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Neurocognitive Disorder and obtaining Social Security disability benefits

Appealing for benefits is best done under the guidance of an experienced disability lawyer.

Can I get disability benefits if I am suffering from the effects of a neurocognitive disorder?

Author: Attorney Lloyd Bemis
Updated: 4/7/2023

Approximately five million people in the U.S. are living with some degree of neurocognitive disorder. Neurocognitive disorder, also called cognitive disorder, is a group of conditions that significantly weaken a person’s mental functions; among those conditions are Alzheimer’s, Huntington’s disease, Parkinson’s disease, prion disease, traumatic brain injury and dementia/neurocognitive issues due to HIV infection.
If you are suffering from the effects of neurocognitive disorder you may qualify for disability benefits.

 Neurocognitive Disorders and qualifying for Social Security Disability Insurance

If you are suffering from a neurocognitive disorder and have been denied disability don’t give up, almost 70% are denied initially! Just call 512-454-4000 for a free, no obligation consultation to learn what your options are.

These conditions affect an individual’s memory, attention span, perception, and learning ability.

People with neurocognitive disorder may also experience difficulty understanding language and have trouble in social situations and performing daily routine tasks. Neurocognitive disorder can be either major or minor in nature and though more commonly seen in older adults, a neurocognitive disorder can affect people of all ages and health backgrounds.

Because many different things can cause neurological disorder and the condition affects different parts of the brain, symptoms vary from person to person and appear suddenly or over time.

The most common symptoms include:

  •    Difficulty remembering and focusing
  •   Headaches
  •   Confusion
  •   Difficulty planning and making decisions
  •   Changes in an individual’s behavior
  •   Increased anxiety and agitation
  •   Vision problems
  •   Difficulty performing daily tasks such as managing money and driving
  •   Trouble with balance and walking
  •   Difficulty with fine motor skills like buttoning a shirt or using utensils

These or a combination of these symptoms can cause you to miss work and jeopardize your ability to maintain employment.

How can I get approved for SSDI if I have a cognitive disorder?

Social Security recognizes neurocognitive disorders in its Blue Book under Section 12.02. Under this listing, Social Security evaluates disorders “characterized by a clinically significant decline in cognitive functioning.”

To qualify for SSDI under this listing, you must be able to show limitations in one or more of the following:

  •    Learning and memory
  •   Paying attention, listening to others
  •   Inability to plan
  •   Decreased judgment
  •   Problems with walking, balance, or coordination
  •   Problems speaking, recalling words, or misuse of words
  •   Inability to determine appropriate behavior in social situations

You must also exhibit an extreme limitation of one, or marked limitation of two of the following:

  •   Understanding, remembering, or applying information
  •   Concentrating and maintaining pace when working on tasks
  •   Interacting with others
  •   Managing oneself in a work environment; i.e., understanding appropriate attire and behavior and being aware of safety hazards.

The Social Security Administration realizes that some individuals will not meet the above requirements because they live in a supportive and supervised situation such as an institution, a group home, or at home where their functional abilities appear better than they would be in real-life situations where the stress and demands on them would be greater.

In these situations, your neurocognitive disorder must be medically documented as serious and persistent over a period of at least two years and you must be receiving medical treatment, mental health therapy, and psychosocial support, or be living in a highly structured setting that diminishes the symptoms and signs of the mental disorder. You must have minimal capacity to adapt to changes in your environment or to handle demands that are not part of your daily life.

To evaluate your case, Social Security wants to see all relevant medical evidence you can provide about your disorder from your doctors and other medical providers, including:

  •    Your symptoms and diagnosis
  •   Your medical, psychiatric, and psychological history
  •   Results of physical and mental status examinations
  •   Imaging results and other laboratory reports
  •   Medications you take, your response and side effects
  •   Type, frequency, and effects of therapy you receive
  •   Observations of how you function during exams and therapy
  •   Information about your cultural background that may affect an evaluation of your disorder
  •   Prognosis of your symptoms

Social Security may also seek information about your disorder and daily functioning from your family, friends and other people who know you and consider whether your statements and those from third parties are consistent with medical evidence provided.

Social Security is more concerned with your ability to function in a work-related setting than what type of neurocognitive disorder you have.

