Multiple sclerosis (“MS”) is a chronic and often unpredictable condition that can significantly impact your ability to work. With symptoms ranging from fatigue and muscle weakness to cognitive impairments and vision issues, MS can make it challenging to keep up with daily job demands. For those struggling to work due to the effects of MS, short and long term disability benefits can offer crucial financial support.
However, navigating the disability claims process can be complex, especially with an illness as variable as MS. This article answers common questions about qualifying for disability benefits with MS, the types of evidence needed to support your claim, and strategies to address challenges specific to MS claimants.
How Can Multiple Sclerosis Impact My Ability to Work?
Multiple sclerosis (“MS”) can affect your ability to work in several ways due to the wide range of symptoms and unpredictable progression of the condition. The impact of MS varies from person to person, but here are some common ways it can interfere with your job:
Fatigue: One of the most common symptoms of MS, fatigue can make it difficult to complete tasks, maintain focus, or meet the demands of a full workday. You may feel drained or need frequent breaks, which can impact productivity.
Mobility Issues: MS can cause muscle weakness, spasticity, or balance problems, making it challenging to move around, stand, or even sit for extended periods. If your job requires physical activity, these symptoms can significantly interfere with your ability to perform essential duties.
Cognitive Impairments: Cognitive symptoms, such as difficulties with memory, concentration, or decision-making, can make it challenging to complete tasks accurately or efficiently. These issues are especially concerning in roles that require attention to detail or quick problem-solving.
Vision Problems: MS can lead to vision issues, including double vision, blurred vision, or even vision loss, which can impact jobs that rely on visual tasks or working with screens.
Pain and Sensory Symptoms: Many people with MS experience chronic pain, numbness, or tingling in various parts of the body, which can be distracting or make specific tasks physically uncomfortable or even impossible.
Emotional and Mental Health: MS can contribute to secondary depression, anxiety, or mood swings, which can affect your emotional resilience and ability to handle work-related stress. These symptoms can make interacting with colleagues or staying motivated more challenging.
The progressive nature of MS can also mean that symptoms worsen over time, making it increasingly difficult to maintain a regular work schedule or continue in the same role.
Can I Qualify for Short or Long Term Disability Benefits with MS?
Yes, you can qualify for short or long term disability benefits with multiple sclerosis (MS) if your symptoms make it difficult or impossible to perform your job duties. Qualifying for disability insurance benefits with MS typically depends on the severity of your symptoms and how they impact your ability to work. The nature of your specific disability policy also plays a role, as each policy has its own standards for defining “disability.” To successfully qualify for benefits, it’s important to understand what insurers look for and how to document the unique challenges that MS brings.
The severity of your MS symptoms is a key factor in your eligibility for disability benefits. Insurance providers will evaluate how MS affects your daily job functions, and if you experience debilitating symptoms such as severe fatigue, cognitive issues, mobility challenges, or other impairments that prevent you from performing essential tasks, you may meet the criteria for benefits. To support your claim, it’s vital to have thorough documentation of your functional limitations.
The type of disability policy you hold also impacts your ability to qualify. Some policies, for example, cover you if you’re unable to perform your “own occupation,” while others require proof that you are unable to work in “any occupation” for which you’re reasonably qualified. Knowing the specific definition of disability in your policy will help guide you in gathering the most relevant evidence. Additionally, because MS is both progressive and unpredictable, insurers typically want to see proof that you’re receiving ongoing, consistent care to manage the condition. Regular medical follow-ups, along with documented treatment efforts, can demonstrate that you’re actively managing your MS and underscore the ongoing nature of your limitations.
If you’re considering filing a disability claim for MS, a long term disability attorney can help guide you in gathering the necessary documentation and submitting a comprehensive application that clearly illustrates to your insurance company how your symptoms prevent you from maintaining employment.
How Does the Progressive Nature of MS Affect Disability Claims?
The progressive nature of multiple sclerosis (“MS”) can significantly impact disability claims, as the condition’s symptoms often change over time and may gradually worsen.
Here’s how the progressive aspects of MS can affect your claim:
Changing Symptoms: MS is characterized by periods of relapse and remission, as well as progressive decline in some cases. Symptoms can vary day-to-day or even hour-by-hour, making it challenging to present a consistent picture of your limitations. Insurers may require thorough documentation to verify that these fluctuations prevent regular, sustainable work.
