You can win disability benefits for MS by showing your specific challenges with medical records and evidence, as well as by working with an attorney who understands the Social Security benefits system. Multiple sclerosis (MS) can cause you to miss work or stop working altogether.
When MS forces you out of your job, important benefits may be available to you from the Social Security Administration (SSA). Unfortunately, getting benefits for MS can be difficult, and one mistake can mean your claim is denied. Our legal team can help.
Our Social Security Disability lawyers have more than 120 years of combined legal experience, helping injured and disabled people move toward a brighter future. Call today for your free consultation and tell us about the challenges you are facing.
Why Multiple Sclerosis Makes Getting Benefits a Challenge
MS can affect any part of the central nervous system and cause neurologic problems with muscle control and strength, spasticity, vision, balance, gait, sensation, pain, bowel and bladder control, emotional regulation, memory, fatigue, and mental disorders.
Multiple sclerosis can be hard to definitively diagnose. Equally important, while MS continually progresses, the symptoms of it tend to wax and wane.
MS also frequently causes autonomic dysfunction, which affects breathing, heart rate, blood pressure, temperature, sweating, and blood glucose. These neurologic problems can lead to cognitive or physical defects and disability.
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Issues Unique to Multiple Sclerosis Disability Claims
Due to the nature of the disease, an MS disability case has distinct hurdles. For example, claim reviewers:
- Will argue that you have worked for many years with MS and should be able to work now. This is especially true with disability insurance companies, which may build an entire denial on this basis for MS-related claims.
- Do not recognize the degree of impact a combination of impairments has on MS patients. Multiple sclerosis never stops progressing, even during periods of remission. With each relapse, there is never a complete recovery to the pre-relapse baseline.
- Are unaware that hot environments, or getting hot from overexertion, can make physical symptoms or cognitive abilities worse for people living with MS. This is complicated further because Residual Functional Capacity testing cannot effectively test for these issues.
- Vastly underestimate the disabling nature of MS fatigue. This alone can greatly obstruct one’s ability to function at home and work.
Proving disability for MS is more complicated than most realize. It’s up to you to furnish clear explanations with supporting medical documentation for these and any issues unique to your situation.
The Social Security MS Blue Book Listing
You might think that with a diagnosis of a chronic, progressive disease like MS, you are automatically entitled to Social Security Disability Insurance benefits. To automatically qualify for MS, you must meet certain criteria that are listed in the Social Security Blue Book.
The Social Security Administration evaluates multiple sclerosis under listing 11.09 of the Blue Book. Meeting this listing can qualify you for disability benefits without moving on to the next stage of the disability evaluation.
Blue Book Evidence That Can Prove Your Claim
To satisfy listing 11.09, your medical records must document severe functional limitations caused by MS. Social Security may review evidence showing:
- Significant problems with movement or coordination.
- Serious vision loss.
- Physical limitations combined with marked problems with memory, concentration, or adapting to daily activities.
Your neurologist’s treatment records play a major role in your claim. MRI findings, neurological examinations, cognitive testing, physical therapy records, and assistive device prescriptions all help show how MS affects your ability to perform full-time work on a consistent basis.
What to Do If You Don’t Meet the SSA Blue Book Criteria
Many people with MS do not satisfy every medical requirement of the listing. That does not mean your claim will fail. We often help clients whose claims depend on showing how their symptoms limit their ability to work, instead of meeting the listing.
When MS symptoms are not severe enough to meet or equal the SSA’s Blue Book listing, Social Security offers another path to winning benefits known as medical–vocational allowance. Here, the SSA looks at your functional, vocational abilities by evaluating your Residual Functional Capacity (RFC).
RFC is what you can still do despite your physical or mental impairments. In this approach, you need to prove to the SSA that your symptoms are severe enough to keep you from regularly engaging in any work activity.
Your Medical Records
The SSA needs your medical history, including your MS diagnosis, diagnostic test results, records of your ongoing treatment and medication, hospital visits, and prescribed assistive devices. Our team can help you assemble the necessary evidence to show the extent of your hardships.
A Psychological Evaluation
The SSA may consider your ability to understand, remember, and apply information, concentrate, sustain a steady work pace, and/or interact with others. You don’t have to be completely unable to carry out an activity, as long as the degree of limitation seriously limits your ability to function independently and complete work–related activities.
Your Treating Physician’s Statement and Recommendation
The SSA will have specific questions for your doctors that will help them understand the nature and frequency of your symptoms and your functional capacity. It is a good idea to provide these questions to your doctor ahead of time.
Your doctor will also fill out RFC forms to show that your physical and mental limitations result in a condition that qualifies you for disability.
A Journal of Your Symptoms
We recommend our clients keep a journal of their daily activities and how their symptoms affect their quality of life. For example, fatigue is a major issue for many with MS. Most tests and exams never document the disabling effect that fatigue has on a person living with MS.
