Wednesday, September 21, 2022

Does Lyme Disease Qualify For Disability

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Applying Special Medical Tests To Your Case

Lyme Disease Disability Insurance Benefit Claim Tips

Applying for SSDI is a lengthy process. You need to provide as much documentation as possible to help provide the needed evidence for your case. The SSA may order a medical evaluation, at their expense, with a physician that they choose. This is for information only, and not for medical treatment. The evaluation is to confirm your symptoms and how they impact your ability to work.

A mental evaluation may also be ordered to determine if your mental state has been altered by Lyme disease and how that will impact your ability to work. The disability process may consist of as many as two denials, which you can appeal. You can then request a hearing before an administrative law judge.

Gathering Evidence And Writing The Appeal

When filing an appeal of a long-term disability claim denial, it is imperative to strengthen your appeal with as much objective medical evidence as possible. We will be sure to gather any and all documentation and file it with your appeal, such as:

  • Test results
  • Reports from your treating physicians
  • Expert opinions
  • Witness statements from you, your family, friends, or co-workers

Thoroughly gathering evidence is crucial, especially for ERISA-governed LTD appeals this is because in ERISA appeals, the administrative appeal stage is the final opportunity that a claimant has to submit substantive evidence into the record. When presenting our appeals, we use this evidence to explain how our clients meet their policys definition of disabled.

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In the taxpayers case, the certificate indicated the taxpayer was not blind, not markedly restricted in speaking, hearing, walking, eliminating, feeding, dressing, or performing the mental functions necessary for everyday life, nor was life-sustaining therapy required, nor were there significant restrictions in any two or more of the above-referenced basic aspects.

Prior jurisprudence has found that being able to produce a positive certificate was mandatory to claim the DTC. In other words, a taxpayer cant access the DTC without a doctors certification that they are living with the defined impairment.

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Medical Conditions That Qualify For Long

Most medical conditions can qualify for long-term disability. However, some long-term disability plans will exclude certain medical conditions.

Assuming you dont have an excluded condition, you can qualify for long-term disability benefits if your medical conditions prevent you from doing your regular work. You wont qualify to apply right away. Most long-term disability plans require you to be continuously disabled for several weeks before you are eligible to apply.

The most common length of the waiting period is 17 weeks, but this can be different for each disability plan.

Most long-term disability plans have a two-tier requirement for disability. For the first two years: you can qualify for benefits if your medical condition prevents you from doing your regular work.

However, after two years, you can only qualify for long-term disability benefits if your medical conditions prevent you from doing any gainful work .

This is an example of a long-term disability requirement from a group long-term disability plan. This is only an example. Requirements and wording vary from plan to plan.

An employee is entitled to payment of a long-term disability benefit if the employee presents proof of claim acceptable that:

  • the employee became disabled while covered
  • total disability has continued beyond the elimination period
  • the employee has been following appropriate treatment for the disability condition

An employee will be considered totally disabled:

What Is The Musculoskeletal System For Va Rating Purposes

Can Lyme Disease qualify me for Disability Benefits?

Your musculoskeletal system includes your bones, cartilage, ligaments, tendons, and connective tissues. Your skeleton is the foundational structure for your muscles and other soft tissues. All these parts work together to support your body weight, maintain your posture, and help you move.

Below is a complete list of VA disabilities for the musculoskeletal system, listed in order by Diagnostic Code from CFR Title 38, Part 4, the Schedule for Rating Disabilities.

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Getting Help From An Attorney

Anyone who is facing the SSDI benefits application process should consult with an attorney before beginning. Many applications are denied after they are first submitted, and confusion about the application process is often to blame. An SSDI attorney is able to guide clients through this process to remove the frustration of being denied when a valid disability is present. When SSDI benefits are needed to pay for basic necessities, applicants need the help of a legal professional.

Ruth F. Kolb, Esquire has been practicing social security disability law since 2003 handling all levels of representation from initial claims through all stages of appeal.

Pursuing Medical Evidence To Support Your Ssd Claim

If rheumatoid arthritis, lupus or Lyme disease is causing symptoms that prevent you from holding down a full-time job, you may be entitled to Social Security disability benefits, either under a listed impairment or through documentation of your functional limitations.

Diagnosing your condition may require going to a rheumatologist or other specialist. Some of these symptoms may also indicate fibromyalgia, chronic fatigue syndrome or multiple sclerosis. We will work with your doctor to obtain the medical records needed for your claim.

At The Law Offices of Kenneth Hiller, PLLC, our knowledgeable lawyers can help you apply for benefits or appeal a denied claim. Contact us to set up a free consultation. Learn more about what our experienced attorneys can do to pursue the Social Security disability benefits you are legally entitled to receive.

