What percentage of disability claims are approved on the basis of cognitive deficits?

[Goldfinch]

I know this topic might belong in the employment forum, but I wanted it to get as much exposure as possible, hence my decision to post here. People not yet in the situation I find myself may envision the topic matter ever being relevant to them. I never thought it would be relevant to me, and I want to spur some thought on how preparation for the worst case scenario is always better than being unprepared.

I am wondering how often social security disability is approved on the basis of cognitive deficits only. I have lost employment twice in the last year solely due to mistakes I've made from the effects of fifteen years of MS. Tasks requiring divided attention, focus, and accuracy have been the bane of my existence at employment, and it has led to a real lack of confidence and outright fear, when before the last relapse, nothing scared me. Now I have nearly constant anxiety in work situations. I am unemployed, even though I have been conducting a relentless job search not even related to my degree in drafting.

I was always up for a challenge and enjoyed problem solving in many past jobs. Now, I break out into a cold sweat if the topic comes up in a job interview. Multitasking? Yeah, right. My processing speed is so slow, you might call me a monotasker. I feel incredibly scared at job interviews having to explain the breaks in employment, the reasons for leaving, pondering the potential for future errors. It has me contemplating applying for SSI or SSDI, which is the last thing I want to do. I don't want to admit defeat; I don't want to be limited in income. I am still in debt for the associate degree in drafting and design that I was convinced to obtain, thinking that the less physical nature of the work would be more compatible with any physical challenges MS threw my way. I never thought I would experience cognitive symptoms.

[Tia1]

Hi Goldfinch, At first I didn't think I had much to add when I read your post, as I gave up my financial career to raise my children full time (much harder than all my previous jobs) so I don't qualify for SSI. But I do in fact feel the impact of loss of cognitive functioning and it is difficult.

I am so sorry that you are facing unemployment, anxiety and loss of confidence. My hope is that you will find a different way to do the task that you have done in the past and that the right job will come along.

If you think you will have to go the disability route, you should be carefully documenting your decline with testing.

I will be praying for you!

[pennstater]

Sorry you are experiencing this Goldfinch. I know the anxiety you are feeling, or at least some of it.

Have you had any neuropsych testing to see what deficits show? I had this done a few times. For me, it showed different deficits each time, but that I was still at highly functioning IQ. But even with that, my doctors argued that fatigue, which I struggle with, causes the cognitive fatigue. And cognitive activities, contribute to the physical fatigue. I was able to get SSDI following appeal, but for me, the fatigue was the driver.


The other thing the neuropsychological testing will provide is an opportunity to see if any occupational therapy may help you and keep you in the workforce longer.


Have you discussed with your neuro? It is important to get your troubles retaining a job in your medical records, along with the problems you experience. You will need your doctor's support if you decide to follow.

Also, since you are experiencing anxiety, you may want to discuss as well.

Finally, you may want to check with your local NMSS chapter. Ours has someone who works on employment related issues and staying in the workforce, even identifying accommodations that may be available that would keep you working.

Good luck. Please keep us updated.

[reasonable]

I was finding it increasingly difficult to keep employment. This was particularly the case when the workplace was under some type of financial or internal political stress and they were looking to get rid of people. A couple of mistakes at meetings (forget things) add lack of confidence due to cognitive issues and its not a good mix. I found I was compensation by doing incredible hours, trying to look unreplaceable. Its awful.

I did not know about cognitive defect but suspect it was there for a while and when tested I was told my memory is abnormal for someone my age. I have had MS for 20 years and stopped working in finance after about 19 as soon as house paid off, kids out of secondary school and was in my 50's. Seriously the stress of the last few years was awful. I found over the last 5 years the type of work I was doing was going down in skill level. By the last 2 years I was doing work 10 years before that I thought I would never do. In the end it was basically anything for a buck.

If you can work for yourself from home that maybe the best option going forward if that's possible. Otherwise it may need to be a change of career. Depending on your age I would be careful trying for insurance unless you can manage your time so that you keep busy.

I cannot answer your question but think that in the higher professional areas (lawyers, accountants) fatigue and cognitive deficit would be a major reason. Financial stress makes it dreadful.

Get a cognitive test see a lawyer.

[Goldfinch]

Thanks to all who suggested cognitive testing. I had a form of cognitive testing done by a psychiatrist twice over a six month interval, courtesy of my state's Bureau of Vocational Rehab. The first test found that I am below average for my age group in processing speed, short term memory lapses, spatial memory, coding, and problem solving (a facet of processing). The spatial memory and coding being particularly knotty prpoblem because my field is drafting.

On the second test (same one but newagian after six months), I took some Ritalin prescribed by my neuro's nurse practitioner, as a test to see if it affected my cognitive abilities. The nurse practitioner and I wanted to see if the Ritalin helped my performance, the theory being that subpar performance was a result of cognitive fatigue. I had never considered cognition to be subject to physical limits like muscle exertion, but she felt that if you're tired, it will affect your cognition also. It was an interesting and previously unexplored idea to me. My second test scores, after having ingested a low dose of Ritalin one hour before the test, were significantly higher than the first.

The psychiatrist would not credit or discredit the Ritalin because it was not a controlled experiment, and we both acknowledged that my first test was done while I was under "duress" and recovering from a vicious relapse, termination from employment, and my first Lemtrada infusions at the same time. However, it did establish that Ritalin did not adversely affect my cognitive performance. I still have Ritalin left from the first prescription and save it for times when I feel especially compromised, like a demanding morning on the job. That is, when I regain employment. *sigh*

On the bright side: I have escaped physical symptoms relatively lightly. The last relapse I had compromised my balance severely, but I got rehab for that, and I am doing much better. I still enjoy being active and there is nothing preventing me from walking. On nthat note, I just interviewed for a position with a local utility company to be a meter reader. It requires being outdoors all day in all kinds of weather, walking all day in various types of terrain, sometimes up to ten miles a day. I thought the interview went very well, and I am hopeful that they will hire me...soon...because this sitting around and sweating over the bills is just not doing it for me.

[22cyclist]

I got mine for cog disability first at the time

and on the first time. Sometimes its the first discrepancy to show up early on. My disability score is now 7.5 I have so much craziness going on right now who cares. My mental score has never gone up, just down. Sure I get used to some of the yearly testing more often I get used to and do better on, but it is supposed to be that way. Do go see a neuropsychiatrist they cab pinpoint actual specific MS problems.]

Good Luck
Lisa