People with MS are, unfortunately, subject to discrimination and stigmatization. Multiple sclerosis and associated diseases in its various variants are still a mystery to most citizens. The ignorance and the ignorance of a disease, the lack of information of the people and the lack of training of professionals in various areas undermine the protection of rights of persons with Multiple Sclerosis.

Several questions that we are asked weekly, such as click on the question :

When I apply for a job I am obliged to inform you that I suffer from MS?

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Multiple sclerosis is a disease not notifiable, in other words, the candidate or employee is not required to inform your employer that you have multiple sclerosis, given that multiple sclerosis is not reported to the notifiable diseases in accordance with the Code of the 10th Revision of the International Classification of Diseases, pursuant to Resolution No. 313/97, of 27 July and constant Ordinance No. 1071/98, of 31 December, unlike, for example, As da, which is notifiable. It should however say that there is a rule that the employee must inform the employer of aspects relevant to the provision of work activity, otherwise be in breach of good faith inherent to the work contract (art. 102º and 106 º, nº 2 do CT). So if your physical condition is not appropriate to the function or is limiting function shall inform the employer in such a situation. It convirá, however, clarify that the employer can and should have carried out tests or medical examinations for admission or continued employment for evidence of physical or mental conditions, when they purport to protect the worker or others, or when special requirements inherent in the warrant, should be provided in writing to the employee with the reasons (art. 19º do CT – Lei nº 7/2009, of 12 February).Tests and examinations shall be made by the occupational physician who can only communicate to the employee if it does not qualify for the activity, but can not tell the employer that suffers from this or that disease (art. 19º, nº 3 do CT).

The worker with MS is positively discriminated by the Portuguese labor law?

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The answer is clearly yes!

Firstly, is framed as a worker with a disability or chronic disease which allows him to exercise some specific duties relating to their situation. From logo, worker with multiple sclerosis can not be required to provide additional or overtime (art. 88º CT). As well as, this type of worker is excused from working if it can harm your health and safety at work, in situations of organized schedules according to the bank of hours or concentrated time or when working at night between 20 h and a day 7 pm the following day (art. 87º). Last, our legislation requires that the employer take appropriate measures to ensure that persons with disabilities have access to employment, can progress, have appropriate training and working conditions, under penalty of committing very serious offenses (arts. 84º, 85º e 86º do CT).

My son has MS. It will be that, I have more rights as a parent?

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It is clear that sim!
From logo, parents are entitled to leave for a period of 6 months and may be extended up to 4 years to assist a child with a disability or chronic illness (art. 53º, nº 1).
In the case of children with 12 or more years of age assistance must be confirmed by a medical certificate (art. 53º. nº 2). Also with respect to faults is possible an employee can be absent from work in order to provide urgent and essential assistance to the child with a disability or chronic disease by 30 days a year or throughout any period of hospitalization (art. 49º). But other rights apply to these parents.
For example, if the parents have a newborn with disabilities or chronic illness to one year, both parents are entitled to a reduction of five hours of normal weekly hours of work or other special conditions to watch son (art. 54º, nº 1). And most employers should adjust the work schedule resulting from the reduction given the worker preference (54º, nº 5).
Another right yet, staff who have disabilities or chronic illness has the right to work on a flexible schedule, in other words, one in which the worker can choose, within certain limits, the start and end of the normal working day (56º, nº 1 and 2 do CT).

What happens if I do not inform the insurance company that I am person with MS?