If your symptoms are not severe enough to satisfy the Blue Book listing, Social Security will consider your mental limitations in combination with your age, education, work experience and skills to determine if you have the ability to perform your previous job or any other job. Doctors working for Social Security will evaluate your mental impairments and complete a mental residual functional capacity form (RFC). Vocational analysts will then review the non-medical parts of your application together with the mental RFC. If Social Security cannot find a job that you can do given your impairments, you may still be approved for disability benefits even though your neurocognitive disorder does not satisfy the listing. This is called a medical-vocational allowance.

“Once Social Security determines the limitations caused by your condition, they will employ a vocational expert to assess whether a person with these limitations is employable. Most vocational experts will find a person to be unemployable if their condition or the treatment rendered for the condition causes the person to regularly be absent two or more days a month or be “off-task” 15% or more of the workday.” – Lloyd Bemis Disability Attorney

Your age or another medical condition may help you get approval.

Many individuals develop neurocognitive disorder at a later stage of their life.

Social Security follows a set of rules to determine when the agency believes an applicant can learn a new job; applicants who are 55 or older often fall under a grid rule, which means they are not expected to learn a new job. For example, a 55-year-old applicant who doesn’t have skills that could be transferred to another job might be found disabled. If you can’t go back to your old job, and you lack the skills to learn a new one, Social Security will likely grant you disability benefits.

You may also be eligible for Social Security Disability benefits if you have another medical condition, such as arthritis.

While one disorder may not meet the criteria of a listing in Social Security’s Blue Book, if you have more than one impairment, Social Security must consider how those combined health issues limit your ability to hold a job and perform necessary daily tasks.

You must also meet Social Security’s basic financial requirements.

The Social Security Administration also has basic financial requirements you must meet before you are eligible for Social Security disability benefits.

You must: 1) have a disability that has lasted, or is expected to last 12 months; 2) you must have worked in a job where you paid Social Security taxes long enough and recently enough; and 3) you must not earn more than Substantial Gainful Activity (SGA), which in 2024 is $1,550 per month for nonblind applicants and $2,590 per month for blind applicants.

What if I don’t qualify for SSDI?

If you don’t meet Social Security’s financial requirements for SSDI, you may be eligible for disability benefits through another Social Security program, like Supplemental Security Income (SSI,) or from long-term disability insurance acquired through your employer or a privately purchased policy.

SSI is a program that pays monthly benefits to people with limited income and resources who are disabled, blind, or age 65 or older. SSI is based on income instead of work credits, and is financed by general funds of the U.S. Treasury.

I have long-term disability insurance – should I file a claim?

Yes – if you have a long-term disability insurance policy, you should file a claim as soon as you become disabled.

Long-term disability insurance (LTD) protects your income if you are unable to work due to illness or injury and is purchased as part of a group employment plan or privately through an insurance company. Policies pay between 50-60% of your salary and benefits continue until you return to work or for the number of years stated in the policy. LTD coverage is good only as long as you are employed, however, so do not quit your job before you file a claim. Remember to check your policy’s definition of “disabled” as each policy will state the definition of “disabled” which is in use. Be aware that long-term disability insurance companies can require a claimant to apply for SSDI in addition to filing an LTD claim.

How do I file for Social Security Disability benefits?

You can apply for Social Security Disability benefits online, over the phone, or in person at your local Social Security Administration office.

If your application is denied, do not be discouraged – most initial applications are; you will have the opportunity to appeal. There are four steps to the Social Security appeal process:

  1.   File a Request for Reconsideration with the Social Security Administration to completely review the case.
  2.   If you don’t agree with SSA’s response to your Request for Reconsideration, you can request a hearing before an Administrative Law Judge (ALJ). ALJs are attorneys who work for the Social Security Administration; they review SSDI cases and either uphold or overturn decisions to deny SSDI benefits. If you are not represented by an attorney, you should obtain legal counsel at this critical point to raise your chance for success.
  3.   If an ALJ does not grant your claim, you can request that the Appeals Council review your case.
  4.   Federal Court review. The final step in the appeal process is filing suit in U.S. District Court.

If you are suffering from a neurocognitive disorder and have been denied disability don’t give up, almost 70% are denied initially! Just call 512-454-4000 for a free, no obligation consultation to learn what your options are. Have some questions? just give us a call, we love to help folks just like you!

