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Disability Benefits for Lyme Disease

Social Security Disability Lawyers Riverside, North San Diego and Orange Counties

Lyme Disease

“Lyme disease” is named for a small town in Connecticut called Lyme, after Yale researchers, in 1975, discovered a tick-borne bacteria in a cluster of children as the cause of their arthritis.

The Centers for Disease Control and Management (CDC) summarizes Lyme disease as follows:

Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system (brain and spinal cord). Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks. Laboratory testing is helpful if used correctly and performed with validated methods. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics. [Refhttps://www.cdc.gov/lyme/index.html]

The CDC has an interest in Lyme disease because the number of cases reported to the CDC has been increasing steadily over the past 25 years. More than 300,000 are reported each year. Most cases occur in the Northeast, but as the map shows, there are reported cases in other states, including California.

CDC scientists, in collaboration with researchers from Colorado State University are working to develop a new type of test to help healthcare providers diagnose early Lyme disease using an innovative approach called “metabolomics.” Metabolomics is a type of science that can be used to identify and measure types and amounts of chemicals the body produces during illness. Each type of infection or stage of infection has a different metabolic “fingerprint” that makes it unique. CDC is using metabolomics to help develop new testing methods for Lyme disease. Id.

Symptoms of Lyme Disease

Symptoms of Lyme Disease usually start about 3 to 30 days after a tick bite and include fever and chills, headaches, myalgias and arthralgias, lymph node swelling, and in 80% of patients, a characteristic skin rash (“erythema migrains”) anywhere on the body that resembles a target or “bull's-eye.”

Months or years later, the headaches (inflammation of the brain or spinal cord) may get much worse, and other symptoms may develop, including persistent arthritis (especially the knees), cardiac arrhythmias (“Lyme carditis”), facial palsy, neuropathy, and cognitive problems (especially with short-term memory). Id.

Laboratory Testing

The diagnosis of Lyme disease is usually confirmed by blood testing for antibodies to the Lyme bacteria. The CDC recommends a two-stepprocess. (1) An “EIA” (enzyme immunoassay) and (2) a “Western blot” test. Both tests must be positive. (The CDC does not recommend skipping the first test and just doing the Western blot because that may lead to “false positive” results and improper treatment.) Id.

Treatment

In the early stages of infection, most patients who develop Lyme disease can successfully be treated for 2-4 weeks with several different antibiotics, including doxycycline, amoxicillin, cefuroxime, ceftriaxone or penicillin.  However, in a small percentage of cases, persistent symptoms that include chronic fatigue and myalgias (muscle aches) can last for months to years after initial treatment. This condition is often called “chronic Lyme disease” (Post-treatment Lyme Disease Syndrome).

For chronic Lyme disease, prolonged treatment with antibiotics has not been found to be successful and is generally not recommended. [Ref:  https://www.niaid.nih.gov/diseases-conditions/chronic-lyme-disease]

Disability Benefits for Lyme Disease

Long-term disability (LTD) benefits for chronic Lyme disease may be available under the Social Security program (SSDI) and/or an employer-provided group LTD-plan (ERISA).

In order to obtain a disability award, it is important to see a doctor who is knowledgeable and experienced in the diagnosis and treatment of Lyme disease, because unfortunately there have been doctors and clinics that have used questionable diagnostic tests and recommended questionable treatments for this condition. [Ref: https://www.quackwatch.org/01QuackeryRelatedTopics/lyme.html]

The Social Security Agency (SSA) does not have a specific “listing” for Lyme disease. However, several listings may be used in combination (if applicable) to “equal” a listing. They include Section 1.00 (Musculoskeletal System), Section 14.09 (Inflammatory Arthritis), Section 4.00 (Cardiovascular System), and Section 12.00 (Mental Disorders).

It is important that the medical records contain objective laboratory confirmation of the diagnosis of Lyme disease (seesupra), documentation of your symptoms and physical findings, and specific functional restrictions and limitations that you have.

Social Security generally looks at exertional restrictions, including the most you can lift/carry (e.g., <10 pounds), stand/walk (<2 hours), and sit (<6 hours). These are the kind of exertional limitations that would preclude you from performing even a desk job (“less than sedentary”).

If there are cognitive limitations (e.g., short-term memory impairment, difficulty concentrating, “brain fog”), they would also require careful documentation by your doctor(s).

At Law Med, we are a doctor/lawyer firm with medical insight and legal expertise in both SSDI and ERISA long-term disability claims.

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