What is Lyme Disease?
Lyme disease is an inflammatory and 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. The disease can develop within days, weeks, or even years after infection if left untreated or improperly treated. In more extreme scenarios, albeit in an ever-increasing number of cases, it can gradually result in long-term disability, leaving people unable to work. This inevitably begs the question: Is there such a thing as a Lyme Disease Disability Claim? The short answer is yes but negotiating disability benefits for Lyme disease is often a long, arduous, and frustrating process.
What are the Symptoms of Lyme Disease?
Chronic Lyme disease symptoms can be diverse and vary in intensity, often making accurate diagnosis difficult or impossible, which is why claiming disability benefits for Lyme disease can be a long stressful process. Initial symptoms can include the development of a rash (sometimes shaped like a “bull’s eye” mark) and flu-like symptoms. Other symptoms can include fever, headache, nausea, jaw pain, light sensitivity, red eyes, muscle aches, and neck stiffness. They can also include arthritis, severe fatigue, headaches, vertigo, sleep disturbances, and mental confusion and can lead to significant functional impairment. Any mix of these symptoms can result in an individual being incapable of continuing to work.
How is it Diagnosed?
There is no accepted diagnostic test for Lyme disease, but according to the Public Health Agency of Canada, cases are on the rise – both literally and statistically. In the early 2000s, cases known to have been contracted in Canada were relatively rare but during the latter part of the decade reached a reported high of more than 2,000 cases. Because the disease causes so many and varied symptoms that can be confused with other ailments, the real figure is almost certainly much higher.
Because diagnosis is based on symptoms and history of tick exposure, those applying for disability benefits for Lyme disease face challenges when dealing with health and insurance systems.
What options are available to me if I require Disability Benefits for Lyme disease?
People who are unable to work as a result of the symptoms associated with a diagnosis of Lyme disease have a couple of potential options: Canada Pension Plan (CPP) Disability benefits or Long-Term Disability (LTD) benefits.
The main purpose of the CPP Disability is to support you if you have a mental or physical disability that regularly stops you from doing any type of substantially gainful work or have a disability that is long-term and of indefinite duration, or is likely to result in death. To qualify for CPP disability benefits, you must have been employed for ]four of the past six years and paid into the CPP program. You will also be required to show that your disability is severe enough to prevent you from working.
The other option is to apply for LTD insurance if you are enrolled in a plan. An LTD plan is commonly part of employee benefits packages and provides benefits should you be unable to work.
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 (environment, sleep, diet, activity level, etc.). In all cases, it is important to be honest and candid about your symptoms and to keep lines of communication open with your physician.
Throughout the LTD claims process, you and your doctor will be asked to provide information on a number of important areas including your symptoms, their impact on you (limitations/restrictions etc.), and any progress or regression you experience. You will be required to report on all treatments you have received, the impact of those treatments, and the future plans and prospects for managing your condition.
What if my Claim is Denied?
If your disability claim for Lyme disease is denied, you can fight the decision through the insurance company’s internal appeal process. This can be done with the help of a disability lawyer. The insurance company may change their decision if you are able to provide new or additional medical evidence. You can also hire a disability lawyer to pursue legal action against the insurance company. No matter which route you choose, seeking legal advice as quickly as possible after benefits are refused is extremely important as 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.]