The COVID-19 pandemic was one of the most significant public health crises in recent times. Even years after contracting the virus, people can still experience its effects in the form of long COVID, which can be debilitating and interfere with their daily activities and ability to work.
Some long COVID sufferers may wonder if they are eligible for Social Security Disability Insurance (SSDI) benefits—fortunately, the answer is yes.
Long COVID is recognized by the Americans with Disabilities Act (ADA), making those affected eligible for SSDI benefits. However, long COVID does not automatically qualify you for disability benefits, and certain requirements must be met to determine if the condition interferes with daily activities.
This article provides a detailed discussion of long COVID and explains how individuals with this condition can qualify for SSDI benefits and other forms of assistance.
Is Long COVID Considered a Disability?
A physical disability encompasses any physiological disease or illness that affects one or more body systems, such as the neurological, respiratory, cardiovascular, and circulatory systems. A mental disability encompasses any mental or psychological condition, including an emotional or mental disorder.
Long COVID is a physiological disorder that can impact one or more of the body’s systems. Some individuals with long COVID may develop:
- Lung damage
- Heart damage, such as inflammation of the cardiac muscle
- Kidney damage
- Neurological damage
- Damage to the circulatory system
- Mental health issues, including persistent emotional disorders
The most recent guidance from President Joe Biden’s Health and Human Services states that long COVID is now officially recognized as a disability under the ADA, the Rehabilitation Act of 1973, and the Patient Protection and Affordable Care Act.
In light of this, both federal and local governments recognize long COVID as a disabling condition and offer the same rights to those who suffer from it as they would to those with any other impairment.
It should be noted, however, that not all cases of long COVID can be regarded as disabilities. Determining whether a case meets the SSA’s disability standards requires an independent assessment of each case.
This requires patients to demonstrate that their symptoms of long COVID significantly affect their capacity to carry out one or more significant life activities (such as standing, sitting, or walking) or have resulted in mental or physical impairment.
This impairment could be anything from a persistent mental illness to damage to the heart, but it must be demonstrated that it is connected to long COVID.
Disabling Symptoms of Long COVID
Long COVID often results in persistent symptoms due to the damage it inflicts on various body systems, including the heart, lungs, kidneys, circulatory system, and brain.
This damage can significantly impact a person’s ability to work, manifesting in several ways:
- Cognitive issues: These may include memory loss and difficulty concentrating.
- Digestive system disruption: Long COVID can affect the normal functioning of the digestive system.
- Reduced kidney function: Long COVID can impair the kidneys’ ability to filter waste from the blood effectively.
- Mobility impairment: Some individuals may experience difficulty moving or performing physical tasks.
- Respiratory function damage: Long COVID can cause long-term damage to the lungs, leading to breathing difficulties.
- Chronic fatigue: Persistent tiredness is a common symptom among long COVID patients.
- Mental health issues: Conditions such as Post-Traumatic Stress Disorder (PTSD), depression, anxiety, and somatoform pain can develop.
Please note, this is not an exhaustive list of the disabling and chronic symptoms of long COVID that may affect a person’s ability to work.
The impact of these symptoms on your work capacity is also influenced by the specific demands of your job. For instance, symptoms that make it challenging to perform cognitively demanding skilled work may differ from those that make physically strenuous manual labor difficult.
SSDI for Long-COVID Survivors
SSDI is a federal program that is managed by the Social Security Administration. Its purpose is to provide financial assistance to individuals who are unable to work due to a disabling physical or mental condition.
This program is funded by an estimated 159 million employees in the United States through their FICA payroll taxes. It is a crucial source of income for those who become disabled.
In 2022, the United States Department of Health and Human Services issued a ruling stating that long COVID is considered a disability under the ADA. By January 2023, the Social Security Administration had identified around 44,000 disability claims related to long COVID, even though it was not always the primary reason for those applications.
It is important to note that not all claims related to long COVID are approved. This is primarily because the SSDI program is designed to support individuals with disabilities that persist for at least 12 months or longer.
However, most applicants do not experience long COVID for such an extended period, and therefore, their claims may not meet the eligibility criteria.
Additionally, the lack of a standardized diagnostic process for long COVID continues to pose a challenge, making it difficult for government officials to evaluate these claims. Unfortunately, the Social Security Administration has not yet issued any specific guidelines on how government officials should evaluate and assess claims related to COVID-19.
How the Social Security Administration Evaluates Long COVID Cases
The Social Security Administration has a well-defined process that determines whether an individual is disabled or not. The process involves five steps, starting with verifying if the individual is engaged in substantial gainful activity (SGA) or if they are unable to work due to a medically determinable impairment (MDI).
Once that is done, the administration proceeds to assess the severity of the individual’s condition to check if it meets the qualifying criteria for “listing level” severity. In the case of long COVID, there is currently no official Blue Book listing for it, however, the Social Security Administration may conclude that the individual’s symptoms match the severity level of another listing in the Blue Book.
The administration examines the individual’s symptoms and limitations based on the criteria of any applicable medical listings to determine if their limitations are of the same level of severity.
