Can I Get SSI or Disability for Lyme Disease?

The information in this article is current as of February 17, 2022.

According to the CDC, more than 475,000 Americans per year are diagnosed with and treated for Lyme disease. So, if you happen to have Lyme disease, you might be wondering, “Is it possible for me to get SSI or disability for Lyme disease?”

Depending on what symptoms you have, you might be able to get SSI or disability for Lyme disease. If you qualify for one of the Sections within the Blue Book, such as 1.00, 4.00, 12.00, or 14.09, you can. Additionally, if you can demonstrate how your ability to work is impacted, you can as well.

What Is Lyme Disease?

Before we go into whether you can get disability or SSI for Lyme disease, we’ll review what Lyme disease is. Lyme disease is a disease that’s caused by four different bacteria species. The most common in the U.S. are Borrelia mayonii and Borrelia burgdorferi.

Lyme disease, in these regions, is the most common of tick-borne illnesses. It’s transmitted through an infected black-legged tick’s bite. This type of tick is known more commonly as the deer tick. It’s easier to get this disease in heavily wooded and grassy areas where the ticks that carry this disease live.

Early symptoms include a bulls-eye rash, neck stiffness, headache, body aches, fatigue, chills, and fever. Later symptoms can include joint pain, erythema migraines, and neurological problems.

If you don’t treat Lyme disease, it can lead to several complications such as heart rhythm irregularities, cognitive defects like impaired memory, neurological symptoms like neuropathy or facial palsy, and chronic joint inflammation (especially in the knee).

It’s crucial to review this information about the disease and speak with a health care provider immediately if you suspect you might have caught Lyme disease.

Getting SSI or Disability for Lyme Disease

The Social Security Administration, or SSA, provides disability benefits to individuals who, due to a severe illness or injury, become so disabled that they are unable to work. The different types of support you can receive include:

• Social Security Disability Insurance, or SSDI
• Supplemental Security Income, or SSI

To qualify for either SSDI or SSI, you need to prove that the symptoms you’re experiencing limit your ability to do work significantly. Depending on your condition, this process can be pretty straightforward or challenging.

Many of the symptoms people experience with Lyme disease can mimic less severe conditions. These issues can end up being treated with medications and antibiotics.

We’ll now review how you can get SSI or SSDI benefits for Lyme disease. For an individual to get these benefits, at least one of two things has to be the case.

The first is that the individual meets the requirements of one of the medical conditions listed within the Social Security Administration’s Blue Book.

When unable to meet the requirements, they must demonstrate how the effects they experience result from Lyme disease interfering with their ability to work.

Is Lyme Disease an SSI Condition?

There is not a specific listing within the Blue Book for Lyme disease. However, this doesn’t mean that it won’t be possible for you to be approved for the benefits of the disability type. However, this means you are unlikely to get automatically approved by equaling or meeting a listing.

Ways You May Qualify

Depending on how severe your advanced symptoms caused by Lyme disease are, there are several ways you may qualify. These include Section 1.00 Muskuloskeletal Disorders, Section 4.00 Cardiovascular System, and two others.

You can qualify through Section 1.00 Muskuloskeletal Disorders if swelling and joint pain limit your ability to use your arms or walk.   

If you experience heart damage caused by Lyme disease, you can qualify through Section 4.00 Cardiovascular System. How does this occur?

The bacteria that causes Lyme disease can enter your heart’s tissue and affect the electrical system of your heart. If you end up with anxiety or cognitive issues caused by Lyme disease, you can qualify through Section 12.00 Mental Disorders.

Finally, you might be able to qualify through Section 14.09 Inflammatory Arthritis.

In this case, you must have arthritis in a weight-bearing joint, such as the knee, limiting your mobility to the point where you’re considered disabled.

Determining Your Ability to Work

Suppose you’re unable to meet any of the listings we just reviewed. You might be wondering, “Can I get disability for Lyme disease or SSI even though I don’t meet any of these listings?” The fact is that you may.

In the case where there are limitations outside of these that you’re experiencing as a result of Lyme disease that makes it impossible for you to work, you might be able to get these benefits.

Using an RFC, or Residual Capacity Form, the SSA tries to determine whether your impairments are severe enough to prevent you from carrying out your daily work activities.

For instance, they might review your ability to grasp, pull or lift items, walk, kneel, or stand or sit for an extended period. 

Depending on which activities you can or can’t do because of Lyme disease, the SSA might deem you capable of doing heavy, medium, light, or sedentary work.

This assessment, combined with your medical records, could demonstrate that you’ll qualify for disability benefits.

What Happens if the Claim Is Denied?

If your disability claim for your Lyme disease symptoms is denied, you can appeal this decision. In this case, it’s a good idea to work with a lawyer who specializes in appealing disability claims.

A lawyer can assist you with gathering the detailed medical evidence you need to appeal the SSA’s decision. Evidence includes doctor’s notes regarding your condition, treatment plan, and diagnosis.

Note, too, that if you’re experiencing cognitive problems due to your Lyme disease, the lawyer might recommend that you undergo a neuropsychological assessment.

The assessment would make it easier to demonstrate how Lyme disease impacts your cognitive functioning, making it impossible for you to perform your job’s essential duties.

What’s the Difference Between Disability and SSI Benefits?

Now that we’ve reviewed how to get SSI or disability benefits for Lyme disease, you might wonder what the difference is between the two. 

SSI benefits are for people who qualify for Social Security Income. Usually, to qualify, people need to prove they are low income or disabled or have children who are disabled and have a low income. 

When it comes to getting SSI benefits, it’s easier if you’re in a position where you have a low income. However, if this isn’t the case for you, it might be easier to get Social Security Disability Insurance or SSDI.

However, if you go this route, it means you have to demonstrate you have what the government considers a “disability.”

Luckily, you may have a general idea that Lyme disease is affecting you in such a way that its effects are causing what the government would classify a “disability.”

Getting SSI or Disability for Lyme Disease

This article should have provided you with a better understanding of the causes, symptoms, and effects of Lyme disease. In addition, you have also learned the Blue Book’s qualifying conditions determining your ability to work due to Lyme disease or if you’re eligible for SSI or Disability for Lyme disease. 

We’ve reviewed how to handle a denied claim and the difference between Disability and SSI benefits.

Finally, you can get SSI or Disability for Lyme disease, depending on your situation.

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