When Multiple Sclerosis Comes and Goes: The Disability Trap of a Waxing and Waning Disease

Welcome to Season 2, Episode 18 of Winning Isn't Easy: Navigating Your Social Security Disability Claim. In this episode, we'll dive into When Multiple Sclerosis Comes and Goes: The Disability Trap of a Waxing and Waning Disease.

What happens when a disabling disease doesn’t look disabling all the time? For many people living with multiple sclerosis, that unpredictability can become one of the biggest obstacles to obtaining Social Security disability benefits. While MS is a serious neurological disease, proving disability under Social Security law is not as simple as presenting the diagnosis itself. In this episode of Winning Isn’t Easy, we examine why multiple sclerosis claims are often denied despite significant symptoms and functional limitations. We discuss how the cyclical nature of MS - with periods of relapse and remission - can make the condition difficult for Social Security judges to evaluate, especially when claimants continue working through flares or experience temporary improvement after stopping work. We also explore the critical importance of documenting MS flare-ups, fatigue, cognitive impairment, absenteeism, and time off task, all of which can play a major role in whether a claim is approved or denied. If you’re applying for Social Security disability benefits based on multiple sclerosis, this episode offers a clearer understanding of what Social Security looks for, and why the strongest cases depend on far more than the diagnosis alone.

In this episode, we'll cover the following topics:

One - Understanding Multiple Sclerosis and Social Security Disability

Two - How One Social Security Judge Rejected the Waxing and Waning Nature of Our Client’s Medical Condition

Three - Workplace Absenteeism Because of Multiple Sclerosis and Your Social Security Disability Claim

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Listen to Our Sister Podcast:

We have a sister podcast - Winning Isn't Easy: Long-Term Disability ERISA Claims. Give it a listen: https://wiedisabilitypodcast.buzzsprout.com


Resources Mentioned In This Episode:

LINK TO YOUR RIGHTS TO SOCIAL SECURITY DISABILITY: https://mailchi.mp/caveylaw/your-rights-to-social-security-disability-benefits

FREE CONSULT LINK: https://caveylaw.com/contact-us/


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Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

Transcript

Nancy Cavey [00:00:11]:
 What happens when a disabling disease doesn't look disabling all the time? Now, for many people who have ms, that unpredictability can become the very reason that their Social Security disability claim is denied. Welcome back to Winning Isn't Easy. Social Security Disability Benefits this is a podcast where we break down everything you need to know about navigating the Social Security claims process. I'm your host, Nancy Cavey. Before we get started, I've got to give you a legal disclaimer. This podcast isn't legal advice. The Florida Bar association says I have to say this, but now that I've said it, nothing will prevent me from giving you an easy to understand overview of the Social Security disability claims process, the games that are played, and what you need to know to get the disability benefits you deserve. So off we go.
 
 Nancy Cavey [00:01:00]:
 Now, if you think that a diagnosis of multiple sclerosis automatically qualifies you for Social Security disability benefits, I want you to think again. Ms. Is a serious, progressive neurological disease. But proving you are disabled under the Social Security law is often more complicated than simply having a diagnosis. I found that one of the biggest challenges in an Ms. Claim is is the nature of the disease itself. Ms. Often waxes and wanes.
 
 Nancy Cavey [00:01:28]:
 Symptoms can flare up suddenly. They can cause severe fatigue, pain, cognitive problems, and mobility limitations, and then partially improve weeks or months later. These cycles of relapse and remission can make it very difficult for the Social Security administration to evaluate the claim. And if we are in a hearing stage of a case, I will tell you that Social Security judges often look closely about whether a person is able to work despite their symptoms. So if you are managing to work through several Ms. Flares or if your symptoms appear less severe after you stop work, Social Security judges are going to try to figure out whether in fact your condition is disabling, even when the medical reality is much more complicated. So in this episode, I'm going to talk about how multiple sclerosis is evaluated by Social Security disability, why documenting flares is crucial and critical, and how to do it properly and how absenteeism and time off tasks can ultimately determine whether or not your disability claim for Ms. Is approved.
 
 Nancy Cavey [00:02:34]:
 So let's get started. I'm going to talk about three things today. One, understanding Ms. And Social Security disability. Two, how one Social Security judge rejected the waxing and waning nature of our clients medical conditions and 3 workplace absenteeism because of Ms. And your Social Security disability claim. But before we get started, let's take a quick break.
 
 Narrator of Disability Insurance Advertisements [00:02:58]:
 Are you considering filing for Social Security disability or has your claim been denied already? Either way, you require a copy of your rights to Social Security disability benefits, which will cover everything you need to know about the Social Security disability claims process. Request your free copy of the book@kvlaw.com today.
 