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It is usual and unfortunately normal for people to help us conclude a contract for personal accident insurance or life, are insurance agents, mediators, bank employees, us "help"Between blades, saying what we should or should not say when filled health surveys. We think we are helping to make life easier and, so we left satisfied and gladly accept all advice. Do not place who has the disease, X, Y ou Z, do not say taking drugs, not tell who smokes, or drinking, etc.. The problem comes after. For regra, when filled health surveys should make them before a doctor and should be truly informed of the responsibility to fill these forms normally with squares. Give a false answer or more as usual, these surveys is put into absolute risk the validity of such document.
In the case of multiple sclerosis omissions worsen because of the stigma of the disease and the risk that the insurance proposal is likely to be refused. Obviously such a risk exists, However, each situation is always an individual case and should be subject to assessment by the insurer, depending on the exact conditions that insured health.
Reason why it is vital that the insured submits provided with detailed reports and medical certificates, precise about their health condition, in particular their skills and abilities. In my opinion the person with MS should never omit their disease before the Insurance Company, both in its celebration, either the validity of the insurance contract. The policyholder is required before concluding the contract to declare exactly all the circumstances and know that affecting the assessment of the risk by the insurer, as stipulated in Art. 24Of the Law of Insurance Contract (Dec.Lei nº 72/2008, of 16 April). This is because, if the contract tainted by intentional misstatements or omissions is voidable, statement sent by the insurer to the policyholder, pursuant to article. 25º, nº 1 Law of Insurance Contract. In other words, at the time the Company is required to pay compensation to the insured, will determine your entire medical history and discovering who suffered from multiple sclerosis and not saying cancels the insurance contract, cancellation must be sent within 3 months of the knowledge (art. 25º, nº 2). Thus, Insurance Company not only pay compensation, as does their all amounts received by the insured, by this bad-faith (art. 25º, nº 4). In practice crime does not pay.

The insurance company may refuse to enter into an insurance contract? You can practice different prices for people with MS? The prices can be double or triple insurance premiums of any other person?

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It is important to note that today, Law of Insurance Contract (Decreto-Lei nº 72/2008, of 16 April), expressly provides in its article. 15No prohibition of discriminatory practices in the celebration, implementation and termination of the insurance contract, breach of the principle of equality of Art. 13Constitution of the Portuguese Republic by Insurance Companies. And more, considers discriminatory practices "on grounds of disability or at risk of exacerbated health, actions or omissions, intentional or negligent, that violate the principle of equality, implying for people in that situation less favorable than that which is given to another compatible situation in treatment. " (art. 15º, nº 2).
However, are not prohibited discriminatory practices that are based on practical and technical assessment, selection and acceptance of the insurer's own risk and are objectively justified, basis by taking statistical data and actuarial rigorous. As one can easily understand to be a contract of insurance must be a risk to insure, so there are risks that are "inseguráveis", as well as risks that are superior to others and as such will have insurance premiums too many. The higher the greater the risk premium, we can say.
In relation to personal insurance contract, where risks are covered for life, health or physical integrity, curial say that everything will depend on the health status and medical examinations to make the person safe, aiming at assessing the risk. So once again reiterates that each case is different and every patient with multiple sclerosis must be analyzed individually (arts. 175º, 177º and 178 º CT).The questions of Insurers can practice different prices for people with multiple sclerosis and these prices can be double or triple insurance premiums of any other person, we say that prices may actually be higher than those in relation to others, However Insurers should provide information to the applicant on the ratio between specific risk factors and risk factors of another person not affected by that disability or aggravated health risk.
So, is necessary for insurance companies in addition to use in good faith, providing the complete clarification of the reasons why the practice will be higher than normal prices and the reasons for such discrimination. In the abstract and in my personal opinion, insurance premiums that are double, triple or quadruple an award for a normal citizen may constitute a prohibited discriminatory practice and be able to be reduced and eventually eliminated. It is important to clarify that the Law of Insurance Contract had the opportunity to indicate to resolve disagreements arising from refusals of insurance contracts or worsening of insurance premiums, the applicant may request a tripartite committee for an opinion on their situation, the Commission being constituted by a representative of the National Institute for Rehabilitation, A representative of the insurer and a representative from the National Institute of Legal Medicine. The opinion is not binding, by the tenderer may still have recourse to the Courts (art. 15º).

Patients with MS, can be legally supported by an association to defend their interests?

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The answer is positive.
Associations such as ANEM could support legal and procedurally people with multiple sclerosis, pursuant to article. 15Da Lei n º º 46/2006, of 28 August (Which law was intended to prohibit and punish discrimination, direct or indirect, on disability and the presence of increased health risk, and punish such acts as it translated in violation of economic rights, social and cultural).
Thus, ANEM can intervene with the locus standi on behalf or in support of all stakeholders in their judicial processes. As well as, these associations still have a right to follow his sister in misdemeanor proceedings enjoy and still have the right to constitute assistants in criminal cases.