Need for Ongoing Medical Updates: Because MS often progresses, disability insurers may require periodic medical updates to assess whether your condition has changed. Consistent documentation from your medical team, including regular appointments, helps demonstrate how MS continues to affect your work abilities and supports the need for ongoing benefits.
Long Term Disability Challenges: For long term disability claims, your insurance company may question whether your symptoms will improve with treatment, potentially arguing that you could return to work in some capacity. Progressive symptoms—such as worsening fatigue, cognitive decline, or mobility limitations—reinforce the necessity for continued benefits and can counter your insurance company’s assumptions of recovery.
Risk of Claim Denials: Due to the unpredictable nature of MS, some insurers may deny claims if they believe your symptoms are temporary or treatable. Showing a clear pattern of progression, even if intermittent, is essential. Regularly updating your insurance company with new information about your condition and its impact on your job can help prevent interruptions in benefit payments.
For progressive conditions like MS, gathering continuous medical records and staying proactive about documenting changes in your symptoms are key to securing long term disability benefits. This approach demonstrates to your insurance company that your limitations are both persistent and increasingly severe, supporting your need for continued support.
Can Cognitive Symptoms of MS Qualify for Short or Long Term Disability?
Yes, cognitive symptoms of multiple sclerosis (“MS”) can qualify you for short or long term disability if they significantly impair your ability to perform your job duties. MS often affects cognitive functions, including memory, attention, and executive functioning, which can interfere with various aspects of work.
Here’s how cognitive symptoms may support your short or long term disability claim:
Impaired Memory and Concentration: MS can lead to memory lapses and difficulty focusing on tasks for extended periods. In jobs that require detail-oriented work or multitasking, these cognitive impairments can prevent you from meeting performance expectations.
Decision-Making and Problem-Solving Difficulties: MS-related cognitive changes can affect your executive functioning skills, making it harder to analyze information, make decisions, and solve problems. If your job relies heavily on these skills, it may become difficult to complete complex or strategic tasks, which can support a claim for benefits.
Processing Speed: Slower information processing is common with MS and can impact your ability to keep up with the demands of fast-paced work environments. Reduced processing speed can be especially challenging if you’re expected to meet tight deadlines or respond quickly in high-stakes situations.
Communication Challenges: MS can cause word-finding difficulties and issues with verbal fluency, making it harder to communicate clearly with colleagues and clients. If these issues affect your ability to interact effectively in your role, they can be substantial grounds for a disability claim.
Medical and Neuropsychological Evidence: To qualify for benefits, it’s important to provide medical evidence that demonstrates how cognitive symptoms impact your work performance. Neuropsychological assessments, which objectively evaluate cognitive functioning, can be crucial in illustrating the extent of your limitations and how they hinder your ability to work effectively.
Cognitive symptoms can severely impact your job performance, especially in roles that demand high levels of focus, memory, and decision-making. If your cognitive symptoms prevent you from meeting the expectations of your job, short or long term disability benefits may be necessary to provide financial support as you manage your condition.
What Evidence Do I Need to Support My Disability Claim for MS?
To support a short or long term disability claim for multiple sclerosis (“MS”), you’ll need comprehensive evidence demonstrating how the condition affects your ability to work. Both medical documentation and other supporting evidence can strengthen your claim, showing your insurance company the full impact of MS on your daily function and job performance.
Complete, up-to-date medical records from your neurologist and other treating physicians are the backbone of your disability claim. These should include:
MRI Results: MRI scans showing lesions or inflammation in the brain and spinal cord are strong indicators of MS. Imaging should ideally include T2-weighted MRIs and contrast-enhanced MRIs to highlight active lesions, which illustrate disease progression.
Spinal Tap/Lumbar Puncture Results: Cerebrospinal fluid analysis can reveal oligoclonal bands, which are often present in people with MS. This test helps confirm the diagnosis and supports that your symptoms are related to MS.
Evoked Potentials Testing: Tests like visual evoked potentials (“VEP”) or somatosensory evoked potentials (“SSEP”) measure the electrical activity in your brain in response to stimuli and can detect abnormalities in nerve pathways affected by MS.
Neurological Exam Findings: Physical exams from your neurologist that document weakness, spasticity, reflex abnormalities, coordination issues, and balance problems demonstrate the neurological impact of MS.
