Short and Long Term Disability for Long Covid

Long Covid can leave you with persistent, debilitating symptoms that severely impact your ability to work.  Navigating the complexities of short and long term disability claims can be overwhelming, especially when dealing with an illness that is still not fully understood by the medical community and insurance companies alike.  At The Maddox Firm, we have experience handling short and long term disability claims for Long Covid, ensuring that our clients receive the benefits they deserve.

In this article, we’ll discuss what you need to prove your Long Covid disability claim and how The Maddox Firm can help.

What Is Long Covid and How Can It Impact Your Ability to Work?

Long Covid, also known as post-acute sequelae of SARS-CoV-2 infection (“PASC”), refers to a range of symptoms that persist for weeks or months after the acute phase of a Covid-19 infection has resolved.  These symptoms can be debilitating and vary widely among individuals, often impacting their ability to work.

Common disabling Long Covid symptoms may include:

• Chronic Fatigue and Exhaustion: Persistent fatigue that does not improve with rest can make even simple tasks overwhelming.  This level of exhaustion can prevent individuals from maintaining a regular work schedule or engaging in physical activities, severely limiting their productivity and quality of life.

• Shortness of Breath and Respiratory Issues: Difficulty breathing and other respiratory problems can make physical exertion, such as walking or climbing stairs, challenging.  For individuals whose jobs require physical activity or even prolonged periods of talking, these symptoms can be particularly disabling.

• Cognitive Impairments: Often referred to as “brain fog,” cognitive impairments include difficulties with concentration, memory, and decision-making.  These issues can hinder performance in jobs that require mental acuity, problem-solving, or multitasking, affecting overall productivity and job performance.

• Muscle and Joint Pain: Persistent pain in muscles and joints can limit mobility and dexterity, making it difficult to perform tasks that require physical effort, fine motor skills, or prolonged periods of sitting or standing.  This can affect a wide range of occupations, from manual labor to office work.

• Headaches: Frequent and severe headaches can disrupt concentration and focus, making it difficult to carry out daily tasks or maintain consistent job performance.  Chronic headaches can also lead to increased absenteeism and reduced productivity.

• Sleep Disturbances: Issues such as insomnia or disrupted sleep can lead to chronic fatigue, irritability, and difficulty concentrating.  Poor sleep quality can impair an individual’s ability to function effectively during the day, impacting their work and personal life.

• Heart Palpitations and Chest Pain: These symptoms can be alarming and physically limiting, often requiring medical evaluation and intervention.  They can prevent individuals from performing physical activities and can cause significant anxiety, further impacting their ability to work and engage in daily activities.

• Anxiety and Depression: Mental health conditions such as anxiety and depression can be exacerbated or directly caused by the chronic and unpredictable nature of Long Covid.  These conditions can impair motivation, focus, and overall mental health, making it challenging to maintain employment and engage in social interactions.

The impact of Long Covid on your ability to work depends on the severity and combination of symptoms you experience.  In many cases, individuals with Long Covid may need to reduce their hours, switch to less demanding roles, or stop working altogether.

Can I Qualify for Short or Long Term Disability Benefits Due to Long Covid?

Yes, you can qualify for short or long term disability benefits due to Long Covid if you meet the typical eligibility requirements outlined in your disability insurance policy.

Here’s how Long Covid symptoms can align with these requirements:

• Short Term Disability (“STD”) Eligibility: STD policies often require that your symptoms persist for a minimum period, usually 7 to 14 days, before benefits can begin.  You must be unable to perform the essential duties of your current job.  Generally, STD policies require that you are actively employed and covered under the short term disability policy at the time you become disabled.

• Long Term Disability (“LTD”) Eligibility: There is usually an elimination period, typically 90 to 180 days of continuous disability, before long term disability benefits begin.  Initially, you must be unable to perform the duties of your current occupation.  After a certain period, often two years, the definition may change to being unable to perform any occupation for which you are reasonably qualified based on your education, training, and experience.  For example, a software engineer suffering from severe brain fog and respiratory issues might initially be unable to work in their specialized role and later unable to work in any job requiring similar skills.  As with STD policies, you must be covered under the LTD policy at the time of your disability onset.

Consider a nurse who contracts Covid-19 and later develops Long Covid.  Persistent symptoms like shortness of breath, muscle pain, and severe fatigue prevent her from performing physically demanding tasks, such as lifting patients or standing for long periods, which are essential parts of her job.  Under her short term disability policy, she may qualify for benefits once her symptoms have persisted beyond the policy’s required duration and she is unable to fulfill her job duties.  If her condition continues and meets the long term disability policy’s elimination period, she may also qualify for long term disability benefits, especially if her symptoms prevent her from working in any capacity related to her training and experience.

Meeting these eligibility requirements is crucial for qualifying for short or long term disability benefits due to Long Covid.  Reviewing your specific policy terms will provide detailed information about the criteria you need to meet.

What Documentation Is Required to Support a Long Covid Disability Claim?

Supporting a Long Covid disability claim involves gathering both medical and vocational evidence to demonstrate how your symptoms affect your ability to work.

