"Applying for Disability Benefits with Lyme Disease
Although Lyme disease can be quite debilitating, its affects
on each patient are different. Additionally, because the symptoms of the
condition can be quite pronounced at times, and go into relatively long periods
of remission, it can be challenging to receive qualify for disability benefits
through the Social Security Administration (SSA) for this condition.
Though difficult, it is possible to prove disability and get
the benefits you need, if your Lyme disease is so severe that it prevents
gainful employment for a period of 12 months or more or is expected to do so,
given the extent and type of symptoms you experience.
SSA Disability
Programs
The SSA has two disability programs for which you can
potentially qualify with Lyme disease. The first, SSDI, or Social Security
Disability Insurance, is a program designed for disabled workers. SSI, or
Supplemental Security Income, is the second program, and it is a need-based
benefits program designed to provide benefits to disabled workers and/or their
dependents.
Basic Eligibility
To be eligible for SSDI and/or SSI, you must meet the basic
medical requirements for proving disability. These include:
- Having a medical
condition that can be substantiated through standard medical means,
meaning it must be proven with significant medical documentation and that
documentation must satisfy the SSA’s evidence requirements.
- Suffering from a
disability that has been, or is reasonably expected to be, present for at
least 12 months or which is terminal.
- Your condition
must prevent you from maintaining gainful employment in any job for which
you would otherwise be qualified.
The previously listed basic eligibility requirements satisfy
the medical portion of eligibility for SSDI and SSI; however, each program also
has technical eligibility requirements.
- For SSDI, you
must have work credits from your previous employment, and must also not
earn more than the SGA, or substantial gainful activity, threshold in
monthly earnings from employment. You can learn more about SSDI here: http://www.disability-benefits-help.org/ssdi/qualify-for-ssdi
- For SSI, you
must have very limited income and other financial resources with which to
support yourself, as this is a need-based program. You can learn more
about SSI here: http://www.disability-benefits-help.org/content/about-ssi
Qualifying with Lyme
Disease
To meet the SSA’s medical eligibility requirements, you must
fully document the affects of your Lyme disease on your ability to work and
your everyday abilities to complete tasks in your personal life as well. While
the SSA has no dedicated listing for the condition under which you can qualify,
there are multiple listings in the SSA’s Blue Book (http://www.ssa.gov/disability/professionals/bluebook/)
that may be applicable to your claim. This is because Lyme disease can have
severe affects on multiple body systems.
To qualify with this condition, you must:
·
match a listed condition in terms of severity
level
OR
·
document that your residual functional capacity
(RFC) is so limited that you qualify under a medical vocational allowance (MVA)
The following conditions may be ones that your Lyme disease
application can match, provided you have the appropriate medical documentation
to satisfy the SSA’s evidence requirements:
·
Musculoskeletal System – Section 1.00
·
Cardiovascular System – Section 4.00
·
Mental Disorders – Section 12.00
·
Inflammatory Arthritis – Section 14.09
It is also important to note that the SSA will take all of
your symptoms under consideration when determining if you meet the eligibility
requirements for receiving Social Security Disability (SSD). In other words, if
your symptoms fall under more than one of these listings, the SSA will consider
the medical evidence you provide in comparison to multiple listings.
Starting Your
Application and Getting Help with Your Claim
If you are ready to begin your application, you have two
options for getting started:
- visit the SSA’s website,
to start your application immediately,
OR
- contact your local SSA
office, to schedule an in person interview during which your application
will be completed.
While it is possible to receive disability benefits for Lyme
disease, it can take a long time for your application to be approved. You may
have to go through more than just one round of reviews before the SSA finds you
eligible, and you may also have to appear at an appeal hearing, if your claim
is denied more than once.
Seeking the help of a Social Security Disability advocate or
attorney before filing your claim is advisable with Lyme disease. However, an
advocate or lawyer can assist you at any stage in the application and review
processes as well, and can potentially increase your chances of being approved
for benefits."
Hopefully that helped somewhat, though it is a mindful to read. I put this out there as a reference for many people starting to navigate the hoops of this illness and survive even when the going has gotten rough.