Lyme disease is a serious health issue, and it’s not just New England’s problem anymore. The blacklegged tick is present in all 50 states. During the last ten years, cases of Lyme disease have increased by 80 percent, mostly in the populous states of Florida and California.
At its core, Lyme disease is a bacterial infection carried by the blacklegged tick, commonly called a deer tick. A tick bite spreads the disease, but it can take 30 to 60 days to manifest after infection. Lyme disease is often misdiagnosed due to this delay. Furthermore, only 20 to 30 percent of cases present with the notorious bull’s-eye rash associated with the condition.
Serious infections typically qualify claimants for individual or group long-term disability benefits, but late-stage Lyme disease is different. Depending on the stage, your individual or group long-term disability insurance company may consider Lyme disease a physical disability, mental health disability, and/or a self-reported disability. It’s more difficult to claim individual or group long-term disability benefits for mental health and self-reported conditions than for physical illnesses.
The award-winning long-term disability attorneys and top-rated ERISA lawyers at DarrasLaw know how to properly claim individual and group long-term disability benefits for Lyme disease. Our founding partner, Frank N. Darras, and his firms have recovered almost $1 billion in insurance benefits. Call us at 800-898-7299 or contact us online to schedule your free disability policy analysis and free claim consultation with America’s top-rated long-term disability litigation firm.
Transmission, Signs, and Symptoms of Lyme Disease
A bacterium called Borrelia burgdorferi, which the deer tick transmits, causes Lyme disease. The tick must attach to a person for 36 to 48 hours to transmit the disease successfully. Deer ticks are the size of poppy seeds, so they’re easy to miss. They like to attach to warm, hard-to-reach areas such as the scalp, groin, or underarms. Other than a blood transfusion with infected blood, there are no other known means of transmitting Lyme disease. You cannot catch the disease from family members, or even by eating infected meat. Owning a pet, however, can increase your risk of contracting Lyme disease if it brings in a tick that decides to attach to you instead.
The following risk factors increase a person’s chances of contracting Lyme disease:
- Pet ownership
- Living in the Northeast
- Exposure to wooded areas
- Exposed skin during outdoor activities
Newborn deer ticks spread Lyme disease more than mature deer ticks, which make Lyme disease more prevalent during the spring and summer. Remember, Lyme disease tests aren’t always accurate and associating these risk factors with the below symptoms can help support your valid claim for individual or group long-term disability benefits.
- Muscle aches
- Joint pain
- Red rash
- Rash with a bull’s-eye formation
- Swollen lymph nodes
These symptoms mirror certain strains of the common cold and flu, so unless they find the tick, most patients don’t realize they’ve contracted Lyme disease.
Treating Lyme disease with antibiotics at this early stage is the best medication to try and prevent the illness from worsening, but it does not work for all patients. Many patients only realize they may have Lyme disease when over-the-counter cold and flu treatments don’t work, and their symptoms worsen.
- Spreading rash
- Severe arthritis, especially in your knees and large joints
- Neck stiffness
- Drooping of the face (loss of muscle tone)
- Irregular heartbeat and/or palpitations
- Nerve damage, including pain, tingling, and numbness in your hands and feet
- Inflammation of the brain and spinal cord
Treating doctors can try to confirm Lyme disease through different blood tests, but only after antibodies form. You may get tested for Lyme disease after finding a tick and experiencing these symptoms, but the test may come back negative. Some patients will suffer for months without a proper diagnosis, only to discover they had Lyme disease the whole time. False negatives may prevent you from obtaining individual or group long-term disability benefits because insurers are looking for compelling medical evidence and objective proof of a covered medical condition.
The Three Stages of Lyme Disease and Post-Treatment Lyme Disease Syndrome
Lyme disease typically manifests in three stages, and may develop into (PTLDS).
The first stage is called Early Localized Lyme Disease, which typically manifests with fever, sore throat, chills, and a rash. This first stage rash is the distinguishing factor between Lyme disease and the flu. It is normally red and may have a bull’s-eye appearance, but the rash isn’t present in all cases. Almost one-third of patients won’t manifest with the rash associated with Lyme disease.
The next stage of Lyme disease is Early Disseminated Lyme Disease. This stage manifests with flu-like symptoms, and may include facial paralysis, chest pain, vision changes, heart palpitations, and pain, weakness, or numbness in your limbs. Your blood will typically show Lyme disease at this stage.
Late Disseminated Lyme Disease often bleeds into Post-Treatment Lyme Disease Syndrome. Late-stage Lyme disease can last years and result in severe disabilities. It typically manifests with fibromyalgia, fatigue, vertigo, insomnia, mental fog, and headaches.
PTLDS occurs in roughly 10 percent of Lyme disease patients, and commonly necessitates long-term disability benefits. Your treating doctors will diagnose you with PTLDS if, despite antibiotic treatments, you suffer from at least the following three symptoms months or years after your initial diagnosis:
- Extreme fatigue
- Mental confusion (short-term memory loss)
- Joint or muscle pain
PTLDS is chronic and may last for years. Some individual and group long-term disability insurers consider PTLDS an autoimmune disorder because your body is fighting the infection after it’s gone.
Other individual or group insurance carries consider PTLDS a Somatic Symptom Disorder, which they typically classify as a mental illness. Somatic Symptom Disorders arise when a person’s loss of mental focus on extreme pain or fatigue causes major emotional distress. Your individual or group long-term disability insurer may limit benefits for mental health disorders at 12, 18, or 24 months. As such, your individual or group long-term disability insurer may group you into this category to avoid paying years of individual and/or group long-term disability benefits.
