Multiple sclerosis disability group revision. Multiple sclerosis - causes, lifespan

Scary, dangerous pathology The central nervous system is multiple sclerosis. It often affects young people from 16 to 46 years old. A person with this diagnosis lives for at least a quarter of a century, but in the future he will face complete disability as the disease progresses. People who have this terrible diagnosis, like sclerosis, are supported by the state.

Patients with a diagnosis are assigned a disability and receive a subsidy from the state.

Carrying out medical examination with mandatory magnetic resonance imaging of the brain.

There is a relationship between the stage of severity and the course of the disease:

• At the first stage, symptoms of the affected nervous system are manifested, but its functioning is not impaired. The patient is fully able to work.
• In the second stage, visual and coordination functions of the nervous system and motor activity are not clearly expressed. The patient has a partial disability.
• In the third stage, persistent dysfunction of the NS is expressed. The person is partially incapacitated, which is expressed in the inability to concentrate, stand for a long time, or fully control the movements of his hands.
• When the patient has the fourth stage, dysfunction of vision and movement is acutely expressed. He cannot take care of himself, he constantly needs outside help. Here there is absolute unsuitability for any kind of work.

Based on the stages of severity of the pathology, we can conclude that a patient who has sclerosis of the first two stages of severity has limited fitness for this, that is, he can work, but not be very physically overloaded.

About disability

What disability group will a patient with multiple sclerosis receive? The patient can receive a conclusion and assignment of a disability group after passing the Medical and Labor Expert Commission (VTEK).

Only VTEK can make a conclusion about the patient’s condition after conducting full medical examinations.

The attending doctor can give a referral to a patient for VTEC, or chief physician medical institution. The commission can examine and examine the patient when the patient himself comes to the institution where the commission meets, or the doctoral board goes to the patient’s home or to the hospital where the patient is being treated.

According to research findings, doctors from this commission decide what type of disability should be, its group and duration, and whether it is worth giving it at all.

The patient can be re-examined regularly if the patient’s condition worsens, in which case he is given another group. If the condition improves, the person becomes able to work, then the disability is removed.

A patient with multiple sclerosis receives a group and is considered disabled; when assigning a group, doctors take into account the following circumstances:

• The first, second or third groups are assigned based on the severity of movement disorders.
• Degree of visual dysfunction.
• General health of the patient.
• Self-care ability.

About disability criteria

Availability organic look symptoms does not serve as a condition for identifying work ability, since when multiple sclerosis the presence of pyramidal signs is clearly expressed in both moderate and mild forms of dysfunction.

When the duration of aggravated conditions in sclerosis drags on for years, an increase in dysfunction is observed in a very slow rhythm, which does not allow one to judge performance by the nature of exacerbations of the pathology.

The number of aggravated conditions is not the main criterion. An assessment of the duration and depth of the remission period is necessary.

The ability to work of a diagnosed patient is always influenced to a greater extent by motor dysfunction of various types.

Accordingly, the group is assigned:

• Third ─ if a person has moderate or mild motor dysfunction, he is fit for work.
• The second is pronounced motor and other dysfunctions.
• The first is strongly expressed motor, support, and visual dysfunction.

About the Expanded Disability Scale EDSS

If a person has multiple sclerosis, then short time he becomes disabled, he develops focal neurological symptoms, which are assessed by a special type of the expanded disability status scale EDSS. It was created in the nineties of the last century.

The EDSS scale evaluates 7 vital functions in the human body. important systems. The EDSS score measures how disabled the patient is. This technique using EDSS scales used by practicing doctors in various studies to obtain drugs to treat a disease.

With the widespread use of the EDSS scale, some scientists have identified shortcomings in patient examination methods:

• Excessive focus on motor activity the subject being studied. Other cognitive functions are not taken into account.
• The cognitive type of dysfunctional state may be the main root cause that a person becomes disabled is not taken into account.
• The need to transform the resulting data used in the neurological type of analysis into point system, in which the doctor is required to undergo additional training and be able to calculate abstract points.
• A gradual switching of the patient from one class scale to the next has not been identified, and this will not allow for proper comparison of the results therapeutic measures.

