Can I receive long term disability for Early-Onset Alzheimer’s Disease?
Yes, you can receive long term disability (“LTD”) benefits for Early-Onset Alzheimer’s Disease (“EOAD”). If you have been diagnosed with EOAD and have disability insurance through your employer or a privately purchased policy, you may qualify for LTD benefits. However, the process of pursuing LTD benefits for EOAD can be incredibly challenging.
It is essential to first review your insurance policy to understand the terms, conditions, and definitions of disability in your policy. Each policy is unique, and comprehending your coverage is a vital first step. To get your claim approved, your insurer will require substantial evidence documenting your diagnosis, progression of symptoms, and proof that your EOAD prevents you from working.
An experienced ERISA attorney can be invaluable during the disability claims process. Riemer Hess has over 25 years of experience assisting professionals and executives to secure their long term disability benefits.
Below we’ll share information and strategies for proving your EOAD long term disability claim.
What are the disabling symptoms of Early-Onset Alzheimer’s Disease?
Alzheimer’s disease, whether it occurs at an early age or later in life, is a progressive neurodegenerative condition that primarily affects cognitive functions. As the disease advances, EOAD causes a range of cognitive and functional impairments that can lead to permanent disability.
EOAD shares many of the same characteristics as late-onset Alzheimer’s disease (“LOAD”), including the accumulation of amyloid plaques and tau tangles in the brain, which lead to cognitive and functional decline. In addition, EOAD can cause secondary emotional and behavioral symptoms that contribute to long term disability.
What are the disabling cognitive symptoms of Early-Onset Alzheimer’s Disease?
EOAD primarily affects your cognitive functions. These cognitive symptoms progress over time, becoming increasingly disabling as the disease advances.
Disabling cognitive symptoms of EOAD may include:
- Memory impairment, such as difficulty remembering recent events, conversations, or important dates;
- Difficulty with language comprehension and expression, such as finding the right words, following conversations, or understanding written or spoken language;
- Impaired judgment and decision-making, which can include poor financial choices, difficulty planning and organizing tasks, and a lack of insight into your own condition;
- Spatial and visual impairments, such as trouble recognizing familiar places, objects, or faces, and difficulty with tasks that require visual-spatial coordination, such as dressing or navigating familiar environments;
- Difficulty with problem-solving, such as solving puzzles or managing daily tasks;
- Loss of orientation to time, place, and identity;
- Inability to plan and execute tasks, such as cooking a meal or managing medications;
- Loss of abstract thinking, making it difficult to understand metaphors, analogies, or abstract concepts; and/or
- Inability to learn and retain new information for more than a short period.
These cognitive symptoms can have a profound impact on your ability to perform your occupational duties and carry out daily activities. The progression of these symptoms varies from person to person, but as EOAD advances, it becomes increasingly disabling, often requiring significant support and care from family members, caregivers, and healthcare professionals.
What are the disabling physical symptoms of Early-Onset Alzheimer’s Disease?
While Early-Onset Alzheimer’s disease primarily manifests as cognitive and behavioral symptoms, it can indirectly lead to certain physical symptoms or complications. Disabling physical symptoms or issues associated with EOAD include:
- Motor impairment, such as problems with coordination, balance, and gait (walking), increasing the risk of falls and injuries;
- Difficulty swallowing (known as dysphagia), which can increase the risk of choking or aspiration pneumonia and lead to unintended weight loss and malnutrition;
- Loss of ability to control bladder and bowel functions, leading to urinary or fecal incontinence;
- Physical restlessness, pacing, or agitation;
- Sleep disturbances which can lead to nighttime wandering, sleeplessness, or excessive daytime sleepiness;
- Muscle stiffness and rigidity; and/or
- Loss of motor skills, making it difficult to perform even basic motor tasks, such as sitting up or holding objects.
What are the secondary emotional symptoms of Early-Onset Alzheimer’s Disease?
EOAD can lead to a wide range of secondary emotional and behavioral symptoms in addition to the primary cognitive and physical impairments. Common secondary emotional and behavioral symptoms may include:
- Restlessness, irritability, and uncooperative behavior;
- Anxiety, nervousness, and unease arising from confusion, fear, or changes in your environment;
- Depression, including sadness, hopelessness, loss of interest in activities, and changes in appetite or sleep patterns;
- Mood swings that cause you to quickly shift between different emotional states;
- Delusional thinking, where you may develop false beliefs, such as thinking someone is stealing from you or that you are in a different time or place; and/or
- Physical and/or verbal aggression.
How do I prove my Early-Onset Alzheimer’s Disease is disabling?
To prove an Early-Onset Alzheimer's Disease long term disability claim, your insurer will require a range of evidence. This includes comprehensive medical documentation establishing the diagnosis, progression, symptoms, and ongoing treatment of your EOAD. Collecting and presenting this evidence is crucial to support your EOAD disability claim and demonstrate eligibility for benefits under your insurance policy.
What can you submit to your insurer as diagnostic medical evidence for Early-Onset Alzheimer’s Disease?
Your insurer will require proof of your EOAD diagnosis to approve long term disability benefits. The diagnosis of EOAD is typically a comprehensive process that involves various assessments, tests, and evaluations to rule out other possible causes of cognitive impairment and confirm the presence of Alzheimer’s disease.
