Long COVID Disability Claim Denials | LTD Attorney

What is Long COVID?

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC) or post-acute COVID-19 syndrome, refers to a range of persistent symptoms experienced by individuals who have recovered from acute COVID-19 infection. While many people with COVID-19 experience mild to moderate symptoms that resolve within a few weeks, some individuals continue to experience lingering symptoms long after the acute phase of the illness has passed.

Long COVID can affect individuals of all ages, including those who had mild or asymptomatic cases of COVID-19. The exact cause of long COVID is not fully understood, but it is believed to result from a combination of factors, including the direct effects of the virus on the body, immune system dysregulation, inflammation, and damage to organs and tissues.

Management of long COVID typically involves a multidisciplinary approach, including supportive care, symptom management, rehabilitation, and mental health support. Individuals experiencing persistent symptoms of long COVID should consult their healthcare provider for proper evaluation and management tailored to their specific needs. Ongoing research is underway to better understand the underlying mechanisms of long COVID and develop effective treatments for those affected by this condition.

What are the symptoms of long COVID?

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC) or post-acute COVID-19 syndrome, refers to a range of persistent symptoms experienced by individuals who have recovered from acute COVID-19 infection. These symptoms can persist for weeks or months after the acute phase of the illness has resolved. While the exact cause of long COVID is not fully understood, it is believed to result from a combination of factors, including the direct effects of the virus on the body, immune system dysregulation, inflammation, and damage to organs and tissues.

The symptoms of long COVID can vary widely among individuals and may affect multiple organ systems. Some of the most common symptoms include:

1. Fatigue: Persistent and debilitating fatigue is one of the hallmark symptoms of long COVID. Individuals may experience profound exhaustion that interferes with daily activities and does not improve with rest. Fatigue can making working impossible.
2. Shortness of Breath: Many individuals with long COVID experience ongoing respiratory symptoms such as shortness of breath, even after mild physical activity. This symptom can alter quality of life and may persist for weeks or months.
3. Cognitive Dysfunction: Cognitive impairments such as brain fog, difficulty concentrating, memory problems, and confusion are often reported by individuals with long COVID. These cognitive symptoms can affect work, school, and daily functioning.
4. Muscle and Joint Pain: Chronic muscle and joint pain, resembling fibromyalgia or rheumatoid arthritis, are common features of long COVID. These symptoms can be debilitating and may persist for a long time.
5. Headaches: Recurrent headaches or migraines are often reported by individuals with long COVID. These headaches may vary in intensity and duration and can upend quality of life.

6. Loss of Taste or Smell: Changes in taste or smell, known as anosmia or dysgeusia, are common symptoms of acute COVID-19 infection. Sometimes these changes may persist for weeks or months after the acute phase of the illness has resolved.
7. Chest Pain or Palpitations: Persistent chest discomfort, tightness, or irregular heartbeats may occur in individuals with long COVID. These symptoms may be related to ongoing inflammation or damage to the heart or lungs.
8. Gastrointestinal Symptoms: Digestive issues such as nausea, vomiting, diarrhea, or abdominal pain may persist in some individuals with long COVID.
9. Mood Disturbances: Anxiety, depression, mood swings, and other mood disturbances are common among individuals with long COVID. These symptoms may be related to the stress of dealing with a prolonged illness or the neurobiological effects of the virus.
10. Sleep Disturbances: Insomnia, difficulty falling asleep or staying asleep, or unusual sleep patterns are frequently reported by individuals with long COVID. These sleep disturbances can exacerbate other symptoms and impact overall well-being.

It’s important to note that the symptoms of long COVID can vary widely among individuals, and new symptoms may emerge over time. If you are experiencing persistent symptoms after recovering from acute COVID-19 infection, it’s essential to consult your healthcare provider for proper evaluation and management.

What is the diagnosis and treatment for long COVID?

Diagnosing and treating long COVID requires a comprehensive approach tailored to the individual’s specific symptoms and needs. While there is no universally accepted diagnostic criteria or standard treatment protocol for long COVID, healthcare providers typically focus on addressing the diverse range of symptoms experienced by individuals recovering from acute COVID-19 infection. Here’s an overview of the diagnosis and treatment for long COVID:

Diagnosis:

1. Clinical Evaluation: Healthcare providers diagnose long COVID based on a thorough clinical evaluation, including a detailed medical history, physical examination, and assessment of symptoms. Individuals who continue to experience persistent symptoms weeks or months after recovering from acute COVID-19 infection may be diagnosed with long COVID.
2. Diagnostic Tests: Diagnostic tests such as blood tests, imaging studies (e.g., chest X-rays, CT scans), pulmonary function tests, cardiac evaluations, and neurological assessments may be performed to evaluate the individual’s condition further and rule out other potential causes of their symptoms.

