Long Covid symptoms can be serious and debilitating. Many who suffer from this condition find that they are no longer able to work as a result.
Does long term disability insurance cover Covid Long Haulers and Long Covid? And how do you prove disability for Covid Long Haulers and Long Covid? We'll discuss the answers to those questions below.
You may qualify for long term disability monthly benefits if you are unable to work due to Long Covid.
However, certain requirements must be met before you can receive disability benefits. You must demonstrate to your insurer that:
If you can adequately prove the above to your insurer, you may be eligible for long term disability benefits.
The central requirement of long term disability policies is that you show you cannot work due to your condition.
Many people assume that to receive disability benefits you must be severely incapacitated, immobile, or bedbound. That is not typically the case. Most insurance policies only require that you show you are unable to work in your “own occupation” for the first 24 months.
After that point in time, some policies require that you show you are disabled from “any occupation”—meaning any occupation reasonably suited for your education, experience, and age. Depending on the severity of your Covid Long Hauler symptoms, you may still qualify for benefits under an “any occupation” definition.
When you file your disability claim, you will need to provide your insurer evidence that your Long Covid prevents you from being able to work. Your insurance company will not automatically approve your claim just because you had a Covid-19 infection. For your insurer to approve your claim, you must convince them that you are a Covid Long Hauler and that your Long Covid is disabling.
Long Covid is a relatively new illness, which can complicate matters. No objective test yet exists to diagnose Long Covid. However, there are alternative ways to procure a diagnosis.
It is likely your doctor will base a diagnosis on the timeline of your symptoms. For example, if you tested positive for Covid-19 and experienced severe symptoms. Then, if you did not recover fully from those symptoms in the following months, your doctor may diagnose you with Long Covid.
Your doctor may also make a Long Covid diagnosis by ruling out other common causes for your symptoms through testing and examinations. Your doctor should be able to provide an opinion that your symptoms are lingering effects of a Covid-19 infection.
Ultimately, demonstrating the frequency and severity of your symptoms through objective measures will be more important than a specific diagnosis.
Common symptoms of Long Covid include:
Make sure to report each and every Long Covid symptom to your doctor at every visit. This way they will be reflected in the treatment notes.
Examples of objective medical evidence to support your claim include:
Medical records and an opinion letter from your doctor can go far, but a personal narrative is your chance to explain in detail how your symptoms affect your job duties. You can share with your insurer, in your own words, how your Long Covid prevents you from working.
Some symptoms of Long Covid, such as fatigue and headaches, are subjective in nature. Writing a personal narrative can further explain and substantiate your subjective symptoms.
Your personal narrative should include details on the following:
A personal narrative is your opportunity to share your side of the story. Your written statement can go into detail and address all aspects of how Long Covid has affected your work and life.
Experts are still learning how to diagnose and treat Long Covid. However, there are existing testing options that can substantiate your Long Covid symptoms. This additional testing is a way to obtain more strong evidence for your insurance company. These evaluations provide objective, measured evidence of your condition and symptoms.
Covid Long Haulers often experience brain fog, memory impairment, issues with problem solving, or other cognitive symptoms. If you are suffering from any cognitive symptoms, you may consider undergoing a Neuropsychological Evaluation.
A neuropsychological evaluation measures your cognitive deficits in an objective, scientific manner. The evaluation is conducted by a neuropsychologist. The neuropsychologist will speak to you about the background of your Long Covid and review your medical records to familiarize themselves with your condition.
The evaluation consists of a series of tests assessing your cognitive abilities, such as attention span and memory. Embedded into the evaluation is “validity testing.” This ensures that you are putting your best effort into the testing.
Once complete, the testing neuropsychologist will draft a report with the test results and their findings. This in-depth report can provide crucial evidence of your Long Covid symptoms and how they interfere with your ability to work.
A CPET assesses whether your heart and lungs have an abnormal reaction to exercise. The CPET monitors your blood pressure, oxygen levels, and lung performance. By doing so, it evaluates your capacity for exertion.
If Long Covid causes you to become short of breath often, or experience exertion-related fatigue, the CPET testing can be helpful. The results of a CPET will provide the insurance company with objective evidence demonstrating how the symptoms of Long Covid impacts your ability to exert yourself with work.
