Is Lyme Disease a Disability?
Lyme disease, like many so-called “invisible” chronic conditions, is often misunderstood. While many people quickly recover from the infection, others struggle with long-term fatigue, muscle aches, and cognitive difficulties. Lyme disease can make working and doing other things you love virtually impossible.
At Bryant Legal Group, we help people struggling with Lyme disease and other chronic conditions get the disability insurance benefits they deserve. In this article, our short-term and long-term disability lawyers explain why Lyme disease is on the rise and describe what you can do to strengthen your disability claim.
What Is Lyme Disease?
Lyme disease is the most common tickborne disease, making up 82% of all confirmed tickborne diagnoses in the United States. Due to a variety of factors, including climate change, Lyme disease has become increasingly common in Illinois and throughout the United States. Since the late 1990s, confirmed Lyme disease cases have tripled. Today, the United States reports roughly 30,000 new Lyme disease cases each year, and experts believe that many more cases go unreported.
In Illinois, there were at least 276 reported cases of Lyme disease in 2018 alone. Many cases occur near the Lake Michigan shoreline, and the disease has also been found in Lake County and Chicago.
Common Symptoms of Lyme Disease
Lyme disease is caused by an infection from the bacteria Borrelia burgdorferi. People contract the disease after being bit by a black-legged or deer tick. The disease has several stages:
- Early Lyme disease: You may experience flu-like symptoms such as a fever, a bull’s-eye rash (a red, circular rash with a clear center) near the tick bite, fatigue, chills, headache, and swollen lymph nodes.
- Late-stage Lyme disease: If Lyme disease goes untreated, it can cause more profound symptoms. Signs of late-stage Lyme disease may include arthritis, swollen joints, muscle and joint pain, dizziness, heart palpitations, and loss of facial muscle tone.
- Post-treatment Lyme disease syndrome: (PTLDS) Even after treatment, some people struggle with chronic fatigue, headaches, damage to their nervous system, muscle and joint pain, dizzy spells, cognitive problems, and arthritis. While doctors aren’t sure what causes PTLDS (sometimes called “chronic Lyme disease”), they suspect an overreactive autoimmune system may be a factor.
Many people living with Lyme disease also report significant problems with short-term memory loss, and some also struggle with mental health issues like depression and anxiety.
In rare cases, Lyme disease can create a heart problem called Lyme carditis. This issue occurs when the Borrelia burgdorferi bacteria enter your heart muscles and cause a “heart block,” which interferes with your heart’s electrical signals. Some people who contract Lyme carditis require a pacemaker.
Lyme Disease Is Difficult to Diagnose
It’s often difficult to diagnose early Lyme disease since not everyone develops the telltale bull’s-eye rash. Currently, doctors use a two-stage blood test that looks for Lyme disease antibodies. However, this test only has a 30-40% rate of detection for those with early Lyme disease. To further complicate matters, the Borrelia bacteria quickly leaves your bloodstream and enters your tissues and lymph nodes.
Antibiotics Can Help Treat Early Lyme Disease but Don’t Help With Advanced Cases
When doctors reach a diagnosis of Lyme disease, they often start treatment by prescribing a short course of an antibiotic like amoxicillin or doxycycline. Some doctors will prescribe a dose of antibiotics after any tick bite as a preventative treatment.
If you have a more advanced case of Lyme disease, you may need to stay on a course of antibiotics for up to four weeks. However, studies have not shown that prolonged use of antibiotics helps those with chronic Lyme disease or post-treatment Lyme disease syndrome.
Unfortunately, there is not a known treatment for PTLDS or chronic Lyme disease. Doctors may instead prescribe medications to treat or reduce your symptoms.
Can I Get Disability Insurance Benefits for Lyme Disease or Post-Treatment Lyme Disease Syndrome?
To qualify for short-term or long-term disability benefits, you must prove that you are unable to work due to your Lyme disease and other medical conditions. It is possible to get disability benefits for Lyme disease and post-treatment Lyme disease syndrome. However, getting benefits may be difficult due to misconceptions about the disease and the limitations of our current testing system.