Document your different symptoms, and state how those symptoms affect your ability to work. Testimony from friends or family that helps reveal how your symptoms disable you can also be very helpful.
An attorney who is board-certified by the National Board of Social Security Disability Advocacy will know these and other means to help Social Security adjudicators decide to award benefits based on multiple sclerosis. These factors apply throughout an initial filing or during the appeals process.
Symptoms That Most Often Prevent Work
Multiple sclerosis affects every person differently. Some people continue working for years after diagnosis. Others develop symptoms that make full-time employment unrealistic. Disability claims succeed because the medical evidence shows how your symptoms prevent reliable work activity.
Symptoms that commonly interfere with work include:
- Severe fatigue that limits physical and mental stamina.
- Neurological conditions that cause weakness affecting the arms or legs.
- Poor balance and frequent falls.
- Difficulty walking or standing for extended periods.
- Cognitive issues affecting memory, attention, processing speed, or decision-making.
- Vision changes, including blurred or double vision.
- Muscle spasms and spasticity.
- Numbness or loss of coordination.
- Bladder or bowel dysfunction requiring frequent breaks.
- Muscle and physical fatigue.
Many of these symptoms fluctuate from day to day. Insurance companies and Social Security sometimes focus on your better days while overlooking how often your symptoms interfere with regular attendance and sustained work activity. Medical records that consistently document these limitations carry significant weight during a disability claim.
How to Win Long Term Disability Claims Based on MS
LTD claims for multiple sclerosis are often denied by insurance carriers. Many claims wind up in litigation. Case law is filled with accounts of insurance companies that have unfairly denied claims based on MS.
Insurers have various strategies for punching holes in a claimant’s initial LTD application. For instance, they won’t deny that you have MS., but they will maintain that your MS does not prevent you from doing your job. To win an LTD claim, our attorneys can help you:
- Carefully review your Long Term Disability policy to understand how it defines disability, including whether it covers your inability to perform your own occupation or any occupation, and when that definition may change.
- Support your claim with medical documentation, including neurologist records, diagnostic tests, and treatment details that demonstrate the severity of your MS.
- Provide detailed evidence showing how MS limits your ability to perform work-related tasks, such as standing, walking, sitting, using your hands, concentrating, and maintaining a full-time work schedule.
- Obtain a detailed statement from your treating physician explaining your specific work restrictions, how your MS symptoms prevent you from working, and whether your limitations are expected to be long-term.
- Submit all requested documentation and meet insurer deadlines promptly to avoid unnecessary delays or potential denial of your disability claim.
- If your claim is denied, carefully review the insurer‘s explanation to identify the reasons for the denial and determine what additional evidence or information is needed for a successful appeal.
Multiple Sclerosis Claims and Veterans’ Benefits
Veterans with MS may be eligible for service-connected compensation from the VA. Under VA Disability Benefit eligibility rules, MS is a presumptive condition, and benefits are based on the presumption that the disability is service-connected. This means that you do not need a nexus statement.
If you were diagnosed with MS during your service in the military, or within seven years after an honorable discharge, you may be eligible for disability compensation without having to prove that your MS is linked to your service.
Neurologic symptoms occurring within seven years of discharge, regardless of date of diagnosis, can be used to support service-connection for MS. If diagnosis occurs after the seven-year presumptive period, you may still be service-connected for MS.
The VA Disability Rating for Multiple Sclerosis
MS is rated at a minimum of 30% based on the VA Disability rating schedule. After the minimum rating of 30%, every veteran is rated individually as the disease affects each person uniquely in terms of symptoms and severity.
Multiple sclerosis often leads to life-changing disabilities for veterans, and the VA may not evaluate the long-term effects of MS properly. Don’t let the VA underrate you. If MS restricts your ability to work, you may also qualify for Total Disability Based on Individual Unemployability (TDIU).
If you need a reconsideration of your MS-related veteran’s claim, or if you need help establishing service connection, call our firm without delay. Your best option is to talk to a Veterans Affairs Disability benefits lawyer who can help you take the necessary steps to prove your case to the VA.
Speak With an MS Disability Claims Lawyer Now
You can win disability benefits for MS by providing the necessary medical evidence and other documentation that proves you are unable to work. While the process can be confusing and frustrating, you don’t have to deal with it on your own.
If you are filing an initial application for disability benefits with your insurer, our disability lawyers can help you develop your claim with as much medical and vocational evidence as possible. If an insurance company has denied your MS-related claim, we can help with your appeal.
Since 1992, Marc Whitehead & Associates has helped injured and disabled workers get the benefits they are owed. Our firm has earned more than 2,500 five–star reviews. Call today to schedule your free consultation and talk to us about your claim.
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