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Multiple sclerosis (MS) is hard enough to live with on its own. The long-term disability insurance system on top of it? Overwhelming.
Many people with MS find themselves struggling to keep up with work demands, only to have their insurer deny the multiple sclerosis disability insurance claim and the very benefits that were supposed to protect them.
If you’re facing this situation, you’re not alone. Insurers deny MS disability claims often, not because the disease isn’t severe but because it’s complex, unpredictable, and often invisible.
Approval for long-term disability benefits with MS comes down to the right evidence, an understanding of what insurers commonly get wrong, and often a firm that handles these claims. At the Law Office of Justin C. Frankel, P.C., we fight for those benefits so you can focus on your health.
MS can qualify, but approval is rarely based on the diagnosis alone. What counts is whether your symptoms stop you from doing your job and how clearly your records show it.
MS affects people differently, as the National Multiple Sclerosis Society notes, and the same person can feel fine one week and be unable to work the next. Symptoms that get in the way of work include:
MS is one of several neurological conditions that may support a long-term disability claim when the records show functional limitations that prevent work.
Approval depends less on proving you have MS than on proving what it prevents you from doing.
Before filing a claim, take time to understand what your policy covers. Pay special attention to:
Knowing these details helps you file correctly and avoid preventable denials.
Insurance companies approve claims based on functional limitations, not simply your diagnosis. To support your claim, gather:
Update older tests, because an insurer may treat year-old scans as proof your condition is stable. Those records also need translating into specific work limitations, and proving MS as a disabling condition takes a coordinated record. Keep a copy of everything you send, and require a signature on delivery so you can prove what was received.
A detailed, well-supported statement from your treating neurologist is essential to your claim. The doctor should clearly explain:
Vague statements like “patient is disabled” will not help. Specific details do.
Insurance companies evaluate disability based on whether you can still perform the essential duties of your job. Describe:
Then explain how your MS symptoms interfere with each of those tasks.
Even with strong evidence, MS claims are frequently denied. Insurers often argue:
An insurer may also send you to an IME medical consultant, a reviewer hired with the outcome in mind. These arguments ignore the reality of MS: fluctuating symptoms, endurance limitations, and unpredictable relapses. This is also why legal representation is so important.
Your policy’s definition of disability can change over time, and that change ends many MS claims. For the first 24 months, most policies pay under an “own occupation” standard, which asks whether you can do the job you held. After that, the standard often shifts to “any occupation,” which asks whether you can do any job you might reasonably do.
That shift is a common point where MS claims end. Symptoms that keep a surgeon from operating or an attorney from running complex cases may be recast as fit for lighter work. If you can still work in a reduced role, you may also qualify for residual or partial benefits.
A denial is not the end of your claim. It starts the appeal, and what you do next can determine whether you recover the benefits you paid for.
If your policy came through your employer, it is most likely governed by ERISA, a federal law that sets the rules for how group disability claims are filed and appealed. ERISA requires the plan to give you at least 180 days from the date you receive a denial to file an appeal, and you must complete that appeal before taking the dispute to federal court.
The administrative appeal is usually your one chance to build the record. In most ERISA cases, the file you submit on appeal is the same file a federal judge later reviews, so evidence left out now may never be allowed in. Our ERISA disability appeals team builds that record for professionals nationwide, including the evidence on which an appeal of an ERISA long-term disability denial depends.
MS is rarely straightforward. Symptoms vary, test results can be misleading, and insurers often misread the disease. We have spent more than 30 years on disability insurance claims, including MS in its relapsing-remitting, primary progressive, and secondary progressive forms, and we turn your symptoms into evidence that a carrier has to take seriously. Most long-term disability claims fall under ERISA, where the appeal is often your one chance to build the record, so we prepare every case as if a judge will read it.
“When my Long Term Disability Insurance Company terminated my benefits after receiving them for two years, I thought life as I knew it would drastically change, until I found the Law Offices of Justin C. Frankel. Mr. Frankel and Sr. Paralegal, Christina Panzarella, are NOT your stereotypical attorney and paralegal. They were responsive, extremely knowledgeable, compassionate, and patient. They explained, in detail, the entire process of filing an appeal and managed my expectations with grace. They were accessible to me over the course of 8 months, and frequently checked in on my welfare. Both Mr. Frankel and Christina Panzarella worked many hours to ensure a SUCCESSFUL OUTCOME of my appeal. If you are searching for the most competent duo to fight for your rights, search no further than The Law Offices of Justin C. Frankel, P.C. I am forever grateful for them.” — Lady J.
“When initiating my disability claim, I contacted several attorneys. Justin was the only one who had specific knowledge of my not-so-common condition, gave me endless time and attention during a free consultation, and was completely transparent about his fee structure and estimated costs. I engaged him to handle my STD and LTD claims, as I wanted them executed impeccably the first time to avoid any unnecessary appeals processes. Throughout the process, Justin and his Senior Paralegal, Christina, were incredibly responsive to any questions I had, set realistic expectations on potential outcomes and timelines, handled all paperwork and contact with the insurance company, and ultimately got me approved and paid on my initial claims. Most importantly, they were professional, patient, and calming voices when the stress of the disability and the insurance process were overwhelming to me. I highly recommend Justin Frankel.” — Valerie H.
Most policies replace between 50% and 66% of your pre-disability income, depending on the policy. For a high earner with MS, that percentage can still leave a real gap.
Yes. A group plan through your employer is usually governed by ERISA, while a private policy you bought yourself, often through a carrier such as Berkshire Life, is generally governed by state law, with broader rights.
Whether your long-term disability benefits are taxable depends on who paid the premiums. If your employer paid with pre-tax dollars, the benefits are usually taxable. If you paid with after-tax dollars, they are generally not taxed.
No, the law does not require a lawyer. MS claims are often denied, and ERISA appeals carry a strict deadline and a closed record, so mistakes can be hard to undo. A disability attorney can review your policy, strengthen your evidence, and handle the insurer while you focus on your health.
Multiple sclerosis creates real, measurable, and often debilitating limitations. Long-term disability benefits exist to protect you, but insurance carriers often fight hard to avoid paying.
With the right medical evidence, a clear understanding of your policy, and representation from the Law Office of Justin C. Frankel, P.C., you can significantly improve your chances of securing the benefits you need and deserve. Call 888-583-4959 or reach us through our contact form for a free consultation.
Justin C. Frankel is committed to fighting for the rights of clients when their long term disability insurance claims have been denied, delayed or terminated. His entire legal career is focused on representing long term disability insurance policy owners. His clients are treated with the utmost of concern and care during very difficult times.