Do I need a disability attorney for SSDI?

Applying for Social Security Disability benefits is a complex process and applicants with neurological disorder may experience particular challenges.

First, you may need the help of a family member or trusted friend. However, even with this support, you will likely need the guidance of an experienced Social Security Disability attorney. Your chances for approval will be greatly increased and you will avoid costly mistakes and delays. At each potential stage of the process, from the initial application stage, the reconsideration stage and the ALJ hearing stage, an attorney can assist you in completing the detailed forms and questionnaires required by Social Security, collecting and submitting relevant medical evidence, and preparing questionnaires for your doctors. At the ALJ hearing phase an attorney can not only continue to assure that the evidence is complete, but prepare you for questioning by the ALJ, prepare an argument on your behalf and question any doctors or vocational experts selected by the ALJ to testify at the hearing. At the Appeals Council and federal court level, a lawyer can present legal arguments to show your case was wrongfully denied. Fees charged by disability attorneys are regulated by federal law and are usually 25% of disability backpay you are owed. There are no out-of-pocket costs, and if you don’t win your case, you won’t be charged anything.

Do I need a disability attorney for a long-term disability insurance claim?

Filing a claim for long-term insurance if you become too disabled to work is equally complicated, whether you have a long-term insurance policy purchased through a private insurance broker or a group policy purchased with your employer.

The wording of policies can be confusing and the laws and regulations which affect the two types of LTD insurance differ in their procedures for filing claims and appeals. An experienced LTD attorney with thorough knowledge of ERISA laws and regulations will avoid mistakes and increase your chance of success. An attorney will act on your behalf, completing your application and filing your claim in a timely manner. They can also negotiate a settlement or file an appeal for you. If it becomes necessary to file suit, an LTD attorney can prepare your case against an insurer. Most LTD attorneys handle cases on a contingency basis and charge approximately 25%-40% of a claimant’s past due benefits. You do not pay an attorney’s fee unless the attorney wins your case.

Bemis, Roach & Reed Neurocognitive Disorder Case Example

A Dickinson client of ours was denied Short Term Disability by Cigna.

She underwent a neuropsychological evaluation which found cognitive impairments. At the suggestion of the neuropsychologist, she then underwent a Functional Capacity Evaluation which found physical limitations. Both of the tests, which are considered the “gold standard” for making disability determinations, found our client incapable of full-time employment. Her doctor described her limitations so as to include two hours of rest with every one hour of activity. These restrictions were indefinite. Although she could perform some functions, she was limited to part-time work and could not earn 80% of her indexed pre-disability earnings unless she could work at least 80% of a full-time schedule. There was no evidence in the record that she could do so.

We fought Cigna when it denied her claim and were granted a settlement.

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At The Texas Disability law firm Bemis Roach & Reed, our attorneys are committed to helping injured or disabled clients receive the benefits they deserve. Mr. Roach is AV Preeminent and SuperLawyers rated and has become a recognized leader in the field of Long Term Disability law. Mr Bemis focuses his practice on Social Security disability while Mr Reed handles both LTD and SSDI claims. Both are AV Preeminent and SuperLawyers rated and all our attorneys have been successfully helping people fight for their rights against big insurance companies and the government since 1993. If you have applied for benefits and been denied call 512-454-4000 for a free consultation and get help NOW.

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"Words can not truly express the gratitude that I feel toward Mr. Lonnie Roach and his professional team. I give them an A+++. Very compassionate and prompt. Their priorities are first and foremost helping you succeed at your case. When you feel helpless, feeling like someone is on your side can mean the world to you. Thank you for working for the people."
-Amy K.

Attorney Lloyd BemisAuthor: Attorney Lloyd Bemis has been practicing law for over 35 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Through his extensive litigation Mr. Bemis obtained dual board certifications from the Texas Board of Legal Specialization. Lloyd is admitted to practice in the United States District Court - all Texas Districts and has argued before the U.S. Court of Appeals, Fifth Circuit. Mr. Bemis is a member of the Travis County Bar Association. He has been active in the American Association for Justice and is a past Director of the Capital Area Trial Lawyers Association. Mr. Bemis and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.

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