How long does a person live

The life expectancy of a person suffering from multiple sclerosis differs little from normal. By observing the correct treatment measures and the benign course of the disease, disability can be avoided.

About the forecast

The patient does not die from the disease, excluding cases of bulbar types of pathology.

Recovery, unfortunately, also does not occur. Sometimes there is a remission period for several decades, but then, as a rule, the painful process worsens.

Regarding the prognosis for performance, it is worth noting that it is generally favorable if a person’s work is not associated with physical overload, prolonged standing, and does not require coordinated motor activity.

Multiple sclerosis (MS) is a disease that is not yet fully understood. Therefore, it raises many questions not only among patients, but also among doctors. In this article we will try to answer the most common questions about multiple sclerosis.

How severe is the disease?

Until recently, this disease was considered one of the most severe. But nowadays, due to the fact that diagnostics have improved, new drugs have been developed, the quality of life has improved and the life expectancy of patients has increased. More than a quarter of sick people rarely suffer from exacerbations and up to old age maintain mental and physical health.

Do you have a disability, what group?

Disability for multiple sclerosis is determined by doctors of the Medical Labor Expert Commission (MTEK) at the patient’s place of residence. They determine the severity of the disease, the patient’s ability to work, and determine which group he belongs to. In this case, the main criterion is not the frequency and severity of attacks, but the impairment of motor functions.

• Disabled people of the third group are able-bodied people with mild or moderate movement disorders.
• Disabled people of the second group – have severe disorders
• Disabled people of the first group have pronounced disorders of the motor system.

Is it inherited?

There is still some debate about this. But according to statistics, if one of the parents has multiple sclerosis, then the risk for the child to get sick is 3-5%. That's enough low rate compared to other hereditary diseases.

What are the consequences of pregnancy for a woman suffering from multiple sclerosis?

In some cases, a woman's condition during pregnancy and after childbirth can improve significantly. This is facilitated hormonal changes, passing through her body. However, there is a risk that an exacerbation may occur in the first year of a child’s life. This is due to the heavy load that a young mother experiences. This factor must be taken into account when planning pregnancy. And after childbirth, provide the woman with support and give her the opportunity to fully rest.

What is the average age of onset of the disease?

It mainly affects young people between 15 and 45 years old. The main contingent consists of patients aged 25-35 years. Cases of the disease are rarely diagnosed after fifty. Sometimes the onset of the disease is noted in children over 2 years of age. In this case, the disease most often occurs in a benign (milder) form.

How does MS progress in young people and children?

Multiple sclerosis is a difficult disease to diagnose. He has similar symptoms with a brain tumor and acute disseminated encephalomyelitis. IN early age MS occurs after a history of viral infection or vaccinations. Seizures may be accompanied by convulsions and loss of consciousness, which is rare in adults. Otherwise, the manifestations of the disease are similar to the symptoms that occur in other patients.

What is the life expectancy?

Life expectancy is practically no different from normal. At proper treatment and in a benign course of the disease, disability may not occur. Modern methods allow people to lead normal image life.

You can learn more about the peculiarities of multiple sclerosis from a neurologist or ask a specialist a question on the website.

Many patients are interested in the question: “Do they give a disability group for multiple sclerosis?” As we know, MS is a damage to the central nervous system, this occurs due to damage to areas of the brain and spinal cord. Life expectancy with MS can reach 70, or even higher, years, and being disabled does not mean not being human. According to Government Resolution 247 of April 2008, a list of 23 diseases was published for which a person is assigned a permanent disability group after two years after the person was recognized as disabled.

