The lawyers at Aaron Waxman & Associates are experienced with Disability, Personal Injury and Employment claims.
It’s almost summertime, when the risk of Lyme disease is at its peak. The symptoms of Lyme disease can be debilitating and can last for an extended period, and you may be unable to continue working and need to apply for long-term disability benefits. This blog post will discuss what Lyme disease is, its symptoms, treatment, prevention tips and what to do if your long-term disability claim has been denied.
What is Lyme Disease?
Lyme disease is an inflammatory infection spread through tick bites from backlegged ticks (a.k.a. deer ticks). According to the Canadian Lyme Disease Foundation (CanLyme) there are 3 stages of Lyme disease and symptoms worsen during each stage of infection:
Where Are Ticks Found?
To find out which areas of Ontario are at the highest risk for Lyme disease, you can refer to the “Lyme disease risk areas in Canada” map on the government of Canada’s website. You should also know that backlegged ticks thrive in wet environments, woodlands, tall grass and bushes and even though ticks are usually found specific locations/environments, because of tick populations spreading, it is possible to be bitten outside of these locations.
What are the Symptoms of Lyme Disease?
There are over 100 known symptoms of Lyme disease. Symptoms can affect your musculoskeletal system, senses, mental capability, psychological well-being, digestive system, respiratory, circulatory and neurological systems.
Symptoms can include, and are not limited to (courtesy of CanLyme):
How is Lyme Disease Diagnosed?
Chronic Lyme disease is often mistaken for other illnesses, making it difficult to diagnose and treat and prolonging diagnosis. Lyme disease is hard to diagnose because blood tests can show negative test results when the disease is actually present. It is recommended that Lyme disease be diagnosed based on symptoms and risk (areas you visited or activities you did. As well, there are only a handful of blood tests can effectively detect Lyme bacteria and that is another reason why the infection is easily missed.
According to the Canadian Lyme Disease Foundation, Lyme disease can be mistaken for many other illnesses/diseases including Fibromyalgia, Chronic Fatigue Syndrome, Colitis/Crohn’s disease/IBS, Early ALS, Encephalitis, Lupus infectious arthritis/Osteoarthritis/Psoriatic arthritis/Rheumatoid arthritis, Multiple Sclerosis, psychiatric disorders, Meniere’s syndrome, Thyroid disease and Sleep disorders.
Is There Treatment for Lyme Disease?
Once you have been tested for Lyme disease and diagnosed, treatment options include oral antibiotics, intravenous treatment, supportive therapies such as physical therapy, antidepressants, anti-inflammatory medication, intramuscular injections of medications, pulse and combination therapy.
How Can Lyme Disease Be Prevented?
The ticks that carry Lyme disease are tiny (less than 4mm) and are hard to spot immediately. Here are some safety tips if you plan on enjoying the great outdoors this summer:
What should I know about Disability Claims?
Lyme disease can have a variety of symptoms, some of which can be severe if left untreated. The symptoms of Lyme disease can interfere with your day to day life and ability to function, including your ability to work.
Because Lyme disease is difficult to immediately diagnose or treat, and because of the nature of the symptoms, it has been referred to as an “invisible illness”. When applying for long-term disability benefits, it is important to show that you have attended treatment, seen specialists and treating physicians on a regular basis and are complying with treatment recommendations.
If at the time you apply you do not have a confirmed diagnosis of Lyme disease, it is important that you have documentation such as clinical notes and records, or specialist’s consultations that show you have been investigating your condition and reporting your symptoms. The insurance company is looking for evidence that you are receiving proper care and treatment and for evidence that your symptoms are as severe as you are reporting. It is important that you report all symptoms to your doctor and see your physicians when you have new or worsening symptoms.
Your insurance company is looking for evidence that your symptoms make you unable to perform your employment duties and to function to an extent that would allow you to work. In particular, the insurance company wants to know what your restrictions and limitations are and if they are medically supported by your treatment providers/physicians and how long they will last. When you apply for long-term disability benefits and you have an invisible illness that cannot be seen on an x-ray or MRI, this type of information is very helpful in supporting your claim.
Why Would My Insurer Deny My Claim?
One of the most common reasons an insurance company denies long-term disability claims is for lack of objective medical evidence. Another reason is for failure to comply with treatment recommendations or be under the care of appropriate physicians.
As mentioned, with invisible illnesses, it is very important to have your symptoms documented and it is necessary to seek regular care. The severity of your symptoms should be documented by your treatment providers so that they can document and explain to the insurance company in the Attending Physician’s Statement (part of the application package) what your symptoms are, clinical findings and your supported restrictions and limitations (things you should avoid/are unable to do). Chronic Lyme disease may cause symptoms that affect the nervous symptom, cause psychological symptoms and various physical symptoms including pain and fatigue, making it difficult to work.
Your insurance company may be aware of your symptoms but may feel you are able to perform your job or some type of alternate employment and decide to deny your application or discontinue benefits. If this happens, you do have the option to fight their decision through appealing with new information and medical evidence or you can seek legal assistance and decide to start a legal action.
If you or someone you know have been denied long-term disability benefits for any reason, you should contact a lawyer to find out what your rights and obligations are as an insured person. The lawyers at Aaron Waxman and Associates are available for a free initial consultation that can be arranged at a date and time that is convenient for you
* This blog is for informational purposes only and is not meant to substitute legal advice. Please read our disclaimer for further information.
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