Here are examples of medical documentation you can use to support your short or long term Long Covid disability claim:

• Diagnostic Testing: Blood tests, pulmonary function tests, and other relevant diagnostic tests can help confirm the presence and severity of Long Covid.  For instance, blood tests might show elevated inflammatory markers or other abnormalities, while pulmonary function tests can reveal reduced lung capacity and breathing difficulties that persist after the acute phase of Covid-19.

• Imaging Studies: X-rays, CT scans, or MRIs are crucial for documenting any physical changes or damage caused by Long Covid.  For example, CT scans of the chest may show lung scarring or other abnormalities that contribute to respiratory issues.  Brain MRIs might be necessary to investigate cognitive symptoms such as brain fog or memory problems.

• Office Visit Notes: Detailed notes from your primary care physician and specialists (e.g., pulmonologists, neurologists) are essential for documenting your symptoms and treatment over time.  These notes should include observations of ongoing symptoms like chronic fatigue, shortness of breath, and cognitive impairments, as well as the effectiveness of various treatments and interventions.

• Functional Capacity Evaluations (“FCE”): The FCE is an assessment of your physical limitations that can provide objective evidence of how Long Covid affects your ability to perform work-related tasks.  An FCE might reveal significant limitations in endurance, strength, flexibility, and cognitive functioning, highlighting the impact of symptoms such as muscle pain, fatigue, and brain fog on your daily activities.

• Neuropsychological Evaluations: These assessments are essential for documenting cognitive impairments associated with Long Covid, such as memory loss, difficulty concentrating, and impaired executive function.  A neuropsychological evaluation provides a comprehensive analysis of your cognitive abilities through standardized tests and can highlight specific deficits that impact your work performance.  For example, if you struggle with tasks requiring sustained attention or complex problem-solving, the evaluation can offer objective evidence of these challenges, supporting your disability claim by demonstrating how cognitive symptoms hinder your ability to perform job-related duties.

• Treatment Records: Documentation of prescribed therapies, medications, and treatment plans is vital for showing your ongoing efforts to manage Long Covid.  This might include records of respiratory therapies, medications for symptom management (such as pain relievers or anti-inflammatory drugs), and physical or occupational therapy sessions designed to improve functional capacity.

• Therapist and Specialist Statements: Reports from therapists, occupational therapists, or rehabilitation specialists regarding your condition and progress provide detailed insights into how Long Covid affects your daily life and work abilities.  For example, a pulmonologist might describe how persistent respiratory issues limit your physical activity, while a cognitive therapist might document the impact of brain fog on your mental tasks and overall productivity.

Additionally, vocational evidence is crucial to demonstrate how Long Covid impacts your ability to perform your material job duties.  Here are some examples of vocational documentation to support your Long Covid short or long term disability claim:

• Official Job Descriptions: An official job description from your employer can be used to support your claim.  If needed, you may also consider submitting a personal statement elaborating on your job responsibilities and duties to provide your insurance company a clear understanding of the physical, cognitive, and emotional demands of your role.  This information helps illustrate how Long Covid symptoms, such as cognitive impairments and fatigue, make it challenging to fulfill these demands.

• Resume: Highlighting your professional background and qualifications offers context on your career path, skills, and experience.  A detailed resume helps to show your employment history and the level of expertise required in your job, making it easier to demonstrate how Long Covid symptoms impede your ability to perform at your previous capacity.

• Vocational Assessments: A vocational expert can conduct an evaluation of your ability to perform work-related tasks.  This report can be critical for providing objective evidence of how Long Covid affects your job performance.  The assessment can measure your capacity to perform specific duties related to your job, such as evaluating your endurance for physical tasks, your ability to concentrate for extended periods, or your dexterity and coordination, showing concrete limitations caused by your condition.

• Witness Statements: Statements from employers or co-workers describing changes in your work performance and capabilities offer firsthand accounts of how Long Covid has impacted your job.  These statements can highlight specific instances where your symptoms have affected your ability to complete tasks, meet deadlines, or interact with colleagues.  For instance, a co-worker might describe how your frequent absences or difficulty concentrating have disrupted team projects, or an employer might note a decline in your productivity since the onset of your Long Covid.

• Work Documentation: Records of missed workdays, reduced hours, or modified job duties due to symptoms provide tangible evidence of how Long Covid has interfered with your ability to maintain regular employment.  This documentation can include attendance records showing frequent sick days, schedules reflecting reduced work hours, or official accommodations made by your employer to adjust your duties.

Gathering and presenting this vocational evidence alongside medical documentation strengthens your Long Covid disability claim by clearly demonstrating the impact of your condition on your ability to work.  This comprehensive approach is essential for convincing your insurance company of the legitimacy of your claim and ensuring you receive the benefits you need to manage your condition.

How Can a Symptom Diary Help Strengthen Your Long Covid Disability Claim?

