Letters of Medical Necessity

*Patient names have been changed to protect their identities.

Letter for Intravenous Treatment

Letter 1October 30, 2007

Ms. Jane has been a patient at Lyme Resource Medical P.C. since April 2006, when she presented with symptoms including numbness and tingling, fatigue, pain and a feeling of heaviness in her body. She had been symptomatic for approximately 5 years.
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Letter 2October 25, 2007

Mr. John Doe is a 55-year-old male who presented to Lyme Resource Medical P.C. on October 2, 2007, with symptoms including severe headaches, burning sensations in the feet, back, arms and hands, and drenching sweats. Onset of symptoms took place 21/2 years ago. Prior to his visit Mr. Doe had been diagnosed with ALS in June 2006, and had been seen and treated by specialists at the University of California at San Francisco, Johns Hopkins Medical Center, the Mayo Clinic, and the University of Pennsylvania Pain Center, which referred him to our practice. Mr. Doe was also acquainted with two other Lyme Resource Medical patients from Pennsylvania. Currently Mr. Doe is being treated with IV IG therapy and has had two of three infusions.
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Letter 3July 30, 2007

Mr. Jones is a 35-year-old male who has been a patient at the Lyme Resource Center since January 3, 2007. At that time he presented with symptoms including fatigue, headaches, neck and back pain, heart palpitations, joint pain, severe pain in his forearms, muscle cramps, weakness in his extremities, decreased exercise tolerance, sleep disturbances, diminished energy, frequent mouth sores, bloating, irritability, and problems with concentration and memory.
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Letter for Disability

Letter 1October 5, 2007

Mrs. Campbell is a 28-year-old female with a history of chronic illness which became significantly worse in the fall of 2006. She presented to the Lyme Resource Center with symptoms including cognitive disorientation and memory difficulties, unrelenting headaches, frequent urination, and extreme fatigue.
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Letter 2July 31, 2007

This is to inform you that Carmela Stewart has been ill for some time with chronic persistent Borreliosis and a co-infection, Babesiosis. On August 6, 2007, I confirmed the diagnosis made by another doctor. For more than five years, Ms. Stewart has been experiencing body aches, chills, malaise and fatigue, and in the last six months, joint pain.
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Letter 3April 2, 2008

Ms. Williams, a pleasant and articulate 41-year old woman, has been a patient at Lyme Resource Medical, P.C., since June 5, 2007, when she presented with symptoms including (but not limited to) severe insomnia, abdominal pain, joint pain, leg pain, heart palpitations, neurocognitive deficits, extreme fatigue and depression. A copy of her complete Lyme symptoms check list has been attached.
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