Social Security Disability Application Experiences of People With Multiple Sclerosis in the United States

Studies suggest that more than half of working-age Americans with multiple sclerosis (MS) are unemployed because of their health. Many turn to public disability insurance for income support, applying through the Social Security Administration for either Social Security Disability Insurance (SSDI), which provides benefits to formerly employed people, or Supplemental Security Income (SSI), which supports impoverished individuals. Anecdotal reports suggest that many patients with MS face considerable problems when applying for federal disability benefits. To gather more systematic information about these experiences, we surveyed 983 working-age people with MS nationwide from May through November 2005. Most (60.2%) were unemployed; 36.4% had federal disability insurance, with 27.8% having SSDI alone. Almost one third (31.3%) had their initial SSDI application denied, and 31.9% used legal assistance when applying for this benefit. Although the time elapsed between SSDI application and approval was <12 months for 60.4% of applicants, 12–23 months passed for 19.8% and 24+ months for another 19.8%. Among people without SSDI, 15.4% had applied for this benefit at some time. Failure to meet disability criteria caused 60.3% of rejections, and inadequate documentation contributed to 32.1%. Neurologists must fully document the breadth of MS-related impairments in their patients' disability applications.