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covid long hauler

Most people who develop COVID-19 have mild symptoms which resolve in a few days at home. They may continue to feel under the weather for a couple of weeks, but eventually, they feel as well as they did before the illness and are able to return to work at their pre-COVID capacity.   

But other COVID sufferers experience effects for weeks, even months, after the virus has cleared their bodies. Many of these individuals — often called COVID long-haulers — report severe fatigue, difficulty concentrating or remembering things, loss of taste or smell, or one of a growing list of other symptoms. The condition may be so debilitating that returning to work is impossible. 

For COVID long-haulers who can’t work, Social Security or long-term disability benefits could be a way forward, but many claimants are being denied. Without clear guidelines about COVID-related disabilities, it’s much more difficult to build a successful case. As they navigate the claim process, these individuals are blazing a new path in disability law. 

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What are post-COVID conditions? 

Post-COVID conditions are characterized by physical, neurological, mental or cognitive symptoms that last more than four weeks after an initial coronavirus infection. It’s unclear how many people are affected by post-COVID conditions. Early estimates have been as high as 40 percent and as low as 10 percent of all COVID-19 patients. 

What does seem to be clear is that anyone who has been infected with coronavirus may suffer from a post-COVID condition, even if their illness was mild or they had no symptoms. 

The CDC defines three types of post-COVID conditions:

Long COVID

Patients with long COVID report various combinations of symptoms including: 

  • Fatigue
  • Difficulty thinking or concentrating (what many call “brain fog”)
  • Persistent headaches
  • Loss of smell
  • Loss of taste or abnormal tastes
  • Dizziness, often upon standing
  • Fast heartbeat or pounding heart
  • Chest pain
  • Difficulty breathing or shortness of breath
  • Cough
  • Joint and muscle pain
  • Depression and anxiety
  • Fever

Because the symptoms mimic many of the symptoms of COVID-19, COVID long-haulers may feel as though they’ve never recovered, even though the coronavirus has cleared the body. For other sufferers, symptoms appear for the first time weeks after the initial infection. 

Multiorgan Effects of COVID-19

COVID-19 may target several of the body systems including heart, lung, kidney, skin, and brain functions. Long-haul COVID patients may sustain organ damage that leads to reduced organ functioning or even failure. Other cases have resulted in autoimmune conditions. In some rare situations, children who have had COVID-19 have been diagnosed with multisystem inflammatory syndrome, and a similar condition has been noted in adults.

Effects of COVID-19 Treatment or Hospitalization

Despite the state-of-the-art treatment delivered in intensive care units, spending time in ICU can be hard on any patient, no matter what condition puts them there. COVID long-haulers who have been in the ICU may develop post-intensive care syndrome (PICS) with issues related to the use of ventilators or other treatments. 

Symptoms of PICS include muscle weakness, problems with thinking or judgement, or mental health issues including nightmares, disturbing memories, depression, anxiety, and post-traumatic stress disorder (PTSD). 

Can COVID long-haulers apply for disability benefits? 

The short answer is, “Yes,” but winning your case is likely to be difficult.

The Social Security Administration (SSA) and LTD insurance carriers use predetermined frameworks to assess disability claims. SSA’s includes five steps: 

  1. Are you working? 
  2. Is your condition “severe”? 
  3. Does your condition meet or equal a listing in the listing of impairments? 
  4. Can you do the work you did previously? 
  5. Can you do any other type of work? 

Let’s look at each of these requirements in more detail. 

Are you working?

The SSA will determine whether you are engaged in Substantial Gainful Activity — that is, if you are still working, do your earnings average more than the level SSA allows? In 2021, that amount is $1310 per month (or $2,190 per month if legally blind). If not, you generally will not be considered disabled. 

If you are not working or not earning an amount above the threshold, your claim goes to Step 2. 

Is your condition “severe”? 

To qualify for SSD, you must have a Medically Determinable Impairment (MDI) that has prevented you from working (or be expected to prevent you from working) for at least 12 months. 

