Jonathan,
First, I want to thank you for putting valuable information about the SSDI process online. I was diagnosed with MS in 1993. I recently left work on an early disability retirement after a 24 year career with the State of ABC.  My question is this – if I have MS and my medical records document cognitive dysfunction, isn’t it feasible that I would be approved with my initial application to SS? Although I did very well in the beginning of the journey, as I have gotten older, (I’m only 44), my disease has started progressing over the last few years. Will the fact that I have taken an early disability retirement from the state weigh favorably towards my case?

Here are my thoughts: the first question I would ask is “are you insured for Title II Social Security disability?”  In some states, employees do not contribute into the Social Security system- instead, they contribute to a state disability program.  I would advise you to contact your human resources office to confirm that you have been making payments into the Social Security system.  You can also call Social Security at 800-772-1213 to inquire as to whether you have been earning credits.  You can also request an earnings and benefit statement (Form 7004) from Social Security directly.

If you are not insured for Title II SSDI, then you might still be eligible for SSI, but that will depend on household income and the value of assets that you own.

Assuming you are eligible for Title II disability, your best chance at an early approval would be to enlist help from your treating doctor to show that you meet or equal the multiple sclerosis listing, which is found at  Listing 11.09.   When you read this listing, it does refer to cognitive issues by referring to Listing 12.02 which describes “organic mental disorders.”

I would print out the entire Multiple Sclerosis listing and the listings referenced in 11.09 and take the printout to your doctor’s office.  If your doctor or someone in his office is willing to write a narrative report describing your symptoms, course of treatment and state that your symptoms meet or equal what is contained in the listing, you greatly improve your chances at an early decision.

I take a similar approach when I am representing an MS client – although instead of a narrative report, I create a checklist for the doctor to complete and submit that to the Social Security judge along with copies of all medical records.

As far as whether your decision to take an early disability retirement will help, that is hard to say.  If you were required to meet certain criteria before you were allowed to take a disability retirement, then, yes, your status as a disability retiree might help a little, especially if there are medical reports and forms associated with this determination.  I still think that an early favorable decision at the administrative level will turn on whether the adjudicator believes that you meet or equal a listing, so that is where I would focus my energy.

Medicare recently announced a breakthrough analysis of MS (Multiple Sclerosis) costs which showed that as the disease progresses, the care costs involved escalate dramatically.  The research firm of JEN Associates and Wyeth conducted a study using a novel computer analysis to sort out MS patients by the stage that their disease was in, basing this on their Medicare payment records.  The result of the study was that this led to a better understanding of MS treatment costs.  The results of the study also indicated how well Medicare could reap more savings if effective treatment could block the advancements of the disease.

Consequently, Teva Pharmaceutical Industries, Ltd. is funding a worldwide study involving 1,350 MS patients in order to determine how safe and effective the medication glatiramer acetate (Copaxone®) for the treatment of the disease.  The standard dose of glatiramer acetate is 20mg but the study is testing a higher dosage of 40mg administered only 3 times per week instead of the daily dosage of the smaller amount.  The study will last a year and has been named the “GALA” Study.

Without getting too technical, the drug glatiramer acetate simulates myelin, a basic protein.  A component of myelin is what insulates the nerve fibers of the brain and the spinal cord against the damaging effects of myelin-damaging T-Cells which is the cause of MS.  The FDA has approved glatiramer acetate for the purposes of reducing relapse frequency in those patients that suffer from relapse-remitting MS.  Additionally, it is administered to those patients who have experienced their first clinical episode that displayed MRI results consistent with MS.

In the US today, some 350,000 Americans are affected by the disease, of which 1/3 of these individuals are Medicare beneficiaries.  If the GALA Study proves out, the lower frequency of a higher dosage could prove beneficial not only to the patient, but to the Medicare budget as well.  The majority of the patients today have the relapsing-remitting form of MS wherein they experience periodic exacerbations of the disease.  However, Multiple Sclerosis can evolve into the “progressive” stage where the symptoms increase in acuteness and continually worsen.

Social Security and Medicare may realize significant savings if MS patients became eligible for Medicare earlier than 2 years from the date of the claimant’s first income benefit payment, or if MS cases were tagged for “fast track” review.

According to The Examiner, Josh Sheldon of Fremont, California took the advice of a friend and began studying the impact of jellyfish protein on Multiple Sclerosis, which he suffered from.  He was so impressed with the results that he was involved in a press release about jellyfish and multiple sclerosis.  He was diagnosed with the condition in 2008 and the debilitating effects were very difficult on him.  The disease not only brings about physical pain and limits a person’s ability to walk, but also mental anguish in dealing with the day to day problems that the condition causes.  Josh decided to begin a regimen of jellyfish protein manufactured by a Wisconsin firm, Quincy Bioscience.  The protein is made to restore a calcium balance in the body common in neurodegentive diseases and age related problems.

The results were immediate and life altering.  According to his press release and The Examiner, after only four weeks Josh began feeling a difference, especially in relief from pain in his skin.  He noted that every day the pain decreased while he continued to improve physically, being able to walk with better coordination and little stumbling.  He also found that he had sensation in his limbs, rather than a tingling feeling.  The protein also gave him the ability to button his shirts, which was a task that had eluded him since his diagnosis.  Overall, the jellyfish health supplement has allowed Josh to feel like himself again, both mentally and physically.