 Nancy Cavey [00:03:23]:
 Understanding Ms. And Social Security Disability Multiple sclerosis, known as MS, is a chronic autoimmune disease that affects the central nervous system that includes the brain and the spinal cord. In ms, the immune system mistakenly attacks the the protective covering of the nerve fibers called myelin, and this damages and disrupts the communication between the brain and the rest of your body, which can lead to a wide range of neurological symptoms. I think of Ms. As attacking, if you will, the coating on an electrical wire. You know, that coating that prevents you from getting shocked. Well, Mississippi is attacking that so that the coating is basically gone, destroyed. Now, Ms.
 
 Nancy Cavey [00:04:08]:
 Is often unpredictable and may progress differently for each individual. Many people can experience periods when their symptoms worsen, and that's known as flares or relapse. And then it can be followed by periods of partial or complete remission called remissions. Okay? Now, this pattern is referred to as waxing and waning, meaning that the condition can improve and worsen over time. There are different types of MS, commonly known as relapsing, remitting, RRMs, secondary progressive SPMs, and primary progressive PPMs. Now, relapsing remitting is the most common form of MS, and it's characterized by clearly defined attacks followed by recovery periods. In my experience, sometimes individuals transition to secondary progressive ms, where the disability is gradually worsening. Now, primary progressive Ms.
 
 Nancy Cavey [00:05:04]:
 Involves a steady progression of symptoms without distinct relapse. It's almost like a straight line, if you will. Now, Social Security needs to understand your particular symptoms of ms, and as I've said, they can vary widely from person to person, but commonly they'll involve fatigue, muscle weakness, stiffness, spasticity, chronic pain, vision problems, balance, coordination difficulties, and cognitive impairments. Some people also experience depression or emotional changes related understandably to the disease. Now, because Ms. Symptoms can fluctuate and worsen over time, that can impact your ability to work. And in severe cases, Ms. Can cause long term disability.
 
 Nancy Cavey [00:05:48]:
 That might make you eligible for long term disability insurance benefits if you have a policy or Social Security disability benefits. It's the problem that we see that can cause a denial of claims. And that's when a person is attempting to work with difficulty and particularly returns to work when they're in remission or they're continuing to work but their symptoms are not yet disabling enough, if you will, to establish that they can't do their past work or other work. And that's where it can be difficult to and I think it's important that clients understand those issues, but more importantly, how to address these types of issues in their medical records. So let's take a break and when I come back, I'm going to talk about how one Social Security judge rejected the waxing and waning nature of our client's medical condition. Because I think in part the judge simply didn't understand or didn't want to understand. Got it. Foreign.
 
 Nancy Cavey [00:07:04]:
 Welcome back to Winning isn't Easy how one Social Security judge rejected the waxing and waning nature of our clients medical conditions. Now, as you know, there are a number of medical conditions that can wax and wane over time which can make it difficult to win a Social Security case. We recently had a case and I thought we had a really good chance of winning, but unfortunately the Social Security judge, known as an administrative law judge, disagreed. So our client MG had Ms. With Ms. Flares. These flares were well documented in her medical records and she testified about the flares she had before she stopped work and why she stopped work and applied for her benefits. But unfortunately, she had managed to work through each one of the flares.
 
 Nancy Cavey [00:07:49]:
 And the judge actually was somewhat impressed that she worked, but nonetheless said that the flares didn't interfere with her ability to work before she stopped work, which I think is crazy. Now, the judge also looked at her number of flares and the nature of her flares after she stopped working. So the question in the judge's mind is what happened to these flares? And she had only had one flare since she stopped work. And it was probably because she had stopped work. The judge ruled that the Ms. Flares weren't severe enough from preventing her to do the lightest job she'd done in the five years before she became disabled. And as a result, her claim was denied. Now I think this is a crappy result, but we learned some lessons about how to document multiple sclerosis flares and the timing of filing a claim.
 
 Nancy Cavey [00:08:40]:
 So the outcome could have been different if the medical records had documented the the nature of the flare, the length of the flare had lasted, the frequency of the flares, and that her physician had instead taken her out of work as opposed to her trying to power through these flares. So it was the nature of the flares, the symptoms of the flares, how long they lasted, how long they interfered with her ability to function and when she had returned to work, what continuing problems she had as a result of the flares. Now, in my experience, many times these flares will leave residual symptoms and functional issues. And those are the things that need to be emphasized in the medical records. In other words, I had the flare, location, duration, intensity, was able to go back to work. But I continue to have these symptoms, location, duration, intensity, frequency. And even though they may not have been as bad as they were when I had the flare, they still impacted my ability to function X, Y and Z ways. The other problem with the medical records was that they should have documented why she eventually stopped work and the fact that her physician had basically told her to stop work.
 
