By Matt Lalande in Long-Term Disability on October 30, 2021
Did you know that every May is Lyme Disease Awareness Month? And for good reason: not only is May the unofficial start of tick season, but cases of Lyme disease are also increasing year after year in Canada and the United States.
After a long, cold winter, it’s natural for Ontario residents to want to get out and enjoy the warm weather with time-honoured outdoor activities such as camping, hiking, bike riding, or fishing. However, every season has its own share of potential risks, and with the warmer months comes the risk of bug bites, including tick bites that can cause Lyme disease.
While it is not as well known as some of the common types of cancer in Canada, Lyme disease is a severe, disabling disease that can lead to long-term complications that place substantial limitations on an individual’s life. However, Lyme disease is also relatively new in terms of research and development, and it has only recently begun to garner adequate attention in the news, media, and society.
If you or a loved one have been bitten by a tick and are suffering from Lyme disease, or the potential long-term consequences of Lyme disease, you may have found yourself severely limited in your daily cognitive and physical functions, which can render you unable to work. Despite this, you will continue to face financial strain and your bills will not stop coming in. When this happens and your insurance company hits you with a denial on top of that stress, life can become incredibly frustrating and unfair.
As Hamilton disability lawyers, we know how difficult it can be to be faced with a denial when you really cannot work. For this reason, we strongly encourage anyone to understand the limitations of Lyme disease and the options available to you if you are denied benefits by your insurance carrier.
Lyme disease is an illness that is caused by a bacteria called Borrelia burgdorferi. It is spread to humans via certain species of Ixodes ticks, known as blacklegged ticks. Tiny, young ticks known as nymphs are responsible for the majority of infections in North America, but mature adult ticks can also carry the disease. However, mature adult ticks are easier to see and remove, while nymphs are extremely small and difficult to detect until they have already attached to the body.
In order for the disease to transmit to humans, a tick must be attached to the body for 36 hours. They often attach to areas such as the groin, scalp, and armpits, but are able to attach to any part of the body if needed and can bite through clothing. Typically, adult ticks bite more often in the fall months, while nymphs tend to bite in the spring and summer months.
Blacklegged ticks tend to live in more humid and most environments, and can’t survive in dry areas. For this reason, they are usually found in areas with lots of brush such as forests.
While Lyme disease cannot be spread from human-to-human contact, it’s possible for women to suffer placenta infections or even stillbirths if they develop the disease while pregnant. If properly treated early enough, Lyme disease will not spread to the fetus. Therefore, it’s important for pregnant women to detect and monitor for Lyme disease as early as possible.
There are over 100 known symptoms associated with various stages of Lyme disease, but some are more common than others. Typically, the symptoms of Lyme disease develop slowly over three stages: early localized Lyme disease (within the first 30 days), early disseminated Lyme disease (within the first three months), and late disseminated Lyme disease (after three months).
In the early localized Lyme disease stage, individuals will experience symptoms such as:
During this stage, some individuals may also present an erythema migrans (EM), which is a small skin lesion localized to the area where the bite occurred. It begins as a small circular rash that can be either red or purple in colour. An EM does not always occur with Lyme disease, but it is very common and is present in approximately 80% of cases. It typically grows in size over time, and in some cases it forms a “bull’s eye” design as it grows. This “bull’s eye” rash is considered to be a trademark sign of Lyme disease.
Within the first three months, symptoms will escalate into the early disseminated Lyme disease stage. At this point, the bacteria may spread through the bloodstream and cause damage to other parts of the body, including the brain and vital organs.
During the early disseminated Lyme disease stage, symptoms may include:
The last stage, late disseminated Lyme disease, is also known as chronic Lyme disease. It begins around the third month after the tick bite, but if not treated early enough, this stage can last multiple years after a diagnosis.
Typical symptoms for late disseminated Lyme disease include:
There is currently no vaccine that can prevent Lyme disease or protect an individual from contracting it if they spend a significant amount of time outdoors. Once it has been diagnosed, Lyme disease can be treated with antibiotics such as amoxicillin, doxycycline, or cefuroxime axetil. Usually the course of antibiotics will last around 10 days. However, severe cases may require more than one round of treatment.
Some more recent evidence indicates that individuals who have recently been bitten by a tick, but are not sure if they have contracted Lyme disease, could prevent the illness with a round of antibiotics. However, this research is still new and is not generally recommended except for in certain circumstances.
