Can I Get Long Term Disability for Babesiosis?

Babesiosis is a tick-borne illness caused by a parasite called Babesia that infects red blood cells, leading to anemia and other serious health complications.  Most cases of Babesiosis in the United States occur in the Northeast and Midwest, including New Jersey, New York, Connecticut, Massachusetts, Minnesota, and Wisconsin. 

Although some people infected with Babesia may be asymptomatic, others may experience a range of symptoms, including fever, fatigue, chills, sweating, and headaches.  In severe cases, Babesiosis can cause organ damage and even be fatal.  Babesiosis may also occur as co-infection with Lyme disease, leading to more severe and lasting symptoms.

If you are experiencing long-term symptoms due to Babesiosis, you may be eligible to seek long term disability benefits.  Below we’ll discuss common questions about filing a Babesiosis long term disability claim and how an attorney can help.

Can I get long term disability for Babesiosis?

Yes.  If you have Babesiosis, you may be eligible for long term disability through your insurance company.  However, this will depend on the nature of your symptoms and their impact on your ability to work. 

Many long term disability insurance plans define "disability" as being unable to perform the material duties of your occupation due to your medical condition.  Some plans also contain an "any occupation" standard, which requires an inability to perform other reasonable occupations due to your medical condition.  In order to be eligible for long term disability benefits, your Babesiosis symptoms must be serious enough to prevent you from working.

There are certain challenges to keep in mind when filing a long term disability claim for Babesiosis.  Though reports of Babesiosis have increased recently in areas like New York, New Jersey, and Connecticut, the disease remains relatively rare.  Some insurance companies and claims examiners may not be familiar with the disease.  This can lead to misunderstandings of your diagnosis. 

Babesiosis can also be a challenging condition to diagnose, and you may not have a definitive diagnosis until you have undergone multiple tests or experienced your symptoms for an extended period.  This can make it difficult to provide sufficient medical evidence to support your claim.

If you have been diagnosed with Babesiosis and are experiencing ongoing symptoms that impact your ability to work, you may be eligible to receive long term disability benefits.  However, the process of applying for and receiving these benefits can be complicated and often requires the help of an experienced ERISA attorney.

How does Babesiosis cause disability?

Babesiosis can cause both physical and cognitive symptoms.  Any of these symptoms may cause disability, depending on how severely and frequently they present.

Babesiosis causes physical symptoms by infecting and damaging red blood cells, which are responsible for carrying oxygen to the body’s tissues.  The Babesia parasite multiplies inside the red blood cells, leading to their destruction and the release of harmful substances into the bloodstream.

While the physical symptoms of babesiosis are well-known, cognitive symptoms may also occur in some cases.  These cognitive symptoms are believed to occur as a result of the Babesia parasite’s ability to invade and replicate within brain cells.  The parasite can disrupt normal brain function by causing inflammation and damage to the brain tissue, leading to cognitive symptoms.

Disabling Physical Symptoms of Babesiosis

Physical symptoms caused by Babesiosis may include:

• • Fatigue and muscle weakness;
  • Flu-like symptoms, including fever, chills, headache, and muscle aches;
  • Anemia, a condition in which the body lacks enough red blood cells to carry oxygen to the body's tissues, leading to symptoms such as shortness of breath, dizziness, and weakness;
  • Neurological symptoms such as confusion, seizures, and loss of coordination; and
  • Organ damage, particularly to the liver or spleen.

Disabling Cognitive Symptoms of Babesiosis

Some of the cognitive symptoms of Babesiosis include:

• • Difficulty concentrating;
  • Memory problems;
  • Confusion;
  • Mood changes; and
  • Cognitive fatigue.

Lyme Disease Co-Infection

Babesiosis often occurs together with Lyme disease.   Both Babesiosis and Lyme disease share the same tick vector, Ixodes scapularis, which is commonly known as the black-legged or deer tick.  In fact, Babesia and Lyme disease can be transmitted to a person by a single tick bite, leading to a co-infection.  Co-infection with both diseases may result in more severe symptoms and a longer recovery time.

Read More: 10 Tips for Lyme Disease Disability Insurance Claims

How do I prove Babesiosis as a disability to my insurer?

Proving Babesiosis as a disability to your insurer can be challenging.  Reports of Babesiosis have increased over recent years, especially during the summer season and in the Northeastern and Midwestern regions of the U.S.  However, much is unknown about the long-lasting effects of the disease.  Because Babesiosis is a relatively uncommon condition, many insurance companies may be unfamiliar with the symptoms and severity of the disease.  Your insurer may be subsequently skeptical of your condition.

To prove your disability, your insurer will require evidence of your Babesiosis diagnosis, symptoms, and their impact on your ability to work.  This means medical documentation from your treating providers and vocational evidence that demonstrates how your Babesiosis symptoms prevent you from working.

