Long Covid’s Catch-22: Too Sick to Work, Yet Not Quite Disabled
Brooke Keaton, who was terminated from her job after health conditions caused by long Covid made it impossible for her to return to work, stands outside her home in Charlotte, N.C.
Photographer: Logan Cyrus/Bloomberg
Nov. 18, 2021, 5:00 AM
It all hit Brooke Keaton at once as she struggled to apply for disability benefits: At age 41, she may never work again.
“It’s coming to terms with the fact that there are things I have wanted for so long that I can’t have now,” said the Charlotte, N.C., resident, who lost her job as lead teacher at a day care center in April when health conditions related to Covid-19 prevented her from returning to work.
The federal government in July declared that long Covid may qualify as a disability. That may better protect so-called long haulers from discrimination and provide them public accommodations. But getting disability benefits is another matter entirely.
That potentially leaves thousands of people too sick to work, but not sick enough to show they’re disabled.
“It’s going to be tricky because these are kind of seen as two separate bodies of law,” said Jasmine Harris, a professor at the University of Pennsylvania Carey Law School.
Long Covid isn’t on the Social Security Administration’s list of disabling medical conditions. The nation’s biggest private long-term disability insurer doubts long Covid causes a long-term disability. Some of long Covid’s most debilitating symptoms are hard to prove. And getting disability benefits is notoriously difficult under routine circumstances; two of every three claims are typically denied.
12-Month Minimum
The Social Security Administration said it’s received 16,000 claims for disability insurance since December where the person’s medical evidence supports identifying Covid-19 as one of their impairments. That’s far from an exact number, and the agency wouldn’t say how many of those claims have been approved.
That doesn’t mean Covid-19 was necessarily the primary reason for applying, or that it’s the impairment that will determine if disability benefits are approved, an agency spokesperson said in an email.
Joint guidance from the departments of Health and Human Services and Justice said long Covid can be a disability under the Americans with Disabilities Act, as well as the anti-discrimination provisions in the Rehabilitation Act and the Affordable Care Act. That means, for example, that businesses that require customers to stand in line may have to give people with long Covid a place to sit.
To qualify for Social Security disability insurance, though, a condition must meet the agency’s definition of a disability. Under the SSA’s rules, the disabling condition or symptoms also have to have lasted, or be expected to last, for a year or result in death.
In a statement to Bloomberg Law, the SSA said its rules allow it to evaluate Covid-19 cases. A person who has limitations resulting from long Covid, who’s met or is expected to meet the duration requirement, “could be found disabled if their limitations equal a medical listing or if the combination of those limitations and vocational factors prevent them from performing substantial gainful activity,” the agency said.
In making its determination, the government looks at whether the person is working now, if their condition is severe and interferes with their work-related activities, whether the condition meets or equals an impairment on the agency’s list of disabilities, if it prevents them from performing any of their past work, and if they can do any other type of work.
“A diagnosis alone is never enough to establish a disability,” said Mark DeBofsky, a shareholder at DeBofsky Sherman Casciari Reynolds PC in Chicago who represents people who’ve been denied disability benefits. “There has to be an associated functional limitation that impacts someone’s ability to do their particular job or work in general.”
Brooke Keaton, who was terminated from her job after health conditions caused by long Covid made it impossible for her to return to work, stands outside her home in Charlotte, N.C.
Photographer: Logan Cyrus/Bloomberg
A Slow Process
Keaton, the former day care teacher in Charlotte, knows how hard it can be to get Social Security disability. She helped her mother apply and then appeal a denial several years ago.
On average 66% of claims for Social Security disability benefits were denied between 2009 and 2018, according an annual report from the SSA for 2019. Only 21% of people on average got benefits on the first try. Another 2% were awarded benefits when they asked for a reconsideration, the first step in the appeals process, and 8% got them after a hearing by an administrative law judge.
It can take three to five months on average for SSA to make a decision. Appeals can take more than a year. About 1.2% of disability applicants who filed appeals between 2008 and 2019 died while waiting for the process to play out, and from 2014 to 2019, 1.3% of applicants filed for bankruptcy, the U.S. Government Accountability Office found in a 2020 report.
Getting benefits through private insurance is no easier.
Sarah Sedor, a claims service analyst at Cigna, had her short-term disability payments cut off after a review showed she didn’t qualify, according to an Aug. 6 notice from her company insurance plan. Sedor has been out of work since February, when she contracted Covid-19.
The 39-year-old from Chattanooga, Tenn. has been struggling with cognitive issues, fatigue, depression and difficulty breathing. But Life Insurance Company of North America, owned by New York Life Insurance Co., said it doesn’t have the clinical evidence or exam findings to support an impairment severe enough to meet the definition of disability. It’s not uncommon for short-term disability claims to initially be approved and later cut off.
