Many who survive or suffer from Long-COVID (or, as the pros call it, post-acute sequelae SARS-CoV-2 infection or PASC) are wondering if they will be eligible for Social Security disability benefits for this illness. Although some post ventilator patients have been granted SSDI, the question remains mostly open so far.
Qualifying for SSDI
Qualifying for Social Security Disability Insurance (SSDI) benefits is not easy at the best of times. Assuming you have worked in enough jobs to qualify for Social Security benefits, you must demonstrate to the Social Security Administration (SSA) that you have been unable to work for a year or more because of your disability. Most Long-Covid patients have not yet met that duration requirement. Nonetheless, a study from September 2021 found that more than 50% of COVID victims suffered one or more Long-COVID symptoms for six months after the initial infection.
SSA Disability Definition
The SSA defines a qualifying disability as a condition meeting all of the following:
- Applicant cannot work or engage in substantial gainful activities (SGA) because of the medical condition
- Applicant cannot do the kind of work applicant did previously or adjust to other work because of the medical condition
- Applicant’s condition has lasted or is expected to last for at least one year or result in death.
SSA Decision Process
Once it determines that you do have a qualifying disability, the SSA will engage in a formal decision-making process regarding your application. This process looks at:
Are you working and having SGA? If you’re earning more than $1,350 a month, you are not disabled and do have SGA.
Is the condition severe? It must significantly limit your ability to do basic work-related acts like lifting, standing, walking, sitting, or remembering for at least 12 months. If not, you are not disabled.
Is long-COVID on the list of disabling conditions? Long-COVID is not on the list of disabling conditions. The SSA indicated in July 2021 that sufferers could qualify for SSDI, but it is not on the list. Thus, the proof process will be arduous.
The Departments of Health and Human Services and Justice has issued guidance stating that Long-COVID can be a disability under the Americans with Disabilities Act and under the anti-discrimination provisions of the Rehabilitation Act and the Affordance Care Act. Unfortunately, this does not affect the SSA and its deliberations.
SSA Decision Results
The SSA has received well more than 16,000 applications for Long-COVID SSDI. It has not released any statistics on how many of those applications have been approved. However, the general denial rate is that, after a usual three to five-month decision process, the SSA rejects four out of five initial applications.
What is Long COVID
About 10% of COVID-19 victims have symptoms that linger on for weeks and months after they begin the recovery process. Among the symptoms of long COVID are:
- Fatigue – not relieved by rest and sleep, some chronic fatigue syndrome
- Brain fog – problems with thinking, memory, and concentrating
- Loss of senses of smell and taste
- Shortness of breath – feeling winded
- Cough – can persist for months
- Joint pain – one-third of long-COVID patients have severe muscle and joint pain
- Chest pain – can persist for weeks; new or different chest pain should be referred to physicians.
You should note that a number of these symptoms may appear in the SSA’s Part A Listing of Impairments. Thus, if the sufferer can meet the duration issue and prove suffering several of the symptoms, it should be theoretically possible to obtain SSDI for long COVID.
Should You Get a Lawyer?
Studies have shown that applicants for SSDI are far more likely to be approved for benefits when represented by counsel. This approval rate isn’t because the SSA will be impressed that you have an attorney. Instead, there are concrete, practical reasons why using an experienced Orange County social security disability attorney is worthwhile.
Having an attorney greatly reduces your risk of denial. Attorneys are experienced with and understand the process. They know how to present a case in the way most likely to demonstrate your disability to the SSA. They also know what documentation is required and how to get it from your doctors and other medical professionals. They also understand the SSA’s disability evaluation under Social Security, known as the Blue Book, and how to show you meet its definitions and requirements.
Even if the SSA rejects your initial application with an attorney, that attorney will make the burdensome and complicated appeals process much easier.
Finally, the attorney will take your case on a contingency fee basis, meaning you pay nothing unless the attorney successfully obtains benefits for you. If you do get benefits, the SSA will take the payment, 25% of your back benefits up to a maximum of $6,000 and pay it directly to the attorney. Even if you decide not to retain a lawyer, it may be worthwhile to contact an SSDI law firm to get an initial evaluation of your case, which is usually at no cost.