 Nancy Cavey [00:09:59]:
 And the record, again, should have documented the progression of the symptoms of from the last flare to the point in time in which she stopped working. So the timeframes I think are really important to document are, here's the flare. This is what happens in the flare. I've gone back to work. Here are the problems that I am still having. And by the way, here's a progression of my symptoms. My symptoms are still so bad that I can't work. And here's what they are, and here's why I can't work on, on a permanent basis.
 
 Nancy Cavey [00:10:33]:
 So I think you need to really document those three distinct stages in an Ms. Case to be successful. It's your medical records, your medical history, the progression of the disease, and the information you're giving to the doctor about how those symptoms are impacting your functionality that is really key. Got it. Let's take a break.
 
 Narrator of Disability Insurance Advertisements [00:10:57]:
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 Nancy Cavey [00:11:27]:
 Welcome back to Winning isn't Easy. Let's talk about workplace absenteeism because of your Ms. And your Social Security disability claim. Is your absenteeism because of Ms. Causing problems with your supervisor? Are you getting written up? Do you think you're going to be terminated? If so, there's some things that I think you need to do before you stop work and apply for your benefits. So let's talk about workplace absenteeism first. According to new research that assesses how Ms. Affects work productivity in the United States, it was found that Ms.
 
 Nancy Cavey [00:12:02]:
 Patients miss a mean of nine Work days per year. Now, that varied geographically with patients in the Northeast reporting higher, significantly higher rates of absenteeism, about 70% higher than those in the Midwest or the West. Why is that? Well, the researchers thought that it was due to environmental conditions such as cold weather that could have a negative impact on the functionality of nerves and muscles, and that in turn could lead to an increase in pain, mobility and missed time from work. Let's talk about the common disabling symptoms that can impact a person's ability to work and cause absenteeism issues. They can include chronic pain, fatigue, depression, muscle stiffness, visual impairment and cognitive impairment. Why is that important? Well, in a Social Security case, one of the key elements to winning the case is the time off task and absenteeism. And so in a vocational world, in the context of a Social Security case, I will tell you that vocational experts opinions about those very things are crucial. Now, vocational experts are generally of the opinion that an employee cannot miss more than one to two days of work per month and keep their job.
 
 Nancy Cavey [00:13:24]:
 So if the studies are showing that people are missing at least nine days, we're not necessarily quite there, which is why also I think that off task is an issue. But let's concentrate first on why absentee is a factor. The claims process requires at step four that you are unable to perform the lightest job you held in in the five years before your claim is decided. And at step five, you have to prove that you're unable to do other work in the national economy in view of your age, education, skills and whatever your functional restrictions and limitations are. Now, obviously in steps four and five, the issue is can you maintain full time employment and what's your level of absenteeism and what's the level of time you're off task? So as a general rule, if you miss at least one to two days a month per week, Social Security and the judge will probably find you're entitled to benefits. But I think that that's only one factor. Remember I said that time off task is crucial. I think that it is really important that your doctor is documenting your absenteeism, but that they're also documenting your chronic pain, fatigue, depression, muscle stiffness, visual issues, cognitive impairment that impact your ability to maintain pace and production.
 
 Nancy Cavey [00:14:39]:
 If you're off task at least 20% of the time because of a combination of your symptoms or other medical conditions, a vocational evaluator is going to say that you can't maintain full time employment. One of the most important forms that I use in a Social Security Ms. Case is what's called an Ms. Residual Functional Capacity Form. And we Social Security lawyers have developed these forms. Most doctors aren't familiar with them generally, but most Ms. Doctors are. They're not, however, going to whip out the form and say, hey, I want to fill this out for you.
 
 Nancy Cavey [00:15:11]:
 So we give the Ms. Form to our clients and to have them take them to our doctors. Now, we work closely with a number of Ms. Physicians, and they know that Nancy Kavy's client is going to come in with one of those Ms. Residual functional capacity forms, whether you're represented or not. I think that that form is really crucial because it's going to quantify objectively your functional restrictions and limitations, your cognitive restrictions, and potentially your psychological restrictions. So how long you can sit, stand, walk, stoop, bend. General questions but how many days of work per month would you miss and how much time would you be off task? If I'm in front of a Social Security judge, I'm pounding on those things in the hypothetical, but let's say you're at the initial application stage.
 
 Nancy Cavey [00:16:01]:
 I have our clients submit that Ms. Residual Functional Capacity form, or even at the recon stage, because I want Social Security to see actual documentation of not only the person's functional limitations, but to see information about number of days they're going to miss and time off task. It's that whole picture, I think, that makes the difference between winning and losing your Ms. Case. So that's it for today's episode, Winning Isn't Easy. If you found this episode helpful, please take a moment to like our page, leave a review, share it with your family and friends, and of course, subscribe to this podcast. Join us next week for another insightful episode of Winning Isn't Easy. Thanks for listening.