However, multiple sclerosis is not included in this list of diseases, so disability for multiple sclerosis is sought on the basis general rules. The disease affects increasingly younger segments of the population, but a single diagnosis of MS is clearly not enough to receive a disability group. And here's why: the manifestation of MS is periodic, and the time between attacks can be calculated in years, and the person himself is able to perform production activities. Such people for a long time no movement disorders, decreased muscle strength or fatigue are observed during long work. Therefore, there is no need to talk about disability in this case. It’s another matter when the health condition is irreversible, namely a significant constant decrease in coordination of movements, expressed movement disorders, inability to perform certain physical actions. The described consequences of MS make life very difficult, but even with them, sometimes they do not give any disability group. Most often this happens if a person continues to work, but is engaged in mental rather than physical activity. To ensure freedom of movement, difficult cases, patients will need a wheelchair. This issue is especially acute for people who are not yet old in age. When assigned a disability group, the patient can receive a stroller through the Department of Social Protection of the Population; in all other cases, he will have to purchase it himself. Large selection of wheelchairs to support active image life and rehabilitation you will find on the website http://baldinelli.ua/reabilitaciya/invalidnie-kolyacki/aktivnye.

The decision to assign a disability group is made based on medical and social examination(an independent examination determines whether a person needs social protection measures or not). If the expert makes a positive decision and assigns you one of the disability groups for multiple sclerosis, you have the right to certain types of social support. This may be financial assistance, which you have the right to refuse in whole or in part, replacing it with a set social services. Disabled people are provided with benefits in the form of free medicines, discounts on transport, tax exemption, etc. Everything will depend on which group you are given.

What disability groups are given for MS: 2 disability group means that the patient has been experiencing significant health difficulties for a long time, but is able to take care of himself. Such people are allowed to work in specially created conditions, and they do not require constant personal care; Group 3 is given to people with a significant decrease in work activity due to disorders of the musculoskeletal system resulting from chronic diseases.

Contrary to popular belief, multiple sclerosis (MS) is not associated with sclerotic changes in the walls of blood vessels, nor with age-related forgetfulness and problems with concentration. This is a disease of an autoimmune nature. The pathological process is expressed in degradation nerve tissue and destruction of the outer layer nerve fibers, consisting of myelin. The development of the disease results in multiple lesions nervous system manifested by decreased vision, fatigue, impaired coordination of movements, tremor, muscle weakness, decrease peripheral sensitivity, local paresis. In severe cases, deterioration in functioning may occur pelvic organs(retention of stool and urination, urinary incontinence, etc.), the appearance of neuroses, depression, hysteria or, conversely, euphoric states combined with a decrease in intelligence.

Source: depositphotos.com

Multiple sclerosis is a fairly common pathology: there are more than 2 million people suffering from it in the world. There are several described forms of MS, but the set of symptoms, severity and specific course of the disease are individual for each patient.

Although MS is not considered a rare disease, most people are not very familiar with its features. Let's try to dispel some of the myths that have developed around this disease.

Multiple sclerosis is a deadly disease

This is wrong. The most severe forms sclerosis, accompanied by serious damage to the central nervous system, are relatively rare. In addition, modern medicines can significantly improve the condition of patients. Unfortunately, the situation is complicated by the fact that clinical manifestations MS often manifests itself late, when about half of all nerve fibers have already been damaged. In such cases, the start of treatment is delayed, which negatively affects its outcome.

Application of modern medicines and improved living standards have a beneficial effect on the condition of people suffering from MS. Even though cases complete cure unknown, progression pathological process Usually it can be slowed down. In general, the life expectancy of patients with multiple sclerosis in developed countries does not differ from that of their peers who have avoided this disease.

MS patients are doomed to immobility

It is believed that every person with multiple sclerosis will eventually experience mobility using a wheelchair and complete helplessness. In reality, forecasts can be much more optimistic: when early diagnosis and timely initiation of adequate treatment, disability may not occur. Of course, a lot depends on individual characteristics course of the disease, but most patients with MS manage to maintain the ability to move independently, take care of themselves and live in their usual routine.

