If you or a loved one have a dementia diagnosis, you may feel overwhelmed. If you’re trying to plan your future, you may be considering long term disability (LTD) insurance and way to protect yourself and your loved ones. While a dementia diagnosis may qualify you for LTD benefits, it’s not always a simple process.
Here, the experienced disability insurance lawyer, Jonathan M. Feigenbaum, Esquire, explains the essentials of a dementia disability claim and explains whether dementia qualifies you for disability insurance benefits.
What Is Dementia?
Dementia isn’t a single disease or disorder. Instead, it’s a term that covers a wide variety of conditions that impact memory and cognitive functioning. Alzheimer’s disease is the most common cause of dementia, but it can also be related to stroke, brain injuries, tumors, infections, substance use, and many other medical conditions.
Common symptoms of dementia include:
- Memory loss
- Confusion and disorientation
- Decreased executive function and decision-making skills
- Mood swings and irritability
- Anger and agitation
- Speech and language difficulties
- Social anxiety
- Diminished gross and fine motor skills
- Muscle loss
- Delusions and hallucinations
Because dementia is typically progressive, these symptoms may worsen over time. People with severe dementia often struggle to care for their basic needs. Some conditions, like Alzheimer’s disease, are considered fatal.
Unfortunately, experts believe that as our population ages, dementia rates will increase in the United States. And while researchers are carefully studying Alzheimer’s disease and other forms of dementia, there is no known cure for the condition.
Does Dementia Qualify for Long Term Disability?
To qualify for long term disability benefits, you must meet the specific requirements of your plan. Generally speaking, there are two definitions of disability that LTD plans use:
- Own occupation: You must demonstrate that your dementia prevents you from doing your actual job.
- Any occupation: You are eligible for benefits if your dementia precludes any type of work within the economy.
Most long term disability plans use the more rigorous “any occupation” standard.
When a disability insurance lawyer assesses your eligibility for LTD benefits, they will consider:
- The severity of your dementia, including your physical, psychological, and emotional symptoms
- Whether treatment alleviates or reduces any of your symptoms
- Side effects from your medications
- Your education and work history
- The precise terms and conditions of your disability insurance plan
- Whether any exclusions within the plan apply to your case
- Any other health conditions that may negatively impact your ability to work
This is a highly personalized and detailed analysis – and the lawyer will tailor it based on your unique circumstances.
Your lawyer will ask you or your loved ones questions about your abilities and challenges. If you have a hard time explaining your symptoms, it’s best to ask someone to go with you to the appointment. You should anticipate questions about your short and long-term memory, your ability to perform specific tasks and self-care activities, and your emotional challenges. While these can be difficult topics to discuss, you need to be candid and open with your lawyer.
At Jonathan M. Feigenbaum, Esquire, we can assure you that we treat all of our clients with the utmost respect and dignity. We will guide you through your consultation with compassion and offer practical advice that you can understand and apply to your claim.
Can the Insurance Company Limit LTD Benefits for Dementia?
Many long term disability plans include limitations on benefits for “mental or nervous disorders.” Sometimes, insurance company representatives try to shoehorn dementia into this category, since there is often a 12 to 24-month limitation on mental disorders.
However, many people’s dementia is due to a physical disease or process, not a purely mental disorder. For example, during Alzheimer’s disease, the brain’s neurons, the powerful nerves that help our body communicate with the brain, become damaged and die. In fact, researchers have identified a myriad of cellular changes in dementia patients’ brains.
Therefore, do not take an insurance company’s denial of benefits at face value. Instead, consult with an experienced attorney who can evaluate your circumstances and claims.
Does Dementia Qualify for Long Term Disability? Get Your Own Customized Evaluation
If you have questions about LTD benefits and dementia, contact Jonathan M. Feigenbaum, Esquire today. Our skilled team of disability insurance professionals will help you understand your legal options and create a plan that protects your future.
