As the summer of 2025 unfolds, the Centers for Disease Control and Prevention (CDC) has reported that emergency room visits for tick bites have reached their highest levels since 2019, driven in large part by unseasonably mild winters and wetter spring conditions that favor the survival of disease-carrying ticks.
Lyme disease is well established across the United States—particularly in the Northeast, Upper Midwest, and Mid-Atlantic regions.
There are long-term consequences of Lyme disease resulting in people who are not treated properly to have devastating symptoms that prevent them from daily activities. Disability claims hinging on a Lyme disease diagnosis often present unique evidentiary challenges, compounded by diagnostic ambiguity, inconsistent treatment protocols, and pervasive misconceptions regarding the severity and persistence of the disease.
Post-Treatment Lyme Disease Syndrome (PTLDS) includes a group of persistent symptoms that may include chronic fatigue, diffuse pain, memory lapses, and executive function deficits—symptoms that are often functionally disabling, despite a lack of positive test results or clear objective findings. These complexities frequently become flashpoints in long-term disability insurance litigation.
Lyme disease is caused by the Borrelia burgdorferi bacterium, transmitted through the bite of infected black-legged ticks. Early symptoms typically include fever, chills, fatigue, headaches, muscle and joint aches, and a characteristic bull’s-eye rash. Untreated or inadequately treated Lyme disease may progress to involve debilitating arthritis, persistent neurological impairments, and profound cognitive dysfunction.
Recent findings published in the Frontiers in Medicine journal show the diagnostic uncertainties of Lyme disease. An analysis of the Lyme Disease Biobank—focusing on patients from Long Island, New York, and central Wisconsin between 2014 and 2023—revealed that a significant number of patients with persistent symptoms failed to follow up with their treating physicians.
Only one-third of patients initially tested positive for Lyme disease, despite the presence of symptoms.
Testing protocols for Lyme are notoriously inadequate at detecting early infections or late manifestations. For patients pursuing disability benefits, these gaps can be fatal to a claim. Insurers will use negative or equivocal laboratory findings to deny benefits, taking the position that absent objective confirmation, a diagnosis of disabling Lyme disease is unsubstantiated.
The study also found that among those with continuing symptoms after treatment, the majority ceased follow-up with healthcare providers. This poses a barrier for disability claimants who must demonstrate a qualifying medical condition AND compliance with appropriate treatment protocols. The failure to maintain a consistent medical record—especially in the context of a controversial and misunderstood illness—can undermine a claim even where disabling symptoms are manifest.
Robust medical documentation is the foundation of any long term disability claim. For Lyme disease sufferers, this is especially important given the episodic nature of symptoms and the absence of universally accepted diagnostic criteria for PTLDS.
Claimants must ensure that they:
- Obtain a definitive diagnosis from a qualified specialist, preferably one familiar with tick-borne illnesses;
- Undergo ongoing treatment as recommended, including any secondary or extended antibiotic courses;
- Document symptoms consistently, particularly in terms of their impact on occupational functioning;
- Respond promptly to insurance requests for additional information, including independent medical examinations (IMEs) or functional capacity evaluations (FCEs).
- Disability insurance carriers are increasingly scrutinizing claims involving Lyme disease. Common tactics employed include:
- Requesting contemporaneous lab results, despite acknowledged limitations of current testing modalities;
- Demanding proof of objective physical impairments, especially when symptoms are primarily cognitive or fatigue-related;
- Asserting that ongoing symptoms are psychosomatic, particularly in cases lacking recent treatment or follow-up;
- Invoking policy exclusions related to pre-existing conditions or subjective complaints.
Tick bites cause many diseases in addition to Lyme: anaplasmosis, babesiosis, ehrlichiosis, Rocky Mountain spotted fever, and Powassan virus, among others. These illnesses may present overlapping or compounding symptoms, complicating diagnosis, and treatment. For disability claimants, recognition and documentation of co-infections may bolster the overall medical narrative and reinforce the legitimacy of a claim.
If you or a loved one is unable to work due to Lyme disease or a related tick-borne illness, you are invited to contact Newfield Law Group to discuss how to protect your disability claim.
Newfield Law Group has successfully represented numerous clients suffering from the long-term consequences of Lyme disease. Our attorneys work closely with infectious disease specialists, rheumatologists, and neuropsychologists to build compelling evidentiary records that withstand insurer scrutiny.
We understand that your condition may not be visible, and your test results may not tell the whole story. But we also know that with the right legal advocacy, your story can be heard—and your rights protected.
If you have been diagnosed with Lyme disease and are struggling to continue working, we urge you to contact our office for a confidential consultation. The path to recovery may be uncertain—but your right to disability protection should not be.
