Multiple sclerosis (MS) is an autoimmune disease that causes changes to the nervous system that can make it difficult to work. It affects more woman than men and most commonly occurs in those ages 20 through 40, although it can happen at any age.
MS symptoms widely vary in type, severity, and duration. The more common symptoms include:
Although a neurological examination can identify symptoms that may indicate the presence of MS, there is no conclusive test. In general, it’s diagnosed only after a physician has ruled out other similar conditions.
Unfortunately, there’s no known cure for MS. The most common treatment is medication, which can slow the disease’s progression and help manage symptoms. Other treatments such as physical therapy, speech therapy, and the use of assistive devices may help, and lifestyle changes such as avoiding fatigue and stress and maintaining an exercise program can also be beneficial.
If you have been diagnosed with MS, you may suffer from symptoms that make it difficult to work. In general, to qualify for Social Security disability benefits due to MS, you’ll need to fit one of two criteria.
The Social Security Administration’s “Listing of Impairments” provides specific criteria for certain conditions that, if met, automatically classify you as disabled. The qualifications for multiple sclerosis are described under listing 11.09. To be found disabled under this listing, you must have documented proof of:
Disorganization of motor function. This requires significant and persistent disturbances in movement in at least two extremities. Examples could include paralysis, tremors, and other involuntary movements.
Visual or mental impairment. There are numerous ways that you can meet the qualifications for a visual impairment, but one of the most common ways for those with MS to meet the visual impairment part of this listing is by having vision in their better eye that is 20/200 or worse (while wearing any prescribed glasses or contacts.)
To meet the mental impairment portion of this listing, you’ll need to show that you have psychological or behavioral abnormalities that can be attributed to a brain abnormality. These abnormalities should be severe enough to result in significantly reduced cognitive function, such as disorientation to time and place, memory impairments, or personality changes. In addition, these abnormalities must result in more than a moderate restriction in your activities of daily living (eating, sleeping, etc.), difficulty in maintaining social functioning, or problems with concentration. You could also fulfill the mental impairment portion of this listing if your mental impairments have resulted in a significant limitation in your ability to do basic work activities, despite compliant medication use and proper social support, along with repeated periods of significant worsening, an extreme inability to handle even small changes, or being unable to function outside of a highly supportive living environment, for at least the past two years.
Muscle weakness and fatigue. This requires that you have significant, increasing muscle weakness and fatigue after activity, resulting from neurological problems in areas of the central nervous system known to be affected by multiple sclerosis. You must be able to provide evidence of the MS-related muscle fatigue, as well as evidence of the physical fatigue, such as the results of an evoked response test during exercise. The SSA will primarily evaluate the degree of activity that caused the fatigue and the severity of the resulting muscle weakness. If your muscle weakness occurs without any activity, you wouldn’t qualify under this listing.
If you’ve been diagnosed with MS, but your symptoms don’t clearly meet the criteria in the multiple sclerosis impairment listing 11.09, there is another way that you can qualify for disability benefits. This is by proving that based on Social Security’s “medical-vocational” guidelines, you qualify as disabled.
The medical-vocational (or “med-voc”) guidelines evaluate your ability to perform basic work-related activities based on your age, level of education, prior work experience, and what’s known as your residual functional capacity (RFC.) An RFC (for example sedentary, light, or heavy) is the most strenuous type of work that the SSA feels you are capable of doing on a consistent basis.
The SSA will determine your RFC in conjunction with an SSA medical expert and based on your first-hand accounts of your symptoms, your medical records, and the results of any consultative exams that you underwent (these are exams that the SSA pays for and sends you to.) If you have other physical or mental conditions that negatively affect your ability to work, the SSA will consider these in conjunction with your MS. In general, being older (especially if you’re over 55) with less education and a history of unskilled labor will increase the chances that you’ll qualify for disability under the med-voc guidelines. For more information, read Nolo's article on how Social Security decides claims based on the medical-vocational guidelines.
If you’re applying for Social Security disability benefits due to multiple sclerosis, there are several pieces of medical evidence that can be very important in getting your claim approved. First, your medical records will need to show a multiple sclerosis diagnosis. If any tests were done to obtain this diagnosis (such as an MRI, lumbar puncture, or nerve function study), it’s important that you provide these. You’ll also need to produce medical records that document how your MS affects you -- such as doctor’s notes where you reported suffering from symptoms like fatigue or dizziness. Depending on how your specific symptoms, you may need to produce other test results or medical records. In addition, if you’re attempting to meet the impairment listing for multiple sclerosis, there could be additional specific evidence that’s required.