Is multiple sclerosis considered a disability by Social Security?
Multiple sclerosis is considered to be a disability by Social Security; however a diagnosis of Multiple Sclerosis does not necessarily mean an allowance or approval for disability benefits. Some individuals with multiple sclerosis have no, or very minimal, functional limitations, meaning that some individuals with MS are able to continue working for quite some time after their diagnosis.
At the same time, however, many patients with MS find the disease to be completely debililtating and the progression of their illness and the functional limitations that come with it completely remove their ability to A) engage in their current or past work and B) engage in some type of other work.
It is for this very reason that that Social Security does not award disability benefits on the basis of being diagnosed with a condition, but, rather, looks at an individual's residual functional capacity (what they are able to do in spite of the limitations of their disabling condition) and their ability to perform substantial gainful activity.
How is MS evaluated by Social Security?
Individuals who have multiple sclerosis are evaluated under section 11, the neurlogical section of the Social Security Disability List of Impairments, referred to, simply, as the listings. Here is an excerpt from the SSDRC page that discusses the MS listing:
Once a diagnosis of MS has been established an individual's symptoms must include one of the following:
1. Constant significant disorganization of function in two of their extremities that results in persistent disturbance of their gross and dexterous movements, or station and gait as described in neurological impairment listing 11.04 B; or
2. Visual impairment that causes a loss of visual acuity that leaves the vision in the better eye after correction (glasses or contacts) at 20/200 or less as described in visual impairment listing 2.02; or a severe contraction of their visual field as described in the vision impairment listing 2.03 A, B, and C; or a visual efficiency in the better eye of twenty percent or less as determined by kinetic perimetry as described in vision impairment listing 2.04.
Click here for the full page: MS is specifically given consideration under impairment listing 11.09.
The listing outlines the qualifications criteria needed to satisfy the severity requirement of the listing if an individual has motor function limitations or disorganization. It lists the criteria necessary for a medical approval on the basis of visual or mental impairments caused by multiple sclerosis. And, finally, it provides the criteria required for an approval based upon muscle weakness for individuals who do not have muscle weakness or motor function disorganization when they are at rest, but develop muscle weakness when they are fatigued from activity.
As with other Social Security Disability impairment listings, it is difficult to satisfy the severity requirements for disability of the multiple sclerosis impairment listing. However, individuals with MS who do not qualify for disability benefits on the basis of the listing can still be approved for disability benefits if they have severe functional limitations that prevent them from performing substantial work activity (SGA).
Individuals with significant functional difficulties may be medically approved for disability benefits through a medical vocational allowance. In this type of approval, Social Security considers a person's age, residual functional capacity, education, and their ability to do their past work or other work (considering their residual functional capacity) when making the disability determination. If an individual's MS prevents them from performing any past work or any other kind of work, they may be approved for disability benefits.
Will you win disability with MS?
As we said, an approval for disability can be made based on the listing. However, when that does not happen, the decision will be made based on work history and medical records, which is a medical vocational decision. This is where disability attorneys do most of their work on a case, particulary when the case will be heard by a federal administrative law judge at a hearing.
Getting disability for multiple Sclerosis and autoimmune disorders
A recent post was made about autoimmune disorders and the need, from my viewpoint as a former disability examiner, for disability claims examiners to have better training (as in ongoing medical information training) to facilitate greater competency as adjudicators.
As I was on the subject of auto-immune disorders, I made a few remarks regarding MS, or multiple sclerosis. First off, the inevitable question: if you have multiple sclerosis, should you file for either Social Security Disability or SSI disability?
Stock answer (but a very correct one): if your condition prohibits your ability to work, yes, file an application for disability benefits and do it immediately because the disability evaluation process is very long and you need to get your application "in the pipe" to minimize any delay.
There's no doubt that multiple sclerosis can become disabling and one aspect of the disease that is problematic is the fact that it doesn't just exhibit a pattern of exacerbation and remission, but rather a pattern of progressive exacerbation and remission; in other words, the condition can remiss and then return with even stronger symptomology.
MS, like the condition ankylosing spondylitis (a spondylarthropathy, a rheumatic disease, and an autoimmune disorder, one that affects the spine and various other joints, but also, possibly, the eyes and kidneys) is a disorder that seems to surface in younger individuals. Each condition tends to be diagnosed before the age of forty. Both conditions also seem to involve an inherited predisposition. In other words, while MS is not passed on directly, the susceptibility for developing multiple sclerosis does seems to have a genetic basis.
As to cause of origin, again, the two conditions share possible similarities. The current opinions regarding ankylosing spondylitis are that genetically susceptible individuals may have the condition triggered by an external environmental component, perhaps bacteriological. Current opinions regarding multiple sclerosis reflect the notion that MS have a viral trigger. Regarding differences between ankylosing spondylitis, AS appears in twice as many men as women, while the incidence of multiple sclerosis may be 3 to 1 in favor of women.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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