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Blog

Long-Term Disability Benefits for Lyme Disease

November 19, 2019 By Rich Frankel

Long-term-disability

In recent years, Lyme disease has become a hot topic — and somewhat controversial among patients and medical professionals. Lyme disease has long been recognized as an illness caused by a bacterium carried by ticks. However, some in the medical community have begun to diagnose a distinct form of the disease, referred to as chronic Lyme disease.

Lyme disease was first diagnosed in 1975 in Old Lyme, Connecticut after being mistaken for juvenile rheumatoid arthritis. Chronic Lyme disease occurs when a person who has been treated for Lyme disease continues to exhibit symptoms. 

Each year, approximately 30,000 cases of Lyme disease are reported to the Centers for Disease Control and Prevention (CDC) by state health departments. Most cases are reported in the Northeast and Mid Atlantic United States, where the ticks that carry the bacterium that causes Lyme disease are prevalent. However, it is possible that as many as 300,000 people are diagnosed with Lyme disease each year in the U.S.

If you have been diagnosed with Lyme disease, you may be eligible for long-term disability (LTD) insurance benefits, depending on the severity of your symptoms and how it impacts your ability to work. A seasoned Cherry Hill disability benefits attorney can shepherd you through the process from the initial application to the final resolution of your case.

What Is Lyme Disease?

Lyme disease is a tick-borne illness caused by bacteria and transmitted through the bite of an infected black-legged tick (known as a deer tick). Because these types of ticks are most commonly found in grassy and heavily wooded areas, individuals who spend time in these environments are more likely to get Lyme disease.

The initial signs of Lyme disease include an expanding red rash at the site of a tick bite or where a tick was removed. This is commonly known as a bulls-eye rash and will appear from 3 to 30 days after a tick bite. During this time, a person bitten by an infected tick may also experience fever, chills, fatigue, body aches, headache, neck stiffness, and swollen lymph nodes.

A month after a bite from an infected tick bite, signs and symptoms of Lyme disease include:

  • A bulls-eye rash appearing on other parts of the body
  • Severe joint pain and swelling, especially in the knees
  • Neurological problems, including meningitis, Bell’s palsy, numbness or weakness of the limbs, and impaired muscle movement
  • Heart problems, such as irregular heartbeat
  • Eye inflammation
  • Liver inflammation
  • Severe fatigue

The majority of tick bites do not lead to Lyme disease. However, the longer a tick remains attached to the skin, the greater the risk of getting the disease.

Prompt treatment with antibiotics can resolve most cases of Lyme disease. Untreated, Lyme disease can cause a number of significant health problems, including:

  • Chronic joint inflammation, especially in the knees
  • Neurological symptoms, including facial palsy and neuropathy
  • Cognitive defects, such as impaired memory
  • Heart rhythm irregularities

Lyme disease is diagnosed with laboratory tests. First, an Enzyme-linked immunosorbent assay (ELISA) test is done. If it is positive, then a Western blot test is done to confirm the diagnosis.

In its early stages, Lyme disease is treated with oral antibiotics, typically for 14 to 21 days. If the disease has progressed and involves the central nervous system, an intravenous antibiotic may be recommended for a period of 14 to 28 days. 

About Chronic Lyme Disease

Chronic Lyme Disease is a sometimes controversial medical condition, as it may be diagnosed without a positive ELISA or Western blot test. For this reason, many medical professionals are reluctant to diagnose Chronic Lyme Disease. However, it is also a term that may be used to refer to Lyme disease that has not responded to treatment: Post-Treatment Lyme Disease Syndrome (PTLDS).

PTLDS occurs when patients have symptoms of pain, fatigue, or difficulty thinking for more than 6 months after they finish a course of treatment for Lyme disease. This may be caused by an auto-immune response triggered by the infection or persistent infection. There is no proven treatment for PTLDS, although patients usually get better over time.

Symptoms of PTLDS include:

  • Fatigue
  • Arthritis and joint pain
  • Severe headaches
  • Difficulty with short-term memory
  • Numbness, tingling, shooting pain, and/or loss of feeling
  • Bell’s Palsy
  • Heart problems
  • Depression 
  • Anxiety

While doctors may treat PTLDS with another round of antibiotics, studies have shown that there is little difference in recovery between those who receive these additional antibiotics and those who did not. For this reason, many patients simply have to wait for their PTLDS to resolve on its own.

