Lyme Disease and Disability Claims: What You Need To Know

Springtime is upon us and with the warmer weather comes greater risk of contracting Lyme disease. Lyme disease is becoming more and more of a concern across Ontario and Canada wide due to global warming and the movement of tick populations.

The symptoms of Lyme disease can be debilitating and can last for an extended period of time, and you may be unable to continue working and find yourself applying for short term and long term disability benefits. Unfortunately, many of the symptoms can be confused for other illnesses and Lyme disease is often referred to as an invisible illnesses and can go undiagnosed for some time.

This blog post will cover:

• What is Lyme Disease?
• What are the Symptoms of Lyme Disease?
• Why Is it Misdiagnosed?
• How is Lyme Disease Treated?
• Prevention Tips
• What You Should Know about Lyme Disease and Disability Claims
• Reasons Your Disability Claim Could be Denied
• What You Can Do if Your Disability Claim is Denied

What is Lyme Disease?

Lyme disease is an inflammatory infection spread through tick bites from backlegged ticks (a.k.a. deer ticks).

According to the Canadian Lyme Disease Foundation (CanLyme) there are 3 stages of Lyme disease and symptoms worsen during each stage of infection:

1. Early infection, which is the first few days after being infected;
2. Spread of infection, where the infection spreads in the days or weeks following the onset;
3. Chronic Lyme, which occurs when the infected is left untreated/has not been properly treated and can last for months or years.​

To find out which areas of Ontario are at the highest risk for Lyme disease, you can refer to the “Lyme disease risk areas in Canada” map on the Government of Canada’s website. You should also know that backlegged ticks thrive in wet environments, woodlands, tall grass and bushes and even though ticks are usually found specific locations/environments, because of tick populations spreading, it is possible to be bitten outside of these locations.

What are the Symptoms of Lyme Disease?

There are over 100 known symptoms of Lyme disease. Symptoms can affect your musculoskeletal system, senses, mental capability, psychological well-being, digestive system, respiratory, circulatory and neurological systems.

Symptoms can include, and are not limited to (courtesy of CanLyme)

• Early on, experienced a “flu-like” illness, after which you have not since felt well
• Unexplained hair loss
• Headache, mild or severe, pressure in the head
• Seizures
• Twitching of facial or other muscles, facial paralysis (Bell’s Palsy, Horner’s syndrome)
• Stiff or painful neck, jaw pain or stiffness
• Double or blurry vision, pain in eyes, or swelling around eyes
• Decreased hearing in one or both ears, plugged ears, buzzing in ears, ringing in one or both ears
• Diarrhea/constipation, upset stomach (nausea or pain) or GERD (gastroesophageal reflux disease)
• Irritable bladder or interstitial cystitis 
• Bone pain, joint pain or swelling, carpal tunnel syndrome, stiffness of joints, back, neck, tennis elbow
• Muscle pain or cramps, (Fibromyalgia), burning or stabbing sensations in the body
• Shortness of breath, can’t get full/satisfying breath, cough
• Heart palpitations or extra beats
• Tremors or unexplained shaking
• Extreme fatigue, Chronic Fatigue Syndrome, weakness, peripheral neuropathy or partial paralysis
• Numbness in body, tingling, pinpricks
• Poor balance, dizziness, difficulty walking
• Mood swings, irritability, bi-polar disorder, unusual depression, anxiety, panic attacks, Over-emotional reactions, crying easily
• Disorientation (getting or feeling lost)
• Too much sleep, or insomnia, narcolepsy, sleep apnea
• Short or long-term memory loss, confusion, difficulty thinking, difficulty with concentration or reading
• Speech difficulty (slurred or slow), stammering speech
• Difficulty finding commonly used words
• Loss of sex drive, sexual dysfunction, testicular or pelvic pain
• Unexplained weight gain or loss
• Swollen glands or lymph nodes
• Unexplained fevers (high or low grade), low body temperature
• Continual infections (sinus, kidney, eye, etc.)
• Symptoms fluctuate, and pain migrates to different parts of your body
• Allergies or chemical sensitivities

Why is Lyme Disease Misdiagnosed?

Chronic Lyme disease is often mistaken for other illnesses, making it difficult to diagnose and treat and prolonging diagnosis. Lyme disease is hard to diagnose because blood tests can show negative test results when the disease is actually present. It is recommended that Lyme disease be diagnosed based on symptoms and risk (areas you visited or activities you did. As well, there are only a handful of blood tests can effectively detect Lyme bacteria and that is another reason why the infection is easily missed. 

