Cognitive Impairment

Do I Qualify For Disability Insurance Benefits For Cognitive Impairment?

Disability insurance companies don’t always make it easy for policyholders who have a cognitive impairment to get the disability benefits they deserve. Cognitive impairment can be caused by a head injury, dementia, stroke, tumors, chronic alcohol or substance abuse.  It also can be found in those with congestive heart failure and kidney or liver disease.

The Common Reasons Disability Insurance Carriers Deny Cognitive Impairment Disability Claims

Many claims are denied because the disability insurance company says:

1. There is no objective basis of the cognitive impairment diagnosis,
2. There is no objective basis for the restrictions and limitations assigned by your physician, or
3. There is no causal relationship between your cognitive impairment and/or your restrictions and limitations, and your inability to do your own or any occupation.

Worse, many disability insurance policies define cognitive impairment as a mental nervous condition, which generally limits benefits to 24 months maximum.

Some policies also limit benefits to 24 months if any mental nervous condition contributes in any way to your overall disability. Your policy also could be so broad that cognitive impairment is considered to fall within the mental/nervous limitation.

Nancy Cavey, who has 37+ years experience handling disability cases, often battles this issue with disability carriers. She works closely with you, your family and your physician to overcome a claims denial or termination of benefits after 24 months.

Nancy Cavey offers a free initial consultation and welcomes the opportunity to speak with you about your disability claim.

What Is A Cognitive Impairment?

The Centers for Disease Control and Prevention define “cognitive impairment” as when a “person has trouble remembering, learning new things, concentrating or making decisions that affect their everyday life.”

Cognitive impairment ranges from mild to moderate, severe and profound.

What Are The Symptoms of Cognitive Impairment?

Mild cognitive impairment (MCI), an intermediate stage of impairment, can involve problems with memory, language, thinking and judgment.  It’s like your memory and cognitive abilities have “slipped.” MCI generally is not severe enough to interfere with the activities of daily living, but it can interfere with your ability to perform any occupation that requires high cognitive ability.

Moderate cognitive impairment involves difficulty with complex communication, difficulty in social situations and problems with social cues and judgment.

Only 3-4% of those with cognitive impairment fall into the severe level. They require daily supervision and assistance with activities of daily living.

How Do I Get The Disability Insurance Benefits I Deserve?

Every occupation has cognitive demands. The key to winning a cognitive impairment claim is to understand how your policy defines “occupation” and, before filing a claim, fully developing the occupational demands of that occupation.

Your occupation may be fast-paced, require you to work with complex data and communicate effectively. If you are a physician, scientist, engineer, attorney, stockbroker, analyst, CEO or CFO, and your memory, thinking, judgment or communication skills have “slipped,’’ you may no longer be able to function properly.

If you no longer can work or your doctor has told you to apply for disability, before you apply for benefits, you should:

1. Obtain a copy of your disability policy. See how it defines “disability,” “occupation” and “self-reported conditions.” You’ll need to understand what you have to prove to get your benefits because of a cognitive disorder. Some policies include a mental nervous limitation that can classify a cognitive disorder as a mental disorder; some policies are silent on the issue. Find out what your policy says before you apply for benefits.
   You also want to know how your policy defines “occupation.’’ It can be defined by how you performed your occupation for your employer, how it is performed in the national economy, or how it is performed according to the Dictionary of Occupational Titles. The definition impacts the medical proof and the vocational proof you will be required to submit.
2. Obtain a copy of your medical records. Review them to see if there is an objective basis for your diagnosis, what your records say about your report of symptoms and your restrictions and limitations.
   Carriers routinely deny cognitive disorder claims on the basis of no objective evidence of impairment. You should have neuropsychological testing and a SPECT of the brain to document the objective basis of the diagnosis and level of impairment.
3. Obtain a copy of your personnel file to see if your cognitive impairment has affected your work performance.
4. Obtain a copy of your job description. Create your own description of your physical duties with an explanation of how your symptoms impact your ability to do your occupation. Explain how your symptoms have impacted your work relationships and your ability to get along with others at work.
5. Provide your doctor with the occupational description. Ask your doctor to prepare a report that explains the objective basis for your diagnosis, the objective basis of your restrictions and limitations, and the objective reasons you can’t perform some or all of the material and substantial duties of your occupation.
6.  Prepare a diary that explains your cognitive impairment and the side effects of the medication you are taking. Be sure to give examples of how your symptoms interfere with your ability to do things on a daily basis.
7. Obtain a vocational evaluation of your occupational duties. Have the evaluator comment on how your cognitive impairment prevents you from performing your occupation or any occupation.
8.  Hire Nancy Cavey to help you file your initial application. The application process is confusing and designed so you and your physician make mistakes that can result in a delay or even a denial of your benefits. Ms. Cavey knows how to prepare and file a winning shock and awe disability application that leaves the carrier little reason to question your claim.
9.  Hire Nancy Cavey to help you appeal a wrongful denial or termination of your disability benefits. Disability carriers are in the business of collecting premiums and not paying disability benefits for a cognitive disorder. They’ll use any reason to deny your claim. The odds of getting your benefits on appeal are greater when you are represented by an experienced ERISA/private ID policy disability attorney.

Contact Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live

A cognitive disorder can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Nancy Cavey can review your policy and your medical records, and explain to you what your policy says and how to get your disability benefits.  Call today for a free consultation at 727-477-3263.