Despite my disappointment that actual jellyfish were not used in this treatment option, it is interesting to think that something that already exists in nature may be a cure and viable therapy for multiple sclerosis.  One may wonder, however, if this treatment will be recognized by an Administrative Law Judge in a Social Security Disability Benefits hearing.  It is likely that as long as the treatment is discussed and recorded by your physician, a Judge will probably take this unorthodox treatment into consideration.

technorati claim code: 34CMB7X5KZ6N

The neurologists confirmed that they are most likely to prescribe the drug Tysabri, among all other medications on the market.  This confirmation also indicated that there had actually been an increase in the prescription of this particular drug.  The doctors did report, however, that they are still hesitant about using Tysabri or expanding its use due to concerns that taking the drug may lead to the development of Progressive Multifocal Leukoncephalopathy, which is a disabling and deadly disease caused by a virus.  They also noted that because of the risks associated with Tysabri, the neurologists often encourage their patients to take a break from using the drug.

Additionally, the report notes that approximately one-third of the neurologists have prescribed the new drug Ampyra, which is used to help multiple sclerosis patients walk better.  What’s more is that about half of those not currently using the drug expect to within the next six months.  The neurologists were also excited about using the highly anticipated oral medications, including Gilenia.  In fact, they remarked that this area was in the greatest need of development for the disease.  They also want to see medications and therapies that actually reduce the progression of the disease.

Reading a report such as this one by BioTrends can help you to better understand your disease and any medications that you are taking.  It may help you to make informed decisions and have a knowledgeable conversation with your health care provider.  Even though your doc has the medical degree, it is important for you to be an advocate for yourself and ask any questions you may have regarding medication, risks, and what is in development.  Hopefully, this and other reports will help multiple sclerosis sufferers to approach their disability and their doctors with confidence.

Usually with this illness, the symptoms tend to develop over a period of time. There are some patients who experience periods of remission. This can be an issue in a Social Security case. This is because the SSA looks for an exact onset date for a claimant’s disability (i.e. at exactly what point did the disability begin?). In a MS case, it can be tough to pinpoint that onset date since you may have had alternating periods of okay times mixed with times of flare-ups and difficulty.

In a publication produced by the National Organization of Social Security Claimants’ Representatives (NOSSCR), there was once an article about a woman who suffered from MS.

The woman experienced her initial debilitating episode of MS back in 1998. This is when she was diagnosed with MS and this is when she stopped working. But as the next few years went by, she only suffered from minor episodes. Then, in February of 2003, she experienced a major flare-up.

In December of 2001, the woman’s insured status for Title II Disability had expired. In September, 2002 the woman applied for SSDI and claimed that her onset date was April, 1998 – the time of her first major MS episode. But Her MS disability case was denied because the SSA noticed that her condition improved after April, 1998, and she could have theoretically returned to the workplace

Fortunately, the woman appealed this decision and won. She appealed on the basis that MS is a disease consisting of periods of flare-ups and remission, and that even though she had some good periods, she was still disabled by the condition. The appeals court sided with the woman because the ALJ was wrong for placing undue reliance upon the short temporary intermission of the plaintiff’s increasingly disabling disease.

Another reason she may have initially lost is because the Judge may not have considered all the evidence. Often times, the SSA judges fail to evaluate medical evidence for treatment following the claimant’s date last insured for Title II. Which means in this case, the Judge may have only looked at evidence up to September of 2002.

According to Drug Watch, researchers conducted a study with eighty-one participants who had been diagnosed with early-stage multiple sclerosis.  The researchers randomly assigned half of the group to receive a dose of Lipitor, a popular statin, while the other half received a placebo.  At the end of the study, the researchers found that over half of the participants taking the Lipitor did not develop any new multiple sclerosis brain lesions.  For those taking the placebo, only thirty percent reported no new lesions.  The results seem to indicate that there is a mechanism in the statin drug that impacts a person’s neurology.  The study is even more interesting because it was conducted over a year, thereby truly validating the results.

Of course, additional studies will need to be conducted regarding just how these statins may impact multiple sclerosis and what, if any, side effects the drugs may cause in patients.  Furthermore, since this study only dealt with a specific statin, it will likely be important that other statins are tested to see if their effects are the same.  As there is currently no cure for the disease and it effects millions of people, uncovering a treatment option that may stave off further neurological impairment would be wonderful.  If you currently have multiple sclerosis and are on statin drugs for high cholesterol you may want to ask your doctor about cross treating the disease.  It is possible that he could monitor new growths on your brain depending on the dosage of statins that you are taking.  It would be great if you could take one pill that both lowers your cholesterol, thereby protecting your heart, while also lower the incidence of brain lesions, thereby protecting your brain.

The drug, which is administered orally, was found to reduce relapses of multiple sclerosis by sixty-two percent in newly diagnosed patients, according to the American Academy of Neurology.  Relapses were reduced by forty-four percent in patients who had already been diagnosed with the disorder.  Moreover, additional data has shown that individuals taking Gilenia over a two year period had significant reductions in relapses, as well as brain lesions.  This data was compared to patients who were taking a more traditional beta blocker before switching to Gildenia.

