Multiple sclerosis disability in multiple sclerosis. What group of disability is put in the diagnosis of "multiple sclerosis"? Criteria taken into account by the medical board
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 an autoimmune disease. The pathological process is expressed in the degradation nervous tissue and destruction of the outer layer of nerve fibers, consisting of myelin. The result of the development of the disease are multiple lesions nervous system, manifested by decreased vision, rapid fatigue, impaired coordination of movements, tremor, muscle weakness, decreased peripheral sensitivity, local paresis. In severe cases, there may be deterioration in functioning pelvic organs(stool and urination retention, urinary incontinence, etc.), the appearance of neurosis, depression, hysteria, or, conversely, euphoric states, combined with a decrease in intelligence.
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Multiple sclerosis is a fairly common pathology: there are more than 2 million people in the world who suffer from it. There are several described forms of MS, but the set of symptoms, severity and specificity of the course of the disease are individual for each patient.
Although MS is not considered a rare disease, most people are not familiar with its features. We will try to dispel some of the myths that have developed around the named disease.
Multiple sclerosis is a deadly disease
This is not true. Most severe forms sclerosis, accompanied by a serious lesion of the central nervous system, are relatively rare. In addition, modern medications able to significantly improve the condition of patients. Unfortunately, the situation is complicated by the fact that clinical manifestations MS often appears late, when about half of all nerve fibers are already damaged. In such cases, the start of treatment is delayed, which negatively affects its result.
Application of modern medicines and improved living standards are beneficial for people with MS. Although the cases complete cure unknown, progression pathological process usually slow 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 for every person with multiple sclerosis, in the future - movement with the help of a wheelchair and complete helplessness. In reality, forecasts can be much more optimistic: early diagnosis and the timely initiation of adequate treatment, disability may not occur. Of course, much depends on individual features course of the disease, but the majority of MS patients manage to maintain the ability to move independently, serve themselves and live in the usual mode.
Multiple sclerosis is a disease of old age
Rather, the opposite: the onset of the disease usually falls within the age interval between 10 and 50 years. Among the children of girls suffering from MS, three times more than boys, but in older age groups the number of men and women among patients is almost the same. In the fairer sex, the disease manifests itself on average 1.5-2 years earlier than in their male peers, but in recent disease proceeds more actively and takes on more severe forms.
Reason for the appearance multiple sclerosis not yet known, only risk factors have been studied:
- ethnic (racial) affiliation. Europeans get MS more often than Africans, and the Chinese, Japanese, Koreans are almost never diagnosed with the disease;
- region of residence (the so-called "latitudinal gradient"). The risk of getting 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 was recorded in the southern parts of the African and South American continents, as well as in Australia;
- stress. There are observations confirming the increased incidence of multiple sclerosis among representatives of "nervous" professions (air traffic controllers, firefighters, pilots, etc.);
- smoking;
- genetics. Having a family history of MS increases the risk of developing the disease tenfold. However, the disease is not considered hereditary, since its appearance is usually due to many factors.
Women with MS shouldn't get pregnant
Multiple sclerosis is not an obstacle to bearing a child. On the contrary, many women with MS experience significant relief during pregnancy, and many years of remission may occur after the baby is born.
Disease future mother does not affect the development of the fetus and the health of the newborn. The only problem is the use of drugs prescribed for the treatment of MS, as some of them cannot be used during pregnancy and breastfeeding. Therefore, the patient must always consult with the attending physician before conception and be under his supervision for the entire period of gestation.
MS patients should avoid physical activity
For a long time, doctors really believed that exercise was bad for people with multiple sclerosis. Numerous studies have shown that this is not so: patients can and should show 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.
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MS patients cannot continue to work
Many people with MS, thanks to adequate treatment for decades, retain not only habitual 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 the reason for leaving work, especially since labor law obliges employers to provide such employees with working conditions that take into account the peculiarities of their condition. Therefore, the majority of MS patients who are of working age are not in danger of being thrown to the sidelines of life.
Multiple sclerosis is a severe 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, to keep an optimistic view of the world, and to maintain normal level life will be a completely solvable problem.
