Filing for Social Security Disability or SSI with Multiple Sclerosis MS
It is estimated that roughly 300,000 Americans have a diagnosis of multiple sclerosis with an additional 200 newly diagnosed cases each week. Multiple Sclerosis is an extremely debilitating disease that can cause significant disorganization of an individual's motor function (i.e. walking, standing, gripping, holding, etc.), visual disturbances, extreme fatigue, and even mental impairment. Unfortunately, multiple sclerosis is a progressive neurological disease for which there is no known cure.
Social Security recognizes the potential debilitating effects of multiple sclerosis. In fact, the Social Security Disability handbook has a specific neurological impairment listing for MS.
Listing 11.09 provides the specific disability criteria for Social Security Disability and SSI disability severity requirements. To meet or equal this impairment listing, an individual must, of course, first have a diagnosis of MS. All disability applicants need objective medical evidence from acceptable medical treatment sources (licensed or certified medical professionals) that documents their diagnosis.
Individuals with MS should be able to provide a medical history that might include but is not limited to:
A. Clinical notes
B. Imaging techniques, i.e. MRI testing of the brain or spine or neuroimaging techniques (imaging techniques that directly or indirectly image the function and/or structure of the brain such as CT scans, x-rays, diffuse optical imaging, etc)
C. A diagnosis, prognosis, response to treatment, and a description of symptoms and limitations.
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.
3. Mental impairment that causes a disorientation as to time or place, impairment of short, intermediate, or long term memory, thinking or perceptual disturbance such as delusions or hallucinations, personality changes, mood disorders, emotional lability (i.e. explosive temper outbursts or sudden crying spells, etc.);
Or a loss of measured intellectual functioning from premorbid levels documented by neuropsychological testing that results in: significant restriction of daily activities, social functioning, maintaining concentration, persistence, or pace, repeated long lasting episodes of decompenstation;
Or, a documented history of MS of at least two years that has caused more than minimal limitation of their ability to do basic work activities with symptoms relieved by medication or psychosocial support along with one of the following:
a) residual disease process that has caused a marginal adjustment in which even a small increase in mental demands or change in environment would be predicted to cause the individual to decompensate,
b) or repeated long lasting episodes of decompensation,
c) or a current medical history of one or more years of an inability to function outside of a highly supportive living arrangement along with a continued need for this type of living arrangement as described in mental impairment listing 12.02 Organic Brain Disorders.
4. Lastly, substantial reproducible fatigue of motor function with significant muscle weakness upon repetitive activity--documented by a physical examination--caused by neurological dysfunction in areas of the central nervous system acknowledged to be pathologically involved in the MS disease process.
If an individual meets or equals the criteria described in the above impairment listing, they may receive disability benefits provided they meet the non-medical requirements of Social Security Disability or SSI (non-disability requirements refer to proof of income, identity, place and date of birth, etc).
Many individuals affected by multiple sclerosis do not meet or equal the impairment listing criteria because this criteria is very specific. However, they still may qualify for disability with Social Security if their MS symptoms have caused significant restriction to their functional abilities. Social Security Disability is not based upon having specific impairments but, instead, on how those impairments limit an individual's ability to perform substantial gainful activity, or SGA as it is more commonly known (see current SGA monthly earnings limit).
The Social Security definition of disability contends that a condition is disabling if it is a medically determinable impairment (in other words, can be proven through medical evidence) that has prevented an individual from performing SGA-level work activity for twelve months, or is expected to prevent and individual from performing SGA for twelve continuous months, or may result in death.
Because of this definition of disability, individuals who do not necessarily meet or equal an impairment listing may be able to qualify for disability benefits based upon a medical vocational allowance.
Medical vocational allowance decisions are based upon several factors. Disability examiners consider an individual's age, education, residual functional capacity (the functional abilities that are left to them despite their condition), past work, the transferability of their work skills and their ability to perform other types of work (considering their limitations) when making a medical vocational determination.
If multiple sclerosis has caused an individual's residual functional capacity to be so restrictive that the individual is no longer capable of engaging in substantial and gainful work activity, they may be approved for disability benefit even if they do not meet or equal the requirements of the multiple sclerosis impairment listing.
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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