For instance, if long COVID has caused damage to an individual’s lungs and they have a chronic respiratory disorder, but they don’t have the lung function test results required to fulfill the criteria for respiratory disorders, Social Security may determine that their condition “equals” the listing.
If an individual’s long COVID does not match any listing, the Social Security Administration will evaluate their residual functional capacity (RFC) to decide if they are capable of retaining employment.
This assessment considers factors like their symptoms, stamina, and endurance. If there is no full-time work available that the individual can perform given their limitations, the Social Security Administration may approve their claim.
Tips for Applying for SSDI With Long COVID
SSDI applicants with long COVID symptoms can maximize their chances of approval by following these simple, but essential, guidelines:
Apply As Soon As Possible
It’s important to apply as soon as possible for SSDI benefits. Applying for SSDI benefits can be a complex process that can take a significant amount of time.
On average, new applicants who received their decision in November 2023 had to wait for around seven months and fifteen days, which is approximately 225 days, irrespective of their condition or outcome. The wait time for new applicants has remained relatively consistent throughout 2023, varying between 218 and 225 days.
Due to the long wait times, it’s important to be aware of this timeline and plan accordingly when applying for SSDI benefits.
Make Detailed Notes on Your Symptoms
You should maintain a detailed record of all the symptoms you are experiencing to provide evidence of your disability. It’s a good idea to arrange regular appointments with your doctor and record the duration, intensity, and frequency of all the symptoms that you suspect may be a result of your long COVID diagnosis.
Additionally, ensure that your physician has access to your complete medical history. This will help in proper diagnosis and treatment.
Check Financial and Other Eligibility Requirements
To be eligible for SSDI, you must meet the disability standards defined by the Social Security Administration. This includes having severe mental or physical symptoms or conditions that prevent you from engaging in full-time employment.
Additionally, your condition must last for at least 12 months or result in death.
The SSDI program has some technical requirements, including income limits that reflect your inability to engage in SGA. This limit means that in order to qualify for SSDI, a non-blind applicant cannot earn more than $1,550 per month.
Other Support Available for Long COVID Sufferers
Apart from the SSDI program, there are other types of support available for individuals experiencing long COVID. Some of these are discussed below.
Reasonable Accommodations
If you are experiencing long COVID symptoms that are affecting your work, it is important to assess their impact and consider requesting reasonable accommodations from your employer.
Reasonable accommodations are any adjustments that enable you to perform your job duties as well as someone without a disability. This can include a flexible work schedule, working from home, a different position, or other accommodations.
The Job Accommodation Network (JAN), provided by the U.S. Department of Labor, is a helpful resource for identifying and discussing potential accommodations with your employer.
Workers’ Compensation
Many states have enacted laws that allow employees to receive workers’ compensation benefits if they contract a communicable disease like COVID-19 while on the job. These benefits include financial compensation and coverage of medical expenses related to COVID-19.
If an employee recovers from COVID-19 but continues to experience symptoms that hinder their ability to work, they may be eligible to extend their workers’ compensation claim to receive additional benefits.
To qualify for workers’ compensation, the claimant must prove that they contracted COVID-19 while working. This can be difficult since the virus is highly contagious and the employee may have been exposed to it elsewhere.
The eligibility for workers’ compensation benefits will depend on the specific circumstances of each case and the state where the applicant resides. The application process for workers’ compensation benefits may vary from state to state.
Employer-Sponsored Disability Coverage
Many companies offer their employees short-term and long-term disability insurance as part of their job benefits. These policies provide income replacement to the employee in the event that they become disabled.
Typically, short-term disability benefits last up to one year, while long-term disability benefits can last for several years or even for the remainder of the employee’s lifetime. However, injuries or illnesses that occur while at work are typically not covered by these policies, as they are already covered by workers’ compensation benefits.
If an employee receives disability insurance benefits and their condition improves, their coverage may be terminated.
What To Do if Your SSDI Claim Is Denied
If you have applied for Social Security Disability benefits and your application was denied, you can request a reconsideration within 60 days of the denial.
If your request for reconsideration is not approved, you can opt for a hearing in front of an administrative law judge (ALJ). If the ALJ also rules against you, you can take your case to the Appeals Council.
Finally, you can file an appeal with a federal court.
How a Disability Attorney Can Help
Each year, the Social Security Administration receives numerous requests for disability benefits. However, only a small percentage of these claims are approved.
Long-term COVID cases are particularly challenging to win, and it’s advisable to seek the assistance of a disability attorney.
According to a study conducted by the United States Government Accountability Office, applicants who engage the services of a legal representative for their disability benefits cases are three times more likely to be approved.
While there’s still no guarantee of SSDI approval, a Social Security attorney can assist your case in the following ways:
- Ensuring that your application is correctly filled out and submitted on time
- Building a solid case for the disability benefits you require
- Providing legal advice to present at hearings
- Communicating directly with the Social Security Administration or a Disability Examiner on your behalf
- Taking your case to appeal, if necessary
Conclusion
It’s common for SSDI to reject applications that are based on long COVID. However, you can increase your chances of approval by following the recommendations mentioned in this article.
Additionally, you may want to explore other options, such as applying for worker’s compensation or requesting accommodations.