Brooke Keaton, who was terminated from her job after health conditions caused by long Covid made it impossible for her to return to work, stands outside her home in Charlotte, N.C.
Photographer: Logan Cyrus/Bloomberg
Nov. 18, 2021, 5:00 AM
- Some long Covid conditions hard to prove
- Insurers can still set limits on benefits awarded
It all hit Brooke Keaton at once as she struggled to apply for disability benefits: At age 41, she may never work again.
“It’s coming to terms with the fact that there are things I have wanted for so long that I can’t have now,” said the Charlotte, N.C., resident, who lost her job as lead teacher at a day care center in April when health conditions related to Covid-19 prevented her from returning to work.
The federal government in July declared that long Covid may qualify as a disability. That may better protect so-called long haulers from discrimination and provide them public accommodations. But getting disability benefits is another matter entirely.
That potentially leaves thousands of people too sick to work, but not sick enough to show they’re disabled.
“It’s going to be tricky because these are kind of seen as two separate bodies of law,” said Jasmine Harris, a professor at the University of Pennsylvania Carey Law School.
Long Covid isn’t on the Social Security Administration’s list of disabling medical conditions. The nation’s biggest private long-term disability insurer doubts long Covid causes a long-term disability. Some of long Covid’s most debilitating symptoms are hard to prove. And getting disability benefits is notoriously difficult under routine circumstances; two of every three claims are typically denied.
12-Month Minimum
The Social Security Administration said it’s received 16,000 claims for disability insurance since December where the person’s medical evidence supports identifying Covid-19 as one of their impairments. That’s far from an exact number, and the agency wouldn’t say how many of those claims have been approved.
That doesn’t mean Covid-19 was necessarily the primary reason for applying, or that it’s the impairment that will determine if disability benefits are approved, an agency spokesperson said in an email.
Joint guidance from the departments of Health and Human Services and Justice said long Covid can be a disability under the Americans with Disabilities Act, as well as the anti-discrimination provisions in the Rehabilitation Act and the Affordable Care Act. That means, for example, that businesses that require customers to stand in line may have to give people with long Covid a place to sit.
To qualify for Social Security disability insurance, though, a condition must meet the agency’s definition of a disability. Under the SSA’s rules, the disabling condition or symptoms also have to have lasted, or be expected to last, for a year or result in death.
In a statement to Bloomberg Law, the SSA said its rules allow it to evaluate Covid-19 cases. A person who has limitations resulting from long Covid, who’s met or is expected to meet the duration requirement, “could be found disabled if their limitations equal a medical listing or if the combination of those limitations and vocational factors prevent them from performing substantial gainful activity,” the agency said.
In making its determination, the government looks at whether the person is working now, if their condition is severe and interferes with their work-related activities, whether the condition meets or equals an impairment on the agency’s list of disabilities, if it prevents them from performing any of their past work, and if they can do any other type of work.
“A diagnosis alone is never enough to establish a disability,” said Mark DeBofsky, a shareholder at DeBofsky Sherman Casciari Reynolds PC in Chicago who represents people who’ve been denied disability benefits. “There has to be an associated functional limitation that impacts someone’s ability to do their particular job or work in general.”
Brooke Keaton, who was terminated from her job after health conditions caused by long Covid made it impossible for her to return to work, stands outside her home in Charlotte, N.C.
Photographer: Logan Cyrus/Bloomberg
A Slow Process
Keaton, the former day care teacher in Charlotte, knows how hard it can be to get Social Security disability. She helped her mother apply and then appeal a denial several years ago.
On average 66% of claims for Social Security disability benefits were denied between 2009 and 2018, according an annual report from the SSA for 2019. Only 21% of people on average got benefits on the first try. Another 2% were awarded benefits when they asked for a reconsideration, the first step in the appeals process, and 8% got them after a hearing by an administrative law judge.
It can take three to five months on average for SSA to make a decision. Appeals can take more than a year. About 1.2% of disability applicants who filed appeals between 2008 and 2019 died while waiting for the process to play out, and from 2014 to 2019, 1.3% of applicants filed for bankruptcy, the U.S. Government Accountability Office found in a 2020 report.
Getting benefits through private insurance is no easier.
Sarah Sedor, a claims service analyst at Cigna, had her short-term disability payments cut off after a review showed she didn’t qualify, according to an Aug. 6 notice from her company insurance plan. Sedor has been out of work since February, when she contracted Covid-19.
The 39-year-old from Chattanooga, Tenn. has been struggling with cognitive issues, fatigue, depression and difficulty breathing. But Life Insurance Company of North America, owned by New York Life Insurance Co., said it doesn’t have the clinical evidence or exam findings to support an impairment severe enough to meet the definition of disability. It’s not uncommon for short-term disability claims to initially be approved and later cut off.
