Multiple Sclerosis Disability Claims Law Firm

Receiving a diagnosis of Multiple Sclerosis (MS) is life changing, and occurs at many different ages, young and older.  MS is an autoimmune disease affecting the brain and spinal cord (central nervous system) that can cause permanent disability and often causes functional limitations.  Obtaining long term disability insurance benefits, from a group disability policy (ERISA) or a private (individual) disability policy is challenging when suffering the Multiple Sclerosis because of the nature and manifestation of this chronic, progressive disease.  Symptoms may be overwhelming one day, occur a few times during any given work day, or they may vanish for a few days or weeks before returning.

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How Can I Protect My Long Term Disability Insurance Benefits If I Have Multiple Sclerosis?

The difficulty of documenting Multiple Sclerosis and its symptoms makes the help of an experienced disability insurance lawyer critical to the success of your claim. Jason Newfield has represented many MS claimants, including those who have been able to keep working until they reached a point where they could no longer manage the tasks and duties of their job. He can be reached to discuss your claim and explain options.

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An application for long term disability insurance benefits for someone suffering from Multiple Sclerosis  must include strong support from a treating doctor who specializes in MS. Ideally, the treating physician should be a neurologist whose practice focuses on MS because the insurance company will push back on the MS claim as soon as they see that treatment is being provided by an internist or general practitioner.

Medical support for an MS claim can be difficult because the disease is usually diagnosed through self-reported symptoms. According to the National Institutes of Health, there is no single test used to diagnose MS. A diagnosis is confirmed when symptoms develop that are related to different parts of the nervous system and other alternative diagnoses have been ruled out. This is known as a “differential diagnosis,” when other conditions that might produce similar symptoms have been ruled out.

There are some tests used to confirm the diagnosis:

  • MRI brain and spinal cord scans to look for characteristic lesions of multiple sclerosis.
  • Lumbar puncture (spinal tap) to obtain a sample of cerebrospinal fluid to search for proteins and inflammatory cells associated with MS.
  • Evoked potential tests, which use electrodes placed on skin and painless electric signals to measure how quickly and accurately the nervous systems responds to stimulation.

My Claim is Being Paid as a Mental/Nervous Behavioral Claim – What’s That About?

A common tactic used by disability insurance companies is to switch claims from a physical disability to a mental/nervous/behavioral claim. This can be done if doctor’s notes include a note about clinical depression, which is frequent among people with MS. Depression can be part of the disease itself and chemical imbalance in the brain, or it can be a response to the life-changing nature of the disease.  Or you might be taking medication, as part of a regimen, which includes an anti-depressant or anti-anxiety medication.  Depending upon policy language, insurance companies may try to leverage such information to limit benefits to claimants.

Disability insurance companies use the tactic of shifting your claim from a medical condition to a mental/nervous disability claim because most disability policies limit these claims to a 24-month coverage period. If you see that this has occurred, contact a multiple sclerosis disability attorney to protect yourself, as the insurance company is making wrongful determinations to your claim and reducing what you are entitled to in disability insurance benefits.

Symptoms of Multiple Sclerosis

Many who suffer from Multiple Sclerosis have an array of symptoms, which may differ among patients and the frequency, intensity, and duration of each may even differ within patients.  Here are several common symptoms of Multiple Sclerosis.

There are many other symptoms which do not manifest to the everyday interaction: 

Cognitive Symptoms of Multiple Sclerosis Impacting Your Ability to Work

More than just the physical manifestations of Multiple Sclerosis, cognitive impairment impacts as many as 75% of people with MS. This can occur at the same time as physical symptoms or develop gradually over time. The severity of cognitive symptoms varies, making disability insurance claims challenging.

Cognitive symptoms of MS may include, but are not limited to:

  • Slowed thinking or worsening executive functions (analysis and decision making)
  • Problem solving becomes challenging.
  • Mood and behavioral changes, including inappropriate and involuntary expressions of laughter, crying or anger occurring when feeling the opposite emotion — pseudobulbar affect. 
  • Difficulty with memory and ability to concentrate on tasks.
  • Speech and communication.

Why Does My Doctor Need to be Involved with an MS Disability Claim to Succeed?

If your treating physician is a neurologist with a focus on Multiple Sclerosis, they may be familiar with the challenges presented to MS claimants and understand the importance of their role in your efforts to obtain disability benefits from your long-term disability insurance policy. But it is not likely they will have the time to create the medical record to ensure your claim’s success.  You need to ensure that the records are powerful support for your claim, particularly when simply having a diagnosis of MS alone is not enough. 

Jason Newfield has more than two decades of representing MS claimants, working closely with claimants and their treating physicians to navigate the long-term disability process for MS.  This begins by comprehensively understanding why the claimant cannot perform their specific work functions.   

We work to ensure your medical record contains the robust documentation needed for your claim from the start. Your initial application and appeal is the only chance you have to submit information to support your claim. If your claim needs to go to court, this information is the only information a judge will review, so it must be complete and as robust as possible. We have done this before, with success, so we can ensure this process is both efficient and effective at all stages of your claim.

In addition to medical records, your application will need a descriptive statement explaining how your ability to work has been changed by having MS and how and why you are unable to perform your work. Our experience in crafting this document, creating a compelling picture of your life before and after MS, provides the disability insurance company claims adjuster a clearer understanding of the specific tasks you used to be able to perform and how you can no longer do so.  This supports the claim issues and makes the claim easier to pay.

Filing a claim for long term disability insurance benefits for an MS claim is complicated by the intermittent nature of symptoms.  Known as paroxysmal symptoms, they are irregular and come on suddenly with no warning. They may last a few minutes or a few seconds, occur throughout the day or once a day. The severity of the symptoms also may vary from stopping you from working for a minute or creating a socially awkward situation.

The fact that one does not always present with significant symptoms is a hurdle to overcome during the claim process.  MS symptoms are challenging in the work place not only because of their impact on performance and fatigue, but often because they are masked by the employee fearful of losing their job. 

Symptoms like an inability to control twitching muscles or muscle spasms, loss of control of bladder and bowel functions, losing balance at random moments and experiencing sudden vision loss make it very difficult to manage working in a professional office or on a job site.   Those cases which are not masked are often filed earlier.  Mostly, since working from home is not an option for everyone, masking symptoms can only last for so long, if possible at all. 

Further Disability Benefit Challenges for MS Claimants

Insurance companies do not reward claimants who have managed to keep working despite a debilitating condition like MS and finally reach a point where they can’t work anymore.  These heroic efforts are often used against claimants.   Instead, the disability insurance company takes the position that people who kept working in the past can still work, regardless of any documented changes in the level of their symptoms and progression of the disease.  They push back and fail to consider both the degenerative impact of suffering from MS for long periods, nor that one is often unable to sustain such levels while utilizing all of their energies to simply get through a work day exhausted.

Jason Newfield has represented many claimants suffering from MS who have been able to keep working and then reached a point where they simply could no longer manage.   Medications for the treatment and management of MS are widespread, but not always effective, and often only serve to mitigate issues.  Often, side effects exist, which must also be documented to support a long term disability insurance claim.  

Newfield Law Group has decades of experience with long term disability insurance claims for people with multiple sclerosis and represents policy owners who have had their claims denied, delayed, and terminated without any regard for their illness or injuries. If you need help with a MS disability claim for a group policy, or a private policy, and have questions, you are invited to call us for a free consultation at 877-406-7883.

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