Lyme Disease and Long-Term Disability

While early detection and treatment often lead to full recovery, chronic or late-stage Lyme disease can cause severe, long-lasting symptoms that interfere with daily activities and make it impossible to work. If Lyme disease has forced you to stop working, you may be eligible for long-term disability (LTD) insurance benefits.

Risk Factors for Lyme Disease

Lyme disease is typically contracted through outdoor exposure to tick-infested areas. Risk factors include:

• Hiking, gardening, hunting, or camping in wooded or grassy areas
• Having outdoor pets that may carry ticks into your home
• Living in or traveling to high-risk regions during tick season (spring through early fall)

Ticks must generally remain attached for 24 to 48 hours to transmit the bacteria. Due to their small size—often no larger than a poppy seed—many people never notice the tick bite.

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Stages and Symptoms of Lyme Disease

Lyme disease progresses in three stages, and the symptoms can vary widely depending on how long the infection has gone untreated.

Stage	Description	Duration	Symptoms
Stage 1	Early localized infection	Days to weeks	Fever, chills, headaches, muscle pain, joint stiffness, ‘bull’s eye’ or ‘target’ rash
Stage 2	Early disseminated infection	Weeks to months	Facial paralysis, neck pain or stiffness, pain or numbness in limbs, heart palpitations, vision loss
Stage 3	Late disseminated of chronic infection	Months to years	Arthritis, cognitive dysfunction (“brain fog”), memory issues, polyneuropathy

Some individuals experience ongoing symptoms even after antibiotic treatment—a condition known as Post-Treatment Lyme Disease Syndrome (PTLDS).

Challenges in Diagnosing and Treating Lyme Disease

Lyme disease remains a controversial topic in some medical communities. Some healthcare providers may mistakenly dismiss persistent symptoms as psychological in origin, especially in patients who no longer test positive for active infection.

This skepticism makes it especially challenging to qualify for long-term disability benefits. Insurance companies may argue:

• That the condition is “subjective” or unsupported by objective evidence
• That your symptoms are related to another condition (like depression, fibromyalgia, or chronic fatigue syndrome)
• That your symptoms should have resolved with standard treatment

For this reason, comprehensive documentation from your treating provider is essential.

Can You Qualify for Long-Term Disability Benefits for Lyme Disease?

Yes—if you meet the definition of disability due to Lyme disease, you may qualify for LTD benefits. Most policies define disability in two phases:

• Own Occupation Period (typically the first 24 months): You are unable to perform your specific job.
• Any Occupation Period (after 24 months): You are unable to perform any job for which you are reasonably suited by education, training, or experience.

Late-stage Lyme disease symptoms, such as debilitating fatigue, chronic joint pain, and cognitive dysfunction, can make it extremely difficult to meet even the minimum expectations of full-time employment.

How to Strengthen Your LTD Claim for Lyme Disease

To improve your chances of approval, your claim should include:

Thorough Medical Documentation

• Laboratory test results confirming Lyme infection (e.g., ELISA, Western blot)
• Clinical diagnosis and detailed physician notes
• Imaging or neurological evaluations, if applicable
• History of treatments (including antibiotics and symptom management)

Residual Functional Capacity (RFC) Assessment

Ask your physician to complete an RFC form that clearly outlines:

• Physical limitations (e.g., difficulty standing, walking, lifting, or sitting for prolonged periods)
• Mental limitations (e.g., brain fog, memory problems, reduced concentration)
• Frequency and severity of flare-ups
• Impact on attendance and reliability

Ongoing Treatment History

LTD claims for Lyme disease are more likely to be denied if there are long gaps in treatment or inconsistent medical records. Try to maintain regular contact with a primary care physician, infectious disease specialist, neurologist, or rheumatologist.

What If Your LTD Claim for Lyme Disease Was Denied?

If your claim was denied or terminated, don’t give up. Many legitimate Lyme disease claims are denied due to lack of “objective” medical evidence or misunderstanding of the condition. You have the right to appeal the decision—and you should submit additional medical evidence to support your case.

Appealing a denial involves:

• Carefully reviewing your denial letter
• Understanding the insurer’s rationale
• Gathering stronger documentation and provider opinions
• Submitting a persuasive appeal within the insurer’s deadline

Get Help from a Long-Term Disability Attorney

Because Lyme disease can present inconsistently and is often misunderstood, working with an experienced long-term disability attorney can significantly improve your chances of success.

An LTD attorney can:

• Review your LTD policy and claim denial
• Help gather and organize medical evidence
• Work with your doctors to complete RFCs and support letters
• Communicate with the insurance company on your behalf
• Represent you throughout the appeal or litigation process

At the Ortiz Law Firm, we help clients across the country fight for the benefits they deserve. We work on a contingency fee basis—which means you don’t pay us unless we win your case.

Contact Ortiz Law Firm for a Free Case Review

If Lyme disease has taken away your ability to work and your insurance company denied your long-term disability claim, we’re here to help.

Call (888) 321-8131 or contact us online to schedule your free case evaluation. We’ll review your claim, help you understand your rights, and fight for the disability benefits you deserve.