Since the pandemic began, millions of people across the U.S. have contracted COVID. The effects of the virus have varied: while some individuals are asymptomatic, others- especially seniors and the immunocompromised- have been completely incapacitated. The majority of those who contract the virus display mild to moderate symptoms similar to a bad bout of the flu: fatigue, fever, cough, runny nose, and body aches. In most cases, symptoms subside within two weeks, depending on their severity and when treatment begins.
A growing number of patients, however, are experiencing ongoing and debilitating symptoms. This condition, known as ‘long COVID,’ can interfere with major life activities and even prevent you from holding a job. There’s even a name for those living with it: long-haulers.
If you’re struggling with symptoms like shortness of breath, brain fog, and fatigue for weeks or even months after your original diagnosis, you may qualify for disability benefits: new U.S. Department of Health & Human Services guidelines confirm that long COVID can be a disability under Titles II and III of the Americans with Disabilities Act (ADA). However, filing a disability claim can be challenging, especially for a newly-recognized condition. In this resource, we’ll go over how you may qualify for disability benefits with long COVID and how an experienced disability attorney at Bross & Frankel, PA, can help.
Symptoms of Long COVID
Long COVID is much more common than most people realize. In a recent study, it was found that a significant percentage of COVID victims experience long-term symptoms. The same study identified four factors that may increase one’s chances of experiencing long COVID:
- How much coronavirus RNA was in your system during the early stages of your infection.
- Whether you have lupus, rheumatoid arthritis, or another medical condition in which antibodies mistakenly attack body tissue.
- Whether you were infected with the Epstein-Barr virus while young.
- The presence of certain pre-existing conditions, such as Type 2 diabetes.
If you suffer from any of the following conditions four weeks or longer after the initial infection, you may have long COVID.
- Chest pain
- Chronic fatigue
- Joint and muscle pain
- Shortness of breath and difficulty breathing
- Irregular blood pressure and/or heart palpitations
Physical impairments such as these can result in long-term disability if they are severe enough. COVID-19 long haulers often experience extreme fatigue, which makes it difficult to keep up with the demands of their jobs. Physical problems such as shortness of breath, dizziness, and joint pain may make even sedentary careers difficult.
COVID long-haulers frequently report mental impairments like the following:
- Trouble focusing or concentrating
- Brain fog
- Problems with multitasking
Brain fog is one of the most commonly reported symptoms. Long-haulers have trouble concentrating and can even suffer short-term memory problems, which makes it difficult to focus on tasks. Long-term cognitive complications can include depression, anxiety, cognitive impairment, and memory loss, all of which can make it impossible to maintain employment.
Long COVID and Long-Term Disability Insurance
Many COVID-19 long haulers are unable to work due to their condition. Since this is a comparatively new phenomenon, no one knows for sure how long these extended symptoms will last, and questions often arise as to whether a long-hauler can qualify for long-term disability insurance benefits.
The answer is yes, it’s certainly possible. If you are having trouble working and your doctor indicates that you may be unable to maintain employment due to your COVID symptoms, you may have a strong claim for long-term disability benefits. A lot depends on your policy, however.
Compared to Social Security Administration (SSA) guidelines, the criteria for disability is easier to meet under long-term disability policies. Check the definition of disability in your LTD policy: most only require you to prove that you can’t work in your ‘own occupation.’ For example, if you have ongoing joint and muscle pain due to long COVID, you likely can’t do warehouse or construction work.
With some policies, you may only have to be unable to work in your own occupation for the duration of the claim. Other policies require you to prove your overall disability after a period of time (usually 24 months), by demonstrating that you can’t do any work reasonably suited to your age, education, and experience. If you’re having difficulties interpreting the terms of your policy, a disability attorney can help.
Proving Long-Term Disability Due to Long COVID
If you are seeking disability benefits, your insurer will require evidence of your long-term COVID-19 symptoms. The following methods can be used to substantiate your COVID-19 disability to the insurer:
- Letter From Your Doctor: Your treating physician can write a letter to the insurer explaining your COVID-19 long hauler diagnosis, treatment history, symptoms, and how the condition interferes with your ability to work. In order to determine your benefits, the insurer will need your doctor’s opinion.
- Treatment Records: To substantiate your claim, you will need your doctor’s notes, hospital records, and test results. Be sure to continue getting regular treatment, and note all symptoms to your doctor so they can be documented.
