Key takeaways:
If you suspect you have long COVID, contact your employer’s human resources department to ask about the Family and Medical Leave Act (FMLA) and short-term and long-term disability.
Record your physical and mental symptoms. Don’t dismiss them as being “in your head.”
If your symptoms persist, immediately begin the process of applying for Social Security Disability Insurance.
- Long COVID syndrome is a blanket term for the debilitating illness that lingers far beyond the initial COVID-19 infection, even if it was mild. Chronic symptoms can include fatigue, shortness of breath, and even organ damage.
Not everyone known as a COVID “long-hauler” will qualify for disability insurance. But it’s important to document your symptoms and make your best case, because long COVID could prevent you from earning money.
Here, we break down what you should know about the evolving standards for disability insurance for long COVID compared with other conditions.
What is long COVID?
Long COVID can occur in anyone who has had COVID-19, regardless of the severity of illness, age, or gender. A recent FAIR Health study of nearly 2 million individuals with COVID-19 found that about 23% of them continued to have at least one COVID-19 symptom 30 days or more after their diagnosis.
The Centers for Disease Control and Prevention (CDC) identifies the following as some long COVID symptoms:
Difficulty breathing or shortness of breath
Tiredness or fatigue
Symptoms that get worse after physical exertion
Difficulty thinking or concentrating (“brain fog”)
Cough
Chest or stomach pain
Headache
Fast-beating or pounding heart
Joint or muscle pain
Pins-and-needles feeling
Diarrhea
Sleep problems
Fever
Dizziness on standing
Rash
Mood changes
Change in ability to smell or taste
Changes in menstrual cycle
Health problems that persist for 4 or more weeks after COVID-19 infection could be long COVID. The duration of long COVID is still unknown.
Is long COVID a disability?
Yes, long COVID can be considered a disability. The civil rights arms of the U.S. Department of Health and Human Services and Department of Justice have both determined that long COVID is a disability.
If your post-COVID symptoms substantially limit your ability to do one or more life activities, the Americans with Disabilities Act considers it a disability. Examples of potential life activities affected include:
Walking
Dressing
Speaking
Eating
Sleeping
The U.S. Equal Employment Opportunity Commission recognizes this definition and provides workplace protections for those with long COVID.
If your long COVID symptoms aren’t being relieved and are affecting your ability to work, document what is happening and start the process of applying for assistance right away, said
Lynn Blewett, professor of health policy and management at the University of Minnesota School of Public Health and director of the State Health Access Data Assistance Center (SHADAC).
If you’re concerned about job loss, contact an insurance navigator or health insurance exchange broker to maintain your healthcare coverage, she said.
Ask your human resources department about options like short- and long-term disability, the Family and Medical Leave Act (FMLA), and contact the Social Security Administration to start applying for assistance, Blewitt said. If you know — and can show — you acquired COVID-19 because of your job, ask about workers’ compensation.
Does SSDI cover people with long COVID?
You’re eligible for Social Security Disability Insurance (SSDI) if you can’t work and your illness is expected to last for at least one year or result in death. Social Security is funded by the Social Security taxes that your employer takes out of your paycheck.
“Make sure that you have documentation from your doctor in terms of your conditions and your physical and mental impairment. To receive disability payments, it has to be medically determined that that impairment is going to last at least 12 months,” Blewett said.
If you are eligible for SSDI and long-term disability, your long-term disability payments will be reduced by the amount of SSDI you get.
Contact the Social Security Administration at 1-800-772-1213 to ask about disability insurance, or use its online benefit-eligibility tool.
SSDI has a 5-month waiting period before you can begin receiving benefits. After 2 years on SSDI, you can receive Medicare, regardless of age. The application process for SSDI alone can take up to 5 months, so it’s important to start as soon as you can.
Many advocacy groups such as Stopthewait.org are pushing for changes to these waiting periods. In an open letter to Congress, the Stop The Wait Coalition writes, “These exclusion periods are fundamentally unfair; they delay people from seeking treatment and eventually returning to work, and they prevent people from accessing the insurance for which they paid.”
People getting SSDI have to wait 2 years for Medicare benefits unless they have end-stage renal disease (ESRD, or permanent kidney failure) or amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease). With ESRD and ALS, there is no waiting period.
Does workers’ compensation cover people with long COVID?
The National Council on Compensation Insurance (NCCI) says “maybe.” Workers’ compensation laws provide compensation for “occupational diseases” directly related to the job — think firefighters and lung disease — but in many states, routine sicknesses like the common cold and flu are not covered.
In most cases, it’s too difficult to prove that an employee acquired a communicable disease through the workplace, said Jeff Eddinger, senior division executive at NCCI. But COVID-19 is unique in that it can be eligible for compensation.
“If you have contracted COVID-19 on the job, or as part of the job, then you are likely covered by workers’ compensation,” Eddinger said.
He noted that anyone eligible for workers’ compensation for COVID-19 would also be eligible for compensation for long COVID.
Coverage applies regardless of when you report your illness, as long as you can meet your state and company’s “burden of proof” by showing that it was work-related.
Because of COVID-19, many states have extended workers’ compensation benefits for COVID-19 for certain professions. For healthcare workers, first responders, and essential workers in some states, if you get COVID-19, it is now presumed that you acquired it through work.
The National Conference of State Legislatures (NCCI) reports that 17 states and Puerto Rico recognize COVID-19 as a work-related illness and provide workers’ compensation.
As of June 2021, the NCCI found that nearly 75% of reported COVID-19 workers’ compensation claims had come from healthcare workers and first responders.
Do short-term and long-term disability cover people with long COVID?
If long COVID is preventing you from working, and your recovery window is unclear, short-term disability may give you enough time to recuperate while preserving your job and health insurance, Blewitt said. Short-term disability provides you with a portion of your paycheck and can last anywhere from a few weeks to 2 years. Payments typically begin right away. Benefits are typically 60% to 75% of your base pay. The median pay rate is 60% of salary.
Long-term disability (LTD) plans can provide pay for a few years, or until the disability ends. All plans have waiting periods before payouts begin and typically work in sync with short-term disability. Most waiting periods are 3 to 6 months. LTD typically pays about 60% of annual earnings.
Unlike the FMLA, disability policies don’t provide job protections. But both short- and long-term provide income more quickly than SSDI can. While employees pay into their Social Security benefits, few pay into short- or long-term disability.
Should I look into private disability insurance if I am at risk for COVID-19?
Individuals can buy private disability insurance and should shop around if they are concerned they may need it, Blewitt said.
There are four key questions to ask insurance companies, according to Usa.gov:
How does the policy define disability?
When do benefits begin?
How long will the benefits last?
How much money will the policy pay?
Does FMLA apply to people with COVID-19 and long COVID?
If you have been at your job for 12 months or longer, you could qualify for the Family and Medical Leave Act (FMLA). It requires certain employers to provide employees with unpaid leave for specific family and medical reasons. If you have a serious health condition or need to care for someone with one, ask human resources about your FMLA benefits. Although the 12 workweeks of leave it provides annually are unpaid, it preserves your health benefits and protects your job.
FMLA doesn’t protect employees who elect to stay home to avoid getting COVID-19.
The bottom line
If your post-COVID symptoms are interfering with your life, don’t wait to ask for help. Talk to your healthcare provider, document your mental and physical symptoms, and contact the Social Security Administration to begin the application process for disability benefits. Contact your human resources department at work to explore options such as FMLA, and short- and long-term disability insurance.
https://www.goodrx.com/insurance/health-insurance/long-covid-and-disability-insurance
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