Lyme Disease and Long-Term Disability Benefits in Canada

Lyme Disease, caused by the bacterium Borrelia burgdorferi, is a complex illness transmitted through the bite of infected ticks. For individuals grappling with the debilitating effects of Lyme Disease, obtaining long-term disability (LTD) benefits can be crucial for maintaining financial stability during periods of illness and treatment. However, denials of LTD benefits for Lyme Disease are not uncommon, highlighting the importance of understanding your rights and seeking legal assistance when facing such challenges.

Understanding Lyme Disease

Lyme Disease can manifest in various stages and present a wide range of symptoms affecting the skin, joints, nervous system, and other body systems. Early symptoms may include a characteristic bull’s-eye rash (erythema migrans), fever, fatigue, headaches, and muscle or joint pain. If left untreated, Lyme Disease can progress to more severe stages, leading to neurological complications, heart problems, and chronic symptoms affecting daily life and work capacity.

Lyme Disease and Long-Term Disability

Living with Lyme Disease can be unpredictable, with symptoms fluctuating in intensity and duration. Chronic Lyme Disease, also known as Post-Treatment Lyme Disease Syndrome (PTLDS), can cause persistent symptoms such as fatigue, joint pain, cognitive difficulties (“brain fog”), and muscle weakness, significantly impacting an individual’s ability to work and perform daily tasks.

Is Lyme Disease Covered by my LTD Policy?

Most LTD policies cover disabilities that prevent individuals from performing the material duties of their own occupation or any suitable occupation based on their skills, education, and experience. Lyme Disease, especially in its chronic and debilitating forms, may qualify for LTD benefits if it significantly impairs your ability to work.

Lyme Disease Disability Benefits

To support your Lyme Disease disability claim, you may need:

Medical Documentation:

Comprehensive medical records documenting Lyme Disease diagnosis, treatment history, symptoms, functional limitations, and impact on work capacity.

Specialist Reports:

Reports from infectious disease specialists, neurologists, rheumatologists, or other relevant healthcare providers detailing the severity of your condition, ongoing symptoms, and treatment plans.

Functional Assessments:

Evaluations from healthcare professionals or vocational experts assessing how Lyme Disease symptoms affect your ability to perform job-related tasks safely and effectively.

Can My Lyme Disease Benefits Be Denied?

LTD benefits for Lyme Disease may be denied due to various reasons such as:

Insufficient Medical Evidence:

Lack of detailed documentation supporting the severity and persistence of Lyme Disease symptoms, functional limitations, and work-related impairments.

Disability Definition Interpretation:

Differences in interpreting occupational duties, work restrictions, and suitable job alternatives based on Lyme Disease-related health status and functional abilities.

Policy Limitations:

Policy exclusions, waiting periods, or limitations specific to certain medical conditions, chronic illnesses, or pre-existing conditions related to Lyme Disease.

Why Are Lyme Disease LTD Claims Denied?

Denials of Lyme Disease LTD claims can stem from challenges in proving ongoing disability, demonstrating work-related limitations, or facing policy-related restrictions. Insurers may also question the necessity of ongoing treatments, accommodations, or job modifications needed due to Lyme Disease symptoms and complications.

What To Do If My LTD Benefits Have Been Denied?

If your LTD benefits for Lyme Disease have been denied:

Review Your Policy:

Understand the denial reasons, appeal procedures, and timelines outlined in your LTD policy.

Gather Strong Documentation:

Compile detailed medical records, specialist reports, functional assessments, treatment history, work restrictions, and any correspondence related to your claim and denial reasons. Make sure your insurance company sends you a hard copy of your denial letter for your records.

Appeal with Support:

Submit a comprehensive appeal with robust medical and vocational evidence supporting your ongoing disability and work limitations due to Lyme Disease.

Seek Legal Assistance:

Consult with an experienced LTD disability lawyer specializing in Lyme Disease-related claims. A lawyer can review your case, provide legal guidance, advocate during the appeals process, and escalate the case if necessary to secure the benefits you deserve.

Contact a Disability Lawyer About Your LTD Denial Today

Dealing with LTD benefit denials for Lyme Disease can be daunting, but legal support can significantly improve your chances of a successful appeal. Contact our law firm today to discuss your situation, understand your rights, and take proactive steps towards appealing and resolving your LTD denial, ensuring you receive the financial support essential for managing Lyme Disease and maintaining your well-being.