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Comments on the material (17):
I'm just quoting my wife:
Thanks
I quote Sidorenkova Ekaterina Valerievna:
I'm just quoting my wife:
I write because beginners can read. My husband has at least 10 years of experience - the first exacerbation was about 15 years ago, the diagnosis was incorrectly made. The symptoms went away on their own serious treatment, diagnosis, etc. Everything is individual. The husband stopped taking drugs (not a guide to action - he was on them for 8 years, he was just tired of the side effects), he lives ordinary life. When there is a financial opportunity, he eats food where there is less gluten, drinks alcohol not on wheat, but on grapes. If possible, eats turkey or lamb, but not chicken. Smokes. And it is no different from peers under 50 - the same lifestyle, etc. Again, I am writing to support newcomers. When I came across pessimistic articles at the beginning, my hands dropped. 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 for a person to move forward and set goals for at least 5 years ahead. Our daughter was born then, there was no time in wheelchair sits down (another son went to grade 1). Then they bought a dacha, and on the rise. The main thing is that a person should not fall out of the list of ordinary and living people. The disease has not been fully studied - with a remitting 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 someone will support.
Thanks
I've been living with MS for 18 years, yes, in the first 10 years I felt noticeably better, but I don't give up either. I also recommend light yoga. She is also very helpful. The main thing is not to be buried alive. Yes, I don’t take any treatment, maybe in vain, but I don’t like to take pills. Yes, it’s better to refuse meat altogether, but it doesn’t always work out.
Quoting Elena:
My husband was diagnosed and he can still walk! Six months later - a stroller, and after 10 years - complete helplessness. And you say there modern medicines? And this is St. Petersburg and they diagnosed and prescribed treatment in 1 honey. There is no cure and no cure.
What was appointed?
I'm just quoting my wife:
I write because beginners can read. My husband has at least 10 years of experience - the first exacerbation was about 15 years ago, the diagnosis was incorrectly made. The symptoms went away on their own, after a serious treatment, diagnosis, etc. Everything is individual. The husband stopped taking drugs (not a guide to action - he was on them for 8 years, he was just tired of the side effects), he lives a normal life. When there is a financial opportunity, he eats food where there is less gluten, drinks alcohol not on wheat, but on grapes. If possible, eats turkey or lamb, but not chicken. Smokes. And it is no different from peers under 50 - the same lifestyle, etc. Again, I am writing to support newcomers. When I came across pessimistic articles at the beginning, my hands dropped. 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 for a person to move forward and set goals for at least 5 years ahead. Our daughter was born then, there was no time to sit in a wheelchair (another son went to 1st grade). Then they bought a dacha, and on the rise. The main thing is that a person should not fall out of the list of ordinary and living people. The disease has not been fully studied - with a remitting 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 removes headaches and spasms. GOOD LUCK! Maybe someone will support.
Thank you!
Quoting Optimist:
In almost the same situation ... the diagnosis was not made on time, initially confused with a violation cerebral circulation. To date, for the sixth year on Glatiran, plus, if possible, protection from stress, i.e. if you can not heat and sun, then you can not! Well, food of course. Sport makes it possible to look better than those who are not sick with such a disease. When I went around 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 one was severe headaches that prevented me from just living a full life, it’s not sleeping and not understanding ... a terrible feeling plus numbness of half of the body and dizziness, impaired speech, swallowing, some movements. I was lucky when I got to a competent doctor who immediately suspected such a diagnosis, especially since two relatives in the family had such a disease. Correctly write the most important thing is not to give up !!! Sports, yoga, walking and positive attitude! Let's keep fighting!Officially I have been sick for 11 years, unofficially for 13-14 years. I prick injections (glatirat). I don't lower my hands. Sports results are already better than healthy ones. I walk a lot. Approaching proper nutrition. I'm 45 years old. Don't be scared and don't despair. It may or may not be cured (I don’t know what was on the MRI, I didn’t do it for 3 years), but it’s quite possible to live a high-quality, ordinary life!) Minimize stress. Thirst for life and faith in yourself works wonders!!)) Good luck and health!!!)
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Multiple sclerosis is a primary demyelinating disease of the central nervous system. This means that there is a destruction of the already formed myelin. The main damage that the disease causes is a violation of transmission nerve impulse. Myelin damage leads to sharp decline transmission speed. In addition, an impulse intended for one group of nerves can be transferred to another. From this, a person loses his ability to work, sometimes it is required to establish a disability group. The frequency of disability in Russia, the Baltic states and Belarus is approximately the same: from 25 to 50 cases per 100 thousand of the population.
Main criteria
Disability in multiple sclerosis is determined by three factors:
- type of course of the disease and defect;
- the number of days of temporary disability in a year;
- the patient's profession.
The medical labor commission considers a combination of factors. Special attention is given to the severity of the process and the defect that has arisen as a result of it (loss of functions). They always try to preserve a person’s ability to work as much as possible, switching off from daily work immediately complicates social adaptation.
