Wednesday, September 21, 2022

Can I Get Disability For Lyme Disease

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Lyme Disease Long Term Disability Insurance Claim Tips

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Getting Ssi Or Disability For Lyme Disease

The Social Security Administration, or SSA, provides disability benefits to individuals who, due to a severe illness or injury, become so disabled that they are unable to work. The different types of support you can receive include:

  • Social Security Disability Insurance, or SSDI
  • Supplemental Security Income, or SSI

To qualify for either SSDI or SSI, you need to prove that the symptoms youre experiencing limit your ability to do work significantly. Depending on your condition, this process can be pretty straightforward or challenging.

Many of the symptoms people experience with Lyme disease can mimic less severe conditions. These issues can end up being treated with medications and antibiotics.

Well now review how you can get SSI or SSDI benefits for Lyme disease. For an individual to get these benefits, at least one of two things has to be the case.

The first is that the individual meets the requirements of one of the medical conditions listed within the Social Security Administrations Blue Book.

When unable to meet the requirements, they must demonstrate how the effects they experience result from Lyme disease interfering with their ability to work.

Getting Disability For Lyme Disease Can Be Challenging

Obtaining Disability for Lyme disease can be difficult. The Social Security Administration doesnt include Lyme disease on its list of impairments that qualify for Disability benefits. This complicates matters, but doesnt mean benefits arent possible.

Even though there is not a specific listing for Lyme disease, the SSA may find you eligible for Disability benefits if your condition is as severe and lasts as long as another medical condition on the list. For example, advanced Lyme disease could be to blame for debilitating conditions within the:

  • Cardiovascular System: Requirements may be met if your heart is damaged.
  • Inflammatory Arthritis: Requirements may be met if you have severe, debilitating inflammatory arthritis.
  • Mental Disorders: Requirements may be met if you have cognitive problems or mental issues.
  • Musculoskeletal System: Requirements may be met if you have difficulty walking or using your arms.

If your Lyme disease doesnt meeting one of the Social Security Administrations qualifying requirements, you could still be awarded benefits if you can prove through extensive medical evidence that your advanced Lyme disease is so debilitating that you cannot work any job even one that is sedentary. You will need to support your claim with detailed medical records. The Disability team at McDonald Firm knows what to do and how to overcome obstacles.

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How To Qualify For Social Security Disability Benefits With Lyme Disease

It is estimated that there are more than 300,000 cases of Lyme disease each year and that number is rising all the time. Lyme disease has a complex set of symptoms that can become disabling. If you have Lyme disease and your symptoms significantly limit your ability to work you may file a claim for Social Security Disability benefits. Disability benefits provide money that can be used for housing, food, and living expenses while you cannot work. There are several requirements that you must meet to file a claim for disability benefits 1) the symptoms of Lyme disease must keep you from working for at least a year and 2) you must have been credited with sufficient Social Security quarterly credits at the time of application, and 3) you will must present medical documentation confirming your disease diagnoses, its severity and how it fully prevents you from working and certifies that you medically qualify for disability.

Can You Get Disability For Lyme Disease

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People who suffer from Lyme disease are eligible for SSDI benefits if complications of the disease interfere with their ability to perform job tasks. There are several listings maintained by the Social Security Administration that apply to complications related to Lyme disease.

If muscle weakness in the arms or legs makes it difficult for a person to walk or carry items, the disabled individual may qualify under the Musculoskeletal System listing. People with heart disease related to Lyme disease may be eligible under the Cardiovascular System listing, while cognitive impairment caused by the disease could qualify a person under the Mental Disorders listing. Severe arthritis in the knees or other joints could make a person eligible for benefits under the Inflammatory Arthritis listing.

If none of these listings apply, a person may still be eligible for benefits. However, the individual will need to undergo a residual functional capacity test. This test helps to evaluate the abilities of disabled individuals in order to determine whether they could work in any position for which they are qualified.

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Symptoms Can Be Debilitating

Lyme disease is not an illness to take lightly. After being bitten by a deer tick, you may experience a red rash, sometimes referred to as a bulls-eye, within a few days of the bite. However, not everyone who contracts Lyme disease develops the red rash. According to the Centers for Disease Control and Prevention , fatigue, chills, fever, headache, achy muscles and joints, and swollen lymph nodes are all among the early symptoms.

If left untreated, the infection may spread to other parts of the body and cause additional rashes, Bells palsy, severe headaches, shooting pains that can interfere with sleep and other symptoms. The CDC says that about 60 percent of patients with untreated Lyme disease may experience periodic arthritis that results in severe pain and swelling, especially in the knees. In 5 percent of untreated patients, chronic neurological problems may develop, including numbness and tingling in the extremities and short-term memory difficulties.

