Can you get Social Security disability for Multiple Sclerosis?

Indiana claimants diagnosed with multiple sclerosis may qualify for Social Security Disability Insurance or Supplemental Security Income benefits.

Multiple sclerosis is a neurological condition affecting nearly one million people in the United States. It is a disease in which the myelin sheaths surrounding nerve fibers in the brain and spinal cord are damaged, disrupting the signals those nerves carry. MS is most commonly diagnosed in young adults and is roughly three times more common in women than men.

Symptoms of multiple sclerosis

MS takes several forms and can produce new symptoms with each relapse. Symptoms may include:

• Weakness or numbness in the limbs
• Loss of vision, usually in one eye at a time
• Pain on eye movement
• Electric shock sensations with head movement
• Loss of coordination and balance problems
• Problems with speech
• Fatigue
• Cognitive difficulty, including problems with memory, processing speed, and concentration
• Bladder and bowel problems
• Heat sensitivity, where symptoms worsen with increased body temperature

Symptoms typically occur in attacks or relapses, during which neurological function is significantly reduced for an acute period. About 85 percent of people are initially diagnosed with the relapsing-remitting form.

What causes MS

Research continues, but three factors are generally thought to contribute.

Genetics. MS is not inherited in a straightforward way, but susceptibility increases where a family member has it. The general population risk in the United States is roughly three in a thousand. For a first-degree relative, such as a child or sibling of someone with MS, the risk rises to around 3 or 4 percent.

Environmental factors. MS is more common farther from the equator, and reduced sunlight exposure and lower vitamin D levels have been implicated.

Infections. Epstein-Barr virus, the virus that causes glandular fever, is now the strongest candidate. Research published in recent years suggests it may be a necessary factor, though not on its own a sufficient one, since the great majority of people infected with it never develop MS. Other microbes have been suggested as triggers without the same support.

How Social Security evaluates multiple sclerosis

Multiple sclerosis appears in the Listing of Impairments at listing 11.09, within Section 11.00, Neurological Disorders.

The listing is characterized by A or B. These are alternatives, and you need only one of them.

11.09A: motor function

Disorganization of motor function in two extremities, resulting in an extreme limitation in the ability to stand up from a seated position, balance while standing or walking, or use the upper extremities.

Two extremities means both legs, both arms, or one arm and one leg. Disorganization of motor function means interference with movement, and the upper extremities include fingers, wrists, hands, arms, and shoulders. Social Security looks for evidence of paresis or paralysis, tremor, ataxia, or other involuntary movements that significantly interfere with walking or with the use of the arms and hands.

Note the word extreme. This is the higher of Social Security’s two severity thresholds, and it is a demanding standard.

11.09B: physical and mental functioning

A marked limitation in physical functioning, together with a marked limitation in one of the following:

• Understanding, remembering, or applying information
• Interacting with others
• Concentrating, persisting, or maintaining pace
• Adapting or managing oneself

This route asks for marked rather than extreme limitation, which is a lower threshold, and for many claimants it is the more realistic path.

Why the cognitive side is often where the claim is won

This is worth understanding, because it is the most commonly missed part of an MS claim.

Cognitive difficulty is common in MS. Problems with processing speed, memory, and sustained attention are a recognized feature of the disease, not an incidental complaint. Yet MS files are frequently built almost entirely around mobility, because that is what a neurological examination measures most readily.

Route B requires a marked limitation in one of four areas of mental functioning, and those cognitive symptoms map directly onto concentrating, persisting, or maintaining pace, and onto understanding, remembering, or applying information.

If cognitive symptoms are part of how MS affects you, formal neuropsychological testing is worth pursuing. A general statement that a patient reports brain fog does very little; quantified testing does a great deal. Ask your neurologist whether cognitive assessment can be arranged.

Relapsing MS and the good-day problem

MS symptoms fluctuate, and someone examined during a remission may present far better than they function across a month.

Social Security looks at the overall pattern rather than a snapshot: how often relapses occur, how severe they are, how long they last, and how completely you recover between them. Your records should support that picture, which means a longitudinal history rather than a single assessment.

This is also the answer to a question relapsing MS naturally raises. Your condition has to have lasted, or be expected to last, at least twelve months, and a course that improves between attacks does not fail that test. It is the pattern over time that counts, not any single good stretch.

Where relapses leave residual deficits that do not fully resolve, that progression is worth documenting explicitly, since it distinguishes a worsening course from a stable one.

If you do not meet the listing

If your condition does not meet or equal listing 11.09, you may still win your claim. Social Security assesses your residual functional capacity, and MS may prevent you from performing substantial gainful activity even where the listing criteria are not satisfied.

An inability to stand, sit, or walk for extended periods, or an inability to stay on task, can each support a finding of disability.

Several features of MS deserve particular attention here:

Fatigue. This is the most common disabling symptom of MS and frequently the one that ends a person’s working life. It is also invisible on examination and produces no test result, so it has to be documented through description: how long you can sustain activity, what a typical afternoon looks like after a normal morning, and how often you need to rest.

Heat sensitivity. Many people with MS experience a temporary worsening of symptoms when their body temperature rises, whether from warm weather, exertion, or even a hot shower. This is characteristic of the condition and has real vocational consequences, since it rules out warm work environments and physically demanding work. It is also easy to leave out of a file because it is intermittent.

Cognitive symptoms, as above, which affect pace and reliability as much as any physical limitation.

Bladder urgency, which creates the same practical problem as any bowel or bladder condition: unpredictable, frequent interruptions that employers do not accommodate.

Vision problems, including optic neuritis and double vision, which may also be relevant under the special senses listings in Section 2.00, at 2.02 for loss of visual acuity and 2.04 for loss of visual efficiency.

Unpredictability and absences. Relapses give little warning. Vocational experts routinely testify that employers will not tolerate more than about two absences a month, and a relapsing condition makes any given month uncertain.

Medication effects, including fatigue and flu-like symptoms from disease-modifying therapies, and drowsiness from medications used for spasticity or pain.

Your age, education, and work history matter at this stage too. A claimant of 50 or older with no transferable skills is in a considerably stronger position than a younger claimant with identical limitations, and at 55 the vocational rules shift again in the claimant’s favor. Since June 22, 2024, Social Security also looks only at work performed in the previous five years rather than fifteen.

The evidence your claim needs

• MRI imaging showing demyelinating lesions, with the full reports
• Neurology treatment records covering an extended period
• A relapse history, with dates, duration, and the extent of recovery
• Examination findings covering strength, coordination, gait, and reflexes
• Neuropsychological or cognitive testing where cognitive symptoms are present
• A record of disease-modifying therapies tried, and their effects
• Documentation of any assistive device and the medical need for it
• A medical source statement addressing standing, walking, use of the hands, time off task, and expected absences

Statements from people who see you regularly can help too, particularly with fatigue and cognitive symptoms, which are difficult to convey in a brief appointment and easy for a claimant to understate.

Talk with an Indiana disability attorney

If multiple sclerosis is preventing you from working, contact my office for a free consultation.

Two things are worth checking early in an MS claim. Whether anyone has quantified the cognitive side, since route B needs it and most files are built around mobility instead. And whether your records describe fatigue in terms of what you can sustain, rather than recording it as a single word in a symptom list.

I represent Indiana residents at every stage, from the initial application through a hearing before an Administrative Law Judge.