Keeping a symptom diary can significantly strengthen your Long Covid disability claim by providing a detailed, day-to-day record of how your symptoms impact your ability to function and work.  This ongoing documentation serves as powerful evidence to support your claim.  By recording your symptoms consistently, you can demonstrate the persistence and severity of your condition over time.  This continuous record helps to establish that your symptoms are not temporary or sporadic but are a chronic issue affecting your daily life.

A symptom diary allows you to provide a thorough description of each symptom, including its intensity, frequency, and duration.  This detailed account is invaluable when explaining the extent of your condition to your insurance company.  It highlights how symptoms such as fatigue, brain fog, and respiratory issues impact your ability to perform daily activities and fulfill your job responsibilities.  By documenting specific incidents where your symptoms prevented you from completing tasks or caused significant difficulties, you can make a compelling case for your disability claim.

Additionally, a symptom diary can show how your symptoms respond to treatments and medications, illustrating the ongoing nature of your condition.  This information can be crucial for demonstrating that despite following prescribed treatments, your Long Covid symptoms continue to impair your ability to work.  The diary also aids in communication with your healthcare providers, helping them understand the full scope of your condition and leading to more accurate and comprehensive medical reports.  These reports, in turn, become part of the essential evidence for your claim.

What Are the Challenges of Proving Long Covid as a Disabling Condition?

Proving Long Covid as a disabling condition presents several unique challenges.  These challenges can make it difficult to convince your insurance company of the severity and impact of your condition.  Understanding these obstacles can help you better prepare your claim.

Common challenges in proving Long Covid disability to your insurance company may include:

• Variability and Unpredictability of Symptoms: Long Covid affects individuals differently, with symptoms ranging from mild to severe and fluctuating over time, making it hard to establish a consistent picture of its impact.

• Relative Novelty of Long Covid: As a newly recognized condition, there is still much unknown about Long Covid’s long-term effects and progression, leading to skepticism from insurance companies.

• Lack of Standardized Diagnostic Criteria: The medical community is still developing standardized criteria and treatment protocols for Long Covid, complicating the process of providing definitive medical evidence.

• Inconsistent Medical Records: Many individuals may not have consistent medical visits due to the episodic nature of their symptoms, making it difficult to maintain detailed and continuous medical records.

• Subjective Symptoms: Symptoms like fatigue, brain fog, and pain are difficult to measure objectively, and insurance companies often require objective evidence such as lab results or imaging studies.

• Impact on Work Ability: Demonstrating how Long Covid symptoms specifically prevent an individual from performing their job duties requires thorough documentation, including job descriptions, vocational assessments, and witness statements from employers or co-workers.

Overcoming these obstacles requires detailed and persistent efforts in gathering both medical and vocational evidence to substantiate your claim.  It is always recommended that you consult with a long term disability attorney when filing a Long Covid short or long term disability claim.  An attorney can help you understand and address these challenges, support your claim, and improve your chances of receiving the disability benefits you need.

How Can The Maddox Firm Prove My Short or Long Term Disability Claim?

Navigating a short or long term disability claim for Long Covid can be complex and overwhelming.  The experienced team at The Maddox Firm understands how to support such claims, ensuring that you have the best chance of securing the benefits you deserve.

Here are a few ways The Maddox Firm can help prove your Long Covid short or long term disability claim:

• We Examine Your Policy and Assess Your Claim: We thoroughly review the terms of your disability policy to understand the specific requirements and definitions that apply to Long Covid.  This allows us to assess the strengths and weaknesses of your claim and develop a tailored strategy to maximize your chances of success.

• We Handle All Communications with Your Insurance Company: Dealing with insurance companies can be difficult and stressful.  We take over all communications with your insurance company, ensuring that information and documentation are provided in a timely manner.  Our team knows how to navigate the complexities of insurance communications, reducing the risk of missteps that could jeopardize your claim.

• We Help You Obtain Evidence to Support Your Claim: Long Covid symptoms can be challenging to document.  We assist you in gathering comprehensive medical evidence, including physician statements, medical records and vocational evidence, such as job descriptions and statements from employers or co-workers.  Additionally, if needed we can refer you for testing in order to obtain objective evidence demonstrating how your symptoms impact your ability to work.

• We Handle Appeals and Litigation: If your claim is denied, we are prepared to handle the appeals process and, if necessary, pursue litigation. Our experienced attorneys will advocate for your rights and work tirelessly to overturn denials and secure the benefits you need.

At The Maddox Firm, we understand the unique challenges faced by Long Covid claimants and are dedicated to providing the support and expertise needed to navigate your short or long term disability claim successfully.

A short term disability or long term disability claim for Long Covid can be a complicated process.  If you need help during the claims process, with appealing a claim denial, or with litigating a final adverse short term or long term disability decision, The Maddox Firm can help.  The experienced team at The Maddox Firm will examine your insurance policy, correspondence from your insurance company, medical records, and any other relevant documentation in order to give you personalized guidance on how we can help you win your short and/or long term disability claim.  Our New Jersey and New York long term disability attorneys help clients nationwide.

Contact us to help you file your claim, appeal, or litigation the right way.