The CDC says that many people make a full recovery if Lyme disease is treated with antibiotics while in the early stages. But even when people are treated with antibiotics, in 10 to 20 percent of cases, they experience chronic, ongoing symptoms. The proper treatment and even the existence of this illness are debated by health care experts.

How Do I Apply For Long Term Disability Benefits For Lyme Disease

To make a successful claim for LTD benefits for Lyme disease, it is important to work closely with your doctor. You will need to discuss your symptoms, limitations, restrictions, and potential treatment options. Your doctor will then be required to provide a diagnosis, describe your symptoms, and record his or her findings. The insurance company will use this information to assess your level of functional impairment and determine whether you qualify for Lyme disease disability benefits.

Because the symptoms of Lyme disease are so diverse and common to so many other diseases and illnesses, confirming an LTD claim for Lyme disease will be challenging.

The foundation for a successful disability claim for Lyme disease is a detailed record of symptoms you are experiencing, along with notes describing how those symptoms prevent you from working. Those notes should also include all the treatments you have undergone, along with their intended effect and their actual effect.

For these reasons, it is crucial to record how the disease has progressed and identify any possible patterns and/or correlations with other factors . In all cases, it is important to be honest and candid about your symptoms and to keep lines of communication open with your physician.

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Do I Qualify For Disability Insurance Benefits If I Have Lyme Disease

Disability insurance companies dont always make it easy for policyholders who have Lyme disease to get the disability benefits they deserve.

Lyme disease is a complex, multi-system inflammatory disease that affects major organs in your body. The diagnosis is complex and, unfortunately, many patients are misdiagnosed with multiple sclerosis, chronic fatigue syndrome, rheumatoid arthritis, or theyre told it is all in their heads.

Because of the wide variety of symptoms and the long period of incubation, it can be challenging to get a correct diagnosis. That is one of the reasons disability carriers are notorious for denying and terminating many Lyme disease claims.

Common Reasons Lyme Disability Claims Are Denied

Disability carriers often argue that coverage under the policy is excluded because of the pre-existing condition clause, or that benefits are limited under the subjective limitation clause. Headaches, pain, fatigue and side effects of treatment can be the most disabling symptoms, but they are subjective complaints. Carriers routinely dispute them.

It is not uncommon for policyholders to have had Lyme disease for years and not been disabled. You will have to overcome the carriers argument that you have been working with these problems for years and nothing has changed. It is crucial that your medical records develop the progression of your symptoms.

Secure The Support And Cooperation Of Your Doctor

Lyme Disease Disability Insurance Benefit Claim Tips

Before filing your disability claim, talk to your doctor to confirm that they not only believe you are disabled, but also that they will participate in the disability claim process. The process will require your doctors time and efforts to complete forms and respond to inquiries from the insurance company. If your doctor isnt willing to cooperate in support of your claim, the insurance company will automatically assume that your claim is not legitimate

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Get Help Winning Disability For Lyme Disease

Social Security requires objective medical evidence to determine whether your symptoms of Lyme disease qualify you to receive disability benefits.

Your disability claim hinges on you providing records of medical evaluations, diagnoses and treatments youve received. Youll also need to share details of your work history, so you can highlight how your condition prevents you from working as youve always done.

It often feels like the Social Security system works against you rather than for you. Most people who apply get denied.

To improve your chances, work with an experienced disability attorney. If you need to take your case to a Social Security administrative law judge, one government study found that your chances of being awarded benefits are almost three times higher when you bring a representative.

At Levine Benjamin, weve helped more than 80,000 people win benefits. Our team understands what youre going through as you navigate the disability system with Lyme disease.

This financial support could help you maintain the life you worked so hard to build. All it takes is a small first step to get started. Tell us about your case.

From applying to appealing, we help you every step of the way.

Undergo A Functional Capacity Evaluation Neuropsychological Evaluation Or Cardiopulmonary Exercise Testing

Insurance companies always want to see objective proof of your disability, where possible. Testing that your doctor recommends for treatment purposes may be helpful to your disability claim.

However, there may be other tests available to substantiate your disability claim with the goal of measuring your symptoms impact on your physical functions rather than as treatment. These tests include the following:

Functional Capacity Evaluation If your Lyme disease causes physical symptoms such as stiffness or muscle weakness, consider undergoing a functional capacity evaluation . An FCE is a series of tests, practices, and clinical observations that objectively measure your physical ability to perform work-related activities. These activities include: sitting standing walking lifting/carrying pushing/pulling performing gross or fine manipulations and many other occupational functions.

Neuropsychological Evaluation If your Lyme disease causes cognitive symptoms such as brain fog, consider undergoing a neuropsychological evaluation. This is an in-depth assessment of how well your brain functions with respect to certain skills and abilities. It involves testing your performance in the areas of: reading language memory attention/concentration processing speed learning reasoning problem solving and more.

