Are the symptoms of Multiple Sclerosis preventing you from doing your job? Have you finally decided to apply for short or long-term disability benefits, or are you facing a disappointing denial of your claims and don’t know where to go from here?
This article is discusses the unique challenges of winning disability benefits for Multiple Sclerosis in Canada. It is part of our series looking at medical conditions and disability benefits.
Disability from Multiple Sclerosis: You’re Not Alone
MS is a chronic, neurological disease that attacks the central nervous system, which includes the spinal cord, the optic nerves, and the brain. It is three times more common in women than in men and typically first appears between the ages of 20 and 40 – when people traditionally first enter the workforce.
Shockingly, Canada has one of the highest rates of MS worldwide. Current figures estimate that one in every 450 Canadians struggles with long-term symptoms of MS. Getting a definite diagnosis for MS is anything but simple and straightforward – there is no specific test that determines whether someone suffers from MS or not, and MS is usually only diagnosed once doctors have eliminated all other possible causes.
No two sufferers of MS will experience the exact same disease, but MS can cause impaired speech, blurred vision, and dizziness amongst other symptoms; sufferers of MS often also struggle with bladder and bowel dysfunctions, and – in some cases – paralysis. Spams and tremors are further common symptoms.
On top of these physical problems, MS patients often suffer from mental health conditions such as depression and will experience cognitive impairments such as problems with memory and thinking.
If you suffer from MS, you are probably already very well aware of these symptoms and the grave extent to which they can make it impossible to hold down a job and go into work every single day.
Which disability benefits for MS do I qualify for?
Once you find yourself in the position of having to claim long-term disability benefits for MS in Canada, it’s crucial to know that you might be eligible for one of two types of disability benefits if you have been working recently.
These two types of disability benefits are the Canada Pension Plan (CPP) disability benefits and the long-term disability insurance benefits.
CPP disability for Multiple Sclerosis
You might not be aware that the CPP, designed to support you and your family after you retire, also covers disability benefits that start once you become disabled and last until you are 65.
After that, these disability benefits are converted into regular pension payments. But in order to be eligible for the CPP disability benefits, you have to have worked for four out of the past six years and paid payroll taxes. This can sometimes be difficult for MS patients, who might have worked part-time or taken short-term leaves in the past to cope with their illness.
And there are other conditions, too — the CPP requires you to prove that your disability is both prolonged and severe, leaving you completely unable to work. This can be difficult when it comes to an illness such as MS, which often comes and goes in waves when it first appears in a patient.
Long-term Disability Insurance Benefits for Multiple Sclerosis
The second type of disability benefits that you might be eligible for are the long-term disability insurance benefits. This type of group disability insurance policy is the most common type of disability insurance in Canada.
If your employer has insured you as part of a group, you are automatically receiving your disability insurance through your job. These group disability insurance policies provide both long-term and short-term disability benefits, which can be great for MS sufferers. If you are suffering from Multiple Sclerosis and are no longer able to work, you can apply for these long-term disability benefits if you qualify.
If successful, these benefits will provide you with monthly income payments during long absences from work to relieve the financial pressure.
How to win disability benefits for Multiple Sclerosis
Applying for long-term disability benefits is never simple and a successful claim always requires careful preparation. If you are applying for benefits for MS, you are facing a unique set of challenges that you need to be aware of before you send in your paperwork.
1. The difficulties of the relapse/remission cycle of Multiple Sclerosis
As mentioned above, MS is often characterized by a cycle of relapse and remission, especially when it first emerges. Therefore, winning disability benefits can be very tricky when all you have is an early diagnosis.
The benefits you are looking to claim are long-term benefits; but the early stages of MS often lead to a short-term disability instead, which disqualifies claimants from long-term payments. A person suffering from MS will often spend years going on and off of work leading up to the moment when they make a final disability claim because they can no longer cope with going back to work.
While this claim is perfectly justifiable, insurance companies will focus on this past pattern of leaving and returning to work and question why this time would be different and why they should now all of a sudden pay for long-term benefits.
It is therefore absolutely critically to document your illness diligently and have evidence to back up your claim to explain why this time is different – why you can’t simply go back to work like before.
2. Getting your doctors on board
Your doctors should be on your side, and they usually are – they want the best for you and your health.
The problem here is that it can take a long time for doctors to get on board with supporting your claim for long-term disability benefits.
This is often due to a misunderstanding; doctors aren’t always aware of the criteria that are needed to win long-term disability benefits. It is therefore important to educate your doctor on what criteria you need to fulfill to be able to win benefits for multiple sclerosis and get the most out of their support.
3. Insurance companies and video surveillance
MS is known for its intense ups and downs; the severity of symptoms varies a lot, especially in the early stages of diagnosis. This can be a blessing and a curse at the same time.
When you are suffering from MS, worrying about how it might look when you are able to enjoy a good day without symptoms is probably the last thing on your mind. Unfortunately, disability insurance companies won’t scare away from taking advantage of this.
It is, in fact, very common for disability insurance companies to conduct video surveillance to obtain footage of the disability benefits claimant on a good day, when they are out and about being active – and use this to claim that they have proof that there is actually no disability in the first place and that the claimant does not have the right to disability benefits. It is shocking to what length insurance companies will go, but I have seen it all.
Insurance companies will take the video in secret and at the same time question the claimant over the phone about their condition. They do this to elicit statements from the claimant that can be viewed as inconsistent with what is seen on tape to undermine their disability benefits claim and get out of the payment. This is a very unusual challenge and a trick that anyone claiming disability benefits for should be aware of to anticipate the possibility of video surveillance.
What to do if you’ve been denied disability benefits for Multiple Sclerosis
You’ve filled out the forms, and you’ve compiled as much evidence as you could get – and yet, the disability benefits insurance companies are denying you the right to disability benefits, effectively forcing you back to work with Multiple Sclerosis.
This is a difficult time, I am well aware of that – I’ve seen it over and over again with my clients. A rejection can feel like a slap in the face, especially if you have in the past always pushed yourself hard to be able to go back to work after a period of relapse and are now physically unable to do so anymore, deciding to finally apply for long-term benefits. A denial can feel like your symptoms are not taken seriously and often adds considerable stress and pressure on top of the physical and cognitive symptoms of MS.
The good news is that you don’t have to simply accept that your rightful claims have been denied. You can appeal the insurance company’s decision, and in most cases, you absolutely should. I have years of experience with disability benefit claims and a lot of experience with disability claims for MS specifically. More than that, I know what you are going through, and I am confident that I can help you. You don’t have to let insurance companies get away with denying you the support you are entitled to by law.
If you would like to learn about alternatives if your claim is denied and inform yourself about the appeal process, you can take a look at my books, which you can order for free to help you consider all your options.
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