Multiple Sclerosis

A. Definition
Multiple sclerosis (MS) is an unpredictable, often disabling, disease in which your immune system attacks the protective myelin sheath that covers your nerves. Myelin damage disrupts the flow of information between your brain and the rest of your body. With MS, the tissues that come under attack are in your body’s central nervous system (CNS), which is made up of your brain, spinal cord, and nerve fibers to your eyes. Clearly defined attacks of worsening neurologic function are called relapses, flare-ups, or exacerbations, and are followed by partial or complete recovery periods (remissions), during which symptoms improve and there is no apparent progression of disease.

B. General information
Signs and symptoms of MS vary widely, depending on the amount of damage, and which nerves are affected. If you have MS, you may lose the ability to walk independently or at all, or you may experience visual acuity issues. You also may appreciate long periods of remission during which you develop no new symptoms. MS symptoms can change over time, so what you experiences in the early stages of the disease may differ from late-stage symptoms. Ultimately, the nerves themselves will deteriorate, a process that is currently irreversible.

The exact antigen — or target that the immune cells are sensitized to attack — remains unknown, which is why MS is considered by many experts to be “immune-mediated” rather than “autoimmune.” Scientists believe the disease is triggered by an as-yet-unidentified environmental factor(s) in people who are genetically predisposed to respond.

There is no known cure for multiple sclerosis and the long-term outcome is difficult to predict. Good outcomes more often seen in women, those who develop the disease early in life, those with a relapsing course, and those who initially experienced few attacks. Life expectancy is on average 5 to 10 years lower than that of those in the unaffected population.
Although many people diagnosed with MS continue to lead productive lives, many others succumb to disabling effects and become unable to sustain full time work for a year or longer.

Social Security Medical Listing 11.09 – Multiple Sclerosis
The Social Security Administration recognizes that, due to the unpredictable nature of MS, many patients will eventually become unable to engage in substantial gainful activity for a year or longer.
The Social Security Administration will evaluate the impact of the disease on your ability to sustain fulltime work in consideration of the following:

A. Significant and persistent disorganization of motor function in two extremities, resulting in the sustained disturbance of gross and dexterous movements, or gait and station. This could take the form of paresis or paralysis, tremor or other involuntary movements, ataxia and sensory disturbances (any or all of which may be due to cerebral, cerebellar, brain stem, spinal cord, or peripheral nerve dysfunction) which occur singly or in various combinations, frequently provides the sole or partial basis for decision in cases of neurological impairment. The assessment of your impairment depends on the degree of interference with locomotion and/or interference with the use of your fingers, hands, and arms.

B. The loss of visual acuity or efficiency severely limiting your ability to distinguish detail, read, or do fine work, as established by testing from acceptable medical sources consistent with the prevailing state of medical knowledge and clinical practice. Results from visual field screening tests will be used to determine whether your visual disorder is severe when these test results are consistent with the other evidence in your case record

C. Psychological or behavioral abnormalities associated with a dysfunction of your brain. History and physical examination and/or laboratory tests are required to demonstrate the presence of a specific organic factor judged to be etiologically related to the abnormal mental state and loss of previously acquired functional abilities.

D. Significant, reproducible fatigue of motor function with substantial muscle weakness on repetitive activity, demonstrated on physical examination, resulting from neurological dysfunction in areas of the central nervous system known to be pathologically involved by the multiple sclerosis process.

Your diagnosis of MS does not mean you automatically qualify for disability benefits under the Social Security Administration. Your representative can help you determine if your MS is severe enough to meet the requirements of Social Security Medical Listing 11.09.