Filing for SSDI or SSI with Long-Haul COVID - Shook & Stone

Filing for SSDI or SSI with Long-Haul COVID

Filing for SSDI or SSI with Long-Haul COVID

Long-Haul COVID-19 and Filing for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI)

Long COVID, Post-COVID syndrome, or long-haul COVID are new terms that have come into use to describe symptoms experienced by people after they recover from a COVID infection. Current estimates are that roughly 10% to 30% of patients might suffer from long COVID even if they did not require hospitalization.

Symptoms of COVID-19

While symptoms can vary many patients commonly report:

  • shortness of breath;
  • extreme fatigue;
  • fast heart rate;
  • fainting;
  • dizziness;
  • or difficulties concentrating.

These symptoms may be so severe as to prevent a previously healthy individual from being able to return to work.
COVID is a relatively recent phenomena, and long-haul symptoms are only now beginning to be studied. While there are many unknowns in regard to long haul COVID the most important thing for social security claimants to understand is that in addition to preventing them from working, it must also do so for an extended period.
Currently many people are applying for social security as these symptoms begin to approach the all-important 12-month mark. To qualify for disability a condition must be so severe as to prevent a claimant from working for 12 months.
This duration is creating large problems for applicants. Claimants exposed during the early days of COVID may have suffered from the disease and recovered prior to reliable COVID testing. They may not have required hospitalization, or emergency care, but still suffer from the effects of long COVID. Absent a positive COVID test, or doctors records that reflect infection it can be very difficult to show your current symptoms are related to long COVID.

Instructions to Social Security on Handling Long-Haul COVID

Social Security has released an emergency message that instructs examiners on how to handle when a claimant alleges COVID related symptoms. Currently Social Security has yet to begin the process of establishing a listing for any Post COVID condition. Instead, the Social Security Administration is relying on current rules.
In order for COVID to be classified as a disabling impairment, Social Security must have evidence establishing it as a medically determinable impairment. A medically determinable impairment, or MDI, must be established using medical records. A claimant’s word is not enough. Currently Social Security is requiring one of the following:

  • a positive viral test for SAR-CoV-2 (not an antibody test)
  • a diagnostic test consistent with COVID (for example, a chest x-ray), or
  • a diagnosis of COVID with signs consistent with COVID (for example, fever and cough).

If later records indicate this was a false positive, the COVID flag from the file can be removed.
Second as noted above the MDI must prevent you from working for 12 months. Social Security will consider more than just long COVID symptoms, for example if COVID causes a new condition, or makes an existing condition worse that can cause you to meet the 12-month duration requirement.

Future Changes

It is hoped that Social Security may release updated polices on how long COVID should be handled. As long COVID is still being tracked it is hoped as more up to date information from the CDC becomes available further changes will be forthcoming. However, it is unlikely the SSA will create a new a listing for the condition. New listings are generally rare. SSA will often studying a condition for years while relying on more common rulings for guidance. It is possible that a listing may be created as Social Security has created a listing for post-polio syndrome. As post-polio syndrome is similarly classified as long COVID many hope it will be treated similarly in the long term.

Determining Disability with Long COVID Symptoms

First the SSA office will determine that you are no longer able to work due to your MDI. After confirming that you are either not working, or working below the thresholds, the SSA will then examine if your long COVID is documented as being severe enough to preclude all work.
If your symptoms are severe enough, you may medically equal a listing, or be granted just based on their affects on your ability to work.
If your long haul COVID is causing you to develop other problems such as lung damage, you may meet or equal a listing. Equaling a listing is when your condition does not exactly match the criteria of a listing but is still documented as being as severe.
In the even you do not meet or equal a listing, Social Security will next look to how your condition has affected your ability to work. The agency will review your medical evidence of your symptoms and how they affect your ability to perform sustained work activities. If the effects on your health are severe enough, the social security admin may find your Residual Functional Capacity to be below Sedentary, and therefore that you are unable to work.

Long-COVID, Long-haul COVID, or Long-Hauler Symptoms

Physical symptoms. For long haul COVID, it is possible you might meet any number of listings depending on your symptoms.

Most symptoms commonly fall into one of five categories:

  1. Fatigue– If COVID has affected your stamina it may be examined similarly to how chronic fatigue syndrome (CFS) is reviewed.
  2. Nervous System Malfunctions–  Symptoms of this nature are reviewed similarly to postural orthostatic tachycardia syndrome (POTS). POTS commonly cause fainting, dizziness, or tachycardia after standing or sitting up.
  3. Respiratory problems– This is handled similarly to pneumonia, COPD, or sleep apnea.  The debilitating effects on a persons respiratory system can quickly leave a person out of breath from even minor exertion.
  4. Cardiovascular System– Long haul COVID has been linked to damage to the heart including congestive heart failure. This can significantly affect a persons ability to exert themselves, making it harder to perform work activities.
  5. Muscle aches and pains–  Long COVID has been linked to muscle or joint pain caused by inflammation,  as well as reactive arthritis. These symptoms will be evaluated similarly to how Rheumatoid Arthritis is reviewed.

Cognitive and mental symptoms.
The most common symptom of long COVID is memory problems and brain fog. People report significant changes in their ability to think clearly, or concentrate. For cases of severe mental impairment Social Security could review listing 12.02, neurocognitive disorders. Listing 11.18 Traumatic Brain Injury can also be argued to be met, or equaled.

Filing for Disability

You will need to provide evidence to Social Security of:

  • First a medical diagnosis that document signs of your illness and your symptoms
  • Second documentation of your limitations and how they affect your ability to work, and
  • Third documentation that your inability to work has lasted, or will likely last at least 12 months.

The most important thing is to keep treating. Keep seeing your doctors so hey can fully document the severity of your condition. It may progress during the Social Security Disability process. Similarly, doctors may have access to new and emerging tools to fully diagnose your condition.  Seek out specialists who can review additional symptoms you may have. While your family doctor may be able to handle some aspects of recovery, a neurologist or pulmonologist will be better equipped to perform the diagnosis and tests you may need to prove your case.
Disability benefits for long-haul COVID is an emerging area full of uncertainty. Claimants with existing severe impairments that are still experiencing the effects of COVID likely have the best chance of proving the severity of their condition. As this is an emerging area it is best to speak with an attorney versed in Social Security Disability Law to help give you the best chance at a successful claim.
If you live in Las Vegas, Henderson, or Reno and you are a long-hauler or suffering from long-haul COVID-19, please reach out to a social security disability attorney by calling (702) 570-0000 for a Free Consultation.