Lyme disease is a bacterial infection that you get through the bite of a deer tick (black-legged tick). Due to the particular nature of Lyme disease, with its exacerbations and remissions, individuals who have Lyme disease can face an uphill challenge when they attempt to pursue either Social Security Disability (SSD) or SSI disability benefits.
The effects of Lyme disease on individuals vary greatly, but Lyme disease generally shows up in three stages; each stage has progressively worse symptoms if untreated.
Stage one begins within days to weeks of being bitten. Infected individuals suffer flu-like symptoms that can include a headache, body ache, and overall feeling of being ill. Many individuals also experience a bull’s eye rash around the site where they were bite.
Stage two begins within weeks to months after being bitten. In this stage, symptoms become more severe. Individuals can suffer muscle, joint, and tendon pain, loss of muscle control in the face, dizziness, meningitis, an altered mental state, shooting pain that interferes with sleep, heart problems, and encephalitis, which can cause memory loss, sleep disturbances, and mood changes.
Stage three begins within months to years after being bitten. At this stage, individuals suffer severe and chronic symptoms that can affect their brain, nerves, eyes, joints, and hearts. There are two neurological illnesses that are common in this stage of Lyme disease that can cause significant impairments: Lyme encephalopathy can cause subtle problems with concentration and short term memory. Chronic encephalomyelitis can cause progressive cognitive problems, weakness in the legs, awkward walking, weakness in the facial muscles, bladder problems, vertigo (feeling that everything is spinning around you), and back pain.
Other physical symptoms may include shooting pains, numbness, and tingling in the hands and feet, significant fatigue, arthritis in the knees and other areas, and mild to moderate pain and swelling in the joints. Other mental symptoms can include loss of memory, panic attacks, anxiety, delusions, detachment from reality, overall changes in emotional statedifficulty understanding or interpreting what one is seeing, and difficulty with more advanced daily tasks, such as scheduling.
The symptoms that individuals with Lyme disease have depend on their individual bodies, and when the Lyme disease was detected. Similarly, the effectiveness of treatment for Lyme disease often depends on when the Lyme disease is diagnosed and treatment is started.
Individuals can receive Social Security Disability benefits if they meet the requirements of a medical condition that is in Social Security's "blue book" of impairment listings or if they can show that the effects of the Lyme disease interfere with their abilities so much that they can't work.
Lyme disease does not have a specific disability listing in the blue book. This simply means that it's unlikely someone with Lyme disease would get an automatic approval by meeting a listing.
However, there are several listings that might be met by those with advanced Lyme disease, including:
The multiple limitations caused by Lyme disease may make it impossible for you to return to work even if you don't meet a listing. Social Security will evaluate your abilities and impairments using the Residual Functional Capacity (RFC) to determine if all of your impairments considered together prevent you from being able to work.
For those with Lyme disease, pain in the muscles, joints, tendons, and back, numbness and tingling in the hands and feet, arthritis pain and swelling in the knees or other joints, and weakness in the legs can make physical activities such as walking, standing, and lifting difficult, depending on the severity of their symptoms. Additionally, problems with sleep, heart problems, and significant fatigue may make it hard to do any type of physical work.
Social Security will also evaluate your ability to do less strenuous, sedentary work. For those with Lyme disease, numbness in the limbs, arthritis, and balance issues may prevent certain physical movements and fine motor skills, if your fingers or hands are affected. In addition, facial weakness can affect eye sight.
Finally, the effects of Lyme disease on your mental abilities can make functioning in the work place difficult. If Social Security finds that you have memory loss, decreased concentration, difficulty understanding or interpreting what you are seeing, and difficulty completing more complex tasks, the agency will include these impairments in your RFC as well. Likewise, panic attacks, anxiety, delusions, and detachment from reality can cause problems interacting with other in the work place and responding properly to supervision and work stresses.
After Social Security has included all of the ways your Lyme disease interferes with your ability to work in your RFC, it will compare your RFC to the requirements of your former job to see if you should be able to still do the job. If not, the agency will then apply a formula to your RFC, your job skills, training, and age to see if you should be expected to do other, less demanding work. If you can't do even a sedentary job because of Lyme disease, you should be able to get disabiity benefits. For more information on how Social Security makes this decision, see our article on disability determinations based on the RFC.
To make sure all of your limitations make it into your RFC, make sure your doctors understand how important it is that your medical records include not only a diagnosis, prognosis, and objective observations (vitals, muscle strength, reflexes), but also include "descriptive" indications of the functional limitations you experience as a result of Lyme disease. For instance, if a Lyme disease patient is suffering neurological deficits that result in a loss of coordination and balance, the doctor should note this in his or her treatment notes. If a patient is experiencing a decrease in grip strength in addition to an overall loss of muscle strength, this should be noted. And, certainly, if a Lyme disease patient is experiencing mental deficits that lead to memory lapses and disorientation, this should be noted also (even when a disability claimant does not specifically allege a mental impairment, the limitations that result from such an impairment can be considered on a claim). For more information, see our article on getting disability for non-exertional impairments.