Individuals with multiple sclerosis who use walkers or wheelchairs, can’t see well enough to drive, or have two or more severe exacerbations a year generally have no problem being approved medically for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) Disability Benefits. Men and women with mild MS symptoms or those who enjoy long-term remissions are often able to work successfully and have no need for disability benefits.
Between the two groups are folks who can do just about anything on a good day or morning but can't function well at other times due to unpredictable interference from MS symptoms. Compared to some people with MS, their doctors may think their MS is not very severe even though the symptoms prevent the patient from working full time. Such individuals often have difficulty with Social Security disability claims.
If you are in this group, there are ways to help your case. The following advice can help a borderline claim for benefits become a successful one.
One of the most important things you can do to help your case is to report your symptoms to your health care providers. Let your doctor know how your MS affects you in daily life, or bring the doctor a list of your symptoms and limitations for your chart so the problems will be documented in the medical records that the Social Security Administration (SSA) obtains. This will also help your doctor explain your symptoms and limitations to the SSA if asked to provide an opinion for your disability case.
Not everyone with multiple sclerosis has these problems, but common symptoms that are "vocationally significant" (affect your ability to work) include:
Even if blurry vision occurs only when you are tired, it can affect any task requiring good vision or hand/eye coordination on a regular basis. There may be times you can see fine and others when you would not feel safe driving or can only look at a computer screen for short periods.
When you’re tired, it’s hard to physically or mentally attend to tasks or keep up speed and accuracy at home or on job tasks. Many folks with MS, if they don’t get enough rest when fatigue hits, risk an exacerbation of severe symptoms.
In the hands, numbness and tingling (parathesias) can affect any job involving typing, writing, and handling small and large objects. In the legs, these symptoms can affect the ability to stand and walk for very long or safely on uneven ground or steps.
Problems with bowel or bladder incontinence or urgency (the need to go urgently or frequently) can affect work if protective garments don’t always do the job or the employee must take bathroom breaks so frequently that it affects their work productivity. It can also be hard for someone with MS to get to a bathroom on time if the person has to walk quickly to a distant restroom.
Some folks with MS experience pain in joints or muscle spasms that interfere with their daily activities and concentration. They may require rest and sedating medication for relief, and have problems even sitting for long due to hip and back pain.
MS involves the brain and central nervous system. Because of this, it’s not surprising that some people with MS experience mood changes, forgetfulness, or even confusion at times. Whether these mental issues are symptoms of MS, reactions to dealing with a chronic illness, or side effects of medications or fatigue, such mental and emotional changes can affect sleep and the ability to learn new things, start or finish tasks, and get along well with others consistently. In addition, since MS is an immune system disorder, emotional changes and stress can also make physical symptoms worse.
Also, ask your doctor about getting an MRI. Your chances of getting benefits improve if you can prove that you have lesion growth or a loss of volume in your brain. Lesions, especially in the brain stem, are an obvious change and help establish decline.
Some medications prescribed to treat symptoms of MS can be associated with side effects—for example, drowsiness or flu-like feelings—that affect concentration and endurance. But don't stop taking your medication. If you have a flare up that becomes debilitating and you have not been taking your medications, it leaves the door open for Social Security to say that you might improve if you would just take your meds.
Some individuals with MS cannot tolerate warm temperatures. Even a warm shower can trigger fatigue. These MSers cannot tolerate warm-temperature work environments and may need cool inside temperatures that other workers would not find comfortable. Others can’t handle air conditioning blowing on them because it sets off muscle spasms.
In addition to calling symptoms and limitations like these to your doctor’s attention, ask your doctor to give you a prescription for a cane, walker, scooter or wheelchair if you need these occasionally—even if you already own an assitive device or can’t afford to buy an ambulation aid. The prescription will become part of your medical record. SSA decision makers sometimes use lack of a prescription to mean that a doctor doesn't think the patient has trouble with balance or walking. If you have resisted your doctor’s advice to use an assistive aid out of pride, but you tell SSA you have trouble walking, don’t be surprised if SSA doesn’t believe you. Difficulty walking is one way to fulfill the criteria for Social Security's disability listing for MS.
During the initial stages of your claim, SSA will send you a form asking you to document your problems and how they affect you (called a function report). For example, you may be asked, "Do you drive a car?" You can check both the "yes" and "no" box or neither and explain your variable or limited abilities. For example, you may be able to drive just fine short distances on better days. Other times, you may not leave the house because of fatigue, blurred vision, or spasms—much less drive. Some days, you may be able to cook a meal and other days, you may be too tired or unable to stand long enough. No one is going to come and take away your license or other privileges if you admit to such limitations, so don't be afraid to let SSA know about them.
Along these same lines, let SSA know other ways you manage in daily life. For example, some of my clients with MS get help from families and friends caring for their children when they weren’t feeling well. Others would rest on a couch or bed when they were tired and supervise their child safely playing or watching TV in a closed, child-proofed room. Let the SSA know your strategies for coping with MS.
If you're still working, keep track of how MS is affecting your attendance and productivity. This can assist with establishing a decline in your functioning at work, and makes it easier for Social Security to note the decline you had in your work ability.
If SSA asks that someone else give a report about your daily activities, choose the person who knows you best to help. A family member, or someone who lives with you, is usually best. Contrary to instructions on some SSA forms, you can have a family member complete them and you don’t have to list more than one person (such as friends or neighbors) as a source of information.
A neighbor or friend who sees you occasionally may not give SSA an accurate picture of how you function in a day, week, or over the past year. He or she may see you smile and wave when you leave the house for an errand or appointment, but not have a clue about how tired you are when you return. You may be upbeat for such friends and acquaintances and not fully reveal your problems to others. It's best to give Social Security one or two contacts who are very familiar with your struggles. Learn more about which letters provide the best testimony for disability.
Be sure to tell SSA about any health problems you have other than MS—for example, hearing loss, arthritis, anxiety, depression, a learning disability, asthma, and so on. These problems may not have prevented you from doing your prior work, but they may be important in proving you can’t do other types of work.
Don't let the process of applying for disability cause you to feel less about yourself because you have to write or talk about your limitations. Unfortunately, it's important to emphasize the problems you encounter in daily life as part of the Social Security disability evaluation process. The fact that you can’t work full time—or do everything you could before your health problems started—does not mean you’re not a good parent, spouse, child, friend, or person.
Finally, remember that a Social Security disability attorney can help develop your claim and make dealing with the disability system less stressful and more successful for you. If you don't get approved for disability benefits after the initial application stage, consider hiring a disability attorney. For help finding a local lawyer, visit our disability lawyers page.
And for more information on the ways to get disability for MS, see Disability Secret's main article on multiple sclerosis disability.