Treatment Records and Medication History: Documentation of medications prescribed for MS—such as disease-modifying therapies, steroids, or other symptomatic treatments—illustrates your attempts to manage symptoms. Records showing side effects from these medications, such as fatigue or cognitive effects, also support your claim.
Physical Therapy and Occupational Therapy Records: Therapy records that detail attempts to manage symptoms, like weakness, gait instability, or coordination issues, can document functional limitations and the need for continued support.
Attending Physician Statements: Written statements from your treating neurologist or other specialists can highlight the specific ways MS impairs your job function. These statements should address your physical and cognitive symptoms and explain why they prevent you from working effectively.
Functional Capacity Evaluation (“FCE”): An FCE assesses your physical capabilities, such as strength, balance, and endurance. It provides an objective analysis of your limitations and can illustrate how symptoms like muscle weakness or coordination issues hinder your ability to work.
Neuropsychological Evaluation Results: A neuropsychological evaluation can provide objective evidence of your issues with memory, attention, executive function, or processing speed. The results help substantiate the cognitive effects of your MS and show how these impairments interfere with work tasks.
Beyond medical evidence, you can also submit documentation substantiating your MS symptoms and how they specifically impact your ability to work. This may include:
Symptom Diary: A personal record of your symptoms, noting their frequency, severity, and how they impact your daily activities, can be valuable evidence. This diary helps to convey how your symptoms vary day-to-day and demonstrates how they interfere with a regular work schedule.
Vocational Documentation: Vocational evidence shows the specific demands of your job and highlights areas where your symptoms interfere with these requirements. Useful documentation includes an updated resume to show your work history, an official job description detailing the physical and cognitive tasks involved, and a vocational assessment from a specialist who can compare your abilities with the demands of your job, emphasizing where MS limits you.
Personal Affidavit: A statement describing your occupational background and demands, your MS symptoms, daily challenges, and the ways MS prevents you from performing your job tasks adds a personal perspective to your claim. Be specific about how each symptom impacts your work capabilities.
Witness Statements: Statements from colleagues, supervisors, or family members who can confirm the changes in your ability to work due to MS can help establish the legitimacy of your claim. These witnesses should describe the specific ways they’ve observed MS affecting your job performance or daily routines.
This combination of medical, personal, and vocational evidence provides a well-rounded picture of how MS impacts your life and work, helping to substantiate your need for disability benefits.
What Challenges Do People with MS Face in Getting Long Term Disability Approved?
People with multiple sclerosis (“MS”) often face unique challenges in securing long term disability (“LTD”) benefits due to the variable and progressive nature of the condition.
Here are some common challenges individuals with MS may encounter when applying for LTD:
Unpredictable Symptoms: MS symptoms can fluctuate, with periods of remission and relapse. Your insurance company may use this variability to argue that your symptoms are not consistently disabling, leading to denials based on claims that your condition does not meet the criteria for full disability.
Invisible Symptoms: Many MS symptoms, like fatigue, cognitive impairment, or pain, are not visible and can be difficult to measure objectively. Insurers may question the severity of these symptoms, particularly if they do not appear in a routine physical exam, making it essential to provide thorough documentation.
Progressive Condition Misinterpretation: Because MS often progresses gradually, your insurance company may argue that your symptoms are mild or manageable and will not prevent you from working long-term. This can lead to initial denials or requests for extensive evidence proving that the progression limits your ability to work.
Difficulty of Proving Cognitive Symptoms: Cognitive impairments from MS, such as memory issues, concentration difficulties, or slow processing speed, can be subtle but significantly impact work performance. Your insurance company may require neuropsychological testing to validate these claims, and without such testing, they may deny cognitive symptoms altogether.
Focus on Physical Abilities Only: Some insurers may focus on your physical abilities while overlooking cognitive symptoms. If your cognitive impairments or fatigue make it impossible to sustain work, this can complicate your claim unless you provide evidence of how these symptoms specifically impact your job.
Inadequate Documentation of Functional Limitations: Your insurance company may require specific documentation, such as Functional Capacity Evaluations (“FCE”) or neuropsychological assessments, to prove the extent of your limitations. Without these, they might claim that your medical records alone do not support a finding of disability.
