LTD for Alzheimer’s and Dementia

Alzheimer’s and dementia are enduring and degenerative conditions that affect memory and brain function. Some may be able to continue working in the early stages of the disease, but at some point they will be unable to continue to support themselves and Long-Term Disability can be a critical support in helping them get the resources and care they need. The process may be intimidating for many, and, in that case, working with a San Diego long-term disability claim attorney from Dawson Rosenthal may help you manage the process more effectively.

What are Alzheimer’s and Dementia

Many people think of Alzheimer’s when they think of dementia, and while it is under that umbrella, there are many types of dementia. The Alzheimer’s Association estimates that California and Arizona have nearly 720,000 and 152,000 cases, respectively. The disease is characterized by a buildup of proteins in the brain. These buildups cause nerve cell death, causing a dramatic reduction in the size of the brain and affecting all areas. Due to the extensive and progressive damage of Alzheimer’s, the disease is ultimately fatal over several years. The Mayo Clinic reports there are five commonly accepted stages of Alzheimer’s. The first two stages are known as the preclinical and mild cognitive impairment stages, where the individual may function relatively normally, and symptoms are not significant enough to detect. The symptoms will often start slow and escalate faster as the disease progresses, meaning you may start considering options for disability in the not-so-distant future once you receive the diagnosis.

Dementia is a Cluster of Symptoms

The term dementia refers to a cluster of symptoms that cause a decline in cognitive functioning. These different types of dementia result from other conditions such as types of hydrocephalus, Parkinson’s Disease, Creutzfeldt-Jakob Disease, or vascular damage from stroke.

What is the Prognosis of Alzheimer’s or Dementia

As of yet, there is no cure for dementia and the diseases that fall under its umbrella. Whether dementia is the cause of death or simply a co-occurring diagnosis at the time of death depends on the type of disease and the individual. However, it is almost guaranteed that the individual will require significant support in the last decade or years due to deterioration. Common signs that more support is needed include:

Poor coordination and movement control (this can make it difficult to drive to and from work)
Trouble with planning or coordinating tasks
Increased trouble with simple problem-solving may make it challenging to complete job duties
Communication difficulty
Inappropriate behavior

Many of the symptoms you may expect from a dementia diagnosis are not conducive to obtaining or maintaining gainful employment. This is where your disability claim can become important. Depending on the individual’s age, they may be eligible to claim Social Security benefits or even Social Security Disability, but it can be difficult to get this approval. Additionally, long-term disability coverage through an insurance plan may provide more comprehensive support to ensure that individuals receive the care they need.

Filing a Claim for Long-Term Disability

Disability insurance can provide people with a sense of security, knowing that they can continue to have some income if they become ill for a prolonged period of time. Long-Term Disability is utilized when the support needed extends past the limits of short-term disability, which is often around one year. These benefits often come in the form of monthly payments and cover some or all costs of needs for daily living. Regarding dementia and Alzheimer’s patients these supports may include in-home services to help with daily tasks, nursing care, etc. More comprehensive plans may also cover care in medical facilities such as assisted living, memory care facilities, or hospice. Your policy details will determine whether services are covered in home or community settings, so you may want to be familiar with those when you seek services.

Bad Faith Practices

The costs of long-term disability care can become incredibly expensive, meaning insurance providers may give additional and illegal pushback to covering services. Some red flags for bad faith practices include denying claims that should be covered according to your policy, delaying payouts, or otherwise intentionally making it difficult to access the benefits you are entitled to. If you have concerns about this, a bad faith insurance lawyer may be able to help you navigate the process more efficiently.

Long-Term Disability Documentation

The foundation of most insurance claim processes is documentation. It is not wholly unreasonable to ensure you are claiming the benefits you are entitled to, but it can be overwhelming for some. Some of the essential documentation for a long-term disability claim include:

Medical records proving the Alzheimer’s or dementia diagnosis
Vocational information
Your own notes from doctor’s visits
Lab or evaluation results
Doctor’s statement regarding limitations to work
Letters from friends and family speaking to the impact of the illness

The details each person will need will differ based on the case details, but you can be confident that the above will likely be part of it. Ensuring you are accurate and thorough with your documentation is critical because a mistake in a document or missing piece can result in a claim denial. Though you can appeal a denial of your long-term disability insurance, it can be a complicated process that prolongs the time you wait for support.

Advocating for the Benefits You Deserve

Managing an insurance claim can be exhausting in the best situation and doing so in the face of a degenerative diagnosis is hardly the best case scenario. When you decide it’s time to utilize your LTD policy, make sure you know what it includes, be prompt and accurate with documentation, and hold your ground if you think they are failing to hold up their end of the agreement. If they are operating illegally by denying claims that should be covered, or otherwise making the process intentionally difficult to avoid payout, you may be eligible to file a bad faith disability claim. These claims can take time to settle, but may provide additional compensation for additional damages caused, and they act to hold bad faith insurance companies responsible.