Social Security Disability for Lyme Disease

Lyme disease is a bacterial infection resulting from the bite of a deer tick. You can suffer severe, debilitating symptoms from Lyme disease that render you unable to perform regular daily activities or continue with your regular work duties. While it may be a challenging case, you may be eligible for Social Security disability benefits if you are experiencing severe symptoms.

You may find Lyme disease is a long, difficult battle. With remissions and exacerbations, it can be difficult to get a claim for Social Security disability approved without a lengthy fight and determination. The Social Security Administration (SSA) has the Social Security Disability Insurance (SSDI) program which provides monthly benefits to those who are disabled who have earned a sufficient number of credits and have paid in adequate taxes to the SSA.

Lyme disease can impact people in different ways, but there are usually three different stages. Within a few days to a few weeks of being bitten by a deer tick, stage one of the infection will begin. It usually shows flu-like symptoms that include headaches, body aches, and an overall feeling of being unwell. Some people experience a rash that makes the area around the bite look like a bull’s eye.

The second stage starts a few weeks or month after you have been bitten. During the second stage, you experience more severe symptoms. You can have loss of muscle control in the face, muscle pain, joint pain, tendon pain, meningitis, dizziness, an altered mental state, shooting pains that interrupt sleep, encephalitis, and heart problems. You can experience sleep disturbances, memory loss, and mood changes.

Lyme Disease Social Security Benefits

The third stage, of course, is even worse. This stage can start months, or even years, after the initial bite. Severe and chronic symptoms can impact the eyes, joints, nerves, brain, and heart. Lyme encephalopathy, which causes problems with short term memory and concentration, and chronic encephalomyelitis can cause vertigo, progressive cognitive issues, awkward walking, weakness in the legs, facial muscle weakness, bladder problems, and back pain.

You may even suffer more physical symptoms, such as numbness, tinging in the hands and feet, arthritis in the knees and other areas, pain and swelling in the joints, significant fatigue, shooting pains, memory loss, panic attacks, delusions, reality detachment, difficulty understanding and interpreting what is being seen, and difficulty with daily tasks, including scheduling.

The symptoms vary from individual to individual and are dependent upon the person’s initial health and how advanced the disease is before it is discovered. There are numerous symptoms that you may experience from Lyme disease.

The Cost of Treating Lyme Disease

The Johns Hopkins Bloomburg School of Public Health reports that the costs of treating Lyme disease are much higher than the general public may initially believe. Anywhere from 240,000 to 440,000 of the disease are diagnosed in the U.S. each year. Costing the U.S. health care system between $712 million and $1.3 billion a year.

On average, it breaks down to $3,000 per patient who may have to see the doctor on several return visits for follow-up testing to investigate lingering symptoms and worsening problems. These visits may come long after taking antibiotic treatment. Of course there are costs related to the antibiotic treatment plans that doctors prescribe as well.

If you apply for SSDI or SSI, you may be able to receive financial benefits to help with your medical costs.

The SSA Evaluation and Medical Qualifications

The SSA has a medical guide that is called the Blue Book. This Blue Book has the established guidelines for being declared disabled and eligible for benefits. While Lyme disease itself does not have a listing in the Blue Book, there are several listings that meet those who have advanced symptoms of the disease.

For those who are suffering from advanced disease, they may find these listings beneficial:

  • Section 1.00 (Musculoskeletal System) – This may be met if you have significant mobility limitations when it comes to using your arms of walking.
  • Section 4.00 (Cardiovascular System) – If you have suffered heart damage from Lyme disease.
  • Section 12.00 (Mental Disorders) – If you have anxiety or cognitive issues from the disease.
  • Section 14.09 (Inflammatory Arthritis) – If arthritis in the knees or other weight-bearing joints are severe enough.

If you don’t meet the Blue Book listing for Lyme disease using one of the listings, you may still qualify for benefits using the medical-vocational allowance with a residual functioning capacity (RFC) form.

Meeting Disability Criteria with an RFC and Medical-Vocational Allowance

You may be experiencing multiple limitations caused by Lyme disease that make it completely impossible for you to return to work. Using a RFC to determine if your impairments keep you from working, Disability Determination Services may find you should be granted benefits based on a medical-vocational allowance.

Using this approach, the SSA will consider your age, education level, work experience, transferable skills, and your ability to sedentary work that is less strenuous. The pain in the muscles, joints, tendons and back, or weakness in the legs can make it difficult or virtually impossible to walk significant distances, stand for at least two hours, or lift and carry items.

If Lyme disease has caused you heart problems, the weakness and fatigue may make it difficult to participate in physical work. Anxiety, depression, or concentration issues may make staying focused or completing tasks challenging, or even impossible. Delusions and detachment from reality can cause major workplace problems, and make interacting with others almost impossible.

After going over how your symptoms from Lyme disease interfere with your ability to work, they will compare the RFC with your requirements with your former job to see if you should be able to return to work. After they realize that you cannot, they will apply a formula to determine if you can do work that is less demanding. After determining you cannot work at all, you may be approved for benefits.

Applying Special Medical Tests to Your Case

Applying for SSDI is a lengthy process. You need to provide as much documentation as possible to help provide the needed evidence for your case. The SSA may order a medical evaluation, at their expense, with a physician that they choose. This is for information only, and not for medical treatment. The evaluation is to confirm your symptoms and how they impact your ability to work.

A mental evaluation may also be ordered to determine if your mental state has been altered by Lyme disease and how that will impact your ability to work. The disability process may consist of as many as two denials, which you can appeal. You can then request a hearing before an administrative law judge.