Some COVID-19 patients continue to suffer from a puzzling array of symptoms months after recovering from the acute infection. Impacting various body systems, these symptoms can make it difficult or impossible for individuals to work or go about their normal lives. With COVID-19 cases in the United States currently closing in on 15 million and counting, the potential for a tsunami of long-term disability claims is on the horizon as the virus leaves a mysterious legacy known as post- acute COVID syndrome, otherwise known as long-haul syndrome, in its wake.
After the virus slammed the New York City area in March and April, health care workers in the Mount Sinai Health System noticed that many patients were experiencing a wide range of symptoms weeks after their acute infection. The health system in May became the first to establish a center to study long-haul syndrome. Dr. Zijian Chen, director of the Center for Post-COVID Care at Mount Sinai, estimated in September that 70,000 New Yorkers were suffering from post-acute COVID syndrome.
The Centers for Disease Control (CDC) is also studying the long-term effects of COVID-19. According to the CDC, even many people with a mild infection suffer from lingering effects. A third of patients who were not sick enough to be hospitalized are not back to their usual health three weeks after their diagnosis, according to a CDC study.
The most common complaints of so-called long-haulers are fatigue, shortness of breath, cough, join pain and chest pain. Other reported symptoms include difficulty with thinking and concentration, which is sometimes called brain fog, depression, sleep problems, muscle pain, headaches, loss of taste or smell, intermittent fever and heart palpitations.
The long-range outlook
Since COVID-19 is a new disease, there is no information about long-term recovery rates. Long-haulers fall into two groups of patients: one group includes those who have sustained some permanent damage to one or more of their organs, such as their lungs, heart, kidneys or brain, that may affect their ability to function and lead to lasting illnesses. For instance, more than one-third of patients who were hospitalized for COVID-19 have suffered from lung tissue death with visible scarring, according to an article in the publication Nature. The other group is comprised of patients without detectable damage to an organ, but who continue to experience ongoing symptoms, some of which can be debilitating.
The CDC has indicated that the symptoms suffered by many long- haulers are similar to those of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and that studies are planned to determine if COVID-19 leads to a ME/CFS-like illness in some individuals. ME/CFS has been triggered by other infectious illnesses, including Lyme disease, mononucleosis and severe acute respiratory syndrome (SARS).
According to the World Health Organization, about 40 percent of people recovering form SARS still had chronic fatigue symptoms 3.5 years after being diagnosed. A potentially debilitating condition that can linger for decades, ME/CFS is marked by fatigue that is not a result of unusual difficult activity and is not relieved by sleep or rest. Other common symptoms include problems with thinking and memory, muscle and joint pain and headaches. Between 1 million and 2 million Americans currently suffer from ME/CFS, according to National Academy of Medicine estimates.
Impact on long term disability claims
It is impossible to measure how much post-acute COVID syndrome will impact long term disability claim activity, but it is clear there will be a significant uptick in applications. COVID-19 cases and hospitalizations in the United States continue to increase and are currently at their highest point so far in the pandemic. Just how high the trajectory will go before vaccinations become widely available is up for debate. It is also unclear how many people will be impacted by post-acute COVID syndrome and how long their symptoms will last.
Individuals who file long term disability claims in connection with post- acute COVID syndrome are likely to face considerable obstacles in getting their benefits paid. Insurance companies will require that claimants prove they have a disabling condition and that the condition prevents them from performing the material duties of their occupation. Claimants will need to get a diagnosis from a qualified physician who treats that condition.
Many people who had an acute COVID infection never tested positive for the virus, especially early on when tests were not widely available, and proving a condition like ME/CFS is typically challenging because of its varied nature and an inability to measure the disabling impact of its symptoms with objective tests. Claimants should consult an attorney experienced in long term disability insurance law as early in the process as possible so they can avoid pitfalls and missteps that could lead to their claim getting denied.
If you are considering filing a long term disability insurance claim, or if your claim is being challenged or has been denied, give us a call. We have the experience, knowledge and tenacity to make sure insurance companies keep their promises. Contact us today for a free consultation.
Evan S. Schwartz
Founder of Schwartz, Conroy & Hack