Lyme disease is a tick-borne illness caused by bacteria transmitted through the bite of a tick. In 2022, over 63,000 cases of Lyme disease were reported to the CDC by state health departments and the District of Columbia.
The majority of Lyme disease cases are successfully treated with antibiotics. However, some people develop chronic symptoms even after treatment. In such cases, individuals may become unable to work and consequently, eligible for Social Security Disability (SSD).
Applying for Social Security Disability for Lyme Disease
If Lyme disease significantly impairs your ability to work, you may qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). To be eligible, you must meet the Social Security Administration’s (SSA) definition of disabled.
- Your condition must last or be expected to last at least 12 months or result in death.
- Your condition must prevent you from performing Substantial Gainful Activity (SGA).
You must also meet the eligibility criteria for either SSDI or SSI to receive Social Security Disability for Lyme disease.
- To qualify for SSDI, you must have paid into the Social Security System by earning work credits. Your disability must also prevent you from engaging in any previous or new relevant forms of work.
- SSI eligibility is based on financial need. Applicants must meet strict income and asset limits to qualify. They must also be ineligible for SSDI, and either aged, blind, or disabled.
If you meet the criteria listed above, then you may qualify for disability benefits with Lyme disease. Continue reading to find out more about how to qualify for SSD.
Qualifying for Social Security Disability Benefits After Contracting Lyme Disease
Qualifying for Social Security Disability benefits can be challenging. This is especially true when dealing with conditions like Lyme disease that don’t have a specific category in the SSA’s Blue Book.
The Blue Book is a guide of qualifying mental and physical impairments, their symptoms, and medical criteria. This guide helps the SSA decide whether to approve or deny disability claims during the review process.
Even though the Blue Book doesn’t list Lyme disease as a qualifying impairment, you can still apply for benefits with this medical condition.
Medical Equivalence
To receive benefits, you must show that your Lyme disease symptoms are medically equivalent to a Blue Book listing. This means proving that your symptoms are as severe as those of a qualifying impairment.
For example, if your Lyme disease causes severe joint pain and arthritis, you might qualify under listing 14.09 for inflammatory arthritis.
Proving Disability With Medical Evidence
Since there is no specific listing for Lyme disease, detailed medical records are crucial to the success of your claim. To qualify for disability, you must provide medical evidence that documents your diagnosis, symptoms, and how your symptoms impact your ability to work. Evidence should include:
- A confirmed medical diagnosis
- Documentation of ongoing symptoms
- Response to previous and ongoing treatments
- Detailed reports from your healthcare provider(s) about how your condition affects your daily life and ability to work
- Detailed notes from your healthcare provider(s) on the severity and persistence of your symptoms, such as fatigue, joint pain, neurological issues, and cognitive impairments
- Medical test results confirming your Lyme disease diagnosis (such as ELISA and Western blot blood test results).
ELISA stands for enzyme-linked immunosorbent assay. If this blood test is positive, your healthcare provider will then perform a Western blot test to confirm the diagnosis.
Non-Medical Supporting Evidence
Non-medical evidence can also support your claim by providing insight into how Lyme disease affects your everyday life. This might include statements from family members, friends, or coworkers describing how your symptoms prevent you from performing daily tasks or engaging in regular activities.
Residual Functional Capacity (RFC) Assessment
If your condition doesn’t equal a Blue Book listing, you may still receive benefits under a Medical Vocational Allowance.
The SSA will evaluate your Residual Functional Capacity (RFC) to decide whether or not you qualify for the allowance. This assessment determines what level of work you can still perform despite your disability. An RFC assessment considers:
- Physical limitations, such as the ability to stand, walk, lift, or carry items
- Mental limitations, including the ability to concentrate, follow instructions, and interact with others
Signs and Symptoms of Lyme Disease
An initial sign of Lyme disease is a red rash at the site of a tick bite, commonly known as a bulls-eye rash. It usually has a circular center with a ring around it and slowly expands over time. This rash typically appears within 30 days after the bite. Other early symptoms can include:
- Fever and chills
- Fatigue
- Headache
- Body aches
- Joint stiffness
- Lack of appetite
- Swollen lymph nodes
As the disease progresses, symptoms can worsen. The following symptoms can manifest weeks or even months after a bite:
- Neurological symptoms, such as weakness or paralysis of the facial muscles (Bell’s palsy)
- Heart problems, such as irregular heartbeat
- Eye issues, including inflammation or vision impairment
- Joint inflammation (arthritis), often affecting weight bearing joints like the knees
- Additional rashes on other parts of the body
- Numbness, pain, or weakness in the hands or feet
- Post-Treatment Lyme Disease Syndrome (PTLDS), sometimes referred to as “Chronic Lyme Disease”
Post-Treatment Lyme Disease Syndrome is when symptoms persist even after treatment. This condition can cause long-term health issues that make it difficult to work. Symptoms of PTLDS can include those listed above, as well as:
- Extreme fatigue
- Severe joint pain and swelling
- Severe headaches
- Memory issues
- Trouble sleeping
- Muscle weakness and pain
- Depression
Why Hire a Social Security Disability Attorney?
A skilled attorney can greatly increase your chances of being approved for disability benefits. At Peña & Bromberg, we have extensive experience helping clients navigate the Social Security Disability claims process. Our team will assist you in gathering all necessary documentation to support your claim. We will also ensure your application is filed properly and on time.
Contact Peña & Bromberg
Our legal team at Peña & Bromberg helps individuals with Lyme disease get the disability benefits they deserve. With decades of experience, we provide compassionate representation and skilled advocacy. You can trust us to guide you through every step of the Social Security Disability process.
If you’re struggling with Lyme disease and Social Security Disability benefits are an opportunity to gain financial support, we can help you file a claim. Contact us today to schedule a free consultation. We serve clients throughout California, including Fresno, Bakersfield, Stockton, and the surrounding areas.
