COVID virus depiction

Is Long COVID a Disability?

The purpose of this article is to discuss whether long lasting residual COVID symptoms qualify as a disabling condition under Social Security Disability Income (SSDI) and Supplemental Security Income (SSI) rules. As expected, the answer to this question is not a straightforward yes or no.

What is Social Security Disability Insurance (SSDI)?

SSDI is an insurance program enacted under the Social Security Act that guarantees certain benefits to workers and their families in the United States.  If you have been working for a living at a job that withholds OASDI contributions and you become to physically or mentally ill to work, you may be entitled to ongoing payments to replace your lost income.  Medical conditions do not have to be work-related, and the benefits are not a handout.  These benefits also include access to Medicare after disability has been payable for two years.

What is Supplemental Security Income (SSI)?

SSI does not have the same work requirements as SSDI.  SSI pays monthly benefits to people with limited income and resources who are disabled, blind, or age 65 and up.  Blind or disabled children whose families meet the financial criteria may also get SSI.  SSI still requires that adults be too physically or mentally ill to work, but the illness does not have to be work-related.  These benefits trigger access to Medicaid (even retroactively) once a disabling condition has been established and SSI becomes payable.

How does Social Security Define Disability?

Regardless of whether a person qualifies to apply for SSI / SSDI, or both programs concurrently, they will be required to prove that they are disabled under Social Security rules.  For adults applying for SSDI or SSI benefits, disability is defined as the inability to engage in substantial gainful activity (SGA) because of a medically determinable impairment (physical or mental) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of 12 months or more.

What are the Symptoms of Long COVID?

By now, most Americans are familiar with COVID-19.  This illness has been particularly troublesome for individuals with co-existing health conditions and has taken the lives of more than half a million Americans.  Most people recover from COVID after suffering flu-like symptoms including fatigue, breathing issues, high fevers, weakness, smell and taste problems, and malaise.  Once the illness passes, most individuals can return to their normal state of being without residual symptoms.  Long COVID appears to be the exception to this rule.

Long COVID happens when patients experience symptoms of COVID-19 and do not completely recover for weeks or months after the start of their symptoms.  Symptoms of Long COVID include fatigue, breathlessness, cough, pain, brain fog, headaches, transient fevers, and heart palpitations.  More serious symptoms may include heart inflammation, issues with lung and kidney function, memory and sleep issues, mood changes, and anxiety.  Long COVID is theorized to be cause by problems with the immune response, inflammation, reinfection, or injury to multiple body systems.  As the United States now crosses the one-year mark from the recognition of the rapid spread and threat posed by COVID-19, the one-year requirement for disability also passes.

Can Long COVID be a Disability?

The short answer is yes, but patients with Long COVID must establish that it is a medically determinable impairment.  A medically determinable impairment is one that results from anatomical, physiological, or psychological abnormalities that can be shown by medically acceptable clinical and laboratory diagnostic techniques. The medical evidence must establish that an individual has an impairment.  Patient complaints and personal narrative are not sufficient to prove the existence of a medically determinable impairment.  Seeking medical care for ongoing Long COVID complaints is necessary not just for health reasons, but is also necessary if those symptoms prevent work.  Securing good and clear documentation of the medical issues and limitations that they cause is of the utmost value when trying to prove disability as a result of Long COVID.

How can I find out more?

A well-qualified disability attorney can answer your questions about how Long COVID or any other condition might affect a disability or SSI application.  Getting disability can be a lengthy and challenging process, and a disability attorney will not get paid unless they win for you.  O’Brien & Feiler would be pleased to speak with you over Zoom or over the phone about your disability claim today.

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