Treatment:

1. Multidisciplinary Approach: Treatment for long COVID often involves a multidisciplinary approach that addresses the diverse range of symptoms experienced by individuals. A team of healthcare providers, including primary care physicians, specialists (e.g., pulmonologists, cardiologists, neurologists), physical therapists, occupational therapists, mental health professionals, and other allied health professionals, may collaborate to develop an individualized treatment plan tailored to the individual’s specific symptoms and needs.
2. Pharmacological Interventions: Medications may be prescribed to manage specific symptoms of long COVID. For example, pain relievers (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs) may be used to alleviate muscle and joint pain, while antidepressants, anxiolytics, or sleep aids may be prescribed to address mood disturbances or sleep disturbances.
3. Supportive Care: Supportive care measures can help alleviate symptoms and improve overall well-being. This may include adequate rest, hydration, balanced nutrition, stress management techniques, and avoiding exacerbating factors such as smoking or excessive alcohol consumption.
4. Rehabilitation and Therapy: Physical therapy, occupational therapy, and pulmonary rehabilitation programs can help individuals with long COVID improve physical function, mobility, and endurance. Cognitive rehabilitation programs may also be beneficial for individuals experiencing cognitive dysfunction or brain fog.
5. Mental Health Support: Long COVID can have a significant impact on mental health, leading to anxiety, depression, mood swings, and other psychological symptoms. It’s essential to prioritize mental health and seek support from mental health professionals, support groups, or counseling services as needed.
6. Patient Education and Self-Management: Healthcare providers may provide education and support to help individuals with long COVID better understand their condition, manage symptoms effectively, and advocate for their needs as patients. This may include guidance on symptom management strategies, lifestyle modifications, and resources for coping with the challenges of long COVID.

The management of long COVID requires a personalized and holistic approach that addresses the diverse range of symptoms and needs experienced by individuals recovering from acute COVID-19 infection. By collaborating with healthcare providers, engaging in comprehensive treatment strategies, and advocating for their needs, individuals with long COVID can improve their quality of life and facilitate recovery from this challenging condition.

Why do insurers deny long-term disability claims for long COVID?

Insurers may deny long-term disability claims for long COVID for several reasons, including:

1. Lack of Objective Evidence: Insurers typically require objective medical evidence to support disability claims. Insurers should be able to demand objective evidence of occupational impairment and not objective medical evidence for illnesses for which there is no laboratory test. Yet diagnosing and assessing the severity of long COVID can be challenging because symptoms are often subjective and may not be easily measurable through traditional medical tests. Insurers may deny claims if they believe there is insufficient objective evidence to support the severity and impact of the individual’s symptoms. Persons suffering from fibromyalgia syndrome often experienced this treatment by insurance companies when those persons filed disability claims about two decades ago. As fibromyalgia syndrome became better understood, insurance companies backed down. Long COVID seems to be following the same pattern.
2. Subjective Nature of Symptoms: Long COVID symptoms such as fatigue, cognitive dysfunction, and pain are subjective and can vary widely among individuals. Insurers may be skeptical of claims based solely on self-reported symptoms, especially if there is a perceived lack of medical documentation or corroborating evidence.
3. Incomplete Medical Records: In some cases, medical records may not adequately document the individual’s long COVID symptoms or their impact on daily functioning. Insurers may deny claims if they believe there is insufficient documentation to support the severity and duration of the individual’s symptoms.
4. Preexisting Conditions: Insurers may deny long-term disability claims for long COVID if they believe that preexisting medical conditions or other factors contributed to the individual’s symptoms. For example, if the individual had a history of chronic fatigue syndrome or fibromyalgia before contracting COVID-19, the insurer may argue that these preexisting conditions are responsible for the individual’s ongoing symptoms.
5. Disability Definition: The definition of disability in the insurance policy may be narrow or restrictive, requiring the individual to show that they are unable to perform the duties of their own occupation or any occupation for which they are reasonably suited. Insurers may deny claims if they believe the individual can still perform some form of work, even if it is not their previous occupation.
6. Incomplete Application or Documentation: Errors or omissions in the disability claim application or supporting documentation can result in claim denial. Insurers may deny claims if they believe the application is incomplete, inconsistent, or lacks necessary medical evidence.
7. Challenges with Long COVID Diagnosis and Recognition: Long COVID is a new and poorly understood condition, and there may be skepticism or lack of recognition among insurers regarding its severity and impact on individuals’ ability to work. Insurers may deny claims based on the belief that long COVID is not a valid basis for disability.