Misinterpretation of Daily Activities: Your insurance company may interpret your ability to perform daily activities, such as light household tasks or social outings, as proof of your ability to work. Surveillance or social media monitoring can also be used to misrepresent your condition, leading to claim challenges.
These challenges make it critical to compile extensive medical documentation, detailed symptom tracking, and strong vocational evidence to demonstrate how MS impacts your ability to work. Working with an experienced disability insurance attorney can help you anticipate and address these challenges, ensuring your claim accurately reflects the limitations MS imposes on your work capabilities.
Can I Work Part-Time or in a Different Role if I Have MS and Still Qualify for Benefits?
Yes, in some cases, you may be able to work part-time or in a different, less demanding role and still qualify for disability benefits with multiple sclerosis (“MS”). However, this depends on several factors, including your policy terms, your specific symptoms, and how your ability to work is assessed by the insurance company.
Here’s what to consider:
Policy Definition of Disability: Many long term disability policies specify either an “own occupation” or “any occupation” definition of disability. Under an “own occupation” policy, you may qualify for benefits if you cannot perform the primary duties of your current job, even if you can work in a different, less demanding role. However, an “any occupation” policy generally requires that you be unable to work in any job for which you’re reasonably qualified by education, training, or experience.
Partial or Residual Disability Benefits: Some policies offer partial or residual disability benefits, which are designed for people who can work part-time but have reduced earning capacity due to their condition. These benefits often cover a portion of the income you’re unable to earn due to MS, making them a valuable option if full-time work is too demanding.
Income and Hourly Restrictions: Some disability policies have specific income or hourly limits that define eligibility. For example, you might be required to work fewer than a certain number of hours per week or earn below a specified percentage of your previous income to continue qualifying for benefits.
Regular Reassessments by the Insurer: If you work part-time while receiving benefits, your insurance company will likely conduct periodic reassessments of your condition and ability to work. This requires continued documentation showing that MS limits your ability to increase work hours or take on a more demanding role, even if you are working in a reduced capacity.
Part-time or alternative work can sometimes help manage the financial impact of MS while retaining eligibility for disability benefits, especially if your policy allows for it. However, it can be difficult to prove partial disability without your insurance company concluding you are capable of full-time employment. Consulting a disability insurance attorney with experience in ERISA can help you navigate these requirements, ensuring your benefits remain intact while you explore manageable employment options.
How Often Will I Need to Provide Updated Medical Records for My MS Claim?
The frequency with which you’ll need to provide updated medical records for your multiple sclerosis (“MS”) claim largely depends on your disability insurance policy’s requirements and the specific practices of your insurance company.
Here’s what to expect:
Initial Claim and Periodic Reviews: After your initial approval, most insurers require regular updates to assess whether your condition remains disabling. These periodic reviews might be requested every 6 to 12 months, although some insurers may require updates more or less frequently depending on your policy terms and the progression of your condition.
Frequency Based on Condition Progression: Because MS is a progressive condition, insurers often request updated records to monitor any changes. If your symptoms are stable or improving, your insurance company may use this as a reason to reevaluate your eligibility.
Ongoing Treatment Documentation: Insurers typically expect that you are actively managing your condition with consistent medical care. Providing documentation from routine visits with your neurologist, along with updates on treatments or therapies, helps demonstrate that you are taking steps to manage your MS, which can support the continuation of benefits.
Requests for Specific Assessments: In addition to general medical records, your insurance company may occasionally request specific tests or assessments, such as MRI results, Functional Capacity Evaluations (“FCE”), or neuropsychological evaluations, to gauge the current impact of MS on your physical and cognitive abilities.
Frequency May Increase with Return-to-Work Attempts: If you attempt to return to work, even on a limited basis, your insurance company may request more frequent updates to monitor your progress and determine whether you can sustain employment. This often includes additional records or functional evaluations to assess any changes in your capacity to work.
By staying proactive with medical updates, you can provide insurers with a clear, ongoing picture of how MS affects your ability to work. Engaging a disability insurance attorney who can obtain the records needed for your claim can also help ensure timely submissions, reducing the risk of delays or interruptions in your benefits.
How Long Do Short and Long Term Disability Benefits Last for People with MS?
The duration of short and long term disability benefits for people with multiple sclerosis (“MS”) depends on the specifics of your policy and the progression of your symptoms.
