By: Jim Allsup
About 15 percent of people diagnosed with MS eventually will become severely disabled, according to some estimates. Recurring symptoms can make it impossible to return to work full-time, adding financial strain to an already stressful situation.
Some people turn to the Social Security Disability Insurance (SSDI) program, which provides benefits to workers who have long-term disabilities. This is an insurance program financed by workers and their employers through FICA taxes, and it’s an important program to understand.
There are factors unique to MS that can make it difficult to determine whether you’ll qualify for benefits.
There are three major issues to consider when determining whether it’s the right time to apply for SSDI: your age and work history, the length of your disability, and your condition at the time you apply.
SSDI eligibility is based on a worker’s earnings over a certain number of years, and a minimum work history is required in order to be eligible. Exact numbers vary depending on income and age, but generally, you can earn four credits per year. You need at least 20 credits to be insured under SSDI. The older you are, the more credits you’ll need. A professional Social Security disability representative can help determine if you have the required work credits to be eligible.
Younger applicants have less opportunity to pay FICA taxes, which is critical considering that MS diagnoses tend to come at younger ages than many other disabilities. The Social Security Administration (SSA) has more stringent rules applicable to younger individuals – those under age 50 – than for those 50 and older. So it’s important to have documentation of your work and medical history.
It’s also important to be able to demonstrate a long-term disability. Given the progressive and unpredictable nature of MS, someone who is clearly disabled by MS may not meet the SSA’s strict eligibility standards. A MS relapse may prevent someone from working for several months at a time, but you must be unable to work for at least 12 months to be eligible for SSDI.
Determining your condition can be complicated because MS is difficult to quantify. To guide them in this effort, the SSA refers to a “Listing of Impairments,” which describes medical conditions that are so severe the SSA presumes any person who has a medical condition(s) that satisfies the criteria of a listing is unable to perform any gainful activity and, therefore, is disabled.
There are several ways to satisfy the medical listing (11.09) criteria for MS:
• Significant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements or gait and station.
• Visual impairments with either best corrected vision in the better eye of 20/200 or less, marked contraction of peripheral visual fields to 10° or less from the point of fixation or visual efficiency in the better eye of 20 percent or less.
• Organic mental disorder with marked restrictions.
• Significant, reproducible fatigue of motor function with substantial motor 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 MS process. For example, an individual requiring assistive devices to ambulate secondary to MS would be a listing level impairment.
In addition to the “medical listings,” a younger individual may be found disabled if he/she is limited to less than a full range of sedentary work and/or his/her impairment precludes him/her from meeting the basic mental demands of remunerative, competitive employment.
Decisions are made on a case-by-case basis. It’s important to be able to demonstrate the effect MS has on your life through documentation, such as doctors’ reports and journals. Even if you aren’t ready to apply, gathering those documents now can simplify the process down the road.
Because these factors can make it difficult to know when to apply for SSDI, you should consider asking a professional for guidance.
If you’re not ready, it’s still important to educate yourself on the process, prepare medical and work histories, doctors’ reports, and personal activity logs. Make financial plans in the interim. When you’re ready to apply, a professional representative can help collect information and fill out forms, gather medical records, complete the necessary paperwork, ensure deadlines are met, and be your advocate throughout the process.
Applying for SSDI is stressful, and the unique characteristics of MS can complicate the process further. Preparing yourself beforehand can help.
Jim Allsup is the founder and CEO of Allsup, a nationwide provider of Social Security Disability Insurance representation and Medicare plan selection services. Allsup offers free disability eligibility evaluations. For more information visit: www.Allsup.com or call 800-678-3276.
(Last reviewed 5/2012)