It’s important for individuals with long COVID seeking long-term disability benefits to carefully review their insurance policy, provide thorough medical documentation supporting their claim, and consider seeking assistance from legal professionals specializing in disability claims if their claim is denied. Additionally, advocating for greater recognition and understanding of long COVID as a disabling condition may help improve access to disability benefits for affected individuals.

How do I seek a medical diagnosis and treatment for long COVID?

Seeking a medical diagnosis and treatment for long COVID requires a comprehensive approach that addresses the diverse range of symptoms experienced by individuals recovering from acute COVID-19 infection. Given that the diagnosis is clinical, and not done by lab testing alone, getting the right healthcare provider is key:

1. Consult with a Healthcare Provider: If you are experiencing persistent symptoms after recovering from acute COVID-19 infection, schedule an appointment with your primary care physician or a healthcare provider specializing in post-COVID care. They can conduct a thorough evaluation and assessment of your symptoms to determine whether you may have long COVID.
2. Medical History: Provide your healthcare provider with a detailed medical history, including information about your COVID-19 diagnosis, the severity of your initial symptoms, any hospitalizations or complications, and the timeline of symptom onset and duration. This information can help guide the diagnostic process and inform treatment decisions.
3. Physical Examination: Your healthcare provider will conduct a physical examination to assess your overall health and identify any specific symptoms or signs associated with long COVID. They may listen to your heart and lungs, check your vital signs, and perform a neurological examination to assess cognitive function.
4. Symptom Assessment: Describe your symptoms in detail, including the type, frequency, severity, and duration of each symptom. Common symptoms of long COVID include fatigue, shortness of breath, cognitive dysfunction, muscle and joint pain, headaches, chest pain, gastrointestinal symptoms, mood disturbances, and sleep disturbances.
5. Diagnostic Tests: Depending on your symptoms and medical history, your healthcare provider may order diagnostic tests to evaluate your condition further. These tests may include blood tests to assess markers of inflammation, imaging studies such as chest X-rays or CT scans, pulmonary function tests, cardiac evaluations, and neurological assessments.
6. Multidisciplinary Evaluation: Given the diverse range of symptoms associated with long COVID, you may benefit from a multidisciplinary evaluation involving specialists from various medical disciplines, such as pulmonology, cardiology, neurology, rheumatology, and psychiatry or psychology. This collaborative approach is the best approach.
7. Individualized Treatment Plan: Based on your evaluation and diagnostic tests, your healthcare provider will develop an individualized treatment plan tailored to your specific symptoms and needs. Treatment for long COVID may include a combination of pharmacological interventions, supportive care, rehabilitation, lifestyle modifications, and mental health support.
8. Pharmacological Interventions: Medications may be prescribed to manage specific symptoms of long COVID, such as pain relievers for muscle and joint pain, anti-inflammatory drugs for inflammation, antidepressants or anxiolytics for mood disturbances, and sleep aids for sleep disturbances. Your healthcare provider will carefully select medications based on your symptoms and overall health status.
9. Supportive Care: Along with pharmacological interventions, supportive care measures can help alleviate symptoms and improve overall well-being. This may include adequate rest, hydration, balanced nutrition, stress management techniques, and avoiding exacerbating factors such as smoking or excessive alcohol consumption.
10. Rehabilitation and Therapy: Physical therapy, occupational therapy, and pulmonary rehabilitation programs can help individuals with long COVID improve physical function, mobility, and endurance. Cognitive rehabilitation programs may also be beneficial for individuals experiencing cognitive dysfunction or brain fog.
11. Mental Health Support: Long COVID can have a significant impact on mental health, leading to anxiety, depression, mood swings, and other psychological symptoms. It’s essential to prioritize mental health and seek support from mental health professionals, support groups, or counseling services as needed.
12. Follow-Up and Monitoring: Long COVID is a complex and evolving condition, and symptoms may change or fluctuate over time. Attend regular follow-up appointments with your healthcare provider to monitor your progress, adjust treatment as needed, and address any new or worsening symptoms.

By following these steps and working with your healthcare provider, you can receive an accurate diagnosis and develop an effective treatment plan to manage long COVID and improve your quality of life. Staying informed about ongoing research and advancements in the understanding and treatment of long COVID can help guide your care and advocate for your needs as a patient.

 How do I record my Long COVID systems?