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Organic Diseases Of The Central Nervous System

8000 Encephalitis, epidemic, chronic.

8210 Tenth , paralysis.

8211 Eleventh , paralysis.

8212 Twelfth , paralysis.

8305 Neuritis, fifth cranial nerve.

8307 Neuritis, seventh cranial nerve.

8309 Neuritis, ninth cranial nerve.

8310 Neuritis, tenth cranial nerve.

8311 Neuritis, eleventh cranial nerve.

8312 Neuritis, twelfth cranial nerve.

8405 Neuralgia, fifth cranial nerve.

8407 Neuralgia, seventh cranial nerve.

8409 Neuralgia, ninth cranial nerve.

8410 Neuralgia, tenth cranial nerve.

8411 Neuralgia, eleventh cranial nerve.

8412 Neuralgia, twelfth cranial nerve.

Va Disability Conditions List By Body System

VA Benefits with 100% Service-Connected Disability | VA Disability | theSITREP

Did you know there are more than 900 conditions eligible for compensation in the official VA disability conditions list?

In this post, we reveal and explain the complete VA disability conditions list by body system and diagnostic code.

Dont forget that to be eligible for VA disability compensation, you must first have:

  • An honorable or other than honorable discharge
  • Medical diagnosis of a disability condition
  • Nexus for service connection either directly related to military service, secondary to another condition, or a presumptive disability, and
  • Current symptoms of the condition that negatively affect your work, life, and/or social functioning

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What Is Lyme Disease

Lyme disease is a bacterial infection that is spread when a deer tick bites a person. The most obvious sign that a bite originates from a deer tick is a bullseye-shaped rash around the site of the bite. People who are bitten by a deer tick do not experience symptoms right away, and it can take a month before any symptoms are noticed.

Initial symptoms of Lyme disease include flu-like symptoms like fever, chills, stiffness in the muscles and headache. A condition known as Bells palsy that causes a loss of muscle tone in the face can also develop. Dizziness, pain and heart palpitations may also occur within the first month. Sleep disturbances, a lack of cognitive function and changes in mood may occur.

If Lyme disease goes untreated, the infection can spread to the joints and muscles. Long-term stiffness, swelling and pain in the joints and muscles may occur, and people who have Lyme disease that has progressed this far may live with these complications in the long term. Arthritis may also develop as a result.

Lyme disease can be successfully treated with antibiotics shortly after a tick bite occurs. Corticosteroids may be prescribed to prevent heart palpitations in order to stop long-term heart conditions from developing. Some people experience long-term fatigue after developing Lyme disease, and there are situations in which treatment options for fatigue do not improve the condition.

How Can Cuddigan Law Help You

If you are unable to work because of Lyme disease, contact Cuddigan Law today for a free evaluation of your situation. The road to winning Social Security disability benefits is long and tricky to navigate. Lyme disease cases can be particularly difficult to win, but at Cuddigan Law we have successfully fought for our clients and won many of these cases. Statistics from the Government Accounting Office show that you are three times more likely to get the benefits you have rightfully earned if you are represented by an experienced disability attorney.

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Can Lyme Disease Prevent You From Working

Lyme disease symptoms can make it impossible for a person to perform the tasks required for their job or any other job. Fatigue, headaches, and chronic pain can interfere with concentration. Additionally, the side effects of the antibiotics can add to the challenges of working while receiving treatment. In some cases, a person might need to be hospitalized for treatment.

For some individuals, Lyme disease results in lifelong medical and emotional complications. A person could work for years with Lyme disease, but the treatment and symptoms finally overcome their ability to continue working. A person might develop additional symptoms, including cognitive disability, impaired memory, joint conditions, and arthritis, years after being infected with Lyme disease.

Even though a person might not develop severe Lyme disease symptoms, the combination of multiple symptoms could prevent a person from working.

Your Lyme Disease Disability Case

Getting Long

Because there is no listing for Lyme disease and treatment allows individuals with the disease to lead otherwise healthy lives, qualifying for benefits may be difficult. The claim must clearly demonstrate that the individual is unable to work and function independently.

For some, this may be difficult to do and their first application might be denied. Applications can be denied because they were incorrectly filled out or the documentation did not meet all the requirements. Fortunately, there are attorneys who specialize in the Social Security Disability benefit application who can help. They offer consultations for little to no charge and can help individuals prepare the correct information. A good disability attorney will even help you present the information to Disability Determination Services. Hiring a Social Security disability attorney often makes the difference between receiving benefits and being denied, and may be a wise choice for someone seeking benefits with Lyme Disease.

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Can Lyme Disease Qualify Me For Disability Benefits

While most bacterial infections can be treated with antibiotics, Lyme disease does not respond to antibiotics and continually affects a persons health throughout their life. The bite of the black-legged tick is the only way someone can become infected with Lyme disease. Initial symptoms of Lyme disease are mild and often mistaken for influenza.

Second symptoms stage of Lyme disease involves more severe symptoms, such as muscle/joint pain, dizziness, lack of facial muscle control, cognitive problems and even cardiovascular disorders. Years after being infected with Lyme disease, many people suffer severe neurological illnesses that eventually become chronic. In particular, Lyme encephalomyelitis is a disabling condition that impacts nearly all physiological systems. People with late-stage Lyme and Lyme encephalomyelitis disease have difficulty walking, arthritis, incontinence, vertigo, shooting pains in the arms and legs, significant fatigue and mental health problems.

