Multiple sclerosis (MS) is a chronic autoimmune disease that affects your central nervous system, including your brain, spinal cord, and optic nerves. MS is generally a progressive disease; over time the symptoms will get worse and more debilitating and eventually, loss of functions will be noted even in periods with few to no symptoms.
There are several types of MS, including relapsing-remitting multiple sclerosis (RRMS), primary-progressive MS, secondary-progressive MS, and progressive-relapsing MS. The symptoms of these types vary depending on the progression of the disease and whether the patient has periods of exacerbations and remissions.
To qualify for disability, Social Security requires that your disability has lasted or is expected to last 12 months. This can be an issue for patients with MS, since most forms of MS are episodic, meaning there are periods when it makes you sick and periods when you have little to no symptoms. The periods of sickness are called episodes, exacerbations, or relapses, and can vary in length and severity. The periods with few symptoms are called remissions. If you are symptom-free for six months, it can ordinarily be hard to prove disability, but Social Security does recognize that MS is episodic in nature, so the agency will evaluate the frequency and length of your episodes, the time between your episodes, and the presence of permanent impairments even in times of little to no symptoms, to determine if you are disabled.
Disabling Symptoms of MS
The effects of multiple sclerosis on the body can be great, and MS can affect multiple parts of the body. Some symptoms include:
- loss of balance
- problems with walking and coordination
- tremors or weakness in the legs and arms
- bowel and bladder problems, including constipation and frequent need to urinate
- vision problems, including double vision or loss of vision
- numbness, tingling or pain in the face, arms, or legs
- hearing loss
- problems concentrating and remembering things
- speech problems, including slurred speech
- difficulties chewing and swallowing food, and
Getting Disability for Multiple Sclerosis
If your multiple sclerosis is advanced, you have a good chance of getting approved for Social Security disability benefits. In order to qualify for Social Security disability benefits for MS, you must meet the requirements of Social Security's disability listing for MS or prove that your MS has limited your functioning so much that you can no longer work.
Meeting the Multiple Sclerosis Listing
MS has a specific listing in Social Security's blue book (the listing of impairments that automatically qualify for disability) under the section for neurological disorders. In order to meet this listing, you must show that you have at least one of the following:
- Difficulty walking or using your hands because of significant impairments of at least two limbs. You may have partial paralysis of your limbs, tremors, or involuntary movements.
- A severe decrease in vision that cannot be corrected with glasses.
- An organic mental disorder causing memory loss, a decrease in IQ, or disturbance in mood, or
- Severe fatigue and muscle weakness that is caused by the central nervous system as a result of MS.
Ask your doctor to fill out the listing for for MS to see whether you fulfill the listing requirements (and if so, submit it to the SSA).
In addition to qualifying under the specific MS listing, individuals who suffer from MS may also qualify under other listings if other body systems have been affected by the disease. Examples of other listings that may apply include bone fractures, loss of speech, and loss of hearing.
Medical Evidence Required for MS Disability
To qualify under the multiple sclerosis listing, you must first have a diagnosis of MS. The test most used to determine MS is magnetic resonance imaging (MRI). This test can give positive proof of demyelination caused by multiple sclerosis. An MRI is so sensitive that it can detect even the smallest evidence of demyelination or plaque. One study suggested that 96% of those individuals diagnosed with MS have an abnormal MRI result.
Another test used to help with the diagnosis of multiple sclerosis is the spinal tap or lumbar puncture. This test is about 85% effective in MS cases, and it is often used to rule out other conditions such as Lyme disease, HIV, or syphilis. When a person has MS, the myelin basic proteins are usually elevated along with other antibodies.
There are a few other tests used to help with diagnosing MS, and these are the electroencephalograph (EEG), computerized axial tomography (CT scans), x-rays, and evoked potentials (exposes the individual to various stimuli). These are usually given in conjunction with MRI scans and spinal taps, though they are not conclusive tests for MS in their own right.
The medical evidence required to prove MS-related impairments includes medical reports from treating physicians and tests related to the alleged impairment. For example, specific eye tests results demonstrating a loss of visual acuity, peripheral vision, or visual efficiency are required to prove a severe decrease in vision. For most MS disability claimants, the visual impairment is lost visual acuity, and in this area SSA is fairly strict. To satisfy the visual acuity criteria, a claimant's eyesight must be so deficient that, even in the better eye and even after best correction has been made, their residual eyesight is 20/200 or worse.
Proof of organic mental abnormalities and their etiological link may be provided by the claimant's medical history, the findings of mental examinations, and the results of tests.
If you are trying to claim severe fatigue and weakness caused by MS, doctor's documentation must be provided that shows a diagnosis of MS and that the fatigue and weakness are a result of the MS.
How MS Limits Your Ability to Work
If you're not found to be disabled under one of the above disability listings, Social Security will evaluate your ability to perform any job based on your current impairments, age, education, and work experience. Social Security will first assess your physical, mental, and sensory limitations using a Residual Functional Capacity (RFC) form.
Social Security will create a physical RFC for you that include any physical and sensory limitations you have. evaluate your ability to sit, stand, and walk, as well as your capacity to lift, carry, and push or pull items. For those with MS, some of the physical impairments that could appear on your RFC are difficulty with balance and walking, numbness and weakness in the arms and legs, and tremors or involuntary movements. Partial hearing loss, low vision, and speech problems, which are common in MS, should be included in the RFC.
Social Security will also create a mental RFC for you that includes any limitations you have in your ability to understand, remember, and carry out instructions. Individuals with MS can suffer from memory loss and have difficulty concentrating on tasks, so if you have these limitations, you'll want to make sure they appear in your medical record so Social Security can include them in your mental RFC. Either of these mental impairments may prevent a return to work if they are considered severe enough.
Next Social Security will compare your RFCs to the jobs that are available to someone with your education and experience to see if there's any work you can do. Social Security will also take into account your age; after a certain age, Social Security won't expect you to learn a new job. For more information, see our article on how Social Security evaluates your RFC to decide if you can work.
Also, read our tips on getting disability for moderate or intermittent MS and what to do before applying for disability for MS.