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Gather And Neatly Organize Your Evidence With An Index

The insurance company will not gather evidence of your disability on your behalf. That responsibility is on you. The more supportive evidence that you can proactively provide, the better.

Gather all medical evidence , occupational evidence , and anything else that might support your claim.

There is no limit on what you can submit, so feel free to get creative. You can submit photographs, witness statements from co-workers or friends, or even work performance evaluations.

Neatly organize, label, and index the evidence. This will help ensure that nothing goes unseen or unreviewed.

In addition to the testing detailed above, youll want to get the results of any serological testing. This is laboratory blood testing that typically involves two tiers to identify Lyme antibodies: the EIA or sometimes an IFA and an immunoblot test, commonly referred to as the Western Blot test.

The Western Blot is arguably a more reliable indicator of Lyme, but it is not necessary to make a diagnosis. Although serological testing is not necessary to diagnosis Lyme disease, positive results will be helpful for your disability claim. Even if the results are not positive, the insurer will still want to see that you have had this testing done.

Recommending Testing To Substantiate Your Claim

Pin on Social Security Disability

Your insurance company will require objective evidence demonstrating how your Lyme disease prevents you from working. You may consider undergoing additional testing to offer further proof of your symptoms and their impact on your physical functioning.

Additional testing options include functional capacity evaluations, neuropsychological evaluations, and cardiopulmonary exercise tests.

Functional Capacity Evaluation

If you experience physical symptoms such as muscle weakness due to Lyme disease, consider a functional capacity evaluation . An FCE is a series of tests, practices, and clinical observations that objectively measure your physical ability to perform activities such as sitting, standing, walking, lifting/carrying, pushing/pulling, gross or fine manipulations, and more.

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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, its 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.

Communication With Doctors During The Appeal Process

A steady flow of communication between you, your doctor, and the insurer is essential to winning your appeal. Unfortunately, sometimes this is not easy to do doctors can be too busy in their day-to-day medical practices to adequately report detailed medical information to your insurer. This is why we teach you how to most effectually communicate with your doctor about your condition, and facilitate the flow of information between your doctor and insurer so that nothing is left out or overlooked.

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What Can I Do If My Disability Claim Is Denied

If your claim has been denied, you can fight the insurance company’s decision to deny your claim. Your insurer will provide you with the option of appealing your claim through their internal appeal process, which can take several months and there is no guarantee their decision will be overturned. Generally you can appeal the decision three times, by providing new information and new medical evidence that supports your inability to work.

You also have the option of consulting an experienced disability lawyer to find out your rights and decide to start a court action against your insurance company.

Our lawyers have successfully represented clients with Lyme disease whose disability claims have been denied. We offer a free initial consultation that can be arranged at a date and time that works for you.

Disability Benefits For Lyme Disease

Lyme disease not the only tick-borne illness to worry about

Lyme disease can be debilitating, and it can make going to work difficult or even impossible. Since the symptoms of Lyme disease can last for a month or more and a person can have several times where the disease rebounds after a remission, getting the disability benefits that a person needs can be difficult. Anyone who is experiencing complications from their infection with the Lyme disease bacteria should find out whether or not they qualify for SSDI benefits for Lyme disease.

There are several criteria that a person must meet in order to qualify disability benefits, and since there isnt a specific listing for Lyme disease in the SSA Blue Book, people who wish to receive benefits must qualify under a different listing. For instance, many people with Lyme disease experience cardiovascular damage, which is listed in the Blue Book. Some other ways that people with Lyme disease can apply for benefits include mobility issues caused by musculoskeletal issues, anxiety or cognitive issues caused by the disease, or inflammatory arthritis caused by Lyme disease.

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Can You Get Benefits When Lyme Disease Forces You Out Of Your Job

It happens: Youve been working with Lyme disease for years and stumbling along. Some days/months are better than others, but youve been determined to keep working in a career you love. But then, gradually, it all becomes too much. Youre not bouncing back as well. Even though you rest from the moment you get home until when you leave for work the next day, giving up social engagements, relying on others to pick up the kids, and getting take-out dinners more than you would like, you are still struggling to get through the workday.

You see your doctor and she tells you the time has come for you to take some time off of work and focus on getting better. You are disabled from working. Now what? How will you live without your income? Here are some options and a plan.

  • There Are Several Sources for Disability Benefits
  • Besides savings , income sources for people with disabilities include:

    • ERISA-governed employee benefit plans . Long-term disability usually starts after 6 months and can last until retirement age.
    • These benefits are usually tax-free if you paid the premiums with your after-tax earnings, but taxable if your employer paid the premiums.
  • Private disability insurance plans .
  • These benefits are usually not taxable.
  • State disability insurance that usually last for a year .
  • These benefits are usually not taxable.
  • Social Security Disability Benefits .
  • These benefits are sometimes taxable, depending on your household income.
  • Your Doctors Role
  • Submitting the Application.
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