Multiple sclerosis is a disease of old age

Quite the contrary: the onset of the disease usually falls within the age interval between 10 and 50 years. Among children, girls suffering from MS are three times more likely than boys, but in older age groups the number of men and women among patients is almost equal. In the fairer sex, the disease manifests itself on average 1.5-2 years earlier than in their male peers, but in recent illness proceeds more actively and takes on more severe forms.

The cause of multiple sclerosis is still unknown; only risk factors have been studied:

• ethnic (racial) identity. Europeans suffer from MS more often than Africans, and among the Chinese, Japanese, and Koreans the disease is almost never diagnosed;
• region of residence (the so-called “latitudinal gradient”). The risk of developing MS is highest for those people who live north of the 30th parallel. For the inhabitants of other regions of the Earth, this parameter gradually decreases in the direction from north to south. The minimum number of cases has been recorded in the southern parts of the African and South American continents, as well as in Australia;
• stress. There are observations confirming an increased incidence of multiple sclerosis among representatives of “nervous” professions (air traffic controllers, firefighters, pilots, etc.);
• smoking;
• genetics. A family history of MS increases the risk of developing the disease tenfold. However, the disease is not considered hereditary, since its occurrence is usually caused by many factors.

Women with MS should not become pregnant

Multiple sclerosis is not an obstacle to bearing a child. On the contrary, many women suffering from MS experience significant relief during pregnancy, and after the birth of the baby, many years of remission can occur.

Disease expectant mother does not affect the development of the fetus or the health of the newborn. The only problem is taking medications prescribed to treat MS, as some of them cannot be used during pregnancy and breastfeeding. Therefore, the patient must consult with her doctor even before conception and be under his supervision throughout the entire period of pregnancy.

People with MS should avoid physical activity

For a long time, doctors actually believed that exercise was harmful for people with multiple sclerosis. Numerous studies have proven that this is not so: patients can and should exercise moderate physical activity(of course, dosed taking into account the manifestations of the disease). Specially selected complexes are very useful for MS patients aerobic exercise: In most cases they reduce the severity of symptoms. Patients are also shown hiking, swimming and just relaxing in the fresh air.

Source: depositphotos.com

People with MS cannot continue to work

Many people suffering from MS, thanks to adequate treatment for decades, retain not only familiar image life, but also physical and mental activity enabling them to successfully perform their job duties. Even the onset of disability does not always become a reason for leaving work, especially since labor legislation obliges employers to provide such employees with working conditions that take into account the characteristics of their condition. Therefore, the majority of MS patients who are of working age are not in danger of being thrown to the margins of life.

Multiple sclerosis is a serious progressive disease, but not a death sentence. By following the instructions of the attending physician, the patient may well remain active, self-sufficient and successful person. It is important not to give up, maintain an optimistic outlook on the world, and maintain normal level life will be a completely solvable task.

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Comments on the material (17):

I'm just quoting my wife:

Thank you

I quote Sidorenkova Ekaterina Valerievna:

I'm just quoting my wife:

I am writing this because newbies can read it. My husband has at least 10 years of experience - the first exacerbation was about 15 years ago, the diagnosis was incorrect. The symptoms went away on their own, after which serious treatment, diagnosis, etc. Everything is individual. My husband stopped taking the medications (not a guide to action - he was on them for 8 years, he was just tired of the side effects), he lives ordinary life. Whenever there is a financial opportunity, he eats food with less gluten, drinks alcohol made not from wheat, but from grapes. If possible, eat turkey or lamb, but not chicken. Smokes. And it’s no different from peers over 50 - same lifestyle, etc. Again, I’m writing to support newbies. When I initially encountered pessimistic articles, I gave up. This is the worst thing for those who have just learned the diagnosis, and most importantly for those who are nearby! The main thing is that a person moves forward and sets goals for at least 5 years ahead. Our daughter was born then, there was no time in wheelchair sits down (my son has just started 1st grade). Then we bought a dacha, and more and more. The main thing is that a person should not fall off the list of ordinary and living people. The disease has not been fully studied - with a relapsing course, all functions are restored depending on age. It is advisable to adhere to a gluten-free diet for at least the first six months and master breathing exercises(Frolova, it seems) - removes headaches and spasms. GOOD LUCK! Maybe it will help someone.

