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Friday, November 21, 2014

Lyme Disease and Proving Disability

Willy Bergdorfer, the doctor who discovered the bacterium that causes Lyme Disease, died last Monday.  Here is a link to the Times' obituary.  The obituary discusses the long course of determining that the disease was caused by a bacterium, which was named in his honor: Borrelia burgdorferi. 

Dr. Burgdorfer's discovery, however, hasn’t been much help to Lyme disease patients seeking long-term disability benefits.  Insurers often deny claims for Lyme disease on grounds that the diagnostic criteria for the condition are not satisfied.  One of the commonly used tests is the Western Blot Test, which detects Lyme disease-related antibodies in the patient.  The Centers for Disease Control’s diagnostic criteria require 5 of 10 bands for Lyme Disease, but many doctors believe that Lyme can exist with as few as two bands, and that some Lyme disease suffers are "seronegative," that is, they lack any evidence of antibodies in their blood.  If the CDC criteria are not satisfied, then it can be difficult to get an insurer to accept a Lyme diagnosis.  Luckily, Lyme disease patients with disability benefit claims in Connecticut have many medical resources to help prove the diagnosis of chronic Lyme, central nervous system Lyme, or seronegative Lyme.

Regardless of the strength of the diagnosis, it is still more important to focus on impairment, rather than diagnosis.  I discussed this in an earlier post here.   Many of the impairments resulting from Lyme are the type of "self-reported" symptoms that insurers love to ignore.  Whatever is causing your fatigue and pain, they are real and disabling. So do what you can to improve your chances of getting benefits:

  • Make sure you tell your doctor how the condition affects your daily life and ability to work, and make sure he notes it in the records.  
  • Keep a log of how you feel each morning and afternoon, and what aspects of your job you can't perform, and what activities of daily living you can't perform or have difficulty performing.  
  • Don't overstate your symptoms in your claimant statement, even a little, so the insurer can't use surveillance to find inconsistencies and argue that you were untruthful. 
Dr.  Burgdorfer's life and work show the crucial role that scientific developments can play in diagnosis and treatment of difficult conditions like chronic Lyme disease.  But to get disability benefits for such conditions, regardless of what is happening with the science, stick with a disciplined course of recording and documenting your impairments.  That's the best proof of disability resulting from conditions, like chronic Lyme, that do not offer many objective medical tests to show the disability.   

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