The SSA released guidance in April that it will accept COVID-19 as a medically determinable impairment if you can provide: 

  • A report of a positive viral test for SARS-CoV-2 (a positive antibody test is not enough on its own)
  • A diagnostic test with findings consistent with COVID-19 (e.g., chest x-ray with lung abnormalities, etc.), or
  • A diagnosis of COVID-19 with signs consistent with COVID-19 (e.g., fever, cough, etc.).

In other words, you can receive benefits because of a disability caused by COVID-19. However, your symptoms are not enough to receive benefits. You must have medical documentation of a positive COVID-19 test or a diagnosis of COVID-19 with lab tests or other signs consistent with the illness. 

Medical documentation will be the hardest hurdle to clear. Researchers suspect that the first infections occurred in late 2019, before health-care providers even had a test for COVID, much less considered it as a diagnosis. In addition, we know that some early tests were flawed, producing inaccurate results. The SSA has indicated that claims that include a false-positive result in the medical record are unlikely to be approved, no matter the symptoms. 

Other sufferers may never have had a test at all. Because of early test shortages, patients who had been exposed to COVID-19 who had no symptoms or mild symptoms were advised to quarantine but were not tested. 

Bottom line: You may get approved without a COVID-19 test, but you have to have a diagnosis that’s backed up by medical evidence. 

And the 12-month requirement? 

Well, it’s been just over a year since the first positive cases in the U.S. As a result, most COVID long-haulers will not have been out of work for 12 months. However, if your doctor does not expect your condition to improve enough within 12 months that you can return to work, you will likely meet this requirement. For example, if you’ve been diagnosed with kidney damage as a result of your COVID infection and will need long-term dialysis or a transplant, the SSA will probably approve your claim. 

For long-COVID sufferers — those who continue to experience symptoms that are similar to those of active COVID — the prognosis isn’t as clear. Studies that follow these patients over months or years are needed to determine what combinations of symptoms are more likely than others to lead to long-term disability. These claims could be much more difficult to prove.

If you meet the MDI and duration requirements, your application goes to the next step. 

Does your condition meet or equal a listing of impairments? 

The Social Security Administration and private insurers maintain their own lists of disabling conditions. COVID-19 isn’t currently on them, but that doesn’t mean you can’t receive benefits. 

The SSA will approve your claim if it is determined that your condition meets or equals the criteria of an impairment that’s listed in the Listing of Impairments. For example, you may have respiratory or organ complications as a result of COVID-19 that are severe enough to meet a listing that has similar symptoms.

If your condition does not meet a listing, the SSA will move on to your relevant work experience in the next step. 

Can you do the work you did previously?

When reviewing your disability application, the SSA or your LTD insurer will consider functional limitations related to your symptoms and how those affect your ability to do any work you’ve done previously. 

This is why, as you seek medical treatment, it’s important that you’re talking to your health-care provider about the specific effects of your symptoms. For example, if you have ongoing breathing difficulties and can’t walk from one end of your house to another without becoming short of breath, your doctor needs to know that and add it to your medical record.

If you cannot return to any past work, the SSA will move to the final step of the assessment. 

Can you do any other type of work? 

Social Security will examine your impairments and consider whether there is other work you could do. The agency will consider medical conditions, age, work experience, education and other skills you’ve acquired that could be used in a different job.

If not, you will be ruled disabled and your SSD claim will be approved. 

Do I need an attorney to apply for disability benefits because of COVID-19? 

You are never required to hire a lawyer to apply for disability benefits, and people looking for representation are often told to wait until they’ve been denied to talk to an attorney. 

But a large percentage of all disability claims are denied on the initial application. For SSD, denial rates are nearly 70 percent, and COVID-19 claims are uncharted territory. Working with an attorney will increase the likelihood of your claim being approved, and it costs nothing to find out if we can help. 

If you’re unable to work because of complications of COVID-19, contact us today to request a free consultation. 

Be sure to follow us on Facebook and bookmark this page to keep up with the latest developments in COVID-related disability guidelines. 

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