According to the Canadian Lyme Disease Foundation, Lyme disease can be mistaken for many other illnesses/diseases including Fibromyalgia, Chronic Fatigue Syndrome, Colitis/Crohn’s disease/IBS, Early ALS, Encephalitis, Lupus infectious arthritis/Osteoarthritis/Psoriatic arthritis/Rheumatoid arthritis, Multiple Sclerosis, psychiatric disorders, Meniere’s syndrome, Thyroid disease and Sleep disorders.

Is There Treatment for Lyme Disease?

Once you have been tested for Lyme disease and diagnosed, there are several treatment options including oral antibiotics, intravenous treatment, supportive therapies such as physical therapy, antidepressants, anti-inflammatory medication, intramuscular injections of medications, pulse and combination therapy.

How Can Lyme Disease Be Prevented?

The ticks that carry Lyme disease are tiny (less than 4mm) and are hard to spot immediately.

Here are some safety tips if you plan on spending time outside this Spring/Summer

Cover up

Wear clothing such as long pants and long-sleeved shirts to cover your arms and legs.

Don't forget the socks

Tuck your pants into your socks for extra prevention.

Keep it light

Wear light coloured clothing so you have a better chance of seeing ticks on your clothing.

Spray it

Always use insect repellent that contains DEET and spray it on your clothing too!

Do the check

Check yourself (and your pets) for ticks when you get home and if you find a tick, experts say DO NOT squash it with your fingers, remove it carefully with a tweezer.

Be alert

Avoid known high risk areas whenever possible

Use heat

Throw your clothes in the dryer on HIGH - the heat can kill any ticks that were hanging on to your clothes.

Take care of your property

Mow your lawn, keep the grass short, get rid of piles of leaves or weeds to avoid creating damp areas.

Know the early signs of Lyme Disease

Rash (can be shaped like a "bull's eye", fever/chills, headache, fatigue, muscle & joint aches, swollen lymph nodes.

What should I know about Lyme Disease and Disability Claims?

Lyme disease can have a variety of symptoms, some of which can be severe if left untreated. The symptoms of Lyme disease can interfere with your day to day life and ability to function, including your ability to work.

Because Lyme disease is difficult to immediately diagnose or treat, and because of the nature of the symptoms, it has been referred to as an “invisible illness”. When applying for long-term disability benefits, it is important to show that you have attended treatment, seen specialists and treating physicians on a regular basis and are complying with treatment recommendations.

If at the time you apply you do not have a confirmed diagnosis of Lyme disease, it is important that you have documentation such as clinical notes and records, or specialist’s consultations that show you have been investigating your condition and reporting your symptoms. The insurance company is looking for evidence that you are receiving proper care and treatment and for evidence that your symptoms are as severe as you are reporting. It is important that you report all symptoms to your doctor and see your physicians when you have new or worsening symptoms.



Your insurance company is looking for evidence that your symptoms make you unable to perform your employment duties and to function to an extent that would allow you to work. In particular, the insurance company wants to know what your restrictions and limitations are and if they are medically supported by your treatment providers/physicians and how long they will last. When you apply for long-term disability benefits and you have an invisible illness that cannot be seen on an x-ray or MRI, this type of information is very helpful in supporting your claim.

Why Would My Insurer Deny My Claim?

One of the most common reasons an insurance company denies long-term disability claims is for lack of objective medical evidence. Another reason is for failure to comply with treatment recommendations or be under the care of appropriate physicians.

As mentioned, with invisible illnesses, it is very important to have your symptoms documented and it is necessary to seek regular care. The severity of your symptoms should be documented by your treatment providers so that they can document and explain to the insurance company in the Attending Physician’s Statement (part of the application package) what your symptoms are, clinical findings and your supported restrictions and limitations (things you should avoid/are unable to do). Chronic Lyme disease may cause symptoms that affect the nervous symptom, cause psychological symptoms and various physical symptoms including pain and fatigue, making it difficult to work.

Your insurance company may be aware of your symptoms but may feel you are able to perform your job or some type of alternate employment and decide to deny your application or discontinue benefits. If this happens, you do have the option to fight their decision through appealing with new information and medical evidence or you can seek legal assistance and decide to start a legal action.

What Can I Do if My Disability Claim is Denied?

If your claim has been denied, you can fight the insurance company's decision to deny your claim. Your insurer will provide you with the option of appealing your claim through their internal appeal process, which can take several months and there is no guarantee their decision will be overturned. Generally you can appeal the decision three times, by providing new information and new medical evidence that supports your inability to work.

You also have the option of consulting an experienced disability lawyer to find out your rights and decide to start a court action against your insurance company.

Our lawyers have successfully represented clients with Lyme disease whose disability claims have been denied. We offer a free initial consultation that can be arranged at a date and time that works for you.