Unfortunately my Neuro is kinda Mr Magoo. I had a good Neuro but he retired, the new guy who took over at the same practice I did not like so I went to this new one right as all the paperwork started to need to be filled. I am afraid to go to another, more cognisant, Neuro because I am afraid to be accused of doctor shopping. Part of the reason for the denial was because the newest did not write the reasons for disability properly. So I used this template:
http://www.nationalmssociety.org/Nat...A-letter_1.pdf
to generate this letter I hope he will sign, or edit to his likeing when I see him in 2 hours.
--To Whom It May Concern:
My patient Mark XXXX has Secondary Progressive Multiple Sclerosis and severe Lassitude. He is limited in daily activities and is unable to work on a sustained basis. My findings have been confirmed through physical examination, medical history, magnetic resonance imaging, and standard neurological examination, including evaluations of strength, spasticity, coordination, gait, sensation, vision, and mental status. Patient?s symptoms include intense fatigue, limb and extremity numbness and tingling, neuralgia in the right arm and left leg, impaired motor control, heat intolerance, flushing, and frequent muscle spasms and tremors.
Patient had MRIs taken in May and June 2010 that showed demyelination damage in the brain and cervical spine. MRIs taken in August 2010 showed a remission. MRIs taken in December 2011 showed new damage in the brain and an intensification of the existing damage in the cervical spine. All MRIs taken since confirm the damage shown in December 2011 has never receded.
Patient?s fatigue manifests as an increasing debilitation throughout the course of a day. Heat and stress hasten the progression of the fatigue. When the fatigue is acute patient has severely reduced memory and cognitive function, ambulation becomes difficult or impossible even with a walking aid. Tunnel vision, tinnitus, and dizziness affect the patient?s ability to interact with people and objects. The fatigue can get so severe the patient can perform no other actions but resting.
Patient is currently taking Tecfedera and is compliant with prescribed medical treatments.
Patient is unable to retain significant employment because of the unpredictable nature of the disease and accompanying fatigue. Patient suffers with significant, reproducible fatigue of motor function with substantial 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.
In my opinion, Mark CXXXX is unable to resume any type of gainful employment due to physical impairment. MS is a progressive neurological disorder, and while disability can be delayed with treatment, there is not a cure. My expectation is that Mark will see a continued decline in function over time.
Sincerely,
--