Thank you

I’ve been living with MS for 18 years, yes, in the first 10 I felt noticeably better, but I’m not giving up. I would also recommend light yoga. She also helps a lot. The main thing is not to be buried alive. Yes, I don’t take any treatment, maybe in vain, but I don’t like taking pills. Yes, it’s better to give up meat altogether, but it doesn’t always work out.

I quote Elena:

My husband was diagnosed and he was still walking! Six months later - a stroller, and after 10 years - complete helplessness. And you say there is modern medicines? And this is St. Petersburg and they diagnosed and prescribed treatment in 1 medical center. There is no cure and they don’t know how to treat.

What did they prescribe?

I'm just quoting my wife:

I am writing this because newbies can read it. My husband has at least 10 years of experience - the first exacerbation was about 15 years ago, the diagnosis was incorrect. The symptoms went away on their own, after serious treatment, diagnosis, etc. Everything is individual. My husband stopped taking the medications (not a guide to action - he was on them for 8 years, he was just tired of the side effects), and lives a normal life. Whenever there is a financial opportunity, he eats food with less gluten, drinks alcohol made not from wheat, but from grapes. If possible, eat turkey or lamb, but not chicken. Smokes. And it’s no different from peers over 50 - same lifestyle, etc. Again, I’m writing to support newbies. When I initially encountered pessimistic articles, I gave up. This is the worst thing for those who have just learned the diagnosis, and most importantly for those who are nearby! The main thing is that a person moves forward and sets goals for at least 5 years ahead. Our daughter was born then; we had no time to sit in a wheelchair (our son also started 1st grade). Then we bought a dacha, and more and more. The main thing is that a person should not fall off the list of ordinary and living people. The disease has not been fully studied - with a relapsing course, all functions are restored depending on age. It is advisable to adhere to a gluten-free diet for at least the first six months and master breathing exercises (Frolova, it seems) - it eliminates headaches and spasms. GOOD LUCK! Maybe it will help someone.

Thank you!

I quote the Optimist:

I’ve been sick officially for 11 years, unofficially for 13-14 years. I give injections (glatirate). I don't give up. Sports results are already better than those of healthy people. I walk a lot. getting closer to proper nutrition. I am 45 years old. Don't be scared or despair. It may not be possible to cure (I don’t know what’s on the MRI, I haven’t had one for 3 years), but it’s quite possible to live a high-quality, ordinary life!)) Minimize stress. A thirst for life and self-belief works wonders!!)) Good luck and health!!!)

In almost the same situation... the diagnosis was made at the wrong time, initially confused with a disorder cerebral circulation. Today it is already the sixth year on Glatiran plus, if possible, protection from stress, i.e. If you can’t have heat and sun, then you can’t! Well, the food itself. Sports make it possible to look better than those who do not have this disease. When I went for the second round to find out the causes of my problems, at that moment there were already a lot of them, and the most serious were severe headaches that made it difficult to simply live full life, this means not sleeping and not understanding... the feeling is terrible, plus numbness of half the body and dizziness, difficulty speaking, swallowing, and some movements. I was lucky when I got to a competent doctor who immediately suspected this diagnosis, especially since there were two relatives in my family with this disease. They write correctly, the most important thing is not to give up!!! Sports, yoga, walking and positive attitude! We will continue to fight!

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In case of multiple sclerosis, a disability group can be issued for certain lesions.

First, the patient needs to undergo examination by doctors narrow specialization. Then get a health report. The attending physician issues a referral using a special form indicating the main and associated diagnoses and the severity of the existing disorders.

