It’s been almost five years since COVID-19 arrived in America, and the virus continues to change the lives of people of all ages. Newfield Law Group has represented many claimants who were unable to return to work after COVID left them with physical and cognitive disabilities. We have been successful in getting claimants the benefits they are due and our approach to facilitating claims for long and short term disability claims has been effective. We have seen the impact upon friends and family suffering.
Expectations for the coming year are not encouraging, with expert virologists thinking 2025 will be similar to 2024—outbreaks as new variants continue to emerge and severe illness for people with immunocompromised systems, those who are not vaccinated or people who simply get extremely sick from the virus. Could a dramatically different variant develop and infect large numbers of people? Unlikely but not impossible. Not a very comforting thought.
Just as in the past, there’s no way to predict how hard COVID will strike and what its after-effects will be. What we do know for certain is that disability insurance companies will continue to push back on short and long-term claims for Long COVID. They continue to suffer mortality issues from the initial burst of COVID and the subsequent advanced life insurance claims paid.
What is Long COVID and When is it Considered a Disability?
Long COVID is also called Post-COVID-19 Syndrome, Long Haul COVID or more clinically, post-acute sequelae of SARS-CoV-2(PASC). Many doctors and medical institutions have recognized Long COVID as a chronic condition. The Mayo Clinic reports the medical term is “infection associated chronic condition.”
Symptoms range from extreme fatigue, difficulty performing tasks (cognitive disabilities), digestive issues, shortness of breath, loss of taste or smell, insomnia. Serious diseases resulting from long COVID, ranging from chronic kidney disease, cardiovascular disease, ME-CFS, Mast Cell activation syndrome and Fibromyalgia to diabetes, among others.
Scientists are still working on understanding how COVID-19 causes long-term illnesses, but the hope is that continuing research will at some point lead to an understanding of how the virus and all of its variants work so better treatments can be created.
What If I Can’t Work Because of Long COVID?
Long COVID was deemed a disability by the U.S. Department of Health and Human Services in 2022, under the Americans with Disabilities Act. It took many months for the Social Security Administration to recognize post-COVID syndrome as a qualifying disability.
Insurance companies putting profits above people was no surprise to this practice when the first COVID disability claims began to be filed. Since then, the insurance sector has continued to try to shut down disability claims with a number of different strategies.
The insurance industry’s first response when COVID claims began coming in was to deny the condition as being unprovable and only a self-reported illness. After more than two decades representing claimants with Epstein-Barr and Fibromyalgia, I know how the insurance companies treat claims they consider to be subjective in nature, and the practice began to prepare for these denials.
When representing a claimant with Long COVID, we use a number of objective diagnostic tests to document the limitations created by the virus. These include testing for respiratory and cardiovascular limitations caused by COVID, along with cognitive testing. We also work with occupational experts who provide detailed proof of the cognitive skills needed to perform the duties of a claimant’s occupation and measure their skillset against someone who is not impaired.
We have also represented claimants suffering from Long COVID who are depressed and anxious about their future. If they can’t work, what will happen to their family? How will they maintain their lifestyle, or pay their bills? These claimants are vulnerable to a common insurance industry tactic of trying to move their claim from a physical disability to a mental disability.
This tactic is more common with ERISA claims, when the disability insurance policy is part of the employee benefits package. That’s because almost all employee disability policies limit mental health disability to 24 months. If the claim can be limited to 24 months, the insurance company has protected its bottom line. This kind of switch can go unnoticed until a letter terminating the claim at 24 months is received.
A similar fact pattern emerges with ERISA cases and Long COVID claims when the policy is “own occupation” for the first 24 months, then switches to “any occupation.” This means the policy is in effect to protect the person’s ability to perform the duties of their own occupation—the one they trained for and went to school for. At 24 months, when the policy shifts to “any occupation,” the insurance company will often attempt to shut down the claim, saying the person could work at another occupation but they chose not to work and therefore are not eligible for disability benefits.
What Can You Do If your Long COVID Claim has Been Terminated or Denied?
Individuals who are suffering from Long COVID do not need the added stress of fighting with an impersonal insurance company. This is what we do and have done for nearly 25 years.
Insurance company representatives dealing with an attorney treat the conversations and exchange of materials differently than they do when talking with an insured. There is an inherent understanding when I speak with a claims person that is different than when a claimant calls. I also take the burden of dealing with the bureaucracy from the shoulders of my clients, which they appreciate.
If your claim has been denied or delayed, find your disability insurance policy. If you can’t find it, contact the HR department, and ask for the policy issued when you became eligible for coverage. Policies change from year to year, and it’s very important to have the policy that was issued to you. If you review the policy and it does not make sense, do not be surprised. These policies are dense, filled with legal loopholes and confusing and often contradictory provisions.
Newfield Law Group offers a free consultation, which you should take advantage of. I can review a policy and determine very quickly what you’ll be up against when filing a claim for Long COVID. My years of experience battling with the disability insurance companies provides a significant advantage for clients.
Whether you decide to hire Newfield Law Group or not, one piece of advice: the time limits on appealing a claim or responding to a denial letter are not flexible, so don’t delay. Once the window of appeals or responses closes, it is nearly impossible to fight for your claim.
