Multiple sclerosis (MS) is a neurological condition that affects the body’s central nervous system. Damage to the myelin sheath, which protects the nerves, interferes with the nerve’s ability to transmit signals between the brain, spinal cord and other parts of the body. The inability to properly transmit signals can lead to a variety of issues, including motor dysfunction, spasticity, fatigue, numbness or tingling in the upper or lower extremities, or vision issues. The intensity and severity of symptoms varies among individuals, and is dependent upon what portion of the brain is damaged.
If you are diagnosed with MS, you may be entitled to social security disability (SSD) benefits. The SSA has specific criteria applicants must meet in order to qualify for SSD benefits based on a MS diagnosis. In addition to meeting those criteria, you must prove that your conditions are expected to last at least 12 months (or result in your death), and that it limits your ability to engage in substantial gainful activity (for 2017, the SSA considers a person gainfully employed if they earn more than $1,170 per month).
Medical Diagnosis of MS
There is no single test to confirm an MS diagnosis. Instead, physicians must examine all the patient’s symptoms, physical findings, and laboratory tests to rule out other potential causes and make a diagnosis. Patients will generally undergo a neurologic exam, MRI, evoked potentials (EP) and spinal fluid analysis, in addition to providing a detailed medical history describing every symptom, as their physician works to make a diagnosis.
An MS diagnosis is made on the following:
- Evidence of damage (as shown on an MRI or other acceptable imaging) to at least two different areas of the central nervous system;
- Evidence that the damage occurred at least one month apart, and;
- All other possible diagnoses have been ruled out.
MS and SSD Benefits
As with any disease or condition, MS falls on a spectrum and can range in severity from mild to aggressive. Mild forms have periods flare-ups (acute attacks) followed by periods of recovery (remission). Applicants who have mild forms will most likely have a difficult, if not impossible, time obtaining SSD benefits, because they are able to work in-between episodes. Aggressive forms of MS are characterized by a steady progression of signs and symptoms with relatively few to no periods of recovery. For these individuals, work would be difficult, if not impossible. Moderate cases fall somewhere in between.
If you have mild to moderate MS, it is important that you focus on how the MS affects you on your worst days when describing your symptoms to your treating physician and on your SSD benefits application. And be specific, using numbers whenever possible. For example, rather than say, “During flare-ups I have difficulty walking”, say,
“Twice a week I experience numbness and tingling in my legs; this leaves me unable to sit for more than 10 minutes at a time in any given position. I am unable to walk without the use of arm crutches because the numbness causes my legs to give out with no notice. During these periods it takes 3-5 minutes to walk 200 feet, and 4 out of every 5 attempts I must sit and rest for up to five minutes before continuing.”
This latter description paints a clearer picture of the impact your symptoms have on your ability to work, and leaves little open to interpretation by the disability examiner. Make sure to maintain regular visits with your treating physician, and to describe your symptoms to her in these terms on every visit. Consistent notations in your medical record about your symptoms shows a pattern and makes your case stronger.
It is also important to maintain any treatment protocol prescribed by your physician to help alleviate symptoms associated with MS, until you both determine that the treatment is either ineffective, or that the side effects outweigh any benefit. Although the SSA doesn’t require patients to undergo every available treatment, providing evidence of those treatments you have attempted shows that you are actively participating in treatment, but that none improves your condition enough to make working feasible.
Evaluation of Multiple Sclerosis for SSD Benefits
When evaluating whether you qualify for SSD benefits based on an MS diagnosis, the SSA will look at all available imaging to verify the damage to your central nervous system. In addition to imaging, your medical history and case file must also support that you experience either of the following:
- Disorganization of motor function in two extremities (arms and/or legs) that results in an extreme limitation on your ability to stand from a seated position, balance while standing or walking, or use the upper extremities (either because you have limits on the ability to move your arms or you use crutches to walk), or;
- Marked limitation in physical functioning, and in either the ability to understand, remember or apply information; interact with others; concentrate, persist, or maintain pace, or; adapt or manage yourself
When evaluating how MS affects your ability to stand up, balance, walk, or perform fine and gross motor movements, the disability examiner will consider signs and symptoms such as flaccidity, spasticity, spasms, incoordination, tremor, physical fatigue, and dizziness. When determining whether you have marked limitations in physical functioning, they will consider other impairments that occur because of your MS, such as fatigue, visual loss, mood swings, or depression. If your impairments in any of these secondary symptoms, such as depression or vision loss, reach the level of disability as stated in the SSA’s other covered conditions, you may consider applying for disability under that condition, in addition to the MS listing.
Do you have MS or another disabling condition that impedes with your ability to work? Are you considering apply for SSD benefits? Contact the Law Office of Neil H. Good by phone #(847) 577-4476
