Multiple Sclerosis is a chronic autoimmune disease caused by damage to the myelin sheath, or the protective covering that surrounds nerve cells. The damage to this covering is caused by inflammation which occurs when the body’s immune cells attack the nervous system; this can affect the brain, optic nerve and spinal cord.
There are four different types of MS: relapsing-remitting, primary-progressive, secondary-progressive and progressive-relapsing. Symptoms of MS include loss of balance, muscle spasms, numbness, problems moving arms and legs, leg or arm tremors, double vision, constipation, dizziness, slurred speech as well as many more. MS affects women more than men, and is most commonly diagnosed between the ages of 20 and 40.
Although there is no known cure for MS, there are multiple therapies that slow down the disease and control symptoms so that the patient is able to maintain a relatively normal quality of life. The prognosis is fairly unpredictable and varies from patient to patient. Although a cure is unavailable, life expectancy is usually normal and people with MS are generally expected to continue to work with minimal disability for 20+ years.
In order to qualify for long term disability with the Social Security Administration (SSA) the disability has to have lasted, or is expected to last at least 12 months. Patients who have episodic symptoms may have a hard time qualifying for this reason, even though their episodes could be more debilitating than the symptoms of someone who is suffering chronically.
SSA has identified MS as a chronic condition or impairment under neurological disorders, that could cause disability severe enough to prevent a person from working. To qualify for long term disability benefits for your Multiple Sclerosis, there are four criteria used to qualify someone as “disabled.” They are as follows:
1. Disorganization of motor function: Must prove severity that their MS has caused difficulty walking or using hands because of impairments of at least two limbs. You may have partial paralysis of limbs, tremors or involuntary movements.
2. Visual impairments: A severe decrease in vision that cannot be corrected with glasses.
3. Mental impairment: An organic mental disorder causing memory loss, a decrease in IQ or disturbance in mood.
4. Fatigue: Severe fatigue and muscle weakness that is caused by the central nervous system.
The SSA will request three things from you in order to determine long term disability benefits. First, you will need to obtain complete medical records, relevant case notes and documentation of inability to work. An MRI is the most common way to prove MS because it can detect even the smallest evidence of demyelination or plaque. Another test used is the spinal tap or lumbar puncture, which is slightly less effective.
Secondly, a Medical Source Statement (MSS) will be requested in the form of a letter from your licensed medical practitioner. It should describe the conditions and impact on major life activities. The MSS should reference the four criteria listed above. The MSS should be submitted to the Disability Determination Services (DDS) along with the medical records. Finally, a Consultative Examination may be ordered if the SSA or DDS determines that medical records and MSS is insufficient. The SSA may request that the patient visit another healthcare provider for the examination in order to avoid any biases.
If for whatever reason it is found that you do not qualify for long term disability benefits under the listed criteria, the SSA will assess your residual function capacity (RFC) in order to determine what type of work you are able to perform, and will assign you more sedentary work when possible.
If you have been denied long term disability benefits, you should consult an attorney who can determine if you should be entitled to benefits and can help you gain them.