COVID-19 long-haulers struggle to prove illness for disability benefits

Americans suffering from "long COVID" may qualify for federal disability protection and benefits, but applying and being accepted by the Social Security Administration remains a major obstacle, The New York Times reported Oct. 27.

On July 26, HHS and the Justice Department said COVID-19 can be considered a disability for people who continue to experience symptoms weeks or months after first becoming ill. According to estimates from the American Academy of Physical Medicine and Rehabilitation, 3 million to 10 million Americans may have long COVID.

However, there's no widely agreed upon method of diagnosing long COVID, and many are having a difficult time proving their illness. Many don't have record of a positive COVID-19 test, which were in short supply at the start of the pandemic. Furthermore, lab results and scans often don't show anything unusual for those with continuing symptoms.

"I expect the tests to come back normal," said Luis Tatem, MD, an infectious disease specialist who treats long COVID patients at the University Hospital of Brooklyn in New York City. "We're used to having a laboratory to back us up. And for this, you don't."

Since December 2020, the Social Security Administration has had about 16,000 applicants able to provide medical evidence supporting COVID-19 as one of their impairments, Nicole Tiggemann, an agency spokesperson, wrote in an email to the Times. She didn't say how many of the applicants had been approved for benefits. Many cases are likely still pending, with wait times for a determination reaching five months or more.

"Addressing the disability backlog is one of our top priorities," Ms. Tiggemann wrote. President Joe Biden called for an additional $1.3 billion for the agency's budget for the 2022 fiscal year, a proposal that is part of current Congress negotiations.

To qualify, applicants must demonstrate a disability significantly limits their ability to work and has lasted, or will last, for at least a year. The administration typically uses medical tests or health records to determine qualification. Between 2009 and 2018, the administration denied an average of 66 percent of applicants.

Ms. Tiggemann said determining qualification has more to do with how symptoms affect an individual's ability to function than the exact diagnosis. A positive COVID test may not be necessary if other evidence plainly shows an inability to work, she said.

The complicated nature of diagnosing long COVID requires coordination between multiple specialists, many of whom are overbooked, according to Stephen Martin, MD, physician and professor at Worcester-based University of Massachusetts Medical School. 

"This really hits us in our Achilles' heel of healthcare," Dr. Martin said. "The American healthcare system really isn't set up to do this at scale."


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