A disability group is given for multiple sclerosis for processing social benefits - pensions and subsidies.
The medical commission is based on the criteria for the severity of the course of the disease, developed in 1996 by Leonovich and Kazakova. According to them, 4 degrees of severity of the course of the disease are distinguished.
- First, there are signs organic damage nervous system, but all its functions are preserved. In this case, the person retains full working capacity, the disability group is not given, it is necessary intermittent treatment in the hospital.
- The second - there is a lack of vision, movement or coordination. Depending on the type of flow, a temporary disability sheet can be extended or a 3rd disability group is established for 1 year, followed by re-examination.
- Third - there are persistent violations various functions movement, coordination, vision, intelligence, which make the performance of professional skills impossible. Disability group 2 is established, with re-examination or indefinitely.
- Fourth - there are pronounced violations vital functions, a person requires extraneous care. We are not talking about a profession at all, a person cannot independently serve himself. 1 group of disability is established, most often immediately indefinitely.
Temporary disability and disability
Timing inpatient treatment in Russia and Belarus are approximately the same. At the first degree of severity of the disease, the patient needs thorough examination and quality treatment which can take 3 to 4 weeks. There is no need to present the patient to the medical labor commission, the certificate of incapacity for work is extended in the usual manner. At the end of treatment, the person returns to former place work, his ability to work is not impaired.
More attention is required to the remitting type of course, when an exacerbation can drag on up to 4 months once. Also, exacerbations can be repeated 2-3 times within one year, the duration of each can be from 1 to 2 months. For medical labor commission not only the state of health matters, but also total number days of disability per year. The question of whether a person with existing disorders can generally return to work is being considered.
If by December the patient spent 2 months in the hospital, and he needs 1-2 weeks to complete the treatment, then the temporary disability sheet can be extended without establishing a disability group.
If the commission sees that the case is moving towards recovery, but the number of days of disability exceeds 4 months in 1 year, then a 3rd disability group is established. A person copes with the aggravation and returns to his previous place of work, but requires lighter working conditions - less work or a decrease in the number of hours. The difference in wages should theoretically be compensated by a disability pension.
A chronic progressive course is considered unfavorable in terms of labor prognosis. Such patients are almost immediately assigned a 3rd disability group, but they still have to spend a lot of time in the hospital. Subsequently, with an increase in disability, disability is aggravated. Sometimes there is a need to present such patients to MSEC ahead of schedule.
Disease and profession
There is a list of types and working conditions that are contraindicated in multiple sclerosis. it common factors and causes that harm this particular patient.
To general harmful factors relate:
- Physical overexertion;
- toxic substances;
- Vibration;
- Increased insolation;
- General overheating.
According to the conclusion medical commission a person can be transferred from a hot shop to another division in the same enterprise.
The ratio of the symptoms of the disease and the profession of a person is always very complex issue. The possibilities of retaining a profession depend on what actions this profession requires.
For example, a person works as a dispatcher transport company, is on duty throughout the day. Due to illness, he developed pyramidal insufficiency (asymmetry and increased tendon reflexes, reflex zones, pathological signs, awkwardness when performing precise movements). In addition, there are visual impairments - the sharpness and ability to navigate have decreased. broke emotional sphere showed signs of depression. It is clear that further hard work as a dispatcher will worsen the state of health. It is best for such a patient to arrange a group, he can be transferred to a daily schedule to perform less responsible work (assistant, secretary, clerk).
The second patient has exactly the same clinical picture, but he works as a day watchman at a mothballed construction site, working time in a furnished house. There is no need to establish a group here (if the number of days of incapacity for work allows), since working conditions do not affect the course of the disease.
Which disability group will be established depends on the specific circumstances.
General indications for referral to MSEC
The indications are approximately the same throughout the post-Soviet space, in Russia and Belarus. These include:
- persistent disturbances in the functions of movement, vision, coordination, mental activity limiting human life;
- progredient course of the disease, in which it is impossible to achieve complete remission, and exacerbations occur at least 2 times within one year;
- duration of temporary disability exceeding 4 months within one year;
- loss of profession or inability to perform previous work in full.
The disability group can be revised when a good quality remission is achieved.
The diagnosis of multiple sclerosis today is not a sentence. The life expectancy of patients reaches 30 years or more. Taking into account typical age the onset of the disease - from 20 to 40 years - a sick person has every chance to live full life, leave offspring and achieve the goal. Life still flows, and what it will be depends largely on the person himself.
Multiple sclerosis is a common disease. Unfortunately, it most often affects relatively young people.
