Multiple Sclerosis and Long-Term Disability Benefits in Canada

Living with Multiple Sclerosis (MS) can be challenging and unpredictable, impacting various aspects of daily life, including work. For individuals facing the complexities of MS, seeking long-term disability (LTD) benefits may become necessary to ensure financial stability and access to essential medical care.

Understanding Multiple Sclerosis

Multiple Sclerosis is a chronic autoimmune disease that affects the central nervous system, including the brain, spinal cord, and optic nerves. According to Multiple Sclerosis Canada, there are about 90,000 Canadians living with the disease, and about 12 Canadians are diagnosed with MS every day (on average). Most people diagnosed with MS are between the ages of 20 and 49 years old.

In MS, the immune system mistakenly attacks myelin, the protective covering of nerve fibers, leading to inflammation, damage, and disruptions in nerve signaling. This can result in a wide range of symptoms such as fatigue, mobility issues, vision problems, pain, cognitive changes, and more. MS symptoms can vary widely among individuals and may fluctuate over time, making it a complex and challenging condition to manage.

Multiple Sclerosis and Long-Term Disability

The unpredictable nature of MS symptoms, their progressive nature in some cases, and the potential for relapses or exacerbations can significantly impact an individual’s ability to work consistently and perform job duties effectively.

Several MS symptoms can significantly impact a person’s ability to work. Here are some of the key symptoms that may interfere with work capacity:

Fatigue:

Chronic and debilitating fatigue is a common symptom in MS, affecting up to 80% of individuals with the condition. Fatigue can be physical, mental, or both, and it can significantly reduce energy levels, cognitive function, and overall productivity at work.

Apart from general fatigue, MS-related fatigue can cause additional symptoms such as muscle weakness, reduced stamina, cognitive fog, and difficulties with concentration and memory. These fatigue-related symptoms can significantly impair work capacity, especially during prolonged or demanding work hours.

Mobility Issues:

Many individuals with MS experience difficulties with mobility due to muscle weakness, spasticity, balance problems, and coordination issues. These mobility challenges can affect the ability to stand, walk, climb stairs, or perform tasks that require physical dexterity, especially in roles that involve manual labor or prolonged periods of standing or walking.

Cognitive Changes:

MS-related cognitive changes can include difficulties with memory, attention, concentration, problem-solving, and processing speed. These cognitive impairments can impact work tasks that require sustained focus, multitasking, information retention, decision-making, and complex problem-solving.

Visual Disturbances:

Optic neuritis, a common symptom of MS, can cause vision problems such as blurred vision, double vision (diplopia), and pain with eye movement. Visual disturbances can affect reading, computer work, driving, and other visually demanding tasks necessary for various occupations.

Pain and Sensory Symptoms:

MS can cause neuropathic pain, tingling sensations, numbness, and sensory disturbances in different parts of the body. Pain and sensory symptoms can affect manual tasks, fine motor skills, and overall comfort levels during work activities.

Bladder and Bowel Dysfunction:

Some individuals with MS experience bladder and bowel dysfunction, including urinary urgency, frequency, incontinence, and constipation. These symptoms can cause discomfort, interruptions during work hours, and the need for frequent bathroom breaks, impacting work productivity and focus.

Emotional and Psychological Impact:

Dealing with a chronic and unpredictable condition like MS can lead to emotional distress, anxiety, depression, and mood changes. Emotional well-being plays a crucial role in work performance, interpersonal relationships at work, and overall job satisfaction.

Heat Sensitivity:

Many individuals with MS experience sensitivity to heat, known as Uhthoff’s phenomenon. Heat can exacerbate MS symptoms such as fatigue, weakness, and cognitive difficulties, making it challenging to work in environments with high temperatures or limited cooling options.

Is Multiple Sclerosis Covered by my LTD Policy?

Most LTD policies cover disabilities that prevent individuals from engaging in the substantial duties of their occupation. Given the disabling nature of MS and its impact on daily functioning, including work capacity, MS-related disabilities often meet the criteria for LTD coverage. However, policy specifics, waiting periods, and the need for comprehensive medical documentation are crucial factors in determining coverage and eligibility.

Multiple Sclerosis Disability Benefits

To support your MS-related disability claim, you may need:

Comprehensive Medical Records:

Detailed documentation of MS diagnosis, symptoms, treatment history, functional limitations, and specialist reports are essential.

Neurologist and Healthcare Provider Statements:

Reports outlining the progression of MS, specific symptoms affecting work capacity, treatment responses, and recommendations for accommodations or modifications at work.

Functional Assessments:

Objective assessments or tests to evaluate cognitive function, mobility, fatigue levels, and other relevant factors impacting work ability.

Employer Statements:

Documentation highlighting work-related challenges, accommodations provided, job modifications, attendance records, and performance evaluations related to MS symptoms.

Can My Disability Benefits Be Denied?

While MS-related disabilities are often eligible for LTD benefits, denials can occur due to various reasons:

Incomplete Documentation:

Insufficient or inconsistent medical evidence documenting the severity, impact, and functional limitations caused by MS symptoms.

Policy Interpretation:

Policy-specific limitations, exclusions, or interpretations related to MS-related disabilities that may differ among insurance providers.

Medical Assessments:

Insurance companies may request independent medical examinations (IMEs) or functional capacity evaluations (FCEs) to assess work capacity and disability status, leading to discrepancies or challenges in assessments.

What To Do If My LTD Benefits Have Been Denied?

If your LTD benefits for MS-related disabilities are denied:

Review Denial Letter:

Carefully review the denial letter to understand the reasons for denial, appeal deadlines, and required documentation.

Gather Additional Evidence:

Collect additional medical records, specialist opinions, functional assessments, and any new evidence supporting the severity and impact of MS on work capacity.

Submit Comprehensive Appeal:

Prepare a detailed appeal with supporting documentation addressing the reasons for denial, medical evidence, functional limitations, and accommodations needed.

Legal Assistance:

Consider seeking legal representation from a disability lawyer experienced in handling LTD denials related to MS. A lawyer can navigate the appeals process, strengthen your case, and advocate for your rights and benefits.

Contact a Disability Lawyer About Your LTD Denial Today

Navigating LTD benefit denials for MS-related disabilities requires a strategic approach and strong advocacy. Our disability lawyers at Preszler Injury Lawyers understand the complexities of MS and LTD claims, and we are dedicated to helping you secure the benefits you deserve. Contact us today for a consultation to discuss your case, review your options, and take proactive steps toward appealing your LTD denial effectively.