Dementia usually involves a progressive decline in your everyday functioning, in which your memory, language skills, judgment, or personality are affected. A variety of medical conditions can cause dementia. The most common conditions are Alzheimer's disease, head injuries, and having a stroke. Although dementia is more likely to occur in elderly patients, the onset of dementia symptoms can occur at any age. Your doctor can give you a neuropsychological evaluation to determine whether you have dementia.
If your symptoms of dementia will prevent you from working for 12 months or more, you may qualify for Social Security Disability (SSD/SSDI) or Supplemental Security Income (SSI) benefits. You can apply for SSDI benefits if you are not currently receiving retirement benefits. Once you reach full retirement age (at either 65, 66, or 67 years of age, depending on the year you were born), your SSDI benefits automatically change to retirement benefits.
The Social Security Administration (SSA) will find you disabled if you meet the requirements of an official disability "listing" in the SSA's listing of impairments, or if your disability has reduced your functioning so much that you can't do your past work or other work. Meeting the requirements of a disability listing is the simplest and quickest way to qualify for disability benefits.
The listing most commonly associated with dementia is disability listing 12.02, neurocognitive disorders. This listing was updated significantly in 2017 (it used to be the listing for organic mental disorders, and the criteria were fairly different). To meet this listing today, you need medical evidence showing that your abilities have significantly declined in one or more of the following areas:
If your records show that you have a significant decline in one of the above areas, the SSA will look to see whether your functioning is severely limited by this decline. Specifically, you must have either an extreme limitation in one of the following areas or a “marked” (more than moderate) limitation in two of the following areas:
You will need medical evidence documenting these factors in order to meet or equal the requirements of this disability listing. The SSA may want to see the results of psychological testing, neuropsychological testing (testing that examines cognitive functioning), intelligence testing, repeated medical visits with clinical testing, and evidence of any hospitalizations.
If your mental condition does not meet or equal a disability listing, the SSA will assess your "residual functional capacity" (RFC) based on all of the evidence you have submitted. Your RFC is the limit of what you can physically and mentally do while working a 40-hour work week.
Physically, you might be limited to sedentary, light, or medium work. Mentally, you might be limited to simple, semi-skilled, or skilled positions. Dementia patients will likely have poor memory and attention skills, so your doctor might limit you to simple, unskilled work. If your cognitive skills have significantly declined, you might be unable to perform any work and be found disabled merely on this basis alone. Similarly, you might suffer from personality changes that affect your ability to work with others. In this scenario, you might be restricted from jobs requiring close contact with the public, co-workers, or supervisors.
In addition, if you are currently taking any medication for treatment of dementia, these drugs could cause side effects including drowsiness or fatigue. The SSA has explained in its Social Security Rulings that fatigue may limit your ability to perform physical demands. If you suffer from fatigue, you might be restricted to only sedentary or light work.
First the SSA will use your RFC assessment to determine whether you can perform your past work. If you cannot, the SSA will use your RFC plus your age, education level, and work skills to see if you can do any jobs in the national economy. The SSA will use its Medical-Vocational Guidelines, which are often illustrated as a grid showing what age, education, and skill groups are deemed disabled at each RFC level. The med-voc grid shows that if you are over age 50, it is more likely that the SSA will find you cannot perform any jobs and will be found disabled. For more information, see our article on getting disability through the medical-vocational guidelines.
When determining your RFC, the SSA will generally place the most weight on your treating doctors' opinions, your medical history, and any psychological or neuropsychological testing. But the SSA will also consider statements given by third persons such as family members and caretakers. These statements are helpful because they give a glimpse into your ability to interact with others, perform daily activities, and concentrate on activities. These statements should contain detailed information on why you cannot perform any work. It is best to have statements from individuals who have known you for a long period of time and who can provide an opinion as to how your daily functioning has declined over at least a one-year period.
In addition, the SSA is also required to consider any work evaluations and any attempts you have made at performing work. The agency must also review any statements you provide about your own treatment and symptoms.