Getting Disability Benefits for Early-Onset Alzheimer's Disease

Alzheimer's disease is a progressive neurological condition that causes brain cells to atrophy (shrink) and eventually break down. The diagnosis is most frequently made in people over the age of 65. When the disease develops in people younger than 65, it's known as early-onset Alzheimer's.

Early Alzheimer's disease is characterized mainly by memory loss and confusion. As the disease worsens, it affects fundamental cognitive abilities such as speech, problem-solving, recognition, and behavioral patterns. The Social Security Administration (SSA) awards disability for Alzheimer's patients who can no longer work due to cognitive deterioration.

Is Alzheimer's a Disability?

Early-onset Alzheimer's affects people who haven't yet reached retirement age, so a diagnosis can often cut short the ability to work for people who thought they'd be in the labor force for many more years. Because the disease is progressive and irreversible, Social Security doesn't expect people with early-onset Alzheimer's to recover enough to return to work, and can award benefits quickly with the proper medical documentation.

Symptoms of Alzheimer's

The first symptom of Alzheimer's is short-term memory loss, which becomes more pronounced as the disease worsens. Later stages of Alzheimer's include the following symptoms:

• Cognitive decline, such as an inability to create new memories, failure to recognize family members and friends, forgetting the names of common objects, disorientation, and delusion, especially in the evening hours ("sundowning").

• Behavioral changes, especially changes in personality like becoming more aggressive or irritable, repeating meaningless words, lacking awareness, and neglecting hygiene.

• Mood swings, with feelings of anger, paranoia, and loneliness prevalent.

• Physical deterioration such as difficulty eating and swallowing, moving without assistance, loss of speech, and incontinence.

Doctors don't currently have a cure for Alzheimer's, so treatment revolves around cognition-enhancing medications and therapy meant to improve quality of life and possibly slow the disease's progression.

Qualifying for Disability Benefits for Alzheimer's Disease

Alzheimer's is a particularly debilitating medical condition that's likely to be considered disabling by the SSA. But you'll still need to make sure that you meet the non-medical criteria for the type of benefit you're applying for, which can include having enough work credits or meeting certain SSI resource limits.

If you've been diagnosed with early-onset Alzheimer's, you might qualify for expedited disability benefits under Social Security's Compassionate Allowances program for the most serious impairments. People with a condition on the compassionate allowances list can be approved in as quickly as one month.

Getting Disability Benefits Quickly by Meeting a Blue Book Listing

The Compassionate Allowances program works by streamlining the amount of evidence Social Security needs to show that you meet the requirements of a listed impairment. Getting benefits this way usually takes a long time, because listed impairments require specific results in your medical record that aren't always present until the disease progresses. But the diagnosis of a compassionate allowance condition signals to the SSA that it's likely you already meet a listing requirement, letting the agency speed up the disability determination process.

Social Security evaluates early-onset Alzheimer's by looking at two listings: listing 11.17, neurodegenerative disorders of the central nervous system, and listing 12.02, neurocognitive disorders. If you have any physical deterioration, the SSA will review your application under Listing 11.17, which requires evidence of the following:

• you're having so much trouble using at least two of your extremities—your arms, legs, or both—that you're unable to perform basic movements like standing up from a seated position without help, or
• you can move independently (but with great difficulty) and you're also having significant challenges with mental activities such as interacting with others, adapting to changes, or finishing tasks.

If your Alzheimer's symptoms are solely mental or cognitive in nature, the SSA will review your application under Listing 12.02. The SSA will look for evidence of significant decline in at least one of the following areas:

• complex attention (the ability to "switch gears" without losing focus)
• executive functioning (making and following through with plans)
• learning and memory (the ability to remember and apply information)
• language (the ability to recall words and name objects)
• perceptual-motor functioning (such as hand-eye coordination), or
• social cognition (the ability to act properly around others).

You'll also need to show that you have an "extreme" limitation in one, or a "marked" limitation in two, of mental functions such as applying information, interacting with others, focusing on tasks, and taking care of yourself. An extreme limitation means that you can't perform the function independently, while a marked limitation means that you can do it yourself only occasionally.

To get a compassionate allowance for early-onset Alzheimer's, Social Security needs to see medical records including doctors' notes documenting progressive dementia and an activities of daily living report filled out by a relative or caregiver. Results from standardized tests, such as the Clinical Dementia Rating (CDR) scale or the Mini-Mental State Examination (MMSE), are also helpful.

For more information, see our article on getting disability benefits for neurocognitive disorders.

Getting Disability Benefits for Reduced Functional Capacity

You can still qualify for disability benefits even if you don't meet the listing requirements if you can show that symptoms from your Alzheimer's disease keep you from working. The SSA will look at your medical records and your functional limitations to assess your residual functional capacity (RFC), a set of restrictions on what you can and can't do in a work setting.

Social Security uses your RFC to determine whether your Alzheimer's symptoms keep you from performing your past work or any other jobs. Depending on your age, work history, and any skills you learned at your past jobs, the agency may use special rules known as the medical-vocational grid to find that you're disabled. Here's how applicants of different ages could get approved under the grid rules:

• People with early-onset Alzheimer's who are under the age of 50 will need to show that they're unable to complete the mental demands of even unskilled work.
• People with early-onset Alzheimer's who are between the ages of 50 and 59 can show that they can't perform their past relevant work and are physically limited to light or sedentary jobs.
• People with Alzheimer's who are between the ages of 60 and 65 can show that they're physically limited to light or sedentary jobs and can't make more than a marginal vocational adjustment to new work (meaning it would be very difficult for them to adjust to a new type of job).

The more severe your Alzheimer's symptoms are, the more likely your RFC will contain restrictions that don't allow you to perform any work. If you're forgetting to complete basic tasks or becoming disoriented over minor changes, for example, it's unlikely that an employer would hire you to perform even the simplest jobs.

Applying for Disability for Alzheimer's

Social Security has several easy ways to apply for disability benefits:

• Call 800-772-1213 from 7 a.m. to 7 p.m. Monday through Friday. If you're deaf or hard of hearing, you can call the TTY number at 800-325-0778.
• File online at the SSA's website. If you're filing for SSDI, you can complete the entire application online, but if you're filing for SSI, you'll need to make an appointment to finish.
• Go in person to your local SSA field office.

If somebody you know with Alzheimer's has difficulty completing their application, you can help them file. Make sure that you let the SSA know how the applicant's cognitive limitations affect how they're able to take care of daily needs such as hygiene, food preparation, grocery shopping, and communication. Include any additional problems they might have, physical or mental, on the application. Social Security must consider the combined effects of all impairments when making a disability determination.

_{Updated January 27, 2023}