Undiagnosed or Unrecognized Medical Conditions: Lyme Disease

Undiagnosed or Unrecognized Medical Conditions: Lyme Disease

A recurring theme of disability claims that are denied by insurers are undiagnosed or unrecognized medical conditions. Insurance company denial letters in such cases say that while they acknowledge that there may be symptoms, in the absence of a recognized diagnosis no benefits are payable as no recognized illness or injury has been documented or established.

Lyme Disease is one of these illnesses that insurers have had great difficulty in accepting or recognizing, as it is often one of the undiagnosed or unrecognized medical conditions. This may in large part be attributable to the fact that Canadian society and the medical community at-large has also been very slow to accept Lyme Disease and health care practitioners that deal with Lyme Disease in Ontario are still very hard to come by.

Undiagnosed or Unrecognized Medical Conditions in Disability Claim Cases

Undiagnosed or Unrecognized Medical Conditions

As we noted in a prior blog:

In many parts of Canada where Lyme Disease is rare, doctors may be unfamiliar with the signs and symptoms of this potentially debilitating disease. In patients with early Lyme Disease infection, the chances of a false negative blood test are high. Moreover, since the bacteria is in the blood of infected individuals for only a brief period of time (usually when they are symptomatic), the road to diagnosis, treatment and recovery may take some time.

The good news is that in recent years the Government of Canada has invested millions in research and prevention strategies to combat Lyme Disease, including working with family physicians to enhance their knowledge and give them tools to order prompt testing, diagnosis and treatment.”

Advances in Research Legitimize Cases with Lyme Disease

Further advances in research will help to legitimize cases of those suffering with Lyme Disease.  In the meantime, as lawyers helping sufferers to advance their disability claims, we must gather as much supportive medical information to show that the suffering is real and the debilitating impact of the symptoms interferes with patients’ ability to carry out gainful employment.

Principles enunciated by the Supreme Court of Canada back in 2004 related to Chronic Pain ring true in cases involving so-called “invisible disabilities”:

“There is no authoritative definition of chronic pain. It is, however, generally considered to be pain that persists beyond the normal healing time for the underlying injury or is disproportionate to such injury, and whose existence is not supported by objective findings at the site of the injury under current medical techniques. Despite this lack of objective findings, there is no doubt that chronic pain patients are suffering and in distress, and that the disability they experience is real.*”

With the top court in Canada continuing to uphold principles such as this, the absence of a specific diagnosis, while making it very difficult to treat the underlying illness, does not mean that a disability claim is not valid.     

In short, if you are facing a rejection of your disability claim for these reasons, you should consult an experienced disability lawyer to assess your chances of challenging the insurance company’s decision to deny your claim, allowing you to focus on your health.

*Nova Scotia (W.C.B.) v. Martin, [2003] 2 S.C.R.

If you have any more questions about this topic, or if you or you think someone you know has a disability claim. Learn more about what Share Lawyers does.

Disclaimer: You should not act or rely on any information in blog. Each person or company’s legal needs are unique, and you should ask a lawyer directly to assess your specific needs. You should also be aware that there are time limitations and notice requirements that may affect your rights.