Individuals with M.S. who use walkers or wheelchairs, can’t see well enough to drive, or have two or more severe exacerbations a year generally have no problem being approved medically for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) Disability Benefits. Men and women with mild M.S. symptoms or who enjoy long term remissions are often successfully working and have no need for disability benefits.
Between the two groups are folks who can do just about anything on a good day or morning but can’t function well at other times due to unpredictable interference from M.S. symptoms. Compared to some people with M.S., their doctors may think their M.S. is not very severe even though the symptoms prevent the patient from working full time. Such individuals often have difficulty with SS disability claims.
If you are in this group, there are ways to help your case. One of the most important is to report your symptoms to your health care providers. Let them know how your M.S. affects you in daily life in person or take a list for your chart so the problems will be documented in medical records that SSA obtains. This also helps your doctor explain your symptoms and limitations if asked to provide an opinion for your disability case.
Not everyone with M.S. has these but common vocationally significant symptoms are:
- Blurred vision: Even if this occurs only when you are tired, it can affect any task requiring good vision or hand/eye coordination on a regular basis. There may be times you can see fine and others when you would not feel safe driving or can only look at a computer screen for short periods.
- Fatigue: When you’re tired, it’s hard to physically or mentally attend to tasks or keep up speed and accuracy at home or on job tasks. Many folks with M.S., if they don’t get enough rest when fatigue hits, risk an exacerbation of severe symptoms.
- Numbness: In the hands, numbness and tingling (parathesias) can affect any job involving typing, writing, and handling small and large objects. In the legs, these symptoms can affect the ability to stand and walk for very long or safely on uneven ground or steps.
- Bowel/Bladder Dysfunction: Incontinence or urgency problems can affect work if protective garments don’t always do the job or the employee must take bathroom breaks so frequently that if affects their work productivity. It can also be hard for someone with M.S. to get to a bathroom on time if the person has to walk quickly to a distant restroom.
- Pain: Some folks with M.S. experience pain in joints or muscle spasms that interfere with daily activities and concentration. They may require rest and sedating medication for relief, and have problems even sitting long due to hip and back pain.
- Mental Changes: M.S. involves the brain and central nervous system. Because of this, it’s not surprising,that some people with M.S. experience mood changes, forgetfulness or even confusion at times. Whether this is an M.S. symptom, a reaction to dealing with chronic illness, a side effect of medications or fatigue, mental and emotional changes can affect sleep, the ability to learn new things, start or finish tasks, and get along well with others consistently. M.S. is an immune system disorder, so emotional changes and stress can also make physical symptoms worse.
- Side Effects of Medication: Some medications prescribed to treat symptoms of M.S. can be associated with side effects, i.e. drowsiness or flu-like feelings, that affect concentration and endurance.
- Temperature: Some individuals with M.S. cannot tolerate warm temperature work environments. Even a warm shower can trigger fatigue. They may need cool inside temperatures that other workers would not find comfortable. Others can’t handle air conditioning blowing on them because it sets off muscle spasms.
In addition to calling any symptoms and limitations like these to your doctor’s attention, ask your doctor to give you a prescription for a cane, walker, scooter or wheelchair if you need these occasionally--even if you already own or you can’t afford to buy an ambulation aid. SSA decision makers sometimes use lack of a prescription to mean that a doctor doesn’t think the patient has trouble with balance or walking. Also, if you have resisted your doctor’s advice to use an aid out of pride—but you tell SSA you have trouble walking, don’t be surprised if SSA doesn’t believe you.
During the initial stages of your claim, SSA sends out forms asking you to document your problems and how they affect you. For example, you may be asked “Do you drive a car?” You can check both the “yes” and “no” box or neither and explain your variable or limited abilities. For example, you may be able to drive just fine short distances on better days. Other times, you may not leave the house because of fatigue, blurred vision or spasms-- much less drive. Some days, you may be able to cook a meal and other days, you may be too tired or unable to stand long enough. No one is going to come and take away your license or other privileges if you admit to such limitations, so don’t be afraid to let SSA know about them.
Along these same lines, let SSA know other ways you manage in daily life. For example, some of my clients with M.S. had help from families and friends caring for their children when they weren’t feeling well. Others would rest on a couch or bed when tired and supervise their child safely playing or watching T.V. in a closed, child proofed room.
If SSA asks that someone else give a report about your daily activities, choose the person who knows you best to help. Contrary to instructions on some SSA forms, you can have a family member complete them and don’t have to list more than one person as a source of information. A neighbor or friend who sees you occasionally may not give SSA an accurate picture of how you function in a day, week or over the past year. He or she may see you smile and wave when you leave the house for an errand or appointment, but not have a clue about how tired you are when you return. You may keep such contacts upbeat and not fully reveal your problems to others.
Be sure to tell SSA about health problems other than M.S --for example, a hearing loss, arthritis, anxiety, depression, a learning disability, asthma, etc. These problems may not have prevented you from doing your prior work but they may be important in proving you can’t do other types of work.
Don’t get the process of applying for disability cause you to feel less about yourself because you have to write or talk about your limitations. Unfortunately, it’s important to emphasize the problems you encounter in daily life as part of the SS disability evaluation process. The fact that you can’t work full time--or do everything you could before your health problems started --does not mean you’re not a good parent, spouse, child, friend, or person.
Finally, remember that a representative or attorney with SS experience can help develop your claim and make dealing with the SS disability system less stressful and more successful for you.
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