Attorney Help When Claims for Multiple Sclerosis Disability Benefits Are Denied
Multiple Sclerosis (MS) is a serious, often crippling disease of the central nervous system that most often occurs in people between the ages of 20 and 50, women more than men. The National Multiple Sclerosis Society estimates that nearly 1 million people in the US alone are living with this disease, with 200 new cases diagnosed every week in the US.
Because these are primary working years for most people, MS claims are always closely examined by insurance providers. In the early stages, symptoms tend to fluctuate, making it difficult to document the seriousness of their symptoms.
New symptoms appear as MS progresses over time. . Severity and progress of the disease can be unpredictable, which makes MS difficult to identify initially and fully diagnose. MS usually becomes worse as it progresses. A diagnosis isn’t enough to prove disability. Medical records must carefully document your inability to work and perform the material aspects of your occupation.
If you are having trouble getting disability benefits for MS, you may benefit from a free evaluation of your claim. We have helped clients throughout the U.S. appeal their denied claims to secure the benefits owed them under long term disability insurance plans, Social Security Disability, and the Veterans Administration’s disability program.
Living with Multiple Sclerosis Disability
Most people with MS experience:
- Loss of muscle control (ataxia)
- Unstable walking
- Vision problems
- Difficulty maintaining balance and engaging in physical activities
- Difficulty using their arms, hands, and fingers to perform tasks
- Cognitive decline such as poor memory and concentration
Other symptoms include problems with:
- Mood changes
- Muscle spasms
- Severe and persistent pain
- Problems with breathing, swallowing or speaking
- Bladder and bowel problems
Not everyone who is living with multiple sclerosis will quality for disability benefits, since every case is different, and different benefit programs have highly restrictive criteria that you must meet. That is why a thorough review of each client’s medical records is necessary to determine the level of constraints and limitations caused by MS.
Disability benefits providers for multiple sclerosis cases favor hard evidence to award a claim. Weakness and fatigue are difficult to measure, so any documentation from your doctor must show that these and other symptoms are a direct result of your MS.
In many cases, we are able to help our clients document and prove the severity of their disability.
Winning Multiple Sclerosis Disability Benefits under Social Security
The Social Security Administration (SSA) identifies multiple sclerosis as a chronic illness that can prohibit a person from working. SSA will decide if you are disabled either by medical eligibility or vocational eligibility. It isn’t enough to just have MS. You must establish that you can no longer work eight hours a day, five days a week, as a result of the symptoms and complications from MS.
Medical Eligibility for Multiple Sclerosis Disability
SSA will evaluate whether your MS symptoms meet or equal the strict disability criteria in the official SSA Listing of Impairments and therefore entitle you to benefits. In the SSA listing, MS is listed under Neurological Listing 11.09, Multiple Sclerosis.
In late 2016, SSA significantly revised the criteria for evaluating all neurological disorders, including multiple sclerosis. In brief, SSA now has two separate listing tests for MS, based on “Extreme” vs “Marked” limitations, as follows:
- Listing 11.09A, “Extreme” Limitations. This listing considers physical-specific criteria involving the disorganization of motor function of two extremities that in effect would impair your ability to work;
- Listing 11.09B, “Marked” Limitations. This listing considers a combination of marked limitations in physical functioning and cognitive functioning that would impact your ability to sustain work-related activities.
While each above medical listing for multiple sclerosis can be challenging to meet, you’ll only need to satisfy one of these two listings. This is assuming your claim fulfills all other SSA requirements (sufficient work history and your condition will last 12 months or until death).
Additionally, SSA will take into account the following alternative listings that often apply to a person’s MS symptoms:
- Listing 2.00 – Visual Dysfunction
- Listing 12.02 – Neurocognitive Disorders
- Listing 12.04 – Depressive, Bipolar and Related Disorders
Vocational Eligibility for MS Social Security Disability Benefits
Because of the progressive nature of MS, claimants may not fully meet all medical listing requirements. The SSA’s medical vocational allowance presents another path to disability benefits if the individual can no longer work for a living.
To be approved under medical vocational allowance, SSA will explore your ability to perform work you have done in the past despite your multiple sclerosis. If the SSA finds you can do your past work, benefits will be denied. If you cannot do your past work, the process proceeds to the next and final step.
SSA will review your age, education, work experience, and physical and mental condition to determine what other work if any, you can do to support yourself. Many disability claims are approved under the vocational allowance when the claim is fortified with the necessary information the SSA needs to make that determination.
As disability attorneys, we will effectively show to the decision maker or the judge how your multiple sclerosis disability prevents you from working. We focus on how your MS symptoms hinder your functional capacity, as well as communicate with your doctors to gather the essential medical documentation and records.