Diagnostic evidence may include:
- Clinical evaluation by a specialist, such as a neurologist or geriatrician, who specializes in neurodegenerative diseases. The clinical evaluation typically involves reviewing your medical history, conducting a physical examination to rule out other medical conditions, and a neurological examination to assess your cognitive function and motor skills;
- Cognitive assessments, such as the Mini-Mental State Examination (“MMSE”), Montreal Cognitive Assessment (“MoCA”), and the Clock Drawing Test;
- Neuropsychological Evaluation, which is a comprehensive assessment involving a battery of tests that evaluate specific cognitive functions in detail to pinpoint the nature and extent of cognitive deficits;
- Magnetic Resonance Imaging (“MRI”) which can reveal structural changes in the brain and detect atrophy (shrinkage) in specific regions associated with Alzheimer’s disease;
- Positron Emission Tomography (PET) Scan, which can assess brain glucose metabolism and the presence of amyloid plaques, which are characteristic of Alzheimer’s disease;
- Lumbar puncture (spinal tap) may be conducted to analyze cerebrospinal fluid for biomarkers associated with Alzheimer’s disease, such as elevated levels of tau protein and decreased levels of amyloid-beta protein;
- Genetic testing, especially for individuals with a family history of EOAD, as certain genetic mutations (such as those in the APP, PSEN1, or PSEN2 genes) are associated with familial forms of Alzheimer’s disease;
- Blood tests to rule out other medical conditions that could contribute to cognitive impairment, such as thyroid disorders, vitamin deficiencies, or infections;
The diagnosis of EOAD is typically made based on a combination of your clinical evaluation, cognitive assessments, and the results of medical tests. It often requires the expertise of healthcare professionals specializing in diagnosing and managing Alzheimer’s disease, especially in younger individuals. All of these medical records, imaging reports, and test results may be obtained and submitted to your insurer to support your EOAD long term disability claim.
What treatment records can I submit to my insurer for Early-Onset Alzheimer’s Disease?
There is no cure for Alzheimer’s disease, but a combination of medical, pharmacological, and non-pharmacological interventions can be employed to manage symptoms, slow disease progression, and improve your quality of life. To get approved for long term disability, it is generally required to demonstrate to your insurer that you are seeking and following appropriate medical treatment and care for your EOAD.
Evidence of appropriate treatment for EOAD may include:
- Medications like donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), which are commonly prescribed to improve cognitive function and manage symptoms like memory loss and confusion;
- Memantine (Namenda) is another medication used to manage cognitive symptoms by helping regulate glutamate activity in the brain and may slow down symptom progression;
- Cognitive training and rehabilitation programs which can help you maintain cognitive function and improve daily living skills;
- Behavioral therapy for managing behavioral symptoms like agitation, aggression, and depression;
- Occupational therapy to help you adapt to changes in your abilities, making it easier to perform daily activities and maintain independence;
- Speech therapy if you experience difficulties with communication and swallowing.
- Physical therapy to address mobility issues and help maintain your physical well-being;
- Clinical trials of experimental treatments and therapies aimed at slowing the progression of EOAD;
- Regular follow-up appointments with your healthcare providers to monitor your disease progression, evaluate the effectiveness of treatments, and adjust your treatment plan as needed.
Your insurer will request ongoing documentation of your EOAD treatment in order to continue your benefits. Medical records and treatment plans help document the presence of EOAD, its progression, and its impact on your ability to work. By seeking appropriate medical treatment, you are providing your insurer with essential medical evidence to support your EOAD claim.
How can a disability insurance attorney help with my Early-Onset Alzheimer’s Disease claim?
Riemer Hess has helped countless clients secure their long term disability benefits, including many with Alzheimer’s disease.
For example, our client "Ben" had spent many years building his career as an investment banker for a large firm when he began experiencing cognitive issues. He was eventually diagnosed with Early-Onset Alzheimer’s disease through brain imaging and neuropsychological testing. Ben continued to work for as long as possible, but a year after diagnosis, his symptoms continued to progress and began affecting his job performance. He knew he would need to file for long term disability soon. Before taking any steps, he reached out to Riemer Hess to prepare a plan.
Riemer Hess warned Ben that if he was terminated from his position before filing a claim, he would be in jeopardy of losing his right to long term disability benefits. Once retained by Ben, Riemer Hess jumped into action to carefully plan his work exit. First, Riemer Hess gathered copies of Ben’s multiple disability insurance policies, his full job description, and all of his medical records. Riemer Hess also arranged for Ben to undergo a neuropsychological evaluation that would offer objective data on his cognitive impairment due to EOAD. Then, Riemer Hess coordinated with his treating specialist to review the evaluation report and write a letter certifying that Ben could no longer work as a result of his EOAD.
Riemer Hess worked to file the claim on Ben’s behalf, helping to complete the necessary paperwork, providing his insurers with medical and vocational evidence of his EOAD disability, and communicating with Ben’s doctors to complete questionnaires from the insurer and write supplemental letters detailing how Ben’s EOAD impacted his cognitive functioning. With this substantial evidence in hand, along with the neuropsychological evaluation report, Ben’s multiple insurers all approved his long term disability claims.
Ben was very relieved to have his benefits secured and decided to retain Riemer Hess to monitor his long term disability claims going forward. Riemer Hess continued to help Ben provide updated medical evidence to his insurers as requested and handle all issues related to his claims.
At Riemer Hess, we have over 25 years of experience in securing long term disability benefits for our clients. Whether you are filing a claim, appealing a wrongful denial, or suing your insurer, our New York disability attorneys understand how best to substantiate your Early-Onset Alzheimer’s Disease claim.