Can You Get Disability For Lyme Disease

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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What Are Neurological Conditions And Convulsive Disorders For Va Rating Purposes

VA disabilities for Neurological Conditions and Convulsive Disorders include conditions of the head, brain, spinal cord, nerves, and epilepsies. The nervous system is divided into two parts: the central nervous system, and the peripheral nervous system. The central nervous system consists of the brain, the spinal cord, and the cranial nerves. The peripheral nervous system is made up of all the nerves that travel from the spinal cord to the rest of the body.

How To Qualify For Lyme Disease Disability Benefits

VA Benefits with 90% Service-Connected Disability | VA Disability | theSITREP

While Lyme disease itself isnt classified by the Social Security Administration as an official impairment for disability benefits, isolated symptoms and effects can make you eligible for Social Security Disability for Lyme disease.

Your eligibility will be based on the SSAs assessment of your residual functional capacitythe measure of the greatest amount of work you can do despite the limitations imposed by Lyme disease.

The SSA will look for these basic circumstances:

  • Whether Lyme disease prevents you from doing your previous job
  • Whether it would prevent you from working a similar, less demanding job
  • If your condition wont allow you to work for at least a year, or could lead to death

Your experience with Lyme disease can vary widely from someone elses, which makes it a challenge to prove to Social Security claims examiners and makes it crucial to document the unique characteristics and symptoms you encounter.

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Meeting Or Equaling A Disability Listing

Lyme disease does not have a specificdisability listing in the blue book. This simply means that it’sunlikely someone with Lyme disease would get an automatic approval bymeeting a listing.

However, there are several listings that might be met by those with advanced Lyme disease, including:

  • Section 1.00 : May be met if you have significant limitations in your ability to walk or use your arms.
  • Section 4.00 : May be met if the Lyme disease caused damage to your heart.
  • Section 12.00 : May be met if you have one of the cognitive problems or anxiety that can be caused by Lyme disease.
  • Section 14.09 : May be met if arthritis in the knees or other weight-bearing joint is severe enough.

Sorting Out Your Symptoms Seeking A Diagnosis

Rheumatoid arthritis and lupus also known as systemic lupus erythematosus are both autoimmune diseases that can affect many parts of the body. Lyme disease is an infectious disease with some similar symptoms, caused by tick-borne bacteria.

Rheumatoid arthritis, lupus and Lyme disease can all cause severe, disabling joint pain, and the three diseases are frequently mistaken for each other during diagnosis.

Other symptoms that may indicate one or more of these diseases include skin rashes, kidney disease, fever, headaches, fatigue and depression. There are a number of tests that can be done to determine whether you suffer from rheumatoid arthritis, lupus or Lyme disease.

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What Are Infectious Diseases Immune Disorders And Nutritional Deficiencies For Va Rating Purposes

Infectious Diseases, Immune Disorders, and Nutritional Deficiencies can display a vast range of symptoms throughout the human body. Infectious Diseases can spread through various means, and include bacterial, parasitic, and viral infections whereas Immune Disorders are conditions that attack the immune system and make the body more susceptible to infection. Nutritional Deficiencies happen when the body is not getting enough nutrients, such as vitamins, minerals, etc.

6300 Vibriosis .

6302 Leprosy .

6304 Malaria.

6305 Lymphatic filariasis, to include elephantiasis.

6306 Bartonellosis.

7541 Renal involvement in diabetes mellitus type I or II.

7542 Neurogenic bladder.

7544 Renal disease caused by viral infection such as HIV, Hepatitis B, and Hepatitis C.

7545 Bladder, diverticulum of.

Ways You Can Strengthen Your Disability Insurance Claim For Lyme Disease

What You Need to Know About Disability Benefits for Lyme Disease

Because disability claims related to Lyme disease are sometimes difficult to prove, its 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 arent 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 cant 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.

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How To Win Disability Benefits For Lyme Disease

Ive already touched on the difficulties of getting a firm diagnosis. Unsurprisingly, this translates directly into how insurance companies and the CPP will handle your disability claim. Youve probably already guessed or even experienced yourself that benefit providers arent exactly eager to give out disability benefits for an illness like Lyme disease, which is often treated as if it was all in the patients head.

Another point to consider are the different stages of Lyme disease. You will have to prove that your illness has progressed into a chronic disease. Meaning it doesnt allow you to lead a normal life anymore. In short, you need to prove that you are legitimately disabled from work.

The nature of the illness and the inadequate testing system makes this difficult, however. The most difficult challenge is to get an official diagnosis for Lyme disease. As mentioned previously, Canada has yet to improve the screening test to detect more than one strain of the bacteria.

So, insurance companies will have no qualms to debate you on this. And they will crush your hopes of receiving disability benefits if they can find a hole in your application. Insurance companies have to make a profit, and your disability claim reduces that profit. Therefore, every single claim will be scrutinized and eventually denied if its not 100 percent bulletproof.

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