Multiple sclerosis: a potentially disabling condition

Multiple sclerosis is a chronic disease of the brain and spinal cord. It occurs when the immune system attacks the protective sheath, called myelin, which covers the nerve fibers in the brain and spinal cord. The attack results in inflammation, which destroys nerve cells and myelin. This causes communication problems between the brain and the remainder of the body. The effects of multiple sclerosis can vary with each individual, but some people with multiple sclerosis may have trouble with getting around and completing their activities of daily living. The majority of people with multiple sclerosis have a relapsing-remitting course of the disease. This is characterized by attacks of new symptoms, or clearly increasing neurological symptoms. These periods of attack are followed by periods of partial or complete recovery. When the disease is in remission, the symptoms may become permanent, or may completely disappear. The first episode of symptoms is referred to as a clinically isolated syndrome (CIS). The episode must last for at least 24 hours. People who experience a CIS may not go on to develop multiple sclerosis. However, if the person who experienced a CIS also has lesions on the brain as confirmed by an MRI, the person has a high likelihood of developing the relapsing-remitting disease. Symptoms of a relapse can include fatigue, numbness, tingling, blurred vision or loss of vision, weakness, and an unsteady gait. The symptoms can then go into remission for weeks, months, or years. Multiple sclerosis can be challenging to initially diagnose as other diseases can have similar warning signs. Your provider will likely order an MRI of the brain, which can reveal lesions on the brain and spinal cord. You may also undergo a spinal tap, where a sample of cerebrospinal fluid is removed from the spinal canal and examined for abnormalities in antibodies. Multiple sclerosis is not curable; the treatment methods available focus on managing the symptoms and slowing the progression of the disease. Ocrevus is the only FDA-approved treatment for primary-progressive multiple sclerosis. It is administered via infusions. Corticosteroids such as oral prednisone or intravenous methylprednisolone may be administered as treatments for multiple sclerosis attacks. These treatments can reduce nerve inflammation. Treatments for relapsing-remitting multiple sclerosis can include interferon beta medications and glatiramer acetate, both of which are injected. Oral treatments include Gilenya, Tecfidera, Vumerity, Aubagio, Mayzent, and Mavenclad. Other infusion treatments include Tysabri and alemtuzumab.

Symptoms of multiple sclerosis can include frequent urination or urgency, impaired coordination, numbness, pain, sensitivity to heat, trouble with memory or concentration, vision changes, weakness, tremors, fatigue, dizziness, and depression. If you are experiencing such symptoms and struggling to maintain your normal work activities, you may be eligible for Social Security Disability benefits. Social Security Disability Insurance benefits are available to those who have worked and paid taxes on their income and are unable to continue working due to a medical condition that has lasted or is expected to last for at least one year or result in death. This is a federally administered program, funded through payroll taxes.

The Social Security Administration follows a five-step process when determining your eligibility for disability benefits. First, Social Security will confirm that you are no longer engaging in “substantial gainful activity.” This means that you are no longer working or have reduced your earnings to less than Social Security’s allowable dollar amount per month. For the year 2022, that threshold is $1,350 per month in gross earnings. Once Social Security has confirmed that you are not engaging in substantial gainful activity, the agency will then confirm that you have a severe impairment. Social Security will determine this by reviewing your medical records. Therefore, it is very important that you keep an accurate list of your providers, including hospitals and any facilities which have performed imaging studies such as MRIs. The local disability office will contact these providers to obtain their medical records when you file your claim. Although your doctor may have received a copy of your MRI results and reviewed it, the doctor’s office may not necessarily include those records when they forward their documentation to Social Security, and it may be necessary to request the imaging from the facility itself. MRIs are particularly crucial for multiple sclerosis as the imaging date of the test can be used to establish your date of the disability. It is important to continue treatment with your providers during the application process, including specialists such as your neurologist. This will provide the best medical evidence which the evaluator has to consider when determining the severity of your impairments.

Social Security will then determine if you meet the criteria of one of the entries on its listing of impairments. There are certain impairments that are considered severe enough to prevent an individual from performing any gainful activity. Multiple sclerosis is a listed impairment; however, you must meet all of the criteria outlined in the listing in order to be approved at this stage of the process. This includes: disorganization of motor function in two extremities resulting in an extreme limitation in the ability to stand up from a seated position, balance while standing or walking, or use the upper extremities (arms); or a marked limitation in physical functioning and in understanding, remembering, or applying information; interacting with others; concentrating, persisting, or maintaining pace; or adapting or managing oneself. Very few people meet all of the qualifications for a listing. However, this does not mean that you cannot be found disabled. Social Security will then proceed to the next step of the evaluation process, which is to determine your residual functional capacity. This is an evaluation of your physical and mental capabilities and what activities you would be able to perform over an 8-hour period. Once your residual functional capacity is determined, Social Security will determine if you can perform your past work, and if not, if you can perform any other work. If you are not able to perform any work within the framework of your abilities, you will be found disabled.

Navigating the disability process is very challenging and retaining an experienced Social Security disability attorney is highly recommended. Give LaBovick Law Group a call at (561) 625-8400 for a free case evaluation.

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