This information is intended to shed some light on the SSD SSI disability evaluation process as it relates to claimants with multiple sclerosis. It may benefit ms claimants with representation, as well as claimants who are not represented by a lawyer or non attorney representative. Understanding how the Social Security Disability system works can make the difference between winning one's claim or appeal...or not. |
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Individuals applying for social security disability or SSI disability benefits on the basis of multiple sclerosis, or simply MS, can be approved in one of two ways: 1. By means of a medical vocational allowance; 2. By meeting or equaling the requirements of the multiple sclerosis listing (listing 11.09) in the social security administration's impairment listing manual (commonly referred to as the "blue book"). To be approved via a medical vocational allowance, an MS claimant's medical records must show that their condition is severe and has lasted, or can be projected to last, for a period not less than twelve months. During this actual or projected twelve month period, the claimant's condition must also prevent them from working at a job they have done in the past, and prevent them from engaging in suitable forms of other work. Medical vocational allowances are how most disability claims are approved. However, an MS patient can be approved for social security disability or SSI disability benefits on the basis of meeting or equaling the requirements of the multiple sclerosis listing. The multiple sclerosis listing (listing 11.09) provides specific criteria for disability approvals made on the basis of MS. Essentially, the listing provides for three separate and distinct types of criteria that, when individually met, may result in an awarding of benefits (in other words, a claimant is not required to satisfy all three types of MS criteria, but, rather, only one). These three categories can be labeled as follows: 1. Motor function impairment 2. Visual impairment (Disability and Loss of vision) 3. Mental impairment. Regarding the first category, motor function impairment, an individual with MS can meet the requirements of the multiple sclerosis listing IF their medical records document a diagnosis of multiple sclerosis and one of the following: 
A. Significant, persistent motor function disorganization in two extremities (two arms, two legs, or one arm and one leg) to the extent that this disorganization causes a sustained disturbance of either gait and station or gross and dexterous movements. OR B. Significant motor function fatigue with substantial muscle weakness (on repetitive activity). This fatigue and weakness must be able to be demonstrated upon physical examination. Additionally, it must be considered to result from multiple sclerosis - related neurological dysfunction. Regarding the second category, visual impairment, a multiple sclerosis patient can be approved for social security disability or SSI disability benefits if their medical records indicate a diagnosis of multiple sclerosis and also demonstrate a loss of visual acuity, peripheral vision, or visual efficiency. For most disability claimants, of course, the visual criteria that will apply will relate to lost visual acuity and it is in this area that 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. Finally, a social security disability or SSI disability claimant can be approved for benefits on the basis of the multiple sclerosis listing if 1. they have been diagnosed with MS and 2. they meet or equal the requirements of the blue book listing for organic mental disorders (listing 12.02). The social security administration defines organic mental disorders as behavioral or psychological abnormalities that are associated with brain dysfunction. To meet the requirements for an organic mental disorder (i.e. for an MS patient to be approved for disability on the basis of an OMD), the presence of a specific organic factor must be demonstrated to be related to the psychological or behavioral abnormalities in question. Proof of this organic factor and its etiological link may be provided by A. the claimant's medical history, B. the findings of physical examinations, and C. the results of laboratory tests. Additionally, beyond documenting the presence of an organic factor for which behavioral or psychological abnormalities are the result, the severity of an organic mental disorder must also be demonstrated. (Additional information on Listing 12.02, Organic Mental Disorders) In general terms, this means more than a minimal limitation of the ability to perform basic work activities, or marked restrictions in the ability to engage in activities of daily living, maintain social functioning, and maintain concentration, persistence, or pace. Another indicator of severity in the area of organic mental disorders would be repeated episodes of decompensation, each of extended duration. Disability Advocates Help with Claims Free Case Evaluation Social Security Disability and noting functional limitations in records Winning Social Security Disability or SSI benefits |
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SOCIAL SECURITY DISABILITY ATTORNEY, REPRESENTATIVE LAWYER LIST ANSWERS TO YOUR SSD & SSI QUESTIONS PAGE 5 ANSWERS TO YOUR SSD & SSI QUESTIONS PAGE 6 |
