Please ensure Javascript is enabled for purposes of website accessibility The complexities of long-haul COVID-19 in SSDI claim evaluation – Brown & Brown Absence Services Group

Sixteen months have passed since COVID-19 cases began to meaningfully spike in the United States, causing many states to close non-essential businesses and institute lockdowns to “stop the spread” in a matter of weeks. Little did we know that those few weeks would turn into one of the greatest healthcare, social, and economic challenges to ever face the world. As of July 8, 2021, at least 606,000 Americans have died as a result of COVID-19, and total cases in the United States have topped 33.8 million. While advanced research, medical treatments, and vaccine rollouts have helped reduce case counts and deaths, we are now facing another obstacle: “long-haul” COVID-19.

Individuals with long-haul COVID-19 report chronic virus symptoms, such as coughing, body aches, joint pain, shortness of breath, fatigue, headaches, and brain fog, months after their initial infection and supposed recovery. The resulting complications leave many feeling desperate for both medical solutions and financial assistance. Brown & Brown Absence Services Group has now worked with several clients with chronic COVID-19 symptoms, and we expect those numbers to increase as time passes and more individuals seek assistance applying for Social Security Disability (SSDI) benefits.

As the number of “long haulers” continues to increase nationwide, SSDI claim evaluations grow increasingly complex. When reviewing an SSDI claim, examiners must determine if the health condition(s) cited on a claimant’s application will prevent him or her from working for at least one year or are likely to result in death. Because the medical and scientific communities are only just beginning to obtain meaningful data about the prolonged impact of long-haul COVID-19 and the Social Security Administration has not published guidelines to direct the evaluation of claims related to long-haul COVID-19, disability examiners are left with little concrete evidence to support the possibility that this condition could prevent a claimant from working for at least one year.

To see a common example of how long-haul COVID may impact a claimant’s life, we will look at the claim of Samuel Smith.* In July of 2020, at age 54, Mr. Smith was admitted to the hospital with shortness of breath and was quickly diagnosed with COVID-19. Over the next 100 days, Mr. Smith struggled against the virus, and while he did manage to overcome it, he has been left with lingering fatigue and shortness of breath ever since. Along with these new symptoms, COVID-19 also exacerbated Mr. Smith’s pre-existing conditions, including hypertension and hyperlipidemia, making his recovery even more difficult.

Because Mr. Smith has pre-existing conditions, evaluating his SSDI claim is particularly complicated. Disability examiners must not only contend with the unknown long-term impact of long-haul COVID-19, but they must also question if/how this new condition may worsen Mr. Smith’s other health issues. As client representatives for SSDI claims, Brown & Brown Absence Services Group has stayed fully up-to-date with any changes or new guidelines regarding how SSDI claims are being evaluated. Because we handle a large volume of claims, we anticipate that, in the coming months, we will have the ability to develop a model to predict the impact of long-haul COVID-19 on SSDI claims, in order to provide the best possible advocacy for claimants seeking benefits.

To learn more about long-haul COVID-19 from a clinical perspective, read this recent blog post written by one of our physician consultants. Additionally, UC Davis has started a long-haul COVID-19 clinic, and you can visit their website for information about the ongoing effects to combat this new chronic condition.

*Claimant information was changed for privacy – no personal information is being shared.

Nothing in this post is intended as advice or a suggestion to elect or not elect to claim benefits of any kind, including Social Security benefits, nor is it intended as financial advice in any way. The decision to claim benefits is a personal one that is contingent upon each individual’s unique circumstances. Nothing herein is considered medical advice, diagnosis, or treatment.