The drug, however, is not without its concerns.  Reuters reports that Gildenia and its oral equivalent made by Merck may have serious complications on the immune system, as well as other challenging side effects.  It will be up to these companies to minimize these risks, as well as show that the benefits of the drug far outweigh any potential problems.  The possible side effects, however, are being taken seriously by the Food and Drug Administration, which has requested an advisory meeting to evaluate these risks and the product.

The company and the medical community remain optimistic, however, that this drug will be on the market sooner rather than later.  They believe that its superior results and the convenience of being able to take it orally will greatly boost the drug’s positive aspects.  It would be nice for the millions of multiple sclerosis sufferers to have an option to take a drug by mouth, rather than having to schedule a doctor’s appointment for treatment.  Additionally, with such a fantastic success rate, it will likely provide relief to many individuals who thus far have been through numerous treatment options with no change in their condition.

What makes this discovery even more exciting is that if a person’s blood work shows that he would not be a viable candidate for treatment with beta-interferon, then he would not have to endure the side effects of the drug, including debilitating flu-like symptoms. Living with multiple sclerosis is hard enough without having to then suffer with a medication’s complicated side effects. The Stanford research team found that a routine blood test could identify which patients would benefit from taking the beta-interferon injectible. Although this particular popular medication is helpful at reducing relapses in multiple sclerosis patients, it may produce side effects that that may dissuade a person from taking it correctly. This current study may be able to show that the drug is even more effective than previously thought if it is used with people who can actually benefit.

The researchers are currently applying for a patent for a blood test that would verify which patients would benefit from beta-interferon medication and which ones would not. It is important to note, however, that despite this exciting research, there is still no cure for multiple sclerosis. This means that even if you were identified as a responder, you could still experience a relapse of the disease and could still be considered disabled for purposes of working. The medication may improve your quality of life for awhile, but unfortunately, the disease never completely disappears. If you currently take a beta-interferon for your multiple sclerosis symptoms and it does not appear to be working, discuss other options with your doctor and also ask about this revolutionary blood testing to determine whether you are a responder or not.

Researchers at the University of Wisconsin-Madison injected mice with a protein that produced a type of myelin damage that is responsible for the creation of multiple sclerosis in humans.  They also exposed some of the mice to UV rays before and after the injection, while another group received no UV exposure.  According to Science News, the mice who received the UV exposure suppressed the development of multiple sclerosis type symptoms, despite an inadequate amount of Vitamin D.  The other mice did not fare as well.  Next, the researchers actually injected some mice with Vitamin D without UV exposure.  They found that this injection without radiation did not decrease the odds of developing multiple sclerosis, nor slowing its progression.  The researchers concluded that the UV exposure must be responsible for delaying or preventing the onset of multiple sclerosis, apart from Vitamin D supplementation.

Although the research team believed they found a link between UV rays and the prevention of multiple sclerosis, they are still uncertain as to how the actual mechanism works.  They indicate that further studies will be needed to see exactly how UV exposure works and whether it influences any other areas of the body’s health.  They do not wholly denounce the role of Vitamin D in fighting multiple sclerosis; however, the team does want to understand how each of these environmental factors work and how future treatment and preventive measures may be discovered.  It appears that there is no doubt that some moderate sunlight will help those who live with multiple sclerosis, whether it is through the UV exposure or Vitamin D.  Talk with your doctor about how you can get some additional sun exposure safely.

Published in the journal Neuro-Rehabilitation, the study examined the effects of the software on two groups of multiple sclerosis patients.  One group used the CogniFit program for twenty to thirty minutes three times a week for twelve weeks.  The other group, the control group, did not use the system at all.  Those using the CogniFit program showed a remarkable increase in their memory skills, exhibiting a twenty-one percent increase in general memory, a twenty percent increase in visual working memory, and a twenty percent increase in the verbal-auditory working memory.  All of these increases were above and beyond those experienced by the non-training group.  The training group also saw increases in cognitive abilities in naming speed, short term memory, focused attention, and speed of object recall, among others.  What is even more impressive, however, is that almost seventy-one percent of the training group stuck with the program through the completion of twelve weeks.  This is especially important because multiple sclerosis often results in severe fatigue, and many treatment options may be halted due to a person’s overall tiredness.

The Head of Cognitive Science at CogniFit remarked that, “While patients in the cognitive training group were significantly improving vital cognitive functions using an enjoyable cognitive intervention at home, in the control group cognitive growth was often non-existent.”  This software is a very exciting advancement in home-based personalized medicine.  Rather than having to go to a health care professional, people with multiple sclerosis can simply click on the software from the comfort of their own homes, on their own time.  It is also exciting because multiple sclerosis radically alters a person’s cognitive abilities, and to date, there is no cure for the disorder, only treatments to lessen the pain associated with it.  With CogniFit, however, people can actually treat the heart of the condition, which will hopefully increase their quality of life overall.  If you would like to learn more about the software, you can visit www.cognifit.com .