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Early-onset Alzheimer's Disease and the SSA Compassionate Allowance

Compassionate Allowance Series By Stephanie O. Joy, Esq., JoyDisability.com

7/16/2021

Early-onset Alzheimer’s disease


Early-onset Alzheimer’s Disease is a recognized Compassionate Allowance disability by the Social Security Administration. Because a diagnosis is often elusive, many people suffering from EOAD and becoming disabled from it, do not successfully apply for their Social Security Disability benefits. Instead, they go without until they can file for early or full-aged retirement benefits often to their tremendous detriment, both health-wise and financially. This need not be the case. The following is a brief primer on the Compassionate Allowance disability of Early-onset Alzheimer’s Disease.

Background

Early-onset Alzheimer’s disease goes by a few other names, including Presenile dementia; Presenile Alzheimer’s disease; Young-onset Alzheimer’s disease; Familial AD; FAD; AD; EOAD.


EOAD, as a form of AD, is an SSA Compassionate Allowance disease and if specific Medical Evidence (from medical records) may be developed and presented, a person with EOAD may be able to more quickly file for and prevail on a claim for SSDIB or SSI. (Scroll below for details on what the SSA suggests be provided and evaluated to determine if a Compassionate Allowance should be determined for a particular claimant.) (https://secure.ssa.gov/poms.nsf/lnx/0423022385)


Alzheimer’s Disease is considered “early-onset” when it is diagnosed for a person under age 65. According to the SSA’s POMs manual, it constitutes 5-10% of all Alzheimer’s diagnoses.


It is extremely disabling, after a certain point of its progression. Very unfortunately, it is irreversible and it is degenerative in nature – it gets progressively more debilitating. It causes the gradual loss of language, memory, judgment and other cognitive abilities, as well as the overall inability to function. It is ultimately fatal. While the average life expectancy is 8-10 years after diagnosis of EOAD, and varies. Unfortunately, many with EOAD will require institutionalization to receive best care.


There is no known cure and no treatment known to slow the progression of EOAD. The symptoms, however, are often treated with drugs, such as galantamine, rivastigmine, or donepezil (known as cholinesterase inhibitors), and/or memantine (an N-methyl D-aspartate antagonist). (https://blog.ssa.gov/relief-for-thousands-suffering-from-alzheimers-disease/; https://secure.ssa.gov/poms.nsf/lnx/0423022385)


There are many, many people with Early-onset Alzheimer’s Disease in the work force still. (https://secure.ssa.gov/poms.nsf/lnx/0423022385). Often, the first unrecognized signs of EOAD include a diminishing ability to perform their work-related tasks that used to be well-performed. A change becomes evident and employer may notice, warnings or write-ups may be issued. In the earlier stages of EOAD, interestingly, depression is often complained of. Later, this worker may manifest more agitation than usual, a change in her personality and behavior, increased restlessness, and a withdrawal from interaction, socializing, etc., may become evident.


Because there is no known specific clinical or laboratory diagnostic test for AD, diagnosis can only be confirmed by brain biopsy or postmortem examination of the brain. As such, the diagnosis of EOAD is based on the combination of clinical/family history; neurological exam, cognitive examination, and/or neuropsychological examination. Neuroimaging is also used.

Clinical information gathered may include description of the cognitive and functional impairments noticed at home and at work. Also, it is possible for repeat/durational Mini-Mental Status Examinations (MMSE) that have scores to be indicative of possible dementia. Neuroimaging, such as CT or MRI can be utilized to observe physical objective changes in the brain that can also excluding other causes of dementia, thereby lending itself to the diagnosis of EAOD.

Evidence for the SSA determination:

Clinical information, generally from medical records is required – and they must illustrate that there is progressive dementia. As such, records from Primary Care Provider or Geriatrician is just the start and a specialist provider should be sought, in the form of a neurologist, neuropsychiatrist, neuropsychologist, or geriatric psychiatrist. Those providers may utilize:

  • Cognitive ability tests

  • Neurological evaluation

  • Brain scan

  • Lab tests to rule out a physical basis for symptoms

  • Mental health evaluations to rule out other conditions causing symptoms (such as depression)

to diagnose EOAD. https://www.healthline.com/health/dementia-doctors#second-opinion


The SSA also advises that further documentation of dementia by standardized testing such as the Clinical Dementia Rating (CDR) scale with a score of = 1, MMSE with a score of = 24, or equivalent test is helpful but not required. https://secure.ssa.gov/poms.nsf/lnx/0423022385


Activities of daily living report (ADLs) completed by relative or caregiver is very helpful. One standard generic form used by the SSA and lawyers representing claimants in their EOAD claims is the Function Report – Adult (SSA-3373).


The SSA Bluebook Listings that an attorney may urge the SSA to consider include 11.176 and 12.02


If your or someone know is or may be suffering from EOAD and you want to discuss helping them prove and prevail on a Social Security Disability claim (or SSI if needed), I welcome you to contact me at stephaniejoy@joydisability.com, or go to http://joydisability.com and fill out the quick and simply evaluation form and I will call you at the contact number you provide.

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Sources:

https://secure.ssa.gov/poms.nsf/lnx/0423022385

https://blog.ssa.gov/relief-for-thousands-suffering-from-alzheimers-disease/

https://www.ssa.gov/disability/professionals/bluebook/11.00-Neurological-Adult.htm#11_17

https://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm#12_02

https://www.healthline.com/health/dementia-doctors

https://www.healthline.com/health/dementia-doctors#specialists

https://www.webmd.com/alzheimers/guide/making-diagnosis-tests#1-4

https://www.ssa.gov/compassionateallowances/

http://www.fammed.usouthal.edu/Guides&JobAids/Geriatric/MMSE.pdf

https://www.assistinghands.com/41/florida/stpete/blog/what-is-the-clinical-dementia-rating/




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