At risk are those whose age ranges from 15 to 45 years. This disease belongs to the category of diseases of the central nervous system (hereinafter referred to as the CNS).
And, although the forecasts regarding the life expectancy of the patient are quite optimistic - at least 25 years from the moment the fact of the disease was revealed, such a person cannot fully live and work.
The state is taking measures to support patients with serious problems with the CNS. One of these measures is the possibility of registering disability and receiving monthly subsidies from the state for accommodation, food and treatment of the patient.
We will talk with you in this article about how to apply for disability with a diagnosis of multiple sclerosis, what documents you need to collect and what payments are provided for.
Multiple sclerosis - what is it?
As mentioned above, multiple sclerosis is a disease in which the central nervous system is affected.Diagnosis of the exact presence of the disease is possible only after comprehensive examination a doctor, an MRI of the brain is required.
Depending on the severity of the disease and the nature of its course, multiple sclerosis is divided into the following types:
- First the degree at which signs of damage to the nervous system appear without disrupting its functions. Employability in this case is preserved.
- Second the degree at which disturbances in the motor, visual and coordination functions of the nervous system are not clearly expressed. Working capacity is partially limited.
- Third the degree at which violations of the basic functions of the nervous system are clearly expressed and stable. Patients experience serious difficulties. The ability to work is impaired, which leads to the inability to engage in professional activities - especially those requiring high concentration attention, long standing, clarity of movements and control over fine motor skills of the hands.
- fourth degree, in which violations of motor and visual function sharply expressed. The patient is not able to independently serve himself, and need constant care and help from outsiders, when performing almost any household activity. The person is completely unfit for professional activity.
Based on the above signs, it can be understood that with the first and second severity of the disease, the patient is limitedly fit for work, yet does not require prolonged physical exertion.
At the third and fourth, the chances of a normal professional activity such people are completely absent - it is difficult for them even to serve themselves.
Is there a disability for multiple sclerosis? How is disability defined?
In order to get a disability based on the existing diagnosis, you must contact the doctors of a special commission - VTEK (Medical and Labor Expert Commission).
They issue a conclusion on the possibility of assigning a disability and its category after the patient has undergone a complete examination.
To receive a referral for examination by the VTEK commission, you must contact your doctor or head physician of the clinic where the patient is being treated. Examination and examination of the patient can be carried out by the commission both in the premises of the VTEC, and with a visit to the patient's home, or in a hospital if he is being treated there.
Based on the results of the examination, the doctors of the commission decide on the assignment of a disability to the patient, its group and the period for assigning the disability. Regular re-examination of patients is carried out, as a result of which, if their condition worsens, patients may be assigned another disability group. With the onset of improvements and the appearance of working capacity, the patient is deprived of the right to be recognized as a disabled person.
With multiple sclerosis, the patient has the right to apply to the VTEK for examination and obtain the right to assign him the status of a disabled person. In this case, doctors are guided by the following factors when making a decision:
- degree of violation motor function patient - depending on its severity, assigned I, II or III group disability;
- degree of visual impairment;
- the general condition of the patient;
- the patient's ability to take care of himself.
Disability of which group is given in the diagnosis of multiple sclerosis? Based on the above data, a decision is made to assign one of the three disability groups:
- Disabled people of the third group - people with moderate or mild movement disorders suitable for work.
- Disabled people of the second group are people with pronounced disorders of motor and other functions.
- disabled people of the first group - people with pronounced disorders of motor, support and visual functions.
Disability benefits vary by group.
Since multiple sclerosis is a serious disease and it occurs most often in young and mature people, the question would be reasonable: is it worth planning a pregnancy with such a diagnosis? In this article, we will consider the psychological and physiological aspect of bearing a child with a similar disease.
Disability pension sizes for different groups
Disability benefits are indexed annually, in connection with which their size increases. For 2015, the statistics are as follows:- disabled children and children with disabilities receive an allowance in the amount of 11,446 rubles;
- disabled people of the first group receive social payments in the amount of 9539 rubles;
- disabled people of the second group can count on payments in the amount of 4,768 rubles;
- invalids of the third (working) group - for a pension in the amount of 4054 rubles.
These types of payments (social) are not affected by the presence or absence of seniority at the patient. They are appointed for a period equal to the period of disability or indefinitely. To receive this type of pension, you will need a passport and documents from the VTEK, recognizing the patient as a disabled person, as well as information about the disability group assigned to him.
Life expectancy in multiple sclerosis is determined by a host of factors.
