What is Lyme Disease?

Lyme disease is an inflammatory, infectious disease spread to humans through tick bites.  It is caused by borrelia bacteria, which commonly infects animals.  Ticks pick up the bacteria by biting infected animals and then passing it on to other animals, including humans.  While treatable if caught early, it becomes more difficult to treat and diagnosis the more time that passes.  Chronic Lyme disease can develop within days or weeks after infection, if left untreated or improperly treated.

What are the Symptoms of Lyme Disease?

Initial symptoms of Lyme disease can include the development of a rash, sometimes shaped like a “bull’s eye” mark and flu-like symptoms. Others can entail a fever, headache, nausea, jaw pain, light sensitivity, red eyes, muscle aches and neck stiffness.  However, chronic Lyme disease symptoms can be diverse and vary in intensity, often making diagnosis difficult. They can include arthritis, severe fatigue, headaches, vertigo, sleep disturbances and mental confusion and can lead to significant functional impairment. Consequently, this can result in an individual being incapable of performing their job.

How is it Diagnosed?

Unfortunately, there are no universally accepted tests for Lyme disease. Diagnosis is based on symptoms and a history of tick exposure.

How do I Apply for LTD when faced with Lyme Disease Disability?

To make a successful claim for long-term disability (LTD) benefits when you have Lyme disease, it is important to work closely with your doctor. You will need to discuss possible causes of your symptoms and potential treatment options.  Then, your doctor will be required to provide a diagnosis and describe your symptoms and their objective findings.  Next, the insurance company will use this information to assess your level of functional impairment.

It can be more challenging to confirm your claim when you suffer from Lyme, or other difficult-to-diagnose conditions.  Therefore, throughout the LTD claims process it is important to keep records of the symptoms you have experienced. Note how your symptoms prevent you from working, the treatments you have undergone, and their intended/actual effect. This is especially true if the cause of your symptoms is difficult to identify and confirm. For these reasons it is crucial to record how the disease has progressed, and to identify any possible patterns and/or correlations with other factors (environment, sleep, diet, activity level, etc.). In all cases, it is very important to be honest and candid about your symptoms and to keep lines of communication open with your doctors.

Throughout the LTD claims process, you and your doctor will need to be able to comment on several important areas. These include the symptoms of your diagnosis, their impact on you (limitations/restrictions caused), and any progress or regression you experience. Feedback will be required on any treatment accessed and its impact, and future plans and prospects for managing your condition.

What if my Claim is Denied?

If your claim is denied, you can fight the insurance company’s decision. Insurance companies have an internal appeal process.  They may change their decision through this process, if new or additional medical evidence is provided.  You can also consult a disability lawyer to pursue legal action against the insurance company.  In all cases, it is strongly advised that you seek legal advice as quickly as possible after benefits are refused. There are time limits to both the internal appeal process and to pursuing litigation.

We are here to help navigate the LTD application process. Consult one of our experienced Disability lawyers at Raven, Cameron, Ballantyne and Yazbeck LLP if you are considering making a claim for disability benefits or if your claim for benefits has been denied. 

[This article is for informational purposes only and does not constitute legal advice, which cannot be given without consideration of your individual circumstances.]