About Emmett Irwin: Emmett is a social security disability and Elder Law Attorney in Baltimore, Maryland, who previously was paid by hospitals and nursing homes to get disability and medical benefits for patients. Several years ago, Emmet started his own law firm, so he could work for private clients, and is the co-chair of the disability benefits section of the Maryland Association for Justice, the Vice-Chair of the elder law and disability Right section of the Maryland State Bar Association and a member of the peer review of the state of Maryland. Emmitt is also a former Division Three basketball player.
In this episode, Steve and Emmett discuss:
1. So how long have you been handling SSD cases?
- Since 2008, so, years.
2. Can you give me a ballpark figure as to when you started seeing early-onset dementia cases?
- It’s been since I started but they were fewer and far between back then. They’ve been getting more and more prevalent. As you know, the population starts to age, the silver tsunami, as you would say, baby boomers are getting a little older, and some people are starting to have some issues with dementia.
3. What would you say are the average age of an early onset dementia client?
- People I’m seeing are from 58 to 64 years old, 65 years old, after 65 SSD really isn’t an issue because you hit full retirement age at 66 or 67 years old. So we’re really not applying for SSD, for people older than about 65.
4. You only take cases up to 65 because after 65 they automatically get social security, retirement, whether they’re disabled or not correct?
- That’s correct.
5. what is the likelihood of the person that comes to you at 58 years old, and they’ve got early onset dementia or Alzheimer’s, being able to get social security disability within a reasonable period of time?
- It’s a really great chance. Early-onset Alzheimer’s and other kinds of dementia, we see vascular dementia, we see Frontotemporal dementia, but the symptoms are really very similar. What happens is short term memory issues, their concentration issues. Most of the clients that I see have higher-level type jobs, very skilled type jobs. Sedentary jobs where they need the brain functioning very well and then once the early signs that the short term memory problems hit, and the concentration issues hit, there’s really no way they can do those jobs anymore. So they either quit or get fired or take an early retirement. Then they come to me and ask, Well, what can I do about this? Really, the driving force in an SSD case is the symptoms, just the diagnosis of one of the dimensions isn’t going to get social security to approve disability. They’re really going to look at the symptoms. How much are the short term memory issues impacting your daily life? How much are the concentration issues affecting your daily life?
6. What are some examples of how it can affect their daily life or affect their ability to do their job?
- Some of the examples are, there’ll be complex problems. I have a client, that was at it at a relatively high level IT job as a middle manager, and would have to project manage these very complex international projects. As you can imagine that, if you’re trying to manage one of these projects, and you keep forgetting what you just read, that that’s going to have a big, big impact on your job and that’s really one of the first things forgetting what you read is, you know that happens with age anyway, to a certain extent, but when you’re having to read things two or three more times, to understand them, then that can be indicative of a problem, the mental fatigue from concentration issues. That is one of the problems that I’m seeing where what you have to do in a 10 hour day and concentrate, the great majority of that time, you start at 8 am. and by about 1 pm, you just can’t concentrate on anything anymore. That’s one of the issues that I see in people that have this diagnosis also.
7. Are the people who are white-collar workers, who have to do a lot of thinking and reading and basically concentrating so that they can show that they just can’t do that, they just don’t have the faculties now to be able to do that job. If they show that, and you can prove it, then what is the likelihood that Social Security is going to approve them?
- It depends on associated issues, such as physical issues, though, when someone’s 60 something years old, and they have dementia, it’s usually not the only thing that they have. So it’s a fairly easy case. If, for example, there are knee problems, documented back problems, documented knee problems, some kind of problems, physical in nature, if we can document those problems and document the cognitive issues Then it’s generally a pretty easy case if there are not any physical issues at all, and it’s just the cognitive issues, that it’s a little more difficult and probably will take a little more time. But in the end, we’re successful with 90% of these cases. I mean, these are, these are generally really good cases to get approved for SSDI social security disability.
8. Would it actually be easier if blue-collar workers got the same symptoms that we described earlier? With the concentration and with memory and just their ability to function mentally, even though they don’t need to do that for their job. The fact that if they have those symptoms, as well as a lot of physical issues, is it actually going to be a smoother ride for them?
- Well, it’s just inherently a smoother ride for blue-collar workers, although we are seeing a lot of denials coming down now for some reason. But traditionally, it’s been a really smooth ride for blue-collar workers, and then adding on the cognitive issues is the cherry on top. Oftentimes not necessary, but we’re never comfortable with the amount of evidence we have. We always want more evidence of someone’s inability to function at 100% on a day to day basis. Whether that functioning is physical knee problems, back problems, or mental with cognitive issues, short term memory issues, concentration issues. The frustration involved also is a factor because as you notice the somebody whose cognitive abilities are going downhill usually gets really easily frustrated, and some depression can kick in also, and we use all of that because social security looks at all of that. And the combination of impairments generally does help with a case.
9. Is Social Security particularly hostile to this type of case? Are the denials just global as far as that, it could be for any type of condition or any type of injury or disease, or is it just focused on the early onset of dementia individuals?
- It’s everything so it’s across the board and the older people are being affected along with everybody else, but I think it’s particularly damaging to our older clients and older people in general, because of the multitude of problems that they have.
10. What is the Social Security Administration looking for? Is there anything written that says if you have this, this, and this, you automatically are eligible for benefits or it’s going to increase your chances of getting the benefits? So what, specifically are they looking for in early-onset dementia cases?
- What Social Security is looking for are activities of daily living away from work that are being affected. I don’t know why that is. I have no idea. Because I would think that it would matter quite a bit. What happens in the workplace. It really doesn’t matter at the initial application level. What they’re looking for is daily evidence of loss of complex attention. executive function, learning, and memory, loss of language ability, something called perceptual-motor, which means is that you’re having trouble picking things up. You’re having trouble judging stares, for example, because your brain isn’t perceiving what’s around you correctly. There’s also then social cognition, which means you’re losing your ability to understand what’s socially acceptable.
“What I prefer is a really good psychiatrist to document things.” — Emmett Irwin
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Show notes by Podcastologist: Kristen Braun
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