SSDI Denials for Multiple Sclerosis

When federal employees who have dedicated years - sometimes decades - to public service suddenly find themselves facing physical and medical uncertainty, they are generally entitled to benefits through Social Security Disability Insurance (SSDI). Yet, securing these benefits is often more complicated and stressful than it should be, and in some cases, federal employees even see their request for fair benefits denied outright.

The Social Security Disability Insurance (SSDI) program is designed to serve as a safety net. But when your condition is unpredictable and symptoms are not visible to others, as is the case with multiple sclerosis (MS), denials prove common.

If your SSDI claim for MS has been denied, you have the right to appeal. Because the stakes of your claim are high, you should not hesitate to speak with the federal employment attorneys at Pines Federal. You will find immense value in speaking with our experienced team.

Key Takeaways - SSDI Denials for MS

SSDI provides income replacement for workers unable to perform substantial employment due to long-term disability
Federal employees can apply for SSDI alongside or after pursuing Federal Employee Retirement System (FERS) Disability Retirement, but timing and coordination are crucial to avoid conflicts or delays
MS symptoms, such as fatigue, cognitive slowing, weakness, or vision loss can qualify you to receive SSDI benefits if they prevent you from fulfilling reliable full-time work
Denials are common in these cases, especially when medical records do not clearly connect your symptoms to functional limitations that affect your work performance
Appeals are the only appropriate response to a denial, and they often succeed when evidence and arguments illustrate the effects of substantial limitations like decreased stamina, spotty attendance, reduced pace, and lessened cognitive endurance
Legal representation should be a no-brainer for any federal employee seeking SSDI benefits, a federal employment attorney can align your SSDI, FERS, and MSPB cases to ensure consistency and maximize benefits

What Is SSDI, and What Purpose Does It Serve for Federal Employees with MS?

Social Security Disability Insurance is a federal benefit program funded through payroll taxes. Unlike short-term sick leave or workers’ compensation, SSDI supports individuals whose conditions prevent them from performing any substantial gainful activity for at least one year or longer.

The eligibility criteria for those seeking SSDI benefits are straightforward:

You must have a disability (which, for this purpose, means a condition that is expected to prevent you from working for at least 12 months, or may result in death)
You must have sufficient work history to qualify for the benefits, and many federal employees do
Federal employees pay FICA taxes, so they are typically entitled to the same SSDI benefits as private-sector workers. However, federal employees face bureaucratic red tape that private-sector workers may not, such as coordinating between your agency, the Office of Personnel Management (OPM), and the Social Security Administration (SSA).

While obtaining your earned SSDI benefits can prove to be a headache, these benefits can be nothing short of a financial lifeline. When a chronic condition like multiple sclerosis makes it impossible to continue performing your essential duties reliably, SSDI benefits can prevent you from falling into dire financial straits.

Why Securing SSDI Benefits Can Be Uniquely Challenging for Federal Employees

Federal employees frequently face overlapping processes that require strategic coordination, and you may have to deal with:

Reasonable accommodation requests: These requests may be necessary to help you remain employed, should you wish to. Modified schedules or telework are among the accommodations you may be entitled to.
FERS Disability Retirement: This option affords you a long-term income solution through the OPM if you can no longer perform your position’s essential functions. There are several types of retirement for federal employees, and we will help you identify the right option(s) for you.
SSDI claims: A successful SSDI claim can deliver you additional federal disability income and eventual Medicare coverage when you meet SSA’s medical and work-history criteria.

Federal employment lawyers help clients manage these considerations and processes many times. They will ensure that your filings are consistent and that none of your claims fall short or clash with another of your claims.

Why Federal Employees with MS Often Qualify for SSDI Benefits

To qualify for SSDI, a federal employee must meet several legal and medical standards, typically including:

Insured status: You must have paid into Social Security for a sufficient number of quarters, typically five of the last ten years. If you have been employed for the past five years, you likely meet this criterion.
Severe impairment: Your MS symptoms must significantly limit your ability to perform basic work activities, such as walking, remembering, focusing, or maintaining the expected pace of work. Considering how debilitating multiple sclerosis can be, many who suffer from this condition undoubtedly live with severe impairment.
The duration of the MS: The impairment must have lasted or be expected to last at least 12 consecutive months or result in death.
Considerable work limitation: You must be unable to perform any substantial gainful activity (SGA) as a result of the MS, meaning you cannot meet the SSA’s monthly income threshold.
No possibility for vocational adjustment: The Social Security Administration considers your age, education, and work experience to determine whether you can adapt to any other work. If it determines that you can adjust to other work, this determination may adversely affect your eligibility for SSDI benefits.

The SSA evaluates Multiple Sclerosis under Listing 11.09, recognizing both motor and cognitive limitations. You can qualify by proving that your MS is contributing to:

Severe motor dysfunction
A combination of limitations, which may include marked physical limitations along with substantial mental or cognitive impairments, such as difficulty concentrating

Even if your case does not perfectly fit the eligibility criteria for SSDI benefits, you may still be approved if your residual functional capacity—what you can do on a sustained basis—prevents you from completing full-time work.

