-dementia/about/alzheimers.html) Accessed on September 18, 2024.
- Mayo Clinic. “Alzheimer’s disease.” Retrieved from: (https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447) Accessed on April 1, 2024.
- Alzheimer’s Association. “What is Alzheimer’s Disease?” Retrieved from: (https://www.alz.org/alzheimers-dementia/what-is-alzheimers) Accessed on April 1, 2024.
Last Updated: September 18, 2024 // Reviewed and Edited by: Ortiz Law Firm