Social Security Disability benefits for those Suffering from Multiple Sclerosis

When considering an application for Social Security disability benefits for Multiple Sclerosis (MS), there are a number of considerations one should keep in mind.  Given the different types of MS and the manner in which the condition can progress differently for each individual, the advice will differ depending on the individual.

There are four major categories of Multiple Sclerosis: 1) Relapsing Remitting MS, 2) Primary Progressive MS, 3) Secondary Progressive MS and 4) Progressive Relapsing MS.   The different categories are important to understand as, ultimately, in a Social Security disability claim, one needs to show that their condition will remain severe and disabling such that the individual will remain totally disabled from all forms of gainful employment for what will be a year or longer.

The most common form of Multiple Sclerosis is Relapsing Remitting MS, which affects the vast majority of individuals suffering from MS. This form of MS ordinarily presents the first signs of the disease to those in their early 20’s.  The initial symptoms may or may not be severe, and many times those with this stage of the condition will find that by undertaking rehabilitation, such as physical therapy, they will recover from most if not all of any loss of function and will experience what is called a remission of their condition for what can be weeks, months or for that matter years.  

When, as a Social Security lawyer representing MS patients throughout Maine, Massachusetts and New Hampshire, we are faced with individuals suffering from a flare of their condition, we need to  advise them of the need to prove that their condition either has remained or will remain severe and disabling for what will be a year or longer.  In many instances, depending on  the stage of the disease, it may not make sense to apply within months of a flare of the condition, and we will caution individuals from applying too soon for benefits.

It is important to show the Social Security Administration (SSA) that one is doing everything possible to address treatment options to speed the recovery process from an attack and to slow the potential progression of the disease.   We always advise our clients that for any condition that remains severe it’s important to be in treatment with a specialist.  And, thus, it will be important that one suffering from the effects of MS are in treatment with a neurologist.  Available medications  include Ocrevus, Copaxone, Tecfidera, Gilenya, Aubagio, Tysabri, Lemtrada, among others.  Likewise, treatment may include physical or occupational therapy, muscle relaxers to reduce uncontrollable muscle stiffness or muscle spasms, in addition to medications, such as Provigil, for fatigue.

Another form of MS is Primary Progressive MS which is ordinarily seen in those who are older, with women outnumbering men in terms of the prevalance of the condition.  As its name suggests, the condition is not associated with periods of remission but instead remains progressive and debilitating.  The only FDA approved medication for Primary Progressive MS is Ocrevus.

Unfortunately, we speak with many individuals suffering from Secondary Progressive MS, after having suffered from Primary Relapsing Remitting MS for many years.  These individuals have reached a point where their condition is in a steady, progressive decline.  Recovery of function is  less likely and establishing the duration requirement of a year or longer becomes easier given the treating neurologist’s prognosis is poor, with an indication that the condition remains “progressive.”   This stage is considered more difficult to treat, with individuals suffering more debilitating effects that no longer involve periods of remission.

The least common form of the disease,  Progressive Relapsing MS, effects only 5% of those suffering from MS. Individuals suffering from this form of MS will experience flares of their condition and, inbetween, will continue to progressively decline.  While there are medications available to  help with the symptoms, there are no approved drugs that will assist with slowing down the progression of the disease.

The Social Security Listing of impairment for MS is 11.09, and  reflects the fact that an individual may be suffering from severe physical and/or cognitive  limitations.   One may be considered to meet the listing if there exists “[d]isorganization of motor function in two extremities resulting in extreme limitation of one’s ability to stand up from a seated position, balance while standing or walking or in one’s use of their upper extremities.”  Should one meet this portion of the Listing for what is anticipated to be a year or longer, entitlement to disability benefits would following.  Likewise, a finding of a marked physical limitation versus extreme in such physical functioning, in addition to a marked limitation in either the ability to understand, remember or apply information, interact with others,  maintain their concentration, persistence or pace, or adapt or manage one’s self will satisfy the listing requirement.

Assuming one does not meet a medical listing of impairment, SSA will look to see, as with any other condition, whether one remains, from a combination of physical and/or mental health conditions incapable of undertaking any manner of gainful employment, despite prescribed treatment, for what has been or will be a year or longer.

If you or someone you care for has been struggling with the effects of Multiple Sclerosis and require legal advice as to whether they might qualify for disability (or wonder why they have been denied their claim), contact the Law Offices of Russell J. Goldsmith at 1-800-773-8622 for a free consultation.