How Can Lyme Disease Qualify for Disability Benefits?

Qualifying for disability benefits based on Lyme disease can be challenging, as the condition and its symptoms can vary widely among individuals. To establish eligibility for disability benefits, the following factors may be considered:

• Medical Evidence: You must provide comprehensive medical documentation that supports your diagnosis of Lyme disease and its associated symptoms.
• Severity of Symptoms: The impact of Lyme disease symptoms and duration on your daily functioning is a crucial aspect of the evaluation.
• Functional Limitations: The effects of Lyme disease on your ability to perform work-related activities are likewise assessed.
• Treatment Response: The Social Security Administration (SSA) may consider the effectiveness of treatment and its impact on symptom management. If you have undergone various treatment modalities without significant improvement in your symptoms, it strengthens your case for disability benefits.
• Work History: Your work history and ability to engage in substantial gainful activity are also evaluated. If your symptoms and functional limitations prevent you from performing substantial work and earning a significant income, your eligibility for disability benefits strengthens.

What Is Lyme Disease?

Lyme Disease is an infectious bacterial illness that is carried by ticks. The disease was not recognized until 1975, possibly because the diagnosis of its many seemingly unrelated symptoms is difficult to ascertain. The Connecticut town of Old Lyme was the site of the first notable outbreak of the disease, giving the illness its name.

Lyme disease can lead to arthritis, heart disease, brain and nervous system problems, memory disorders, and decreased concentration.

Is Lyme Disease A Disability?

Yes, Lyme disease may be considered a disability. Meeting the medical criteria alone may not guarantee approval for disability benefits. The SSA also considers other factors, such as age, education, work experience, transferable skills, and the ability to adjust to other types of work.

If left untreated, Lyme disease may worsen with time, causing various cognitive and neurological problems. This condition is commonly called “Chronic Lyme Disease” or “Post-treatment Lyme Disease Syndrome”.

What are the symptoms of Lyme Disease?

Lyme disease is caused by the bacteria Borrelia burgdorferi, which is transmitted to humans through the bite of infected black-legged ticks. The symptoms of Lyme disease can vary and typically progress in stages. Some common symptoms associated with the disease are as follows:

Early localized stage (3-30 days after a tick bite):

• Rash: Often, but not always, a red, expanding rash called erythema migrans appears at the site of the tick bite. It may have a characteristic bull’s-eye appearance.
• Flu-like symptoms: Fever, fatigue, headache, muscle and joint aches, swollen lymph nodes may also be experienced during this phase.

Early disseminated stage (days to weeks after infection):

• Multiple rashes: Erythema migrans may appear in different areas of the body.
• Flu-like symptoms: Fever, chills, fatigue, headache, muscle and/or joint aches continue for an elongate period.
• Neurological symptoms: Facial palsy (weakness or drooping of the facial muscles), meningitis (inflammation of the membranes surrounding the brain and spinal cord), numbness or tingling in the hands or feet typically occur weeks after infection.

Late stage (months to years after infection):

• Arthritis: Recurrent episodes of joint swelling, particularly in large joints like the knees.
• Neurological symptoms: Cognitive difficulties, memory problems, nerve pain, sleep disturbances, difficulty concentrating, and mood changes.
•  Heart problems: Heart palpitations, chest pain, and shortness of breath can be developed over time.

Types of Lyme Disease

Lyme disease can be categorized based on the stages of infection and the clinical presentation. Some commonly recognized types of Lyme disease are as follows:

•  Early Localized Lyme Disease: This is the initial stage of Lyme disease, and the hallmark symptom is the appearance of a red, expanding rash called erythema migrans, often with a bulls-eye pattern.
•  Early Disseminated Lyme Disease: If left untreated, Lyme disease can progress and spread to other parts of the body. Multiple erythema migrans rashes may develop in different areas of the body.
•  Late Disseminated Lyme Disease: If Lyme disease remains untreated for an extended period, it can progress to the late stage.

Is Lyme Disease a Qualifying Disability?

To qualify for Lyme disease disability benefits, you need to meet the criteria outlined by the Social Security Administration. The SSA has a ‘Listing of Impairments’, often referred to as the Blue Book, which contains specific medical criteria for various conditions. Here are the key factors considered when evaluating disability claims:

• Meeting a Listing: The Blue Book describes impairments for each body system, along with the specific medical criteria necessary to establish disability. If your condition matches the severity and requirements outlined in a specific listing, you may automatically qualify for benefits.
• Residual Functional Capacity (RFC): If your condition does not meet a specific listing, the SSA assesses your RFC. RFC refers to your ability to perform work-related activities despite your impairments. It evaluates the functional limitations and restrictions caused by your condition, such as mobility limitations, cognitive impairments, pain, fatigue, and other physical or mental limitations.
• Duration: Your condition must be expected to last for at least 12 months or result in death.

What is the Next Step After Meeting the Criteria of Lyme Disease?

After meeting the criteria for Lyme disease disability, the next step would be to apply for disability benefits through the Social Security Administration.

• Collect vital documentation: Collect all relevant medical records, test results, treatment history, and any other supporting documentation.
• Complete the application: Fill out the application forms provided by the SSA.
• Submit your application: Submit your completed application, along with all the supporting documentation, to the SSA.
• Medical review process: The SSA will review your application and medical evidence to assess your eligibility for disability benefits.
• Decision and notification: The SSA will make a decision on your disability claim based on the medical evidence provided and their evaluation of your functional limitations. You will be notified in writing about their decision.
• Appeal, if necessary: If your claim is denied, you have the right to appeal the decision.  

Understanding An Ineligibility Decision

If you do not meet the eligibility criteria of the Social Security Administration for Lyme disease, it means that your condition and symptoms did not meet the specific requirements outlined in the SSA’s Listing of Impairments or did not demonstrate sufficient functional limitations to qualify for disability benefits based solely on your Lyme disease diagnosis.

In such cases, it’s important to remember that the decision is specific to your claim and does not necessarily reflect the severity of your symptoms or the impact of your condition on your ability to work. It is possible to be denied benefits even if you are experiencing significant challenges due to Lyme disease and disability.

How Much is the disability check for Lyme Disease?

The actual check amount may vary depending on the severity of your disability and your work history. If you qualify for SSI, $914 will be the maximum monthly benefits and if you qualify for SSDI, $3627 will be the maximum monthly disability payment. 

Contact Chermol & Fishman, LLC if your Lyme Disease Disability Claim is Denied

A Texas disability lawyer can help you in the appeals process by collecting and organizing additional medical evidence and other documentation to strengthen your claim. 

Moreover, they will prepare and present your case before an administrative law judge, presenting arguments and evidence to support your claim for disability benefits. Schedule a free consultation if you need further assistance regarding the disability claim procedure by calling (888)-774-7243.