Next, the patient goes to the medical office expert commission(VTEC), where he provides all documents and undergoes consultation. If the severity of the condition meets certain criteria, the patient is assigned a disability group.

You may also be interested in, in which we will talk about such a popular procedure as mesotherapy and tell you whether it will help alleviate sclerosis.

How to get it?

Disability status and its group are assigned after passing a medical and social examination (passing). VTEK experts and doctors conduct additional examination the patient in the clinic or at home (if the person cannot move independently).

According to the diagnosis of the patient and the conclusion of the examination, a decision is made to assign a group indicating the period of its validity, after which a re-examination is carried out. If for past term If the condition worsens, the group may be changed (for example, assigned to a second group instead of a third). When the condition of the patient with multiple sclerosis improves, the disability is removed. Typically, VTEC registers one of the groups for multiple sclerosis.

The basis for making a decision is a general disease. When prescribed, personal rehabilitation is established, which determines the needs, methods and means of transportation, hygiene products for the patient. They also conduct training courses to restore lost actions and abilities.

Criteria for assignment

The VTEK Commission uses the following criteria:

Before making a final decision on the group, the commission considers the following aspects:

1. a person’s inability to self-service;
2. pathology visual function and the level of its violation;
3. pathologies of motor function;
4. the degree of health of the patient.

The patient's ability to self-care

It is one of the evaluation criteria. The degree of independence in self-care ranges from complete self-care to loss motor function and the emergence of a need:

• in additional care;
• complete care from the outside;
• ability to orientate in space;
• communication and interaction.

Vision, its impairment and absence

The assessment per group is based on the severity (scotoma) of one or both:

1. Low degree of visual impairment – ​​up to 0.7.
2. Average degree – from 0.1 to 0.3.
3. Expressed degree – from 0.05 to 0.1.
4. Significantly expressed – from 0 to 0.4.

Severity of damage to the nervous system

Characterized by disturbances in speech function, cognitive abilities, sensitivity and perception. Also includes memory and its preservation, psychomotor functions.

What disability group do they give?

The VTEC Commission establishes a group according to the criteria and aspects of the diagnosis.

Assigned the following groups disability in multiple sclerosis:

Payment amounts for a given period of time

The pension benefit depends on the disability group received (as it depends on the degree of the citizen’s ability to work).

Scale

The disability scale for multiple sclerosis is calculated in points (from 0.0 to 9.0) using a special calculator.

The scales are represented by the following parameters:

1. Visual functions.
2. Condition of the spinal cord trunk.
3. Functions of the pelvic organs.
4. Pyramid system.
5. Sense organs.
6. Functions of the cerebellum.
7. Cognitive abilities.

Kurtzke scale 10 points

Reason for establishment

The general disease is the reason for determining disability in multiple sclerosis. In this case, the patient is prescribed rehabilitation program and training courses that are aimed at restoring lost abilities.

Read about the causes of the disease in, and you can find out whether it is inherited by going to.

Rehabilitation program

The program is designed for timely diagnosis and appointment, application and suspension from work. Medical examination is prescribed for a period of three months to a year. After rehabilitation courses, socialization, limited activity and rationalization of work are carried out.

For the second disability group, restrictions on work or retraining in a light specialty are introduced. Some patients are prescribed psycho-emotional correction.

Registration deadlines

According to the Federal Law "On social protection disabled people in the Russian Federation”, a group is formed and a monetary benefit (pension) is assigned. The benefit is assigned within the framework of an insurance or social nature.

The final decision on loss of ability to work and registration of disability is made after the stages of treatment, recovery and re-exacerbation. This usually takes from four months to a year. Deadlines for obtaining a certificate:

• definite– established for a period of two to four years with a positive prognosis for recovery, subject to verification by VTEK after the completion of the medical report.
• unlimited– established in the absence of positive prognosis for rehabilitation and in the presence of severe incapacity.

It will tell you how to live with such a disease