Prognosis and Duration of disabling effects
The course of multiple sclerosis is highly varied and unpredictable. In most patients, most commonly when multiple sclerosis begins with optic neuritis, remissions can last from a few months to over 10 years.
Multiple sclerosis is not a fatal disease although in severe cases may pose a risk because of life-threatening complications. It also shortens the average life span by about six years and in nearly all cases, the negative emotional impact of this disease and its symptoms is considerable. Women tend to have a better outlook than men although the severity of the disease varies widely from patient to patient:
- About 10% to 35% of patients have a very mild form of the disease, with little if any disability, no need for medication and a normal life expectancy. People who have only optic neuritis and symptoms that affect the senses have a better outlook than if symptoms are more widespread.
- About 70% of patients will experience some degree of progression. MS, however, can sometimes remain asymptomatic or become only mildly symptomatic (‘Benign’ MS).
Generally where relapses become more frequent, people become increasingly disabled, sometimes permanently. Nonetheless, about 75% of people who have multiple sclerosis never need a wheelchair and for about 40% normal activities are not disrupted.
Life expectancy is shortened only slightly with MS and the average survival of patients from the time of diagnosis is over 30 years. The survival rate is linked to disability and secondary complications such as kidney or chest problems or psychiatric disorders.
Remissions of varying length are common, particularly in the early years of the disease; they can last for months or years and in some instances appear to be life long. However, the primary progressive form of the disease can take a rapid downhill course.
The most common pattern is recurring relapses leading to chronic disability with associated complications and eventually some degree of dependency and impaired mobility. Customers with relapsing and remitting type are likely to have periods of greater disability. When considering duration of awards for them all facts must be taken into consideration including the duration of any previous relapses when advising on duration of award.
Customers diagnosed with primary or secondary progressive multiple sclerosis are likely to have ongoing needs once needs are established and indefinite awards are recommended.
You may need to consider whether H/R Mob SVI deeming provisions are satisfied – H/R Mobility Severely Visually Impaired (SVI) deeming provisions
All information must be taken into account when considering the duration of disabling effects and the duration of disabling effects must be based on the particular circumstances of the individual claimant.
Amended December 2011