According to the Center For Disease Control, approximately 20% of individuals live with long-term, permanent complications after treatment. This is known as post-treatment Lyme disease syndrome (PTLDS).
PTLDS can lead to some or all of the following long-term symptoms and conditions:
Many individuals with PTLDS experience a “brain fog.” This is a common trademark symptom of the disease that can impact a number of aspects of daily life, especially in most jobs or workplaces when this presents a physical safety risk and/or a productivity limitation.
Receiving an official diagnosis for Lyme disease in Canada can be difficult for a variety of reasons. The two primary reasons this can be difficult are a potential lack of symptoms or causation between symptoms and the difficulty in testing and diagnosing Lyme disease.
Signs and symptoms of Lyme disease do not develop overnight, and can take up to a few weeks to begin to appear. It’s easy to forget that you were bitten by a tick weeks ago, which makes it even more difficult to associate disease symptoms with the tick bite. Further, tick bites are typically painless, and often someone may not realize they’ve been bitten by a tick at all. As a result, doctors may either misdiagnose the disease or not realize the causation until the
symptoms have progressed severely.
Another issue in detecting and diagnosing Lyme disease in Canada is testing. Usually, Lyme disease is detected through blood tests, which will analyze the blood for measurable levels of antibodies.
The body will naturally produce antibodies that fight off a Lyme disease infection, but it can take up to six weeks for the body to produce enough antibodies to result in a positive blood test. That means that the individual may be living with symptoms for six weeks before the disease is detected, and by this time, those symptoms could become severe and lead to permanent damage. This also means that it’s common for people to receive negative tests even when they have been infected with Lyme disease, further delaying treatment and allowing symptoms the time to grow worse.
If you are living with severe symptoms of Lyme disease and cannot work even after treatment takes its course, you may be eligible to apply for long-term disability benefits. This is an ideal option to help supplement your lost income during the time you are suffering from your symptoms but cannot earn an income to keep up with bills, mortgage payments, insurance payments, and any other financial responsibilities that continue while you are sick.
In order to be approved for long-term disability benefits, you need to prove to your insurance carrier that you are totally disabled and cannot perform the duties of your “own occupation.” After two years, most long-term disability plans in Canada undergo a Change of Definition, at which time you will likely be required to prove that you are too disabled to perform the duties of “any occupation.” This means you must now prove that you can’t work any occupation for which you are suited, such as through your industry experience, training, education, or other qualifications.
It’s important to know that it is not always easy to receive an approval for long-term disability benefits for Lyme disease – but it’s not impossible with the help of an experienced Hamilton disability lawyer.
When applying for long-term disability benefits for any illness or injury, you will need to provide sufficient medical evidence that you have received a diagnosis or are undergoing treatment and that your symptoms have become too severe to allow you to continue working. However, the issue with Lyme disease in particular is that many Canadian insurance companies consider it to be an invisible medical condition.
In Canada, receiving an accurate diagnosis for Lyme disease is more difficult than it seems. Testing does not always properly detect the disease, and even when it does, your insurance carrier may reject you based on their own lack of understanding or education about the disease’s long-term symptoms. For this reason, receiving an approval for long-term disability benefits for Lyme disease can be a long, frustrating, and strenuous process.
With this knowledge and experience in mind, our Hamilton disability lawyers will assist you by structuring a strong defense for your case. We use a multidimensional approach, enlisting the assistance of the top specialists, doctors, and occupational professionals to match your insurance company’s teams and prove beyond a doubt that you qualify for long-term disability benefits.
Dealing with the bureaucratic nightmare of proving that your Lyme disease can be a difficult process. If you’ve been denied long-term disability benefits, we would always suggest working with a reputable, experienced Hamilton disability lawyer instead of following the internal appeal route with your insurer.
Matt Lalande has been practicing disability law in Ontario since 2003, recovering millions of dollars in wrongfully denied long-term benefit payments for ill and injured individuals across the province. He never represents insurance carriers, only the disabled, and has gone up against the major insurance carriers in Canada in trials, litigations, or negotiations.
Book a free, no-obligation consultation and tell us about your situation. We never charge up front fees, and we don’t charge you anything until you win your case. You can get in touch with us local in the Hamilton/Niagara/Burlington areas at 905-333-8888 or toll-free throughout Ontario at 1-844-LALANDE (1-844-525-2633). Alternatively, you can request a call back through our online contact form to get started.
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