A CNN report cited medical research showing that “long Covid creates a higher burden of disability than either heart disease or cancer.” Studies have also found that long Covid has “forced between two million and four million Americans out of the workforce.” Long Covid causes sufferers to experience a host of symptoms, but the most debilitating ones are related to the brain and nervous system – brain fog, headaches, fatigue, and post-exertional malaise, which scientists believe is likely due to a failure of the autonomic nervous system.  Long Covid is also frequently associated with another autonomic condition – POTS (Postural Orthostatic Tachycardia Syndrome), as well as with Mast Cell Activation Syndrome, which results from an inflammatory response. Moreover, individuals who have experienced traumatic brain injuries (TBI) often suffer from more severe long Covid symptoms.

Despite experiencing such profound symptoms, claimants seeking disability benefits for long Covid frequently face a major challenge in qualifying for benefits.  Because symptoms such as fatigue and pain are unmeasurable, disability insurers often dispute long Covid claims, asserting a lack of objective evidence.

This blog offers a guide to winning a long Covid disability insurance claim.

What Kind of Doctor Is Most Helpful for Long Covid?

Due to the prevalence of Long Covid, many medical centers have established Long Covid clinics to treat patients with that condition.  Such clinics take a multidisciplinary approach to long Covid and physicians in multiple relevant specialties – internal medicine, infectious diseases, neurology – are called upon to treat long Covid patients.  Doctors who practice in specialty clinics are usually the most up-to-date on the latest testing and treatment for long Covid and can offer greater expertise than most primary care physicians.  Physicians who focus on treating long Covid are also more likely to order testing that could be beneficial in a long Covid case.

What Kind of Testing Is Most Helpful for Long Covid Symptoms?

Any testing that can help corroborate the symptoms of Long Covid can be beneficial in establishing disability due to that condition.  Such testing includes:

  • Tilt-table testing to verify orthostatic intolerance (POTS); i.e., symptoms worsen when sitting up or standing.
  • Neuropsychological testing (or other forms of cognitive testing) to verify problems with memory, concentration, or the ability to focus.
  • Blood testing – inflammatory activation may be due to small blood clots that form in the bloodstream.
  • Cardiac testing to evaluate cardiac abnormalities.
  • Cardiopulmonary exercise testing to evaluate post-exertional malaise (PEM).

What Other Type of Treatment Is Helpful for Long Covid Claims?

Physical therapy, occupational therapy, and speech therapy can also be helpful in documenting symptoms of long Covid and identifying functional limitations due to that condition.  The value of working with such professionals is that they can help identify specific problem areas; and over the course of treatment, they professionally document the persistence of symptoms and their functional impact.

How is Evidence of Long Covid Evaluated?

The Social Security Administration has published a guide for physicians to assist them in documenting impairment due to long Covid.  Although the guidance specifically relates to the Social Security disability program, it offers helpful advice that is applicable to long-term disability insurance claims as well.  The key point made by the guidance is to encourage treating physicians to relate as much detailed information as possible, especially objective findings.  While a documented COVID-19 infection preceding the onset of Long Covid symptoms is helpful, it is not essential.  However, clinical observations over time help convey the full picture of a claimant’s impairment.  It is not particularly helpful, though, for a physician to merely state their patient is “disabled.” What is useful is for the physician to correlate clinical observations and test findings with physical and mental functions that are necessary to perform a particular occupation or work in general.

What Else Is Helpful With Long Covid Disability Benefits Claim?

Although Long Covid is a new condition, its symptoms are not.  Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), as well as other post-viral illnesses, have been studied for a long time.  While there have been very few court decisions involving Long Covid claims, instructive rulings involving CFS/ME offer valuable lessons.  Lessons learned in what makes a successful case include the following:

  • Treatment by specialist physicians over a significant period is essential to establishing disability.
  • A strong work record – claimants who have a record of professional or career success are more likely to win their cases because it would be illogical for a successful employee at the peak of their career to claim disability if their symptoms were not genuine.
  • Willingness to pursue testing and treatment. Claimants who have left no stone unturned in pursuing testing and treatment for their condition are more likely to be successful in applying for benefits.  Such efforts bolster a claimant’s credibility. The converse is also true, though. An unwillingness to try recommended treatments or an appearance of “doctor shopping” just to try to find support for a disability claim is likely to undermine a claimant’s credibility.
  • Corroborative testing – cognitive testing performed by speech therapists and neuropsychologists can be invaluable in establishing. Likewise, testing for autonomic symptoms and other testing to validate symptoms can have a cumulative effect of creating a strong evidentiary record.
  • Keeping a symptom diary may also be helpful. Courts have recognized such records as “objective” evidence supporting disability.

When Should I Get an Attorney Involved in a Long Covid Claim?

There can be value in consulting with an attorney at the outset of a claim for advice and counsel on how to best present the evidence.  A small investment in legal fees at that stage from an attorney who is willing to offer consultation on an hourly fee basis can save thousands of dollars in legal fees later.

If there has been a disability claim denial, though, hiring a disability insurance benefits lawyer is essential. The claim appeal process is complex and can be difficult to navigate alone. Finding an attorney who has the expertise in handling disability claim appeals and who has experience in handling Long Covid disability claims levels the playing field and markedly enhances the chances of overturning an unjustified denial.  At DeBofsky Law, our attorneys have successfully represented doctors, lawyers, executives, professionals, and other workers in obtaining disability benefits for Long Covid.  Let us put our experience and expertise to work for you.

Contact Us Now for a Personalized Consultation

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