Multiple sclerosis (MS) is a chronic neurological disorder that disrupts communication between the brain and the body. This autoimmune disease causes a range of devastating symptoms that can significantly impact an individual’s ability to work.
While some people with MS may continue working for years, others experience progressive disability that forces them to leave the workforce. For those unable to work due to MS, long-term disability (LTD) benefits governed by the Employee Retirement Income Security Act (ERISA) can provide essential financial support. Understanding how MS is addressed when it comes to ERISA disability claims is crucial for patients seeking benefits.
ERISA disability insurance and MS claims
ERISA is a federal program that governs employer-provided disability insurance plans. Naturally, the federal law imposes strict rules to help ensure that those who qualify for benefits truly deserve it. This means that applicants should pay keen attention to how they file their claims to increase their odds of securing benefits.
Most applicants with MS are those who tried to maintain employment but were eventually unable to perform their job duties. Since MS symptoms can fluctuate, some individuals experience periods of remission followed by relapses, making steady employment difficult. Over time, the disease may progress to a point where working becomes impossible, necessitating long-term disability support.
Challenges in obtaining ERISA disability benefits for MS
Many LDT applicants with MS may struggle to provide total disability because the symptoms of their illness can be subjective and vary in severity. Insurers may argue that since MS symptoms fluctuate, the applicant may not be permanently disabled.
To demonstrate how their MS symptoms prevent them from performing their job duties, applicants can demonstrate functional limitations by undergoing:
- Functional capacity evaluations
- Neuropsychological testing
- Physician statements
Some insurers may use surveillance or request independent medical evaluations to dispute claims. Due to an applicant’s fluctuating symptoms, insurers may argue that the applicant can work despite their diagnosis.
Living with multiple sclerosis is challenging enough without the added stress of navigating ERISA disability claims. Since MS is progressive, securing long-term disability benefits early on can provide financial stability when working is no longer feasible. However, ERISA’s stringent requirements mean applicants must build a strong case with consistent medical evidence. For this reason, applicants with MS should consider enlisting experienced legal support to improve their chances of approval.