Disability insurance adjusters tend to deny claims where there isn’t a clear diagnosis that’s proven by objective evidence, like a blood test, MRI, or nerve conduction study. Unfortunately, many people with Lyme disease get inconclusive test results or receive a tentative diagnosis of “probable Lyme disease.”
The insurance company may argue that your chronic Lyme disease or PTLDS diagnosis is “self-reported” since symptoms like fatigue, pain, and dizziness are subjective and cannot be proven by a test. Most long-term disability insurance plans limit benefits for “self-reported” conditions to two years.
To fight back against these insurance company tactics, you’ll need help from an experienced ERISA lawyer who can help explain your complex diagnosis and bloodwork to the insurance company and a judge.
4 Ways You Can Strengthen Your Disability Insurance Claim for Lyme Disease
Because disability claims related to Lyme disease are sometimes difficult to prove, it’s best to consult a disability insurance lawyer early in the application process. Your disability lawyer can help you collect evidence that supports your claim, and they can also educate the adjuster about the nuances of Lyme disease.
Because many people aren’t familiar with chronic Lyme disease and post-treatment Lyme disease syndrome, your lawyer may need to get detailed statements or letters from your doctors and other experts. These letters will explain how the doctors arrived at your Lyme disease diagnosis, how the disease impacts your daily function, and how your diagnosis is supported by objective medical evidence.
Building a disability insurance claim strategy for Lyme disease takes attention to detail and extensive medical and legal knowledge. While we can’t give specific advice without knowing the details of your claim and your health status, we can provide some general tips to create a strong disability claim.
1. Never Minimize Your Symptoms
You should never minimize your Lyme disease symptoms while talking to your doctor, especially if your symptoms involve shooting nerve pain, swollen joints, or a racing heartbeat. Insurance adjusters will have a harder time denying your LTD claim if you have a consistent record of symptoms for your Lyme disease.
2. Consider a Neuropsychological Evaluation
Many people living with Lyme disease have memory problems, short attention spans, and struggle to complete even simple tasks. While these issues can be hard to talk about, it’s important to be open with your doctor about your struggles. Your doctor may recommend neuropsychological testing, which measures your ability to think and process information. A neuropsych evaluation that clearly documents deficits in your memory and processing abilities will strengthen your disability insurance claim.
3. Don’t Shy Away From Testing For Arthritis, Nerve Issues, and Heart Damage
The more evidence you have to document your condition, the stronger your claim will be. If you’re living with late-stage or chronic Lyme disease, you may have arthritis, joint and nerve damage, and even cardiac issues. To document these issues, your doctors will need to assess your joint, nerve, and heart health by using diagnostic tools like x-rays, MRIs, EMGs, and EKGs.
4. Undergo a Functional Capacity Evaluation
A functional capacity evaluation (FCE) is a test that gauges your ability to work and do daily activities. When you have a hard-to-understand diagnosis, like Lyme disease, it can be helpful to undergo an FCE.
During the examination, a physical or occupational therapist will have you perform a variety of tasks while observing your effort and abilities. Based on your performance, the therapist will assign detailed restrictions that may limit your ability to walk, lift, sit, bend, twist, and perform other physical activities.
Bryant Legal Group: Illinois’ Trusted Disability Insurance Law Firm
At Bryant Legal Group, we guide disabled individuals through their complex short-term and long-term disability claims. If you or someone you love is living with Lyme disease or another tickborne illness, contact us today. We can help you understand your legal rights and suggest ways to strengthen your disability insurance claim.
Bai, N. (2018, May 16). Lyme disease is on the rise—An expert explains why. UCSF. Retrieved from https://www.ucsf.edu/news/2018/05/410401/lyme-disease-rise-expert-explains-why
Jobe, D. A., Nelson, J. A., Adam, M. D., & Martin, S. A., Jr (2007). Lyme disease in urban areas, Chicago. Emerging infectious diseases, 13(11), 1799–1800. https://doi.org/10.3201/eid1311.070801
Lyme disease (2019, December 11). National Institute of Allergy and Infectious Diseases. Retrieved from https://www.niaid.nih.gov/diseases-conditions/lyme-disease
Lyme disease data (n.d.) Illinois Department of Public Health. Retrieved from https://www.dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/lyme-disease/lyme-disease-data
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.