Disability Denied Lyme disease patients may need a legal advocate to face down disability insurance gatekeepers

By Mala Rafik, Esq.

F or almost twenty years, our firm has represented chronically ill and disabled individuals trying to access health insurance coverage and disability benefits. While every few years there seems to be a new illness upon which insurers focus their attention, no illness in my experience has garnered the level of negative treatment as Lyme disease. In the last five years, the number of chronically ill individuals suffering from Lyme who have called our office has grown exponentially, to the degree that we receive at least two calls a week from individuals seeking health or disability coverage. The numbers are staggering. Even more distressing, however, is the destruction imposed upon the lives of these individuals and their families due to the denial of health or disability coverage.

I have rarely seen an illness faced with as much skepticism as Lyme disease.

My clients — hardworking individuals with families and careers — have been called malingerers, mentally ill, addicts … anything but what they are: individuals struck with a disease that the medical community has yet to find a foolproof way to diagnose and cure. Most individuals who contact us follow a similar pattern. They began experiencing flu-like symptoms, including overwhelming fatigue, which soon progressed to joint and muscle pain and worrisome cognitive limitations…… Join or login below to continue reading.

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11 Reader Comments

  1. Omg I think I may have Lyme disease this fits everything I have suffered from since age 16 I am now 45 my cognitive difficulties are getting so bad and I can not focus multi task any longer I believe after 10 years with a,state agency that I am going to lose my job. Been separated for 6 years now my husband dropped the bomb at the same time that he is filling for divorce now that the kids are old enough he won’t have to pay child support but for a year now , and I will lose my health insurance I am on methotrexate, plaqunil, prednisone, Erythromycin, 3 BP meds, and my teeth have been an ongoing issue papladeema, with migraine that don’t stop cervical stenosis the pain and fatigue in unbearable other then a pos ANA all my life and A pos SCL70 but no signes of schleroderma I’m about to lose my job because of my lack of brain function did I say that already. I need help and I need it quick, I still have 2 of my 5 daughters at home that are in middle school and high school I can’t lose this fight now and I feel like I am oh and I has gastroperesis too.

  2. Heather, do you have any questions about Lyme disease? We would be glad to help in any way that we can.

  3. Good morning! I hope. There’s no doubt I have Lyme(+) – long story. So I tackle one challenge@ a time but there’s one I just can’t find a way to move forward on. I have a Aetna short/long term disability plan and I’m to the point I need legal assistance to file my appeal for claim denial. I even had to go to FL Insurance Commissioner just to get a copy of the policy summary. But all the law offices I contact don’t do personal disability cases, either they do insurance injury or SSDI. I live in Northeast PA. Please, is there anyway or anyone who can help me find a referral? This is so typically of the hardship/discrimination I face due to the (doctor supported) cognitive issues. Thank you for your time and consideration.

  4. How can disability apply to women who have been a stay at home mom for 20+ years and find themselves divorced and unable to work with no other income available?

  5. I am a family nurse practitioner and co own a wellness clinic. I was unable to work for 6 months last year due to debilitating Lyme symptoms. I got a positive Lyme result through Igenix Labs. My MD partner and I diagnosed my Lyme disease (I had been to the usual specialists concerned about ALS, MS, cancer, etc. My disability insurance claim refuses to acknowledge me since I was diagnosed in my own clinic. We are so weary. Can you help us? I live in TN.

  6. I am 58 years old an was diagnosis is lyme disease. I take mexotrexate shoots once a week due to pills not working.i have it so bad i habe problems walking and balance. Been in bed. All day due to so much pain turned down for disability. I have appealed all my denials. Im getting a new lawyer soon. God bless and good luck like me.

  7. I just got my results back from IGeneX and my Western Blots are positive. I have been researching Lyme disease since I got home from the doctors office. I have been severely sick since November 2017 after catching a stomach pay. After numerous tests and many mystifying test results (high levels of Parvo and mono) I asked to do a Lyme test. Which as well came back positive. After calling the specialist office I’m wondering if
    there is any financial assistance to help with addition and treatment. I’ve been unable to work due to my symptoms. Thank you I’m advance for any help!

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