Multiple sclerosis - autoimmune disease, as a result of which the myelin sheath of the nerves of the spinal cord and brain is affected.
In this case, the nervous tissue is replaced by connective tissue.
The consequence will be muscle weakness and, as an ending, paralysis. In patients diagnosed with multiple sclerosis, life expectancy depends on the rate of progress of the disease.
More than 150 thousand people in Russia suffer from this disease. Get sick in early age, from the age of 15 to 40. Cases of the disease at an earlier age have been registered. However, after 40-50 years, there is practically no chance of getting sick.
Multiple sclerosis has nothing to do with senile insanity, memory loss does not apply. Sclerosis means scar connective tissue, and scattered - multiple.
Causes of sclerosis
Exact reasons The development of multiple sclerosis has not yet been identified, however, there are assumptions that take place.
To genetic factors can be attributed to a certain combination of genes that cause a violation in immune system organism.
There are also non-genetic factors. It can be stress, unfavorable living environment, malnutrition, bacteriological or infectious diseases, smoking, frequent injuries, the influence of radiation and ultraviolet radiation.
The cause of multiple sclerosis may be a combination of external and internal factors that caused this disease.
It has been proven that multiple sclerosis is not hereditary disease However, the risk of getting sick increases if there are such patients in the family. But the percentage of transmission from parents to children is only 2-10%.
There are risk factors that can trigger the development of multiple sclerosis:
- A certain area of residence or insufficient production of vitamin D. People who live far from the equator are more likely to suffer from multiple sclerosis. These are northern areas with insufficient income sunlight. These people do not produce vitamin D in the right amount and can cause the development of sclerosis;
- Stressful situations, strong neuropsychic stress;
- excessive smoking;
- low uric acid;
- Made vaccine against hepatitis B;
- Diseases caused by viruses or bacteria.
Symptoms of the development of the disease
There are many symptoms of multiple sclerosis. Some number about 50. Therefore, rarely is anyone diagnosed in initial stage diseases. The manifestation of each individual in people and it is impossible to predict further progression.
- Decreased visual acuity up to blindness (possibly a decrease in one eye);
- Violation of color perception;
- Impaired coordination of eye movements;
- double vision;
- Dizziness;
- Spasm of the muscles of the arms or legs, aggravated by walking;
- Trembling of fingers and hands, aggravated by small movements (button fastening);
- Loss of coordination, unsteadiness when walking;
- Pain unclear etiology in the arms or legs;
- Excessive fatigue throughout the day
- Numbness in hands or feet;
- slurred speech;
- Memory impairment, decreased concentration;
- Depression;
- involuntary urination;
- Violation of sexual desire;
- Increased symptoms with elevated temperature environment.
Diagnosis of the disease and observation
The diagnosis of multiple sclerosis is made after the discovery of two foci of sclerosis in the brain or spinal cord. An attack of symptoms should recur within 24 hours, and a stable deterioration should be observed within 6 months.
To determine the foci of sclerosis, magnetic resonance imaging is prescribed. It is she who allows you to see the location of the scars. However, even during an exacerbation of symptoms, the doctor will not see the presence of foci of sclerosis, since they take time to develop.
Therefore, MRI is prescribed once a year, and if necessary, 2 times a year, to monitor the situation.
In addition to MRI, an immunoglobulin test may be prescribed. Their number is important cerebrospinal fluid. It is necessary to constantly monitor the state of the immune system.
No less accurate than MRI examination is electromyography and the method of evoked potentials. These studies help to accurately determine the location of the scar formation and the extent of the lesion.
Cerebrospinal multiple sclerosis, disability
There are two types of multiple sclerosis: cerebral, when the lesion affects only nerve fibers brain, and spinal, when the fibers of the spinal cord are affected. However, there are people in whom the lesion affects and spinal cord, and head.
There are several types of multiple sclerosis. Disability depends on the type of flow.
- relapsing sclerosis. It is characterized by periods of exacerbation of the disease, which are replaced by remission. During remission it is possible full recovery affected organs and tissues. Does not progress over time. It occurs quite often and practically does not lead to disability.
- Benign. Begins suddenly and is characterized large quantity severe attacks. The peculiarity of benign sclerosis is that the symptoms gradually subside, and everything is given to the damaged organs. more time for recovery. This type of multiple sclerosis can be considered curable.
- Primarily progressive. Deterioration begins with the first symptom. Quite quickly leads to disability and further disability.
- Secondary progressive. The deterioration is gradual, but within 5 years will steadily lead to disability.
There are no specific contraindications to the birth of a child, his feeding and further education. 