Recording your long COVID symptoms is essential for monitoring your condition, tracking changes over time, and communicating effectively with healthcare providers. Here’s how to effectively record your long COVID symptoms:

1. Keep a Symptom Journal: Start by maintaining a symptom journal or diary to track your long COVID symptoms. You can use a notebook, a smartphone app, or a spreadsheet to record relevant information. Use a paper calendar. It’s an easy way to make daily notes. Pen to paper notes sometimes come across as more impressive compared to electronic notes.
2. Document Daily Symptoms: Record the frequency, severity, and duration of each symptom you experience, including fatigue, shortness of breath, cognitive dysfunction, pain, headaches, gastrointestinal symptoms, mood disturbances, and sleep disturbances.
3. Use a Rating Scale: Use a simple rating scale (e.g., 0-10) to assess the severity of each symptom. For example, rate the intensity of fatigue, pain, or shortness of breath on a scale from no symptoms to severe symptoms. This can help you track changes in symptom severity over time.
4. Record Triggers and Patterns: Identify and record any triggers that worsen your long COVID symptoms, such as physical exertion, stress, weather changes, or specific activities or foods. Note any patterns or trends in your symptoms, such as worsening symptoms at certain times of day or after certain activities.
5. Include Date and Time: Make sure to record the date and time of each symptom occurrence to track patterns and trends over time. This can help you and your healthcare provider identify potential triggers or exacerbating factors.
6. Track Medication and Treatment: Record any medications, treatments, or interventions you use to manage your long COVID symptoms, including dosage, frequency, and any changes in treatment. Note any side effects or adverse reactions to medications.
7. Monitor Functional Limitations: Document any limitations or challenges you experience in daily activities, work, or social interactions due to your long COVID symptoms. This can help you assess the effect of your symptoms on your quality of life and functional ability.
8. Share with Healthcare Provider: Bring your symptom journal to your healthcare appointments to discuss your symptoms, treatment plan, and any concerns. Your healthcare provider can use this information to evaluate your condition, adjust treatment as needed, and provide personalized care.
9. Stay Consistent: Make it a habit to record your long COVID symptoms consistently, ideally daily or as often as needed to capture relevant information. This can help ensure that you have accurate and up-to-date information to share with your healthcare provider.

By maintaining a detailed record of your long COVID symptoms, you can empower yourself to actively manage your condition, advocate for your needs, and work collaboratively with your healthcare team to optimize treatment and improve your quality of life.

How can a long-term disability attorney help me receive benefits for long COVID?

A long-term disability attorney can play a crucial role in helping you receive benefits for long COVID by navigating the complex process of filing a disability claim and advocating on your behalf. Here’s how an attorney can assist you:

1. Evaluation of Eligibility: A long-term disability attorney can assess your eligibility for disability benefits based on your medical condition, symptoms, employment history, and the terms of your insurance policy. They can determine whether you meet the criteria for disability benefits due to long COVID.
2. Guidance Through the Application Process: Applying for long-term disability benefits can be daunting, especially when dealing with a new and poorly understood condition like long COVID. An attorney can guide you through the application process, helping you complete forms accurately and gather the necessary medical evidence to support your claim.
3. Obtaining Medical Evidence: Long COVID symptoms are often subjective and may require extensive medical documentation to support a disability claim. An attorney can work with your healthcare providers to obtain medical records, test results, treatment notes, and other evidence documenting the severity and impact of your long COVID symptoms on your ability to work. A long-term disability attorney can provide invaluable assistance in navigating the disability claims process and increasing your chances of successfully obtaining benefits for long COVID. By enlisting the help of an experienced attorney, you can focus on your health and well-being while your attorney handles the legal aspects of your disability claim.
4. Representation in Appeals: If your initial disability claim is denied, we can represent you in the appeals process and prepare and submit appeals on your behalf, handle negotiations with insurance companies.
5. Representation in litigation: Make sure you retain an attorney who has a history of successfully litigating disability claims in court. This includes ERISA and individual disability insurance claims. Ask the attorney to show you a history of litigating cases. We have a great deal of experience in both. We have been involved in representing an individual in a very early long COVID disability claim to a successful resolution against one of the largest insurance companies in the entire world.
6. Providing Support and Advocacy: Throughout the disability claims process, we provide you with support, guidance, and advocacy. We can answer your questions, address your concerns, and advocate for your best interests to ensure that you receive the benefits you deserve.
7. Providing Peace of Mind: Dealing with the complexities of the disability claims process can be overwhelming and stressful, particularly when coping with the challenges of living with life altering diseases or injuries. By enlisting help from a knowledgeable and compassionate attorney, you can gain peace of mind knowing that your case is in capable hands. We can provide guidance, support, and reassurance throughout the process, alleviating the burden on you and allowing you to focus on your health and well-being.

Contact a Long-Term Disability Denied Claims Lawyer

Getting it right the first time is always best and can get you your much needed benefits faster. Contact our skilled Denied claims lawyer Jonathan M. Feigenbaum, Esquire, at 617-357-9700 today!