Long Covid may cause bouts of dizziness, fainting, or general lightheadedness. These symptoms can be difficult to validate objectively in routine doctor appointments. If you are pursuing a disability claim and experience these symptoms, you may consider undergoing a Tilt Table Test.
A Tilt Table Test can determine if any of these Long Covid symptoms are due to your heart rate or blood pressure. If so, you may be suffering from a dysautonomia – a problem with your autonomic nervous system. Your autonomic nervous system is the system responsible for maintaining your internal temperature, regulating your breathing, maintaining your blood pressure, and controlling your heart rate.
A Tilt Table Test will involve lying flat on a motorized table. During the test, the table will move to various positions for periods of time, depending on your reported symptoms. You will be asked to report symptoms like nausea, clamminess, or lightheadedness. Your heart and lungs will be monitored.
The results of a Tilt Table Test will provide the insurance company with objective evidence demonstrating how the symptoms of Long Covid impacts your ability to sit, stand, or transition between sitting or standing while at work.
Many Covid Long Haulers suffer from physical conditions causing abnormal movements, limited movement, muscle weakness, difficulty positioning, balance issues, numbness/tingling, pain, poor dexterity/gross movements, or fatigue with physical activities. If you experience any physical deficits due to Long Covid, you may also consider undergoing a Functional Capacity Evaluation (FCE).
An FCE is a series of tests conducted over a two-day period. The FCE measures many aspects of your physical condition, including:
The tests involve different tools and maneuvers. Your FCE evaluator will repeat many of the tests on the second day to determine whether your functional capacity has decreased. That is another measure of how fatigue affects your physical functioning.
When considering your claim, your insurer will value factual evidence of your Long Covid symptoms most. Your FCE results will offer an objective measure of your physical capabilities and limitations. Because the FCE also demonstrates reduced functional capacity from one day to the next, you also can show your insurer that you are unable to maintain a regular work schedule.
Common symptoms of Long Covid include vestibular issues such as:
Vestibular testing measures the function of your inner ear. This testing objectively determines any vestibular abnormalities that can explain the above symptoms. It may also assess the severity of your symptoms.
For disability claim purposes, the results can explain your difficulty with focus, how staring at a computer screen triggers your symptoms, and disorientation when moving positions. If you suffer from feeling off-balance or dizziness, your Long Covid disability claim may be substantiated with the results of vestibular function testing.
You should be aware that your policy may contain a Mental Illness Limitation. A Mental Illness Limitation is an insurance policy provision limiting disability benefits for those with mental illnesses. If you are disabled due to a mental illness, you may only be eligible for benefits for two years. However, this provision varies. Some policies with Mental Illness Limitations exempt certain mental illnesses from the limitation as well. Be sure to review your policy to fully understand its Mental Illness Limitation.
The Mental Illness Limitation does not mean you are ineligible for benefits past two years if you suffer from a mental illness. However, your mental illness must be secondary to your primary diagnosis.
Naturally, long term disability insurers often focus strongly on a claimant’s depression, anxiety, or other mental illness, even if the claimant has a non-mental illness diagnosis. By determining the mental illness symptoms are causing the disability, they can limit how long benefits are paid. Covid Long Haulers may be especially at risk of this happening, as Long Covid is a newly emerging condition and its symptoms can be cognitive in nature.
If your policy contains a Mental Illness Limitation, it is essential to show your insurer objective proof of your cognitive and/or physical impairment.
While much is to be learned about Long Covid, experts agree it is a serious medical condition. The debilitating symptoms of Long Covid may result in disability. It is vital to understand how to prove your Long Covid disability to your insurer.
To get your Long Covid long term disability claim approved, your claim needs sufficient medical evidence. Additional testing and personal statements can also strengthen your claim. However, we always recommend consulting with an attorney. An experienced ERISA attorney will best what evidence to produce to the insurer, manage the gathering of medical records, and handle all communications with the insurer.
If you are a Covid Long Hauler suffering from any of the symptoms above, or if you have already been denied disability insurance benefits for your Long Covid, our New York long term disability lawyers can help. Call Riemer Hess LLC at (212) 297-0700 or click the button below for a consultation on your disability case.
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