Getting Social Security Disability Benefits for Dementia

Dementia is the general term for a progressive decline in your cognitive abilities, affecting your memory, language skills, judgment, or personality. Dementia isn't a disorder on its own, but covers the symptoms of a wide variety of medical conditions, such as Alzheimer's disease, traumatic brain injury, and stroke.

Although dementia occurs more often in older people, the onset of dementia symptoms can happen at any age. If you're concerned about memory loss or have trouble functioning cognitively—and your symptoms can't be explained by another mental disorder—ask your doctor to give you a neuropsychological evaluation to determine whether you have dementia.

Is Dementia a Disability?

You may qualify for Social Security disability benefits (SSDI or SSI) if you have symptoms of dementia that keep you from working full-time for at least 12 months. You'll also need to meet preliminary eligibility requirements depending on the type of benefit you're applying for—SSDI eligibility is based on your work history, while SSI is needs-based and subject to financial limits. People over the age of 62 may opt to retire early rather than collect SSDI disability benefits.

Can You Automatically Qualify for Disability If You Have Dementia?

Under certain conditions, yes. The Social Security Administration (SSA) maintains a list of about one hundred medical impairments that are considered especially severe. The SSA can award benefits automatically to people who provide specific evidence required by a listed impairment. Stroke victims, for example, may qualify under listing 11.04 for vascular insult to the brain, while people who've experienced traumatic brain injuries might qualify using listing 11.08.

Broadly speaking, the SSA evaluates disability claims for dementia under listing 12.02 for neurocognitive disorders. In order to get disability automatically by meeting the listing requirements, you'll need to demonstrate "significant cognitive decline" in one or more of the following areas:

• complex attention
• executive functioning
• learning and memory
• language
• perceptual-motor, or
• social cognition.

Say you used to cook complicated meals with many ingredients, but you currently struggle to follow instructions for microwave dinners. The SSA will likely find that you have a significant decline in your learning and memory ability. Once the SSA determines that you demonstrate a significant cognitive decline in one of the above areas, the agency then needs to see how severely your daily functioning is affected by the loss of cognitive skills.

Social Security will review your medical records for evidence that you have an "extreme" limitation in one, or a "marked" limitation in two, of the following work-related areas of mental functioning:

• understanding, remembering, or using information (the ability to understand instructions, learn new things, and apply new knowledge)
• concentrating and being able to complete tasks at a reasonable pace
• adapting or managing oneself (being aware of, and taking precautions to avoid, normal hazards), and
• interacting with others in a socially appropriate manner.

"Extreme" limitations are worse than "marked" ones. If you have a marked limitation in social interaction, you might go out of your way to avoid communicating with your coworkers or supervisors, but are able to coherently respond to questions when asked. However, if you respond to questions with disjointed or nonsensical answers, you're more likely to have an "extreme" limitation in that functional area.

Even if you don't have marked or extreme limitations, you can still get disability under listing 12.02 as long as your dementia symptoms have been "serious and persistent" for two years, and you live in a highly structured setting such as a group home. The SSA recognizes that such supportive environments may curtail symptoms and help increase independence for people with dementia who would otherwise have marked or extreme limitations (in Social Security lingo, they have "marginal adjustment" to other environments).

How Does Social Security Consider If Someone With Dementia Can Work?

Not everybody with dementia has enough evidence of cognitive decline to qualify for disability automatically. But you can still get disability even when your dementia symptoms don't meet the listing requirements. Social Security does this by assessing your residual functional capacity (RFC) to see whether you can return to your past work or do another job.

What's In a Typical RFC for Dementia?

Your RFC represents the limit of what you can do, physically and mentally, at a full-time job. People with dementia often don't have the mental capabilities to perform complex job tasks, so their RFC will likely contain a limitation to simple, routine, unskilled work. Or, if dementia has resulted in personality changes such as increased irritability, they might be restricted from jobs requiring close contact with the public, coworkers, or supervisors.

The more severe your symptoms are, the more restrictions you'll have in your RFC, and the fewer jobs you'll be able to perform. Social Security is required to consider the combined effects of all your medical conditions when assessing your RFC, so if you have additional physical limitations, they'll be included in your RFC as well.

How Does Social Security Use Your RFC to Determine If You Can Work With Dementia?

Social Security compares the restrictions in your RFC with the duties and demands of your past work to see whether you can still perform those jobs today. If you can't, then the agency needs to determine whether any other jobs exist in the national economy that you can do, despite the limitations in your RFC.

Because dementia most often affects people who are older, Social Security may use its medical-vocational grid—a special set of rules for applicants nearing retirement age—to help decide whether you should be able to do other work. The grid only applies to people over the age of 50 who have physical restrictions in their RFC, however, so if you're younger than 50 or have solely mental limitations, you won't be able to use the grid to get disability.

Instead, you'll need to show that you aren't able to perform even the simplest jobs on a regular basis. People with dementia might get easily confused when following basic instructions, or constantly forget where they placed their work tools. If you don't have the cognitive ability to work full-time or communicate with others appropriately, Social Security can find that your RFC is "inconsistent with competitive employment" and award you disability.

Can Accommodations Help People With Dementia Work?

Because dementia is progressive—meaning symptoms will get worse over time—some people in the early stages of the condition may be able to work full-time with a little help. According to the Americans with Disabilities Act (ADA), certain employers are required to make reasonable accommodations to help employees with disabilities perform their jobs.

For example, workers with memory loss due to Alzheimer's disease may request accommodations such as color-coding of important information, checklists for routine job duties, and extended training periods when significant workplace changes occur. You can learn more in our set of articles about reasonable accommodations under the ADA.

Medical Records You'll Need to Get Disability for Dementia

Your medical records are the foundation of your disability claim. Social Security needs to see documentation of your dementia for purposes of determining whether you meet a listing or are unable to work. The agency will be on the lookout for the following evidence in your records:

• clinical notes from your doctor's visits
• results from psychological, neurophysical, or intelligence tests
• intake and discharge reports from any hospitalizations
• medication lists, including any side effects you experience
• witness letters detailing changes in your cognition, and
• medical source statements.

When you first apply for benefits, tell the SSA about the names, locations, and dates of service for all medical providers you've seen since your alleged onset date of dementia. Contact the SSA whenever you change doctors, start a new type of treatment, or change addresses. The agency can deny your claim if you don't keep in touch, and missing medical records will lengthen the amount of time it takes to decide your claim.

Additional Resources for People With Dementia

If you're ready to apply for disability benefits, check out our article on filing a disability application with Social Security for tips and contact information. You may want to consider hiring an experienced disability attorney for help with the application (or an appeal if your claim is denied).

Some states offer supplemental living allowance benefits for people with dementia who qualify for SSI and reside in a group home. For more information, consult our relevant article on filing for disability in your state. And because most people who are considered disabled for SSI also qualify for Medicaid, you may also be interested in our article on when Medicaid will pay for assisted living for people with dementia.

_{Updated April 18, 2024}