Multiple sclerosis, or MS, is a chronic autoimmune disease that attacks the central nervous system. An estimated 947,000 people in the U.S. have multiple sclerosis (MS) — more than double the long-accepted figure of 400,000 — according to a newly completed study organized and funded by the National Multiple Sclerosis Society (NMSS). Multiple sclerosis affects all age groups, but most people are diagnosed with MS between the ages of 20-50. Because those are key working years for most people, multiple sclerosis disability claims are subjected to close scrutiny by long-term disability insurance companies.
MS is a progressive disease with symptoms that range from barely noticeable to being unable to function. Some are able to continue working, but in other cases, the severity of symptoms makes it impossible for others to maintain their careers. The waxing and waning nature of the symptoms impacts upon a claimant’s ability to document the severity of the impairment. Under a claimant’s long-term disability insurance policy, often covered under ERISA, it is imperative to demonstrate how and why someone is unable to work, regardless of diagnosis. Symptoms include overwhelming fatigue, pain, stiffness, tremors, or bladder and bowel control problems. In some patients, major symptoms disappear; in severe cases, symptoms become permanent and can include partial or complete paralysis, vision loss, and difficulty with speech.
Multiple sclerosis patients and anyone else with a chronic illness will not be awarded disability benefits based solely on a diagnosis. Medical records have to clearly report the inability of the claimant to perform the material duties of their job. The range of symptoms and their varied intensity makes MS a challenging disability claim. A surgeon with multiple sclerosis may not be able to perform the duties of their occupation, but depending on the severity of the illness, they may be able to continue to see patients in an office setting. An engineer may be able to design software, but not be able to leave their apartment to travel to an office.
Multiple sclerosis manifests in a variety of physical, emotional, and mental symptoms. Our disability lawyers understand how these symptoms affect one’s ability to perform at work, and use this information to support the disability insurance claim.
“I first contacted Jason when it became apparent my multiple sclerosis symptoms were progressing too rapidly to continue a full-time career. He gave me lots of great advice and we were planning to file the paperwork for a partial disability claim. Days before completing the paperwork, however, I had an acute exacerbation significantly affecting my mobility and the claim became ‘total and complete’ disability. MS can be challenging and many people I know have their claims rejected the first round. One of my policies was an ERISA policy and needed a Social Security application. ALL of my claims were approved FIRST round! (Granted, I had to do my part, but Jason certainly did his!) It has been over 6 years and he continues to help manage my insurers and what information they are entitled to and what isn’t relevant. I even tried starting a small business (didn’t succeed), but he helped guide me through different scenarios and how they might affect my claim. Though this illness has given me many challenges, one thing I haven’t had to worry about is my disability insurance payments. I’m glad to have Jason as my advocate!”
Disability claimants must be aware that the disability insurance company may attempt to shift your claim to a mental/nervous/anxiety claim if your medical records report any mental illness. We work with treating physicians to ensure that medical records properly reflect the complex nature of MS and cannot be manipulated by the insurance company to limit benefits.
For the purposes of a claim, it is recommended that MS patients obtain a diagnosis and ongoing care from a doctor who is known to focus their practice on MS. This is typically a neurologist, whose specialty is diseases of the nervous system. A neurologist who has had additional training in MS and who primarily sees MS patients may be your best resource through the progression of this disease. If you are about to make a claim on your disability policy, make sure that your doctor understands the importance of their role. Your medical record must strongly support the diagnosis and must outline very specifically your performance limitations. Because there is no single defining test used to diagnose MS, disability insurance companies seeking to avoid paying often try to use this to their advantage, denying claims for as long a time period as possible.
If your MS is severe and you cannot perform the tasks of your job, you need to speak with an experienced MS long-term disability insurance lawyer who has successfully represented MS patients in disability claims. If you have questions, call Jason Newfield or Justin Frankel at 1-877-LTD-CLAIM (1-877-583-2524) or click here to send an email.
Further complicating claims, MS is a disease where symptoms may appear and then disappear for a while, so MS claims are often considered to be either “Relapsing or Remitting.” If you are suffering from a flare-up and cannot work for a few days, weeks, or months, the insurance company may place you in a special category. Make sure that every flare-up is documented, as well as every doctor visit. Frankel & Newfield works with MS patients to help prepare disability insurance claim forms because they understand that this is going to be a long, uphill battle and want to try to alleviate the stress. We have represented many MS patients before, during, and after claims have been filed, delayed, and denied.
Click here to read about an MS patient with Multiple Sclerosis who had his long-term disability benefits wrongfully terminated by CIGNA. We represented him in an ERISA disability appeal and were able to overturn the denial. To learn more about filing a claim for disability benefits, read this article from Disabled World, which examines everything from filing a claim to what you can do if your claim is denied or terminated. If you are about to file for a disability insurance claim because of MS, or if you have filed and are experiencing problems with getting benefits paid, speak with an experienced long-term disability insurance policy attorney who has successfully represented MS claimants.
Secrets the Disability Insurance Companies Don't Want You to Know!