Chronic Lyme disease also refers to a condition that can be diagnosed without evidence of a tick bite or bacterial infection. This illness is diagnosed based on subjective complaints, rather than objective diagnostic criteria. Symptoms of chronic Lyme disease may include:

  • Persistent swollen glands
  • Sore throat
  • Sore soles
  • Joint pain
  • Fevers
  • Joint swelling
  • Confusion
  • Word search, name block
  • Forgetfulness
  • Disorientation
  • Mood swings
  • Unexplained back pain
  • Seizures
  • Tremor
  • Headaches
  • Light sensitivity
  • Ear pain
  • Double or blurry vision, floater
  • Dental pain
  • Lightheadedness
  • Irritable bladder
  • Insomnia
  • Napping during the day
  • Unexplained weight loss or gain
  • Queasy stomach or nausea
  • Head congestion
  • Night sweats
  • Pain in the genital area

Chronic Lyme disease is typically treated with multiple courses of intravenous antibiotics.

Applying for Long-Term Disability Benefits for Lyme Disease

If you have been diagnosed with Lyme disease, you may qualify for LTD benefits based on how the symptoms of your illness impact your ability to work. The approval of your application will depend on the unique facts of your case, and whether you are able to provide sufficient evidence of your diagnosis and how your condition affects your daily life.

A long-term disability insurance policy provides benefits, usually 50 to 60% of your salary if you are unable to work due to a disability. These benefits are paid on a monthly basis after a waiting period, which is typically 3 to 6 months. Each insurance policy is different and should be examined for terms, conditions, limitations, and exclusions.

To qualify for LTD benefits with Lyme disease, PTLDS or chronic Lyme disease, you will need to prove that you have been diagnosed with the condition. After documenting that you have the diagnosis, you will then need to demonstrate that the symptoms of your disability are so severe that they prevent you from working.

With Lyme disease, proving a diagnosis should be relatively straightforward, as it is confirmed using two blood tests. Similarly, medical records should be able to demonstrate that you had Lyme disease and that your symptoms have not improved with treatment, leaving you with a diagnosis of PTLDS.

Proving that you have chronic Lyme disease can be more challenging, as there is not an objective test to diagnose the condition. Many health care professionals who diagnose chronic Lyme disease do not believe that the ELISA and Western blot tests are accurate, and as such, do not rely on them for diagnosis. As a result, the diagnosis may be based on your subjective complaints and other diagnostic tests.

While this does not make your symptoms or suffering any less real, insurance companies often view this type of evidence as less trustworthy than an objective test like the Western blot. For this reason, it is important to carefully compile proof of your diagnosis from your treating providers to document your condition.

After you have proven your diagnosis, you will need to show that your symptoms affect your ability to work. For example, severe fatigue, joint pain and swelling, and neurological issues may make it difficult to concentrate or to work effectively. Impaired memory — found in Lyme disease, PTLDS, and chronic Lyme disease — can also impact your job performance.

To best demonstrate that you are unable to work due to your diagnosis, your treating physician should write a letter explaining how specific symptoms affect you. Your doctor may state that your joint pain and swelling limit your ability to stand, or that impaired muscle movement limits your ability to lift anything over 10 pounds. In this way, you can document exactly how your condition prevents you from working.

Work with a Cherry Hill Disability Benefits Attorney

Whether you have been diagnosed with Lyme disease, Post Lyme Disease Treatment Syndrome, or chronic Lyme disease, if you are unable to work due to your health, you may qualify for long-term disability benefits. Because Lyme disease is often misunderstood, particularly chronic Lyme disease, a Cherry Hill disability benefits attorney can help you put together a strong application for benefits.
The lawyers of Bross & Frankel are committed to helping individuals with disabilities obtain the benefits that they deserve to help them through a difficult time in their lives. We offer compassionate representation combined with skilled advocacy, along with free disability claim reviews to help you understand your rights. Contact us today at 856-795-8800 or online to schedule an appointment.

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