Multiple Sclerosis Awareness Month: MS-Specific Issues in Disability Claims

If you or someone you love suffers from Multiple Sclerosis (MS), you already know how debilitating this progressive and incurable illness can be. Nearly one million people in the United States currently live with MS. In honor of MS awareness month, we highlight this all-too common illness and share tips and resources for succeeding in MS-based disability claims.

MS is an autoimmune disorder that attacks the central nervous system – the part of your body that controls your ability to walk and think. It causes unpredictable symptoms such as pain, fatigue, impaired balance and walking, issues with memory and cognition, mood changes, blindness and/or paralysis. Although there is no cure for MS, there are therapies and medications available to treat its symptoms, reduce the frequency and severity of attacks, and to slow the progression of the disease.

MS affects everyone differently, and the nature and severity of its symptoms will vary by patient.  Many people who have been diagnosed with MS can continue to work for years before their ability to complete their job duties is impacted. We’ve previously shared examples of the types of accommodations that can be requested when that happens. Once symptoms have progressed to a point where accommodations are no longer enough, it may be time to submit a disability claim.

Although our Courts have recognized that MS is a totally disabling disease, it takes more than a diagnosis of MS to succeed on a disability claim. Proving that that your particular MS symptoms, (and the severity of those symptoms) prevent you from working can be harder than you think. Insurance companies will often disregard self-reported MS symptoms and deny claims based on the stability of MRI imaging, the presence of “normal” neurological exams, and/or the treating physician’s failure to fully establish their patient’s impairments during the claims process.

Insurance companies will require a claimant’s treating physician to complete forms documenting their patient’s symptoms and particular restrictions and limitations. These forms were designed by the insurance company, and are not specific to MS. As a result, they often include questions that do not apply to MS claimants and leave out important clinical information. A doctor who is unfamiliar with the disability claims process might incorrectly assume that the insurance company is asking for all of the information that is needed, and might not realize that they are permitted to supplement it with additional reports and/or different forms.

In the face of these pitfalls, having the collaborative support of doctors (and attorneys) who are experienced in navigating MS-based claims can make all the difference.

I was selected to consult on a project with the National Multiple Sclerosis Society to create a comprehensive new form, the Universal Attending Physician Statement, to address these issues and assist MS patients with their private disability claims. This form was specifically created with MS patients in mind, and has been tailored to fit their specific needs. The National MS Society suggests that the Universal APS be utilized instead of the forms designed and sent by the insurance companies.

The Universal APS is just one tool available in the National MS Society’s Guide for People with MS and Their Healthcare Providers. This valuable resource includes an explanation of Key Concepts in Private Disability Insurance, a Glossary of Disability Insurance Terms, Frequently Asked Questions, a Physician’s Checklist, and a MS Symptom Tracker for patients. If you or a loved one is interested in or currently pursuing a disability claim as a result of their MS symptoms, it is important to review this information and discuss it with the doctors who will be involved in the claim. It is up to claimants and their doctors, together, to make sure the insurance company has as much evidence as possible to have their claim approved.

An attorney can help by acting as a liaison between claimants, doctors, and insurance companies. Experienced disability attorneys take the lead in screening and facilitating the exchange of information to protect their client’s rights, ensure that their clinical information is presented in the most compelling way possible, and allow claimants to focus on their much-needed medical care. We at Bonny G. Rafel LLC, provide legal counsel to individuals seeking to obtain (or overcome a denial of) long term disability benefits, and advocate for our clients as the Voice of the Disabled.  See our website for video presentations and information on our boutique practice and contact us to discuss your case.


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