Here’s a breakdown of what to expect:
Short Term Disability (“STD”): Typically, STD benefits last between 3 to 6 months, though some policies may cover up to a year. These benefits are intended to provide financial support during temporary periods when MS symptoms prevent you from working. After this period, if your condition remains disabling, you may transition to long term disability.
Long Term Disability (“LTD”): LTD benefits generally last longer and may extend for several years or even until retirement age, depending on the policy. The exact duration is typically specified in your plan and may vary by provider. Some policies cover benefits only for a set period, such as 2, 5, or 10 years, while others provide coverage up to age 65 or retirement if you remain unable to work due to MS.
“Own Occupation” vs. “Any Occupation” Policies: Many LTD policies shift from an “own occupation” definition to an “any occupation” definition after a certain period, usually 24 months. This means that after the initial period, you must prove that MS prevents you from performing any job for which you are qualified, not just your previous occupation. This change can impact the duration of benefits if your symptoms are mild enough to perform some work.
Progressive Nature of MS: Since MS is a progressive condition, insurers may require ongoing proof that your symptoms prevent you from working. This means periodic reassessments to ensure you still meet the policy’s definition of disability. If your condition worsens over time, LTD benefits may continue as long as you meet these requirements.
Potential Policy Limitations: Some policies have limitations for disabilities due to mental health symptoms or “subjective” symptoms like fatigue or pain, which are common in MS. If your MS claim is categorized under these limitations, benefits may only last 12 to 24 months. However, if your MS diagnosis is supported by objective medical evidence, you may be eligible for benefits beyond these limitations.
Understanding the terms of your specific disability insurance policy and preparing for potential transitions, like from STD to LTD or “own occupation” to “any occupation,” can help you better anticipate the duration of your benefits. Consulting with a disability attorney may also help clarify your coverage options and protect your benefits for as long as you remain unable to work due to MS.
How Can The Maddox Firm Prove My Short or Long Term Disability Claim?
The Maddox Firm understands the unique challenges MS claimants face in proving their short or long term disability claims. With fluctuating and often invisible symptoms, MS can be especially difficult to document and explain to insurance companies. Our experienced team builds a strong, evidence-backed claim that effectively demonstrates the impact of MS on your ability to work.
Here’s how The Maddox Firm can help prove your MS short or long term disability claim:
We Examine Your Policy and Assess Your Claim: We start by carefully reviewing your disability insurance policy to identify the specific definitions of disability it requires, such as “own occupation” or “any occupation.” This helps us strategize the best approach for your claim, knowing exactly what evidence will be necessary. We assess your claim in light of your MS symptoms, whether they involve fatigue, mobility issues, cognitive impairments, or vision problems, to determine how we’ll substantiate your case.
We Handle All Communications with Your Insurance Company: Insurance companies may request extensive documentation, ask for frequent updates, and even conduct surveillance in an attempt to deny or reduce your benefits. We manage all communication on your behalf to avoid common pitfalls, ensuring that your insurance company receives complete, accurate information and preventing them from using tactics that could weaken your claim.
We Help You Obtain Evidence to Support Your Claim: Proving an MS disability claim requires more than just a diagnosis—it requires medical, vocational, and sometimes personal evidence that shows how your symptoms prevent you from working. We work with your medical providers to obtain records, secure Functional Capacity Evaluations (“FCE”) with trusted vendors, arrange neuropsychological testing for cognitive impairments, and gather statements from specialists who can describe your condition and limitations in detail.
We Handle Appeals and Litigation: If your claim is denied, we are prepared to fight on your behalf. The Maddox Firm specializes in navigating the appeals process and, if necessary, pursuing litigation to challenge unfair denials. We use expert knowledge and compelling evidence to build a strong case, addressing any reasons for denial and highlighting how MS has affected your ability to maintain employment.
A short term disability or long term disability claim can be a complicated process. If you need help during the claims process, with appealing a claim denial, or with litigating a final adverse short term or long term disability decision, The Maddox Firm can help. The experienced team at The Maddox Firm will examine your insurance policy, correspondence from your insurance company, medical records, and any other relevant documentation in order to give you personalized guidance on how we can help you win your short and/or long term disability claim. Our New Jersey and New York long term disability attorneys help clients nationwide.