After months of fighting with an insurance company over short and long term disability claims and being denied after the first 30 days (lyme is cured with in 30 days so they say!) we have come to the conclusion that we need help.

My husband and I are both very non-confrontational but this company's reaction to my husband's claim is basically "proove it!"

They not only want proof of his current symptoms but proof of the symptoms he was experiencing 6 months ago!

My husband was off work for months due entirely to this diesase. They do not deny that he has Lyme they just expect him to provide clinical evidence of each of his symptoms.

Our LLMD and primary care provider are both stumped. They have done every test they can think of as well as write several letters. His employeer even fought with the company on his behalf!

How do you prove you do not have the energy to get out of bed some days? He did very poorly on a tredmill test, but they did not care. He was only able to stay on it for about 3 minutes at a slow pace but his heart worked properly, thank God, so they say he is fine. The case worker commented that she is tired most mornings too but she goes to work!

How do you prove you are in pain? He went to the ER a couple of times and is being treated for pain but they don't care.

He has had severe brain fog from time to time (he even forgot my name!) but he tested well on the neuro-psy evaluation so they accuse him of lying about it.

We have been very blessed that he is responding well to treatment and has been able to return to work 4 hours a day most days.

Our problem is we can't pay our bills on four hours pay and we have medical bills etc left from the time he was off.

They now owe us thousands of dollars in back pay, but how do we get it???? Do we get a lawyer and sue or is there a better way of doing all this? I hope!

Why pay for disability insurance if it won't pay you when you are disabled!

I am sure many of you have been in this situation. Any and all advice is very welcome!

Thank you very much in advance!

May the Lord bless each of you as you battle your own Lyme wars!

It's a good idea to talk to a lawyer at least once. Our guy did not charge for the initial consultation; he gave all kinds of excellent advice; helped me figure out the critical paperwork and doctors notes; and said if our final attempt didn't work he'd happily take us on contingency. We did win our case (so far -- the battle never ends, and there are always unpleasant surprises).

Look here for some excellent resources for winning disability cases:
http://flash.lymenet.org/ubb/Forum1/HTML/030280.html

First off, document everything. Are you under the care of a llmd? The doc should right letters for you and provide medical support documents for your case.

I think that having a lawyer helps. It takes some of the pressure off you because they will work with you to get all the information compiled and submitted, and represent you if you need to file an appeal.

That really stinks. You need the big guns. Go to the site I posted read all about your state's insurance laws.

Write another letter if you want to the Insurance Company using information from the site and let them know you have educated yourself.

Or skip too the chase and file a complaint.

If you think you still need an attorney this site should be able to help you get one familiar with your state's laws.

Note: 1)Go to the files/links areas and print off those links so you can check them off as you read.

A template for your SSDI application (can also be obtained from disinissues site, files section, "useful advice for SSDI applications"): http://www.cfids-me.org/socsec.html

NOTE: Print the ENTIRE post of the female doctor's statements detailing what she could NO longer do. Can be used as a template for your SSDI claim.

Also on Minoucat's links of info is something about lawyer Scott Davis, Phoenix. I would NOT advise hiring Scott.

He was my lawyer of almost 4 yrs. this Nov. He quit me in Aug. 04 after my lyme diagnosis. He can NOT represent anyone in CIVIL/FEDERAL court after appeals council denies anyone! He never told me that.

He also screwed me by NOT sending a detailed brief to Virginia's appeals council 2.5 yrs. ago when he submitted the request to appeal.

Scott did send them a certifed letter asking that a copy of my ALjudge hearing tapes be sent to him; they never sent them.

AC never sent me my ALJ hearing tapes either even after I faxed a letter explaining all of this 12-3-04 BEFORE appeals council denied me 12-23-04 WITHOUT even looking at my file since lawyer Scott Davis HAD NOT SENT DETAILED BRIEF.

So if you hire a lawyer, make sure they can represent you in civil/federal court to appeals the appeals council denial! They only have to look at what the judge decided on rules; NOTHIGN ELSE!

Betty G., Iowa...

Taking care of the kids and just surviving are about all we have managed to do lately. Fighting with the insurance company is something we haven't had the energy for but now we must.