Objective Medical Evidence for Babesiosis

Objective medical evidence is one of the most important types of evidence to submit with your long term disability claim.  This is especially essential for Babesiosis disability claims, where many of your symptoms may be subjective in nature.  While insurers cannot dismiss self-reported symptoms (such as fatigue, pain, etc.) outright, having objective medical evidence to support your claim will greatly improve your chances of claim approval.

Examples of objective medical evidence you can use to support your Babesiosis long term disability claim may include:

• • Office visit notes: Office visit notes from your physicians will document your ongoing Babesiosis symptoms and the observations from any clinical examinations.
  • Blood tests: Blood tests can be used to detect the presence of Babesia parasites in your blood.  This can confirm a diagnosis of Babesiosis and provide objective evidence of the infection.
  • Imaging studies: Imaging studies, such as MRIs or CT scans, may be used to evaluate the extent of any neurological symptoms such as seizures or confusion.
  • Neuropsychological Evaluation: Undergoing a Neuropsychological Evaluation can assess your cognitive functioning, such as memory, attention, and problem-solving. This can provide objective evidence of your cognitive impairments related to Babesiosis.
  • Cardiac testing: Babesiosis can cause cardiac complications such as irregular heart rhythms.  Cardiac testing, such as an electrocardiogram or echocardiogram, can provide objective evidence of any cardiac impairments related to Babesiosis.
  • Cardiopulmonary Exercise Test (“CPET”): Undergoing a CPET can be useful in assessing the functional limitations and disability caused by Babesiosis.  The CPET measures your exercise capacity, including your ability to perform physical tasks, and can provide objective data to support your long term disability claim.

By providing sufficient medical documentation of your Babesiosis symptoms and impairments, you may be able to demonstrate the extent of your disability to your insurer and improve your chances of receiving long term disability benefits.

Vocational Evidence for Babesiosis

Beyond providing evidence of your Babesiosis diagnosis and symptoms, your insurer will require you to prove how your condition prevents you from working.  Vocational evidence can explain your occupational duties and responsibilities, and demonstrate to your insurer how you cannot perform these functions due to your Babesiosis.

Examples of vocational evidence you can use to support your Babesiosis long term disability claim may include:

• • Your resume;
  • Your official job description; and/or
  • Personal statements from your co-workers explaining your role and their firsthand observations of how your Babesiosis affects your job performance.

You may also consider undergoing a vocational assessment.  A vocational assessment is a detailed analysis conducted by an expert that explains why your disability prevents you from working.  The assessment typically includes an accurate and comprehensive description of your job responsibilities that highlights the skills and abilities necessary to perform your job successfully.  The expert will also clearly explain your inability to meet particular work demands due to your Babesiosis and provide an expert opinion as to whether you can perform your own occupation or any other occupation.  The resulting report may be used as evidence in support of your Babesiosis long term disability claim.

Other Evidence for Babesiosis

Aside from objective medical and vocational evidence, you may consider submitting additional documentation to support your Babesiosis long term disability claim.

Examples of other evidence may include:

• • “Bad news” diary: You may consider keeping a contemporaneous diary of all your Babesiosis symptoms.  Each day, record in writing what symptoms you are experiencing, their severity, and their frequency.  You may also include details on what activities you are able to perform each day, how many rest breaks were required, and how your symptoms prevent you from carrying out daily activities of living.  For instance, if you could not get out of bed due to your fatigue, you should record that in your diary.  Be as detailed as possible.  Specificity makes your Babesiosis symptoms more credible and allows them to be viewed and evaluated in context.
  • Personal affidavit: Writing a personal statement outlining your background, the onset of your Babesiosis, your struggle with working, and how your symptoms have impacted your life (work, family, friends, social activities, etc.) can offer a more comprehensive picture of how your Babesiosis disables you.  This can be submitted to your insurer in support of your claim.
  • Statements from family and friends: It can be a good idea to have a close family member or friend write a statement on your behalf.  This statement can explain their firsthand experiences of how your Babesiosis symptoms have affected your ability to work and function in daily life.

How can an attorney help me get long term disability for Babesiosis?

An experienced ERISA attorney can help you navigate the complicated process of applying for and receiving long term disability benefits for Babesiosis.  Babesiosis is a serious and complex medical condition that may result in total disability.  To file a successful long term disability claim, your claim should be supported by objective medical evidence and proof that your symptoms impair your ability to work.  Given the subjective nature of many Babesiosis symptoms, this can be difficult to do.

At Riemer Hess, we have over 25 years of experience in securing long term disability benefits for our clients.  Our New York disability attorneys understand how best to substantiate your Babesiosis claim with evidence and testing results.  We know the appropriate testing that should be included for your disability claim or appeal and will refer you for any testing you need.

If you have been diagnosed with Babesiosis and are experiencing ongoing symptoms that impact your ability to work, or if you have already been denied disability benefits for Babesiosis, our New York long term disability lawyers can help.  Call Riemer Hess LLC at (212) 297-0700 or click the button below to schedule a consultation on your disability case.