Department of Veterans Affairs VHA HANDBOOK 1011.06
Veterans Health Administration Transmittal Sheet
Washington, DC 20420 December 7, 2009
Common MS symptoms include fatigue, cognitive impairment, mood disorders, visual difficulties, motor and sensory deficits, incoordination, gait dysfunction, speech and swallowing deficits and impairments of bowel and bladder control as well as sexual functioning. Because the symptoms of MS are diverse, and occur dynamically over the course of many decades, patients are optimally managed in a comprehensive and specialized center.
Background and Assumptions: Based on the 2006 National Ambulatory Medical Care Survey conducted by the National Center for Health Statistics, MS is the seventh most common disorder to be evaluated by neurology specialists, making up 6 percent of all referrals. Patients with MS have variable degrees of disability with complex symptoms and histories. The VA MS population is more disabled than the MS population in the private sector. The average MS disability is 0.5-1.0 points higher on the Patient Determined Disease Steps among Veterans with MS compared to non-Veterans. MS is a dynamic disease with relapses and remissions early in the course but ultimately progression in neurological disability ensuing in most individuals.