Bartolic Law has helped clients suffering from Lyme disease succeed with their long-term disability claims. Insurers are often hostile towards claims based on Lyme disease, especially when treated for longer than 30 days. In one client’s case, we demonstrated that health and disability insurers lobby to set the treatment standards for Lyme disease, which produce false-negative tests approximately two-thirds of the time. They then use those same standards to deny long-term disability claims. We demonstrated that many states have passed legislation addressing this position on treating Lyme disease, and the high rate of false-negative diagnoses. Despite terminating our client’s claim, we were ultimately able to get the client paid.
Many states have enacted legislation addressing overly narrow diagnostic and treatment criteria for Lyme disease and state medical boards disciplining doctors for their treatment of Lyme disease. Illinois enacted legislation acknowledging that the CDC reports approximately 30,000 Lyme disease cases per year, but the actual number is as high as 300,000 per year. The State of Connecticut Attorney General’s Office conducted an investigation and concluded that the Infectious Disease Society of America guidelines for diagnosing and treating Lyme disease were influenced by a financial conflict of interest, and studies demonstrated those guidelines were inaccurate and unreliable.
Lyme disease is an infection caused by the Borrelia burgdorferi bacterium. In some cases, this condition is curable within two to four weeks using oral antibiotics. However, some patients may suffer the symptoms of Lyme disease for months, even after completing their treatment. Such prolonged cases are called Post-Treatment Lyme Disease Syndrome (PTLDS). At times, the term “chronic Lyme disease” (CLD) is also used to describe the condition. This disease has different symptoms, some of which include fever, erythema migrans (a form of skin rash), headaches, insomnia, irritability, and fatigue. Failure to treat the illness on time or entirely might cause long-term complications.
For instance, it might spread to other vital body parts like the nervous system, heart, and joints. When this condition reaches complicated levels, a patient might suffer severe symptoms like challenges with short-term memory and other thinking capabilities. Around 50% of all patients suffer some kind of arthritis, and others develop depression, facial palsy and neuropathy, and an abnormal heartbeat. Many patients may lose their ability to concentrate on and effectively perform their regular daily duties with such complications. For example, memory lapses can negatively impair one’s ability to retain their job, leading to job loss and the need for disability benefits.
Ferrin v. Aetna Life Ins. Co., 336 F. Supp. 3d 910 (N.D. Ill. Sept. 28, 2018) (holding insurance policy’s grant of discretionary authority is void under Texas law due to certificate being issued after effective date of regulation, and policy renewing after effective date, and holding Plaintiff was disabled from Any Reasonable Occupation where treating doctors certify she can sit at the occasional level, and insurer’s consultants opine Plaintiff can sit frequently, as weighing all evidence together would make capacity likely at low end of frequent range at best).
Sadowski v. Tuckpointers Local 52 Health & Welfare Trust, 281 F. Supp. 3d 710 (N.D. Ill. Dec. 20, 2017) (holding plan was arbitrary and capricious in denying medical benefits for removal of spinal cord stimulator following a fall down the stairs and infection where plan argued the expenses were caused by the same injury as the car accident necessitating implantation of the stimulator years earlier)
Tassone v. United of Omaha Life Ins. Co., 264 F. Supp. 3d 867 (N.D. Ill. Aug. 30, 2017) (awarding client long term disability benefits denied by United of Omaha despite insurer’s doctor opining there was no objective evidence of functional impairment)
Suson v. PNC Fin. Servs. Grp., Inc., No. 15-CV-10817, 2017 WL 3234809 (N.D. Ill. July 31, 2017) (holding Liberty Mutual’s denial of client’s long term disability benefits was arbitrary and capricious where Liberty Mutual disregarded client’s carpal tunnel syndrome and relied on a vocational opinion to which client never had an opportunity to address before litigation)
Although Lyme disease has many health and financial consequences, there are options for support. You can consult with Bartolic Law if your condition interferes with your ability to earn a living.
Our legal team has handled many such cases and can help you determine if you qualify for disability insurance benefits. Contact us today.