Lyme Disease as a Self-Reported Condition
The lack of reliable Lyme disease testing leads some individual or group long-term disability insurers to categorize Lyme disease and PTLDS as self-reported conditions. Notably, no objective blood test can determine whether a person has PTLDS, and treating doctors typically rely on standardized questionnaires to diagnose it. The answers to these questions are self-reported, meaning that patients rarely have objective medical tests to prove their symptoms.
Claiming individual or group long-term disability benefits for self-reported conditions requires circumstantial and/or third-party evidence of your disability. This may mean:
- Statements from friends, family, and coworkers regarding your fatigue and mental confusion
- Blood testing revealing an overactive immune system
- Hospital and treating physician records indicating treatment for known symptoms
- Compelling medical evidence and proof of previous Lyme disease diagnosis
These records can confirm your symptoms, but remember, you’re asking your individual or group long-term disability insurer to trust that you can’t perform the important duties of your occupation.
Your individual or group long-term disability insurer may only permit you to recover Lyme disease benefits for one or two years after a late diagnosis based on the self-reported symptoms limitation. It may further categorize the disease as a mental health condition if no objective tests support the diagnosis. Remember, chronic Lyme disease is characterized by immune system malfunction without the presence of the bacteria.
The Long-Term Effects of Chronic Lyme Disease
Many patients with Lyme disease respond well to antibiotics, provided they start taking them within a few weeks of the contact. The complications from undiagnosed Lyme disease and PTLDS, however, can leave you permanently disabled.
If you cannot get past the self-reported or mental/nervous limitation for Lyme disease itself, you might successfully claim benefits for one of the following associated conditions:
- Meningitis – This inflammation of the lining around your brain and spinal cord can cause fever, vomiting, confusion, headaches, seizures, difficulty sleeping, sensitivity to light, and lack of appetite.
- Bell’s palsy – This neurological condition occurs when the muscles on one or both sides of your face become paralyzed or weak from damage to your facial nerve. This causes your face to droop. It can take months to recover from this paralysis, and some patients may suffer lasting damage to their facial muscles.
- Lyme arthritis – This systematic arthritis (swelling in your joints) occurs during and after Lyme disease. The majority of Lyme disease patients who don’t receive early treatment develop arthritis. Lyme arthritis typically manifests in larger joints such as the knees and elbows. This is the most common complication.
- Heart damage (Lyme carditis) – The bacterium that causes Lyme disease can also damage your heart. It may inflame the heart muscle or surrounding tissues and interfere with the electrical signals in the heart. This causes heart block, rapid heartbeat, lightheadedness, fainting, and chest pain. Some patients may need a pacemaker while undergoing treatment.
- Depression – Extreme fatigue and constant pain from Lyme disease may result in a depressed mental state. Some long-term disability insurers severely limit coverage for mental health conditions.
- Chronic migraines – The inflammation caused by Lyme disease may also cause chronic migraines and headaches. These migraines can lead to mental fog, confusion, and memory loss, but might also be subject to policy self-report limitations.
- Neuropathy (nerve damage) – The infection and swelling from Lyme disease can cause permanent nerve damage. Neuropathy can cause pain, swelling, numbness, and tingling.
- Hepatitis – This is another term for liver inflammation. The bacterium that causes Lyme disease can also damage the liver. So can the strong antibiotics necessary to treat the infection.
Individual and group long-term disability insurance companies also categorize chronic Lyme disease as an autoimmune disorder. These disorders occur when your immune system attacks the healthy cells in your body. Your body may keep fighting the infection even after it’s cleared up. This leads to difficulty classifying Lyme disease and continuing to receive individual or group long-term disability benefits.
Individual and Group Long-Term Disability Benefits and Lyme Disease
Painful arthritis throughout their bodies plagues most patients suffering from chronic Lyme disease. Arthritis itself is common among elderly Americans, and individual and group long-term disability insurers often deny claimants benefits for “age related” arthritis. This is because your individual or group long-term disability insurer suggests age-related or degenerative conditions such as osteoarthritis are rarely disabling.
Chronic Lyme disease is often referred to as an imitation disorder and is often misdiagnosed as one of the following conditions:
- Chronic pain syndrome
- Chronic fatigue syndrome
- Mental health conditions such as depression and somatic symptom disorders
- Multiple sclerosis
- Parkinson’s disease
- Dementia and Alzheimer’s disease
Your treating doctors may test you for everything from lupus to ALS before considering chronic Lyme disease. As a result, Lyme disease often goes undiagnosed when it manifests with rare but reported symptoms such as menstrual problems, TMJ, tremors, trouble speaking, personality changes, difficulty reading, gastritis, hair loss, and aversion to light.
Many patients never find the tick before it detaches and doctors can misdiagnose Lyme disease as a common cold.
Contact the Award-Winning Long-Term Disability Lawyers and Top-Rated ERISA Attorneys at DarrasLaw Today
Lyme disease is one of the most frustrating health conditions a person can experience. There is no reliable vaccination available for Lyme disease, and the symptoms and side effects are often severe and debilitating.
DarrasLaw’s award-winning long-term disability lawyers and top-rated ERISA attorneys can help you avoid or help fight a wrongful delay, denial, or termination of individual or group long-term disability Lyme disease benefits. Led by nationally renowned ERISA lawyer Frank N. Darras, our team knows how to get people with Lyme disease and other disabling conditions their individual or group long-term disability benefits. No case is too large or small for DarrasLaw and no venue too far.
DarrasLaw will work with your treating physicians to analyze your disability policy, and fight for your rightful individual or group long-term disability benefits. To schedule your completely free disability policy analysis and free claim consultation with one of America’s top-rated disability lawyers or award-winning ERISA attorneys today, call DarrasLaw at 800-898-7299 or contact us online.