Multiple sclerosis (MS) is an incurable disease that can lead to disability. Common symptoms include visual disturbances; muscle weakness; trouble with coordination and balance; sensations such as numbness, prickling, or "pins and needles"; and thinking and memory problems. The severity of symptoms vary significantly, but MS may prevent an individual from working.
Diagnosing and Treating Multiple Sclerosis
When MS is suspected, a family doctor will likely refer her patient to a specialist. The appropriate specialist to diagnose and treat MS is a neurologist. There isn’t one single test to diagnose MS, but the most common diagnostic testing includes MRIs, lumbar punctures (also known as "spinal taps"), and evoked potential tests. An MRI of the brain may reveal lesions. A neurologist will review her patient’s medical history to rule out other conditions that cause similar symptoms to MS. Once MS is established as the correct diagnosis, the neurologist will determine which type of MS the patient is experiencing: relapsing-remitting MS, secondary-progressive MS, primary-progressive MS, or progressive-relapsing MS.
Although there is no known cure for MS, there are a variety of medications and therapies used to relieve symptoms or slow progression. Medications such as beta interferons, Copaxone, Tecfidera, Gilenya, Aubagio, Tysabri, and Novantrone aim to decrease the formation of new lesions. Physical therapy, muscle relaxants, or other medications may also be utilized to lessen the symptoms of MS. During a flare-up, patients may take Prednisone or undergo a plasma exchange.
Short Term & Long Term Disability Claims
When MS forces an individual to stop working, they should carefully review their options to apply for disability benefits. If you are covered for short term disability and/or long term disability benefits, then an application should be submitted to the insurance company immediately. Disability insurance coverage provided as part of an employee benefit plan is most likely governed by the Employee Retirement Income Security Act (ERISA).
In short term and long term disability (LTD) claims, you must prove that you meet all terms of the policy including the insurance company’s definition of “disabled.” In an LTD policy, it is common for the definition of disability to initially require that you are disabled from performing your regular occupation. However, this definition of disability often changes after you receive disability benefits for a set time period—such as 24 months—and then the policy requires that you prove you are disabled from performing any occupation. If the insurance company decides that you meet its definition of disability and all other terms of the policy, then your disability benefits will be approved.
If your claim for short term disability or LTD benefits has been denied, contact Keller & Keller right away to speak with an experienced disability attorney. Be aware that any denial of disability benefits must be timely appealed or else you may forfeit your rights to receive benefits.
Social Security Disability Claims
If MS causes you to become disabled, you may also be eligible for Social Security Disability Insurance (SSDI) benefits or Supplemental Security Income (SSI) benefits. Unlike disability insurance companies, the Social Security Administration (SSA) has criteria specific to evaluating multiple sclerosis. Medical Listing 11.09 states that an individual is found disabled if they prove “A. Disorganization of motor function as described in 11.04B; or B. Visual or mental impairment as described under the criteria in 2.02, 2.03, 2.04, or 12.02; or C. Significant, reproducible fatigue of motor function with substantial muscle weakness or repetitive activity, demonstrated on physical examination, resulting from neurological dysfunction in areas of the central nervous system known to be pathologically involved by the multiple sclerosis process.”
Even if you do not meet Listing 11.09, you may still be found disabled if you can prove that you are 1) not performing substantial gainful activity and are otherwise eligible for either SSDI or SSI benefits, 2) MS and other conditions are severe impairments that cause work restrictions, 3) your work restrictions prevent the performance of past relevant work, and 4) your work restrictions disable you from performing any other substantial gainful activity.
An experienced Social Security disability attorney can make the difference of whether or not you get approved for disability benefits. If you are applying for Social Security disability benefits or your claim has been denied, call Keller & Keller at 317-926-1111 for a free consultation. If your claim has been denied, be aware that there are time constraints to appeal, so contact Keller & Keller immediately.