For these and many other reasons, the importance of having a Board Certified Social Security attorney fighting for your SSDI benefits can make the difference in overturning a denied claim on appeal.
When Insurance Providers Deny Multiple Sclerosis Disability Claims
If you’ve received a diagnosis of MS, you may be wondering if it’s time to stop working. If your symptoms and condition are being well-managed, you may be able to continue working without problems. It may not necessary to stop working right away, or to notify your employer of your condition. Many symptoms are manageable with treatments and therapy, allowing you to continue working as long as you can.
If your symptoms progress to the point where working becomes a little more difficult, you may be able to request a special accommodation from your employer as needed so that you may continue to work.
When MS makes it impossible to continue working, many people turn to their disability insurance policies for benefits. This can either be through an employee benefit plan or through their own private insurance policy. But before you quit or retire and assume you can rely on your long-term disability policy, you’ll need to do a little homework first.
If you’re considering filing a claim for MS long-term disability, the first thing you must do is read it carefully. What does it say about MS, or does it mention MS at all? You need to know exactly what the policy contains before you do anything.
Some policies describe a disability by when you are no longer able to work in your own occupation. Others define it as “any occupation,” so it’s important to know what your policy says. You may be required to work a different job—for substantially less than your current occupation—in order to be considered for any kind of benefits. To qualify for a claim with MS, you will have to prove that your condition has progressed to the point where you can no longer work. Doctor’s records, treatment and diagnostic evidence of other symptoms are a necessary part of qualifying. Tests for symptoms such as vision loss should also be included. Medical evidence such as an MRI, which shows the process of demyelinization from MS in even the smallest degree, is the best diagnostic available for an MS patient.
Even if your doctors support your claim, representation from a qualified disability attorney can assist you in the claims and appeal process. A major factor in appealing a multiple sclerosis claim denial to the insurance company is to provide them with complete and objective evidence where it becomes unrealistic for their doctors or decision makers to justify a denial.
If your claim has been denied, we encourage you to contact our disability insurance lawyers as soon as possible. We offer a free case evaluation where we’ll answer all of your questions, and inform you of your legal options and the best way to proceed with your case.Veterans Benefits for MS Disability
The VA follows their Schedule for Rating Disabilities in order to evaluate the level of a veteran’s service-connected medical condition. Multiple sclerosis disability is listed in the schedule under Neurological Conditions and Convulsive Disorders and is rated according to loss of function and the effect on your ability to work and earn a living.
VA presumes that certain disabling conditions diagnosed in certain veterans were caused by their military service, including Multiple Sclerosis.. Disability benefits are based on the presumption that the disability is service-connected. Veterans with symptoms of MS in the military or within seven years after honorable discharge may be eligible for VA disability benefits. However, if your diagnosis was after the seven-year period, your doctor can offer a “nexus letter” indicating that your MS is actually service connected, there is no other apparent cause for the condition, and offer evidence to support the connection.
It can take time for multiple sclerosis to be properly diagnosed. Since symptoms take a long time to manifest and become noticeable, a formal diagnosis may be long delayed. Even if you’ve been discharged from service for more than seven years when your MS was first diagnosed, you could still be considered eligible for service-connected disability benefits.
The initial basic rating for this disease is 30 percent. Secondary disabilities, such as depression are rated separately, which may result in a higher combined rating leading to an increase in disability benefits.
If MS inhibits your ability to work, you could also be eligible for Total Disability Based on Individual Unemployability (TDIU).
We are accredited Veteran’s claim attorneys, with many years of experience helping veterans overcome the challenges involved in successfully preparing and appealing veterans’ benefits claims for multiple sclerosis disability.
We welcome your call to discuss how we can help you establish service connection, or assist you in any other way to appeal and win your denied VA disability compensation.
Ask Experienced Multiple Sclerosis Disability Lawyers to Review Your Case
Because multiple sclerosis is progressive, it is critical that you keep all documentation and medical evaluations organized and available. For example, you should obtain and file your medical results that relate to each symptom as it appears and progresses, such as visual complications, loss of use of one or more extremities, and pain. Keeping them in a notebook or file folder in date order will go a long way in helping your attorney gather evidence and build your case.
We can help you with all of these details. At Marc Whitehead & Associates, we take care of everything for you.
When you retain our legal services, we will outline a strategy designed to win the claim on appeal. We will help you obtain expert vocational reports and in-depth medical evaluations to strengthen the evidence in the file. We will submit a thorough and conclusive legal brief detailing the errors in the original denial. You only pay us if you are successful in your appeal.
A denial for Multiple Sclerosis is not the end of your claim. If you or a family member suffers from MS and cannot work, please call our disability denial attorneys toll free at 800-562-9830 or request a free consultation online with a lawyer today to discuss your MS disability case.