 

Myth truths
“MS is fatal”

In the earliest epidemiological studies the life expectancy of patients with MS was considered not very different from the general population, although in patients with high failure can occur early death from complications such as pneumonia. In more recent studies comparing and patients who were treated for 21 years with interferon beta with those who were not treated, it was found that in patients treated there was a longer survival, pointing to a benefit in the long term with treatment.

“Sooner or later I will be in a wheelchair”

It is likely that each of us know someone with MS in a wheelchair but this does not mean that all patients become wheelchair. It is difficult to predict the degree of disability but the use of disease modifying drugs to delay disease progression.

“The treatments are all the same”

Currently there are several therapies for MS, Since drugs that treat disease (disease-modifying) treatment directed to the outbreaks and symptoms of the disease. Regarding disease modifying drugs, those approved in Portugal are interferon beta 1b (Betaferon® e Extavia®), interferon beta 1a (Avonex® e Rebif®), o acetato de glatiramero (Copaxone®), o natalizumab (Tysabri®) e o fingolimod (Gylenia®). They differ in the form of administration, the side effects and effectiveness. The first three are injectable and are approved as first-line drugs. Despite being injectable and therefore less comfortable for the patients known to be safe in the long term it is. The other two are more effective and have been approved for aggressive forms of the disease because despite more convenient administration are considered less secure. Natalizumab requires pesquiza serology for JC virus and the positive patients should not make more than two years of treatment. The fingolimod requires cardiac monitoring in the first 6 hours and regular reviews of the control of lymphocytes and liver enzymes. to 4 months is also performed ophthalmologic evaluation for macular edema screening. For outbreaks are used corticosteroids that can decrease the duration of outbreaks and speed recovery. For the symptoms there is no pharmacological treatment (as physiotherapy) and drug as muscle relaxantes for a espasticidade, anticholinergics for urinary dysfunction, sildenafil for sexual dysfunction, antidepressants

“People with MS can not have children”

MS affects 3 times more women than men in fertile age and so this question usually care much patients. However pregnancy phase is considered a protective layer to reduce the number of relapses especially during the 2nd and 3rd trimester, not seem to affect the long-term disability.

“I IN, so my children will also have the disease”

MS is not considered a hereditary disease and so the fact that the disease does not mean that your child too will have the disease. However studies suggest that children of parents with MS have about 4% of developing the disease, which is more frequent than in the general population.

“My MS was triggered by an infection”

It is thought that the etiology of MS is multifactorial, i.e, that there are several factors that may play a role in their appearance. These include genetic predisposition, environmental factors such as viruses, Vitamin D and deficit associated with smoking a dysregulation of the immune system

“People with MS can not sunbathe”

Studies have shown that MS patients have vitamin D deficit and so it is important sunbathing (if properly protected and avoiding peak hours) vitamin D as transmitted by the sun can benefit the treatment of MS.

“People with MS can not go to the gym”

It was once thought that physical exercise worsened the disease, however now it is known that physical activity is important because it can improve many of the symptoms of MS but should be adapted to the physical capabilities of the patient. It is known that overheating can worsen the symptoms of the disease and so it is important to avoid this extreme making frequent intervals.

“MS is easy to diagnose”

The symptoms of MS can be observed in other neurological disorders, and therefore it is necessary that they be excluded before doing the diagnosis of MS. There must be evidence of demyelination at two points in time and at different sites within the central nervous system. There are several tests that may aid in the diagnosis such as MRI, Evoked Potentials and lumbar puncture. The latter is particularly important when there is diagnostic doubt.

“I can not do anything to help my illness”

There are many things that patients can do to have a balanced diet, do not smoke, exercising, sunbathing and take the medication prescribed by your doctor.

Ana Paula Sousa, Neurologist – Neurologic Senior Campus

 

In conclusion, have rights. We have the right to be informed and the duty to inform ourselves, but above all we must have the courage to fight for the defense of our rights if we want to progress and end discrimination that all patients experience in their day-to-day.

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