- Personal Affidavit: If your symptoms interfere with your ability to work, you may want to write an affidavit outlining your work history, COVID-19 diagnosis, and symptoms you are experiencing.
- Witness Statements: Having a family member, friend, or coworker write a letter explaining the changes you’ve undergone since your diagnosis can be helpful.
Long COVID and Social Security Disability Benefits
One of the biggest questions about long COVID is whether it counts as a disability under the federal disability programs.
As stated earlier, the Office of Civil Rights within the HHS determined that long COVID could qualify as a disability under the Americans with Disabilities Act if one or more major life activities are substantially limited. However, to qualify for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), applicants must be unable to work due to a condition that’s expected to last at least one year or end in death.
SSDI with Long COVID
If you are applying for SSDI, you must be under 65 years of age and have worked long enough in Social Security-covered jobs to earn a sufficient number of credits. Long COVID claims, however, may be problematic since SSDI is designed for disabling conditions lasting 12 months or longer, and most claimants haven’t experienced symptoms long enough to meet these disability qualifications.
If you want to apply for SSDI, you can improve your chances of approval by taking the following steps:
- Document Your Symptoms in Detail: Keeping a detailed record of your symptoms is essential for proving disability. See your doctor regularly and document all symptoms related to your long COVID diagnosis, such as length, severity, and frequency.
- Confirm Your Financial Eligibility: Your declared income must reflect that you cannot engage in substantial gainful activity (SGA). As of 2022, a non-blind individual must earn less than $1,350/month to qualify for SSDI benefits.
- Submit an Application with Medical Documentation: This includes your doctor’s confirmation of your COVID diagnosis, along with the results of all medical tests. Depending on your symptoms, you may also want to include notes from other healthcare providers, such as a psychologist (if you’re suffering from severe depression) or a physical therapist.
While the Blue Book, which is the official SSA listing of impairments, does not specifically include long COVID as its own listing, you may qualify for benefits if you can demonstrate that your symptoms have left you completely disabled, are expected to last for at least a year, and are keeping you from engaging in substantial gainful activity. The SSA Social will consider both your past work experience and education when determining whether you are eligible for disability benefits based on your residual functional capacity.
NOTE: If you have not paid FICA taxes, you won’t be eligible for SSDI benefits, but you may qualify for Supplemental Security Income, or SSI. These benefits are, however, means-tested and have asset limits of $2,000 per individual or $3,000 per couple. Note: Some beneficiaries receive both Social Security disability and SSI benefits due to their eligibility for both.
How can a Disability Attorney Help My Long Covid Claim?
The Social Security Administration receives thousands of disability claims each year, but only a small percentage are approved. When it comes to long COVID claims, it can be especially challenging to win, so you might consider hiring a disability attorney.
A study conducted by the U.S. Government Accountability Office shows that people who hire an attorney for their disability benefits cases are three times more likely to receive benefits in the end. Even though approval isn’t guaranteed, a Social Security lawyer can help by:
- Ensuring that your application is completed in full and submitted on time
- Making a persuasive case for the disability benefits you need
- Providing you with representation at hearings
- Directly interacting with a DDS Examiner or the Social Security Office on your behalf
- Representing you in any appeals that may be necessary
What if My Long Covid Claim is Denied?
The process for appealing a denied disability claim depends on the type of benefits you’re seeking.
With private or employer-sponsored health plans, your policy will usually outline the process for filing an administrative appeal. With Social Security Disability benefits, you have up to 60 days after your application was denied to request reconsideration. If your request for reconsideration is denied, you may ask for a hearing before an administrative law judge (ALJ). In the event your claim is denied by the ALJ, you can request a review by the Appeals Council. The very last stage of appeal is federal court.
A well-prepared appeal can ultimately result in your claim being approved. A skilled and compassionate disability claims attorney can guide you through the process with the goal of getting the benefits you need sooner rather than later.
Get Help With Your Long COVID Disability Claim
Although many unknowns remain regarding COVID-19’s long-term health effects, emerging evidence suggests that complications and symptoms can persist even after the acute phase has passed. Even those who report improvement may later report relapses, highlighting COVID-19’s serious and unpredictable long-term effects.
At Bross & Frankel, PA, our disability lawyers have years of experience handling both SSDI and long-term disability claims. If you need to apply for benefits or your application was denied, schedule a free consultation by calling 856-210-3345 or contacting us online. If long COVID is affecting your quality of life and ability to function, Our team will evaluate your case, explain your options, and help you seek the long-term benefits you deserve.