MS and Social Security Disability

The test imposed by the Social Security Administration for disability benefits is that the applicant cannot engage in “substantial gainful activity”.  Multiple Sclerosis disability benefits have a specific listing.

Listing 11.09A for Multiple Sclerosis.

In order to qualify pursuant to Listing 11.09A for Multiple Sclerosis two of the claimants extremities must be impaired. Coordination and walking ability will be evaluated.

In order to qualify for benefits under listing 11.09C, the patient must be able to demonstrate reproducible motor function problems, substantial weakness on repetitive activity, neurological dysfunction associated with MS.

The level of strength of the extremity is examined in order to determine whether or not the individual can perform general tasks relating to their occupation.

Because there is a visual impairment associated with Multiple Sclerosis Listing 11.09B provides the guidelines applied for visual impairment resulting from MS.  Listing 11.09B refers to listing 12.02 which is the listing for cognitive difficulties.

Multiple Sclerosis: What Is It?

Multiple Sclerosis (MS) is a degenerative disease generally afflicting one in every thousand Americans and often results in claims for Social Security Disability benefits. It is a condition where the immune systems attacks the protective covering (called myelin) surrounding nerve cells in the brain and spinal cord. Early symptoms (which generally emerge during young adulthood) include tingling, numbness, loss of balance, weakness in the extremities and impaired vision. Less common symptoms at this stage also include slurred speech, sudden paralysis, lack of coordination and impaired mental functioning.

Fatigue becomes an ongoing problem as MS progresses as does confused thinking. Those afflicted with MS typically have a life expectancy 5-10 years lower than the general population.

Four Types of MS

  • Relapsing-remitting MS entails a series of episodes between periods of complete or partial recovery and followed by some relapse.
  • Primary-progressive MS manifests itself as a slow decline towards clinical severity, sometimes with minor stabilization.
  • Secondary-progressive MS starts out as relapsing-remitting and later develops into a primary-progressive form.
  • Progressive-relapsing MS involves worsening punctuated by sudden increases in severity. Primary-progressive MS and Relapsing-remitting MS are the types we most often see in our office for Social Security disability (SSD) benefits.

There is no known way to completely halt the progression of the disease.

Many steroids, which are not recommended for long-term use due to their numerous side effects, have been used to slow the progression and lessen the severity of MS episodes. Inteferons have also been approved by the FDA for the treatment of relapsing-remitting MS. Fingolimod is one such variety of interferon that has yet to be certified by the FDA, though it may prove to be successful in the future. In severe cases, a potentially dangerous drug called Natalizumab maybe be used. Given that one must be diagnosed with a severe case of MS to receive such treatments, most people receiving the drug generally qualify for Social Security benefits.

New Drug for MS Being Studied

See AARDA’s report on a new MS drug being studied.  While treatment has primarily consisted of high doses of steroids, like prednisone, or immuno-suppressive drugs, a more recent approach has been the use of interferon, proteins that suppress immune activity, which involves daily injections.  Oral preparations became available recently.

The latest is a new preparation identified by its industry name as BG-12. Taken by mouth twice per day, it was shown to reduce lesions by 70-99 percent. Over a two-year period, it reduced the progression to disability by 38 percent.

Optical Coherence Tomography (OCT) Test for MS

John Hopkins University research has indicated that widespread nerve damage can be quantified using a less invasive technique known as Optical Coherence Tomography (OCT).  This represents a more cost effective method of measuring the disease’s progression which is easier on the patient.

American Autoimmune Related Diseases Association (AARDA)

A new report by the American Autoimmune Related Diseases Association (AARDA) examining the economic impact of autoimmune disease (AD) on Americans, their families and the United States was released today at a congressional briefing as part of AARDA’s  National Autoimmune Diseases Awareness Month activities.

“The Cost Burden of Autoimmune Disease: The Latest Front in the War on Healthcare Spending,” presents an assessment of current economic data available on AD, including patient out-of-pocket costs, patient job earnings and productivity losses and the impact on Social Security Disability and Medicare.

“Autoimmune diseases are, and will continue to be, a mounting public health concern for the foreseeable future,” said Virginia Ladd, executive director, AARDA. “While it’s difficult to determine exact costs of all 100-plus autoimmune diseases, it is clear that these chronic illnesses constitute a major component of U.S. health care spending, totaling perhaps hundreds of billions of dollars in direct and indirect costs to individual patients, insurance companies and the federal government.”

Ladd added the report offers solutions for easing the future burden, including:

  • Streamlining the diagnosis process which right now can take years and numerous doctor visits.
  • Creating a new medical specialist – the autoimmunologist.
  • Coordinating and managing patient care through community-based autoimmune triage centers rather than costly hospital emergency room visits and extended hospital stays.
  • Focusing and expanding federal research funding for autoimmune disease that leads to better diagnostic tools, new treatment options and perhaps one day a cure.
  • Increasing awareness amongst the general public about autoimmunity and autoimmune disease so they can be better advocates for their own health and their loved ones.

Of the 50 million Americans coping with AD, more than 75 percent are women. AD is one of the top 10 leading causes of death of women under the age of 65. ADs include multiple sclerosis, lupus, Crohn’s disease, rheumatoid arthritis and Grave’s disease.

AARDA is the nation’s only non-profit organization dedicated to bringing a national focus to autoimmunity as a category of disease and a major women’s health issue, and promoting a collaborative research effort in order to find better treatments and a cure for all autoimmune diseases. To download the report, please visit www.aarda.org.

SOURCE American Autoimmune Related Diseases Association (AARDA)