How to Apply for Social Security Disability Benefits
One of the biggest challenges facing Lyme patients is the debilitating symptoms that render patients unable to work along with the large out-of-pocket costs for treatment. This challenge is further compounded by the inequitable health systems we have in the United States. This resource outlines a background of why Lyme treatment can be so expensive as well as showcases options for financial relief.
There are two main schools of thought for treating Lyme disease. There is the IDSA and CDC which recommend a standard 10- to 14-day course of a single antibiotic therapy to those who receive positive Lyme disease tests. While this may work for most patients, 10-20% will end up with persistent symptoms which require additional treatment.
In contrast, ILADS holds a more clinical approach. Typically, ILADS doctors prescribe treatment options depending on the length of time a person has been ill, symptoms, response to treatment, and the types of therapies they’ve already received.
Since insurance companies only cover what is outlined by regulators as necessary, any additional treatment may result in patients having to pay out of pocket.
Medically Qualifying for Social Security Disability Benefits
All of the conditions that qualify for disability benefits are listed in the Social Security Administration’s Blue Book; however, there is no specific SSA-Blue Book listing for Lyme disease. To medically qualify for disability benefits under a Lyme disease diagnosis, you will need to meet the symptom qualifications for another condition that is listed. Since many of the symptoms found in Lyme patients are seen in other listed conditions, you can still qualify for disability benefits due to Lyme disease.
Below is a list of conditions that fall into the existing Blue Book categories:
- Section 1.00 (Musculoskeletal System) – This applies if you have significant mobility limitations.
- Section 4.00 (Cardiovascular System) – This applies if you have suffered heart damage or developed heart disease from Lyme disease.
- Section 12.00 (Mental Disorders) – This applies if you have anxiety or cognitive issues from Lyme disease.
- Section 14.09 (Inflammatory Arthritis) – This applies if you have arthritis in the knees or other weight-bearing joints that limits your mobility to a level that is considered disabled.
Medical records, tests results, treatment plans, and other medical documentation are necessary to support your claim for disability benefits. Your doctor needs to carefully prepare records and letters that will support your disability claim.
Applying For Social Security Benefits
Social Security is a good option to assist Lyme patients financially impacted by the disease. The debilitating systemic issues attributed to persistent tick-borne infection may force you to leave work, which is one of the main qualifiers for Social Security Benefits. To consider applying, you first need to understand the difference between the types of Social Security benefits for afflicted individuals. There are two types of benefits:
SSDI- Social Security Disability Insurance
The Social Security Disability Insurance (SSDI) program provides benefits to people who
- Are “insured,” meaning that you or a family member worked long enough – and recently enough – and paid Social Security taxes on your earnings; and
SSI- Supplemental Security Income
- The Supplemental Security Income (SSI) program pays benefits to disabled adults and children who have limited income and resources.
Besides the financial differentiation, both programs are the same in terms of requiring the recipient to meet the below criteria:
- Showcase an inability to do any substantial gainful activity; and
- Can be expected to result in death; or
- Has lasted or can be expected to last for a continuous period of not less than 12 months.
To find out if you qualify you can take a screening tool designed by the Social Security Administration.
You can apply for SSA benefits both online or in person. If applying for the Residual Functional Capacity evaluation we recommend you apply in person. You can locate your local SSA office and make an appointment to file a claim. Do not forget to bring copies of all of your medical, mental health, and adjunct treatment documents with you. The process can be time-consuming and quite detailed, so make sure you use the SSA’s helpful application checklist.