Multiple Sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system. People with MS experience a wide array of symptoms, such as extreme fatigue, lack of coordination, weakness, tingling, impaired sensation, vision problems, bladder problems, cognitive impairment, mood changes, and more. These debilitating symptoms often make it hard for sufferers to work. As a result, many individuals with MS have to turn to disability benefits to help them cope with the life-long disease. However, winning disability benefits for Multiple Sclerosis is no easy task.
Despite the severity of the condition, there are several hurdles sufferers must face in order to get approved for benefits. As part of our series on medical conditions and disability benefits, this article discusses those unique challenges and gives a step-by-step guide on how to win disability benefits for MS.
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. According to current estimates, one in every 400 Canadians suffers from MS. Getting a definite diagnosis for MS is anything but simple and straightforward. To date, there isn’t a specific test that determines whether someone suffers from MS or not. More often than not, MS is only diagnosed once doctors have eliminated all other possible causes.
No two MS sufferers will experience the same symptoms. However, typical symptoms include impaired speech, blurred vision, dizziness, spasms and tremors. People with MS often also struggle with bladder and bowel dysfunctions and – in some cases – paralysis.
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 to work every single day.
Which Disability Benefits Do I Qualify for?
The two most common disability benefits people with MS can claim are the Canada Pension Plan (CPP) disability benefits and long-term disability insurance benefits. Other benefits they may be eligible for include EI, short-term disability insurance benefits, the disability tax credit, and workers’ compensation benefits.
CPP disability for MS
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 to be eligible for the CPP disability benefits, you must 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 MS
The second type of disability benefit that you might be eligible for is long-term disability insurance benefits. This type of group disability insurance policy is Canada’s most common type of disability insurance.
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 MS and can no longer work, you can apply for these long-term disability benefits.
If successful, these benefits will provide you with monthly payments during long absences from work.
Challenges of Getting Approved for 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.
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.
You are looking to claim long-term benefits, but the early stages of MS often lead to a short-term disability, which disqualifies claimants from long-term payments. A person suffering from MS will often spend years on and off work until they make a final disability claim.
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, critical to document your illness diligently and have evidence to explain why this time is different.
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 is that doctors can take a long time to get on board with supporting your claim.
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.
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 what lengths insurance companies will go to, 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 should be aware of to anticipate the possibility of video surveillance.
How to Win Disability Benefits for MS
As discussed earlier, getting approved for disability benefits for MS is no easy task. So here are a few things you can do to improve your chances of winning disability benefits for MS.
Get a diagnosis
Securing a diagnosis of MS can be challenging. However, having a diagnosis will vastly improve your chances of winning disability benefits. Without one you are significantly less likely to get approved. If you haven’t already, book an appointment with your doctor to start your journey to getting diagnosed.
Get the appropriate treatment and document it
When considering your claim, disability benefits providers will look to see if you received the appropriate treatment for your condition. Not getting the right treatment is one of the most common reasons people get denied.
This requirement covers all other conditions as well. For example, if you also have depression along with MS, you must get treatment for each condition. This can include medications, consultations with psychiatrists, or psychological treatments.
Make sure your doctor is accurately documenting all of this as well. At the end of the day, benefit providers base their decisions on the medical documents they have received. Even if you received world-class treatment for MS without the proper documentation, you received no treatment from the insurer’s standpoint.
Evidence of work-related limitations
You will also want to record all the ways in which you have modified your work habits in order to maintain employment while dealing with MS.
You should also try easier jobs within your workplace before you apply. Until you do, the disability benefits providers will always doubt you. You might show that while your job had medium duties on paper, your employer made accommodations to qualify your duties as light.
If you were forced to change jobs as a result of MS, make a note of that too.
Being credibility is key
It is vital that a person seeking disability benefits for MS maintains a level of total honesty throughout the process. Credibility is intensely important when making a legal claim for disability benefits associated with MS. Any exaggerations or inconsistencies in descriptions of pain or disability can hurt credibility, even if the inconsistency is an honest mistake.
Things that hinder your creditability:
- Contradicting medical records or earlier statements
- Making excuses or blaming others for problems
- Criticizing other parties in the claim (even if they deserve it)
- Filing complaints against professionals you see as negative, biased, or unprofessional
- Using aggressive, sarcastic, or confrontational tones in your claim or testimony
- Blocking or stalling reasonable requests for information
- Fighting with doctors over your diagnosis instead of focusing on the disability
- Acting like a medical expert
- Making sure what you say matches the medical records
- Taking responsibility for errors or problems with your claim (not blaming others)
- Being cooperative and respectful of everyone in the claim
- Accepting expert advice and opinions
- Making good faith efforts to try all reasonable advice, even if you disagree with it
- Obvious efforts to keep working
What To Do After a Denial
You’ve filled out the forms, and you’ve compiled as much evidence as you could get – and yet, the insurance company is denying you the right to disability benefits for 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 letter 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 apply for long-term benefits finally. 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 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 benefits 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.
Next Step – Get Your Free Book
Learn more about how to win disability benefits for Multiple Sclerosis by downloading our free books.