MS Disability: Claiming Benefits, Eligibility, and Further Information
Navigating the process of applying for Social Security Disability Insurance (SSDI) can be complex, especially for those living with chronic conditions like Multiple Sclerosis (MS). This article aims to provide a clear and straightforward guide for MS patients considering applying for SSDI.
Understanding SSDI for MS
The Social Security Administration (SSA) determines eligibility for Disability Insurance for MS patients primarily by evaluating whether the MS condition meets the specific medical criteria in the SSA’s Blue Book listing 11.09 or by assessing if the impairment is medically equivalent or severe enough to prevent substantial gainful activity (SGA) for at least 12 months or until death.
The Blue Book Listing 11.09
MS is specifically listed in the SSA's official "Listing of Impairments," known as the Blue Book. To qualify automatically, MS patients must provide medical documentation that meets certain severity criteria, including major neurological symptoms such as marked limitation in motor function or cognitive abilities.
Severity and Functional Limitations
Even if the exact Blue Book criteria are not met, an applicant may qualify if they can demonstrate impairments of equal severity and duration. This is determined by evaluating the residual functional capacity (RFC), which measures whether MS symptoms prevent the patient from doing any kind of full-time work in the national economy, considering age, education, and past work experience.
Duration Requirement
The impairment must be expected to last at least 12 continuous months or result in death. Temporary or short-term conditions do not qualify.
Work Credits
Applicants must have earned sufficient work credits, typically 40 credits with 20 earned in the last decade before applying, reflecting a work history covered by Social Security payroll taxes.
The Five-Step Sequential Evaluation Process
The SSA uses a five-step process assessing whether the applicant is able to perform SGA, whether the condition is severe, if it meets or equals a Blue Book listing, and if the applicant can do prior or other work available in the economy.
Preparing for the Application Process
Before applying for SSDI, it's essential to gather all necessary documentation to determine eligibility. The SSA offers a list of information people should gather on their website. This includes contact and demographic information about their doctor, dates and results of tests, and current medications, their intended use, and the doctor who prescribed them.
Discussing with Your Doctor
If you suspect or have documented that your symptoms could last longer than 12 months, it's crucial to discuss this with your doctor. They can advise whether applying for disability benefits would be a good idea and may be able to help start the process.
The Role of a Disability Lawyer
If financially feasible, hiring a disability lawyer can help get a person through the application process and increase their chances of acceptance. A person can find a disability lawyer by making a personal reference or searching in local or wider directories such as www.lawyers.com/find-a-lawyer or www.avvo.com/find-a-lawyer.
Short-term Disability Benefits
Short-term disability benefits often work in conjunction with long-term benefits and typically start once short-term benefits end. The coverage for short-term disability benefits typically lasts only a few weeks.
Other Considerations
Employer Accommodations
Talking with an employer about living with MS can be challenging, but HR can help a person get accommodations for their work and may be a good resource when considering applying for disability benefits.
Additional Listings for MS
The National MS Society (NMSS) notes that while MS has a Listing under number 11.09, a person's symptoms may qualify under two additional listings: 2.00 Special Senses and Speech and 12.00 Mental Disorders.
The Application Process
A person living with MS typically needs to go through the Social Security Administration (SSA) to apply for Social Security Disability Insurance (SSDI). The SSA may contact a person for more information to help it decide on eligibility. In addition to answering several medical questions and providing test results, the application will ask about employment history, personal information, direct deposit information, highest levels of education, and job training.
Decision Notification
The SSA will send a notification of its decision through the mail. If the SSA denies an application, a person typically has 60 days to appeal the decision.
Disabilities and Their Impact
Disabilities can affect a person's ability to move, think, learn, communicate, remember facts, or maintain social relationships, vision, hearing, and mental health. The SSA defines the criteria needed to apply for long-term disability benefits for various health conditions, including MS, in a document known as the Listing of Impairments or the Listing.
Common Reasons for Denial
The SSA's common reasons for denying a person's eligibility for SSDI include the impairment not being severe enough, the person being able to continue working at their current job or another profession, the impairment not being expected to last 12 months, insufficient medical records, not following treatment plans, impairments due to alcohol or drug use, or returning to substantial work.
In summary, an MS patient qualifies for Social Security Disability Insurance if their documented MS-related impairments meet or equal the SSA’s neurologic listing criteria or otherwise reduce their ability to work substantially and permanently, accompanying sufficient recent work history.
- Living with Multiple Sclerosis (MS) can qualify individuals for Social Security Disability Insurance (SSDI), but the process can be complex.
- The Social Security Administration (SSA) determines eligibility using the Blue Book Listing 11.09, which specifically lists MS, or by assessing if the impairment is medically equivalent or severe enough to prevent substantial gainful activity (SGA).
- To qualify automatically, MS patients must provide medical documentation that meets certain severity criteria, including major neurological symptoms such as marked limitation in motor function or cognitive abilities.
- It's essential for applicants to gather all necessary documentation, such as contact and demographic information about their doctor, dates and results of tests, and current medications.
- If financially feasible, hiring a disability lawyer can help increase the chances of acceptance in the application process.
- Despite meeting the necessary criteria, common reasons for denial include the impairment not being severe enough, the person being able to continue working at their current job or another profession, the impairment not being expected to last 12 months, insufficient medical records, not following treatment plans, impairments due to alcohol or drug use, or returning to substantial work.
