A person living with multiple sclerosis (MS) may experience symptoms severe enough to qualify for disability benefits. There are different kinds of disability benefits a person can receive depending on their employment and health status.
MS can cause several symptoms that range in severity. For some, living with MS will eventually make it difficult to continue to perform their job. If this occurs, they may apply for disability benefits.
Though an employer may offer short- and long-term disability benefits, a person may need to consider applying for Social Security Disability Insurance (SSDI).
The following article covers information about short- and long-term disability benefits, SSDI, and what a person needs to know when applying for coverage.
MS can cause a large range of symptoms from numbness and fatigue to paralysis and blindness. How MS affects a person varies, which means some people living with MS may qualify for disability benefits while others may not.
Disability benefits may come from any of the following:
- privately purchased insurance
- an employer’s benefits package
- the federal government
A person living with MS may qualify for one of the following benefits programs as a result of their symptoms.
Short-term disability benefits
Short-term disability benefits can replace some or all of a person’s salary when they have a temporary disability that requires them to miss work. A person can purchase the plans on their own or may be able to get them through their employer.
When an employer offers short-term disability benefits, the person often has to go through a short waiting period before receiving benefits.
Often, the benefits cover a portion of the person’s base pay. Coverage typically only lasts a few weeks, though this can vary based on the company a person works for or their insurance plans. For example, Johns Hopkins Medicine offers its employees 60% of their base pay for up to 11 weeks for non-union and 24 weeks for union workers.
A person should check with their employer to see how much and how long their short-term disability will cover. Short-term disability does not guarantee a person will be able to return to their job. In other words, an employer can terminate an employee while they receive short-term disability.
Long-term disability benefits
Long-term disability benefits often work in conjunction with short-term disability benefits. Several employers offer long-term disability benefits that typically start once short-term benefits end.
Some considerations for long-term disability benefits include:
- There may be a waiting period.
- For example, long-term disability benefits from John Hopkins Medicine come into effect after 26 weeks.
- Plans may have a lifetime cap of coverage.
- They do not provide job security.
In some cases, a person may receive long-term disability benefits as they wait for approval of Social Security Disability Insurance (SSDI).
A person living with MS typically needs to go through the Social Security Administration (SSA) to apply for SSDI, which provides long-term disability.
In order to qualify for SSDI, a person needs to fulfill the following criteria:
- Meet the SSA definition of qualifying impairment.
- Impairment is expected to or has already exceeded 12 months.
People living with MS who do not meet the criteria for long-term disability may be able to receive short-term disability through their employer.
How SSA defines qualifying MS impairment
The SSA defines criteria needed to apply for long-term disability for a variety of health conditions, including MS. They include these criteria in a document known as Listing of Impairments, or the Listing.
According to the Listing, a person living with MS could qualify for SSDI if they experience at least one of the two criteria.
First, a person must have extreme motor impairment in two extremities, which limits a person’s ability to stand up, balance, or use their arms.
The second criterion states that a person needs to have a definite limitation in physical functioning along with at least one of the following:
- trouble interacting with others
- difficulty remembering, understanding, or applying information
- trouble managing themselves
- issues with concentrating
The National MS Society (NMSS) further notes that while MS has a Listing under number 11.09, a person’s symptoms may also qualify under two additional listings. These include:
- 2.00 Special Senses and Speech: May be used if MS causes visual impairments or issues with speech.
- 12.00 Mental Disorders: May be used if MS causes mood or cognitive disorders.
Some additional symptoms that may help qualify a person for SSDI include:
- trouble seeing
- difficulty walking
- impairments affecting speech, swallowing, or breathing
- extreme fatigue that limits ability to think or perform physical tasks for long periods of time
- persistent, severe pain
Disabilities come in several different forms. According to the
- ability to move, think, learn, communicate, remember facts, or maintain social relationships
- mental health
They further define “disability” as having three parts. These include:
- limitation on activities due to impairments in movement, hearing, vision, or thinking abilities
- impairment to vision, movement, or mental capacities
- inability to participate in social, work, or recreational activities
A person living with MS may fit into one or more types of disability since MS can affect their movement, vision, mental cognition, and health.
When a person receives short- or long-term disability insurance from work, they should talk with their human resources (HR) department. The HR department should have information on the steps a person needs to take to activate their short-term disability benefits.
A person living with MS should talk with a doctor about their condition. Their doctor may recommend starting the process of applying for SSDI if they suspect or have documented that the symptoms could last longer than 12 months.
A person living with MS can apply for SSDI online on SSA’s website here.
Before applying, a person should talk with their doctor about the application process. To help with the application process, a person should make sure they know:
- contact and demographic information about their doctor
- dates and results of tests
- current medications, what they’re used for, and who prescribed them
The SSA also offers a list of information a person should gather before applying. A person can access the list here. In addition to answering several medical questions and providing test results as the SSA requires, the application will ask about:
- employment history
- personal information such as date of birth, children, spouse, and military service
- direct deposit information
- highest levels of education and job training
A person should be prepared to supply proof, as needed, for any information requested.
During the applications process, a person should not return to work. The SSA lists returning to work as one of several potential reasons a person may not receive benefits.
Once a person submits all necessary forms and documentation to the SSA office, a staff member there will review the application.
Primarily, an applicant needs to show:
- impairment that has lasted or could last for 12 months or longer
- physical or mental impairments that limit a person’s ability to work, which can include:
- vision issues
- trouble walking
- other severe symptoms of MS
As part of the process, the SSA office may reach out to the person for more information to help them make a decision.
Once the SSA office reaches their decision, they will send a notification through the mail either accepting or denying the disability benefits.
The SSA does not qualify everyone living with MS to receive SSDI. According to their own data, SSA denies an average of 22% of first-time applicants.
If denied, a person typically has 60 days to appeal the decision. The SSA defines four levels of appeal, including:
- hearing by an administrative law judge
- review by the Appeals Council
- Federal Court review
They also note that a person should check their denial letter. The letter will contain information on which level they should appeal their case. A person can find the SSA appeal forms on the SSA site here or file online using the appropriate link on their site.
The SSA provides some vague information on reasons why they may deny a person’s disability. Some noted reasons include:
- Impairment is not severe enough.
- Person can continue to work at their current job or work at another profession.
- The impairment is not expected to last 12 months.
- Person provides insufficient medical records, does not follow treatment plans, has impairments due to alcohol or drug use, or returns to substantial work before decision is made.
Talking to an employer about living with MS can be a challenging decision. According to the NMSS, a person may not want to talk to certain people at their company, including their boss and coworkers.
However, they do note that a person may find talking to someone in HR helpful for the following reasons:
- Unlike a boss or coworkers, they legally cannot disclose the information to others.
- They can help a person get accommodations for their work.
- They may be a good resource when a person is considering applying for disability.
The Rocky Mountain MS Center also notes that the Americans with Disabilities Act (ADA) can provide some protections when disclosing a person is living with MS. In addition, the ADA requires larger employers to provide reasonable accommodations so long as it does not place a substantial burden on their business.
If a person living with MS believes they can no longer perform their job duties, they should talk with their doctor. Their doctor can then advise whether applying for disability would be a good idea, and they may be able to help start the process.
A person living with MS may qualify for short-term or long-term disability or SSDI. Some employers offer short- and long-term disability benefits, or a person can apply for them privately.
A person may be able to use these benefits as they wait on a decision from SSDI. To qualify for SSDI, someone needs to have a substantial impairment due to their MS, as well as evidence the impairment will last for 12 months or longer.
An individual should work with their doctor to gather all medical information regarding their qualifications for disability benefits.