The SSDI Application Process for Federal Employees

The SSDI process is both medical and administrative in nature, requiring evidence that connects your condition to your work limitations. This is how the SSDI application timeline generally looks for federal employees:

Initial application: You submit medical evidence, employment history, and information about how your case of MS limits your ability to work at full capacity.
Disability determination review: State examiners review your records and may schedule a consultative examination to assess the severity and persistence of your MS symptoms.
Reconsideration: If the examiners deny your application, you have 60 days to appeal. Submitting additional medical evidence, written arguments, expert testimony, and other supplementary assets can produce a new decision. This is one stage in which Pines Federal’s attorneys deliver tangible, substantial value to our clients.
Administrative Law Judge (ALJ) hearing: If you do not receive the decision you seek, you may have a hearing in front of an ALJ. Your attorney can present evidence, cross-examine the SSA’s vocational experts, make verbal arguments in favor of your claim, and demonstrate that you cannot sustain full-time employment.
Appeals Council and federal court review: If the ALJ decision is still insufficient, your attorney can pursue further appeals. These appeals are generally based on legal or evidentiary errors.

Each of these steps is pivotal to the final outcome of an SSDI claim. Our federal employment lawyers’ meticulous preparation, intimate familiarity with the client, and relentless pursuit of a fair claim decision will be integral in securing the outcome you deserve.

Why SSDI Claims for Multiple Sclerosis Are Often Denied

MS symptoms come and go, and that is one reason why it can be difficult to succeed in your initial attempt to secure SSDI benefits. If your initial claim is denied, the SSA might justify its denial by:

Claiming that if you can sit, you can work full-time, overlooking cognitive fatigue and attention issues common to those with MS
Indicating that periods of relief from your symptoms suggest that you can work full-time, ignoring the fact that MS symptoms can arise at virtually any time, even if the employee appears fine right now
Stating that have not shown a sufficient commitment to mitigating your symptoms
Citing a lack of evidence or testimony from medical professionals

Our firm is familiar with these and other reasons for denying claims of deserving applicants. We have an extensive, well-worn playbook for combating such justifications for withholding SSDI benefits from those who deserve them.

How an Attorney Appeals SSDI Denials for Federal Workers

A federal employee lawyer knows that the effects of MS show up in many areas beyond your medical charts. This condition can sap you of energy and purpose, alter your identity as a public servant, and rock your sense of financial stability. We handle SSDI appeals with precision and empathy, and we also provide valuable services that include:

Analyzing the SSA denial: We critically assess the decision to identify precisely where the claim went wrong and what evidence we may provide to correct the decision.
Collecting agency documentation: We obtain performance appraisals, PIPs, accommodation files, and other assets that reveal a history of MS-fueled decline.
Collaborating with treating providers: We will collaborate with your neurologist and other medical providers to produce a detailed residual functional capacity statement describing your specific limitations.
Preparing you for the hearing: We coach clients to ensure they are ready for any ALJ hearing and other claim-related proceedings.
Cross-examining vocational experts: We challenge the SSA’s wrongheaded assumptions about your condition and any experts they present to defend those assumptions.

We will also handle any other actions you are taking in pursuit of benefits. An attorney can bridge the gap between medical language and federal employment realities, ensuring your case portrays the complete story of your limitations and losses.

How We Produce Strong SSDI Appeals

Every appeal is a prime opportunity to fight for the benefits you deserve, and we build strong appeals through a meticulous, evidence-driven process. We may:

Request your full SSA file, reviewing the evidence that the SSA relied on to identify missing or misunderstood documentation
Identify functional gaps, determining whether your records clearly describe the MS-related symptoms that are interfering with your ability to work
Documenting the work-related effects of your condition, possibly encouraging you to keep a symptom diary showing how often fatigue or heat sensitivity disrupts daily life
Bring on experts to present the strongest case we can, as doctors and other professionals can be indispensable when fighting for fair SSDI benefits

A well-prepared appeal can be undeniable.

Your SSDI Benefits Should Cover the Majority of Your MS-Related Difficulties

When approved, SSDI provides more than replacement income - it can provide stability and long-term protection through:

Monthly income replacement
Medicare eligibility
Benefits for your dependents
Retirement protection
Retroactive payments for benefits you should have received in the past

For federal employees, these benefits can combine with FERS Disability Retirement benefits to put you on a firm financial footing.

Frequently Asked Questions - SSDI Denials for MS Diagnosis

Through our many years of helping federal employees seek fair SSDI benefits, we know that they often wonder:

Can I apply for SSDI while still working for my agency?

Yes. You can apply while on medical leave, telework, or light duty. SSA focuses on whether you can sustain substantial gainful activity, not whether you’re still formally employed.

Will a FERS Disability Retirement approval guarantee SSDI approval?

No. OPM and SSA use different legal standards, but a successful FERS claim can strengthen your SSDI appeal by showing credible federal recognition of your work limitations.

How long does an SSDI appeal take for someone with MS?

Timelines vary, but most cases reach a hearing within several months to a year. We can use this waiting period to gather substantial medical and occupational evidence.

Can I work part-time while the process is ongoing?

You typically can, as long as your earnings remain below the substantial gainful activity threshold. Always check with your attorney before accepting part-time work to avoid jeopardizing eligibility.

Don’t Wait to Speak with a Federal Employment Attorney

Deadlines for SSDI appeals are strict. You generally have 60 days to appeal an SSA denial. Other related deadlines for FERS or MSPB cases may expire even sooner. Missing them can permanently bar your claim.

If your SSDI claim for Multiple Sclerosis has been denied - or if you are preparing to apply - now is the time to act. Call Pines Federal today at (800) 801-0598 or contact us online today to schedule a confidential consultation. Your years of service matter, and we’ll make sure they count when your health stands in the way of your work.