GETTING BENEFITS FOR CHRONIC LYME DISEASE

Lyme Disease is transmitted to humans by the bite of the black legged tick, commonly called a "deer tick."  The infectious agent is a little bacterium called Borrelia burgdorferi.  Symptoms can include a rash (but not always),  fatigue, dizziness, neurological symptoms, joint aches,  and sometimes a fever.  Getting a correct diagnosis for Lyme Disease may be difficult because the symptoms of Lyme Disease are quite similar to many other illnesses and doctors often have never encountered a case of Lyme.  Lyme is usually curable with a few weeks of antibiotics.  However, if the disease goes untreated, it can cause severe symptoms, including joint inflammation (Lyme arthritis), heart problems, disorders of the central nervous system, and more.

There is no specific listing for Lyme Disease in the Social Security blue book.  If there are severe associated symptoms, a claimant may meet a listing for another body system:  nervous system disorder, heart impairment, etc.  If that is not the case, the claimant must prove that the combined symptoms of the disease are so severe that full-time work cannot be maintained.

I have recently won cases involving Lyme Disease.  Here is a little of what I have learned with regard to Lyme Disease and Social Security.

1)  Try to see out a specialist to confirm the diagnosis.  Specialists are few and far between.  Social Security will be skeptical that symptoms are being caused by Lyme Disease.  It is essential to get a firm diagnosis by a doctor who understands the disease.  Many doctors will tell you that there is no such thing as chronic Lyme Disease, or that it is impossible to diagnosis it accurately.  Some will try to send you off to a psychiatrist because they think it is a mental impairment.

2)  Be sure your doctor ties the cause of symptoms to the yme Disease.  In other words, the doctor should confirm that such symptoms as chronic fatigue, dizziness, nausea, palpitations, cognitive problems, etc. are being caused by the late affects of Lyme Disease, not something else.

3)  If possible, get a medical source statement or residual capacity form from your doctor (specialist) which specifies your physical and mental limitations.  Have the doctor address the work-like activities that you are not able to perform, and to state the severity or degree of each impairment.

4)  Be sure to follow prescribed treatment to the extent possible. If you have a complicated case of Lyme, especially one that was not treated early, treatment may take months or years. It's easy to get discouraged and give up.  Find a doctor who will support you and stay with it.

5)  Try to find an attorney or advocate to represent you who has experience with Social Security disability cases based on Lyme Disease.  Some of the basics of good representation apply to these cases, however, there are things about Lyme cases that are approached differently. 

https://forsythefirm.wixsite.com/website

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The Forsythe Firm in Huntsville is available for free consultations for any impairment leading to a Social Security disability claim.  We will meet with you without cost or obligation.  If we agree to represent you, you do not owe a fee unless you win your claim and collect past due benefits.  We can be reached at (256) 799-0297. 

WHEN SOCIAL SECURITY SENDS YOU TO THEIR DOCTOR

In about 30 percent of Social Security disability cases, the agency will send claimants to one of their contracted doctors for a consultative examination (CE).  This usually occurs when there is limited evidence from the claimant's own treating doctors.

Social Security contracts with doctors in private practice to perform these exams.  Here is generally what to expect at a consultative exam (CE):

• It will be brief.  The doctor may spend as little as 15 minutes with you.  Usually there are no tests.
• The doctor has been provided with a checklist of things to look for.  He/She will focus only on what is on the list.
• CEs are often not helpful for the claimant.

Here are a few tips that may help the examination go smoothly:

• If you cannot attend the examination, call the Disability Determination Service (DDS) which scheduled the exam as early as possible.  This should only be for an unavoidable emergency. Also call the doctor's office.  (The doctor will not call DDS for you; it's important you call them, too). Never be a No-Show.

• Arrive at the exam site 15 minutes early.
• If possible, have someone drive you to the exam.
• Take a list of all medications and dosage with you.
• Be cooperative with the doctor.  Failure to do so will guarantee a bad report to Social Security.  Put forth your best effort.
• Don't try to "sell" the doctor on the fact that you are disabled and should be on disability.  The doctor cannot approve you or sign you up for benefits.  He is a fact finder and has a checklist of medical items to check during the exam.
• Answer the doctor's questions as directly as possible.  Get to the point and avoid unnecessary details or rambling.

Doctors are allowed 30 days to send in their examination reports to Social Security. 

What happens if you just don't show for a CE?  It almost always guarantees a denial and it may hurt you in the future appeal process, as well.