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This is a short version of the documented application/decision process that has been cut and pasted from
the webpage listed and linked on the previous page ("Appendix 1 to Subpart P of Part 404"). It follows the federal
regulations through the different referenced regulations for an applicant
applying for disability benefits with MS. If you don't separate applicable regs, from the
entirety of the regs, it quickly becomes overwhelming. This short
version doesn't follow the regulations to include mental disorders or for
children under 18. That specific information can be found in the full documentation ("Appendix 1 to Subpart P of Part 404") listed and linked on
the previous page.
Scroll down to
"START HERE"(11.00 E)
and well... start there (ha ha ha). The regs are listed in
numerical order (both above and below the START HERE text), so you can scroll up and down to follow the referenced
text. But please start with the "START HERE"(11.00 E) bolded place holder
directly below (1/2 page down). It will help avoid unnecessary confusion.
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Applicable excerpts from the Code of federal regulations
Appendix 1 to Subpart P of Part 404 - Listing of
Impairments
2.02 Impairment of visual acuity. Remaining vision in the better eye after best
correction is 20/200 or less.
2.03 Contraction of peripheral visual fields in the better eye.
A. To 10° or less from the point of fixation; or
B. So the widest diameter subtends an angle no greater than 20°; or
C. To 20 percent or less visual field efficiency.
2.04 Loss of visual efficiency. The visual efficiency of the better eye
after best correction is 20 percent or less. (The percent of remaining visual
efficiency is equal to the product of the percent of remaining visual acuity
efficiency and the percent of remaining visual field efficiency.)
11.00 Neurological
C. Persistent disorganization of motor function in the form of paresis or
paralysis, tremor or other involuntary movements, ataxia and sensory
disturbances (any or all of which may be due to cerebral, cerebellar, brain
stem, spinal cord, or peripheral nerve dysfunction) which occur singly or in
various combinations, frequently provides the sole or partial basis for decision
in cases of neurological impairment. The assessment of impairment depends on the
degree of interference with locomotion and/or interference with the use of
fingers, hands, and arms.
START HERE:
E. Multiple sclerosis. The major criteria for evaluating
impairment caused by multiple sclerosis are discussed in listing 11.09.
Paragraph A provides criteria for evaluating disorganization of motor function
and gives reference to 11.04B (11.04B then refers to 11.00C). Paragraph B
provides references to other listings for evaluating visual or mental
impairments caused by multiple sclerosis. Paragraph C provides criteria for
evaluating the impairment of individuals who do not have muscle weakness or
other significant disorganization of motor function at rest, but who do develop
muscle weakness on activity as a result of fatigue.
Use of the criteria in 11.09C is dependent upon (1) documenting a
diagnosis of multiple sclerosis, (2) obtaining a description of fatigue
considered to be characteristic of multiple sclerosis, and (3) obtaining
evidence that the system has actually become fatigued. The evaluation of the
magnitude of the impairment must consider the degree of exercise and the
severity of the resulting muscle weakness.
The criteria in 11.09C deals with motor abnormalities which occur on
activity. If the disorganization of motor function is present at rest, paragraph
A must be used, taking into account any further increase in muscle weakness
resulting from activity.
Sensory abnormalities may occur, particularly involving central visual
acuity. The decrease in visual acuity may occur after brief attempts at activity
involving near vision, such as reading. This decrease in visual acuity may not
persist when the specific activity is terminated, as with rest, but is
predictably reproduced with resumption of the activity. The impairment of
central visual acuity in these cases should be evaluated under the criteria in
listing 2.02, taking into account the fact that the decrease in visual acuity
will wax and wane.
Clarification of the evidence regarding central nervous system
dysfunction responsible for the symptoms may require supporting technical
evidence of functional impairment such as evoked response tests during exercise.
11.04 Central nervous system vascular accident. With one of the following more
than 3 months post-vascular accident:
A. Sensory or motor aphasia resulting in ineffective speech or
communication; or
B. Significant and persistent disorganization of motor function in two
extremities, resulting in sustained disturbance of gross and dexterous
movements, or gait and station (see 11.00C).
11.09 Multiple sclerosis. With:
A. Disorganization of motor function as described in 11.04B; or
B. Visual or mental impairment as described under the criteria in 2.02,
2.03, 2.04, or 12.02; or
C. Significant, reproducible fatigue of motor function with substantial
muscle weakness on repetitive activity, demonstrated on physical examination,
resulting from neurological dysfunction in areas of the central nervous system
known to be pathologically involved by the multiple sclerosis process.
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