Does your disability insurance cover long COVID? What's at risk for employers and employees

Four years into the COVID-19 pandemic, and millions of people are still getting sick or dealing with chronic, debilitating conditions brought on by the initial infection. Employers may have to ask themselves if their benefits are ready to meet a new wave of disabled workers.

The CDC estimates that 18 million Americans have suffered from or currently have long COVID, a set of symptoms lasting three months or longer after they caught the virus. These symptoms can include anything from extreme fatigue, dizziness and brain fog to heart palpitations, gastrointestinal issues and mobility impairments. Research from think tank Brookings suggests that around 500,000 Americans were missing from the workforce due to long COVID in 2022 alone.

But can those workers successfully file for disability? ERISA attorney John Joseph Conway of J.J. Conway Law is currently representing a plaintiff who was denied disability coverage by Hartford Life and Accident Insurance Company for her post-COVID-conditions, otherwise known as long COVID. The plaintiff, who worked as an administrator for a long-term care facility, now suffers from seizures, memory loss and digestive issues after contracting COVID on the job in November 2020. She found that her symptoms only worsened after taking short-term disability leave and filed with Hartford to continue with long-term leave.

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“She just continued to experience new things that were really problematic, like chronic pain, life-altering fatigue and this brain fog where she just became forgetful all of a sudden,” says Conway. “Doctors said they don’t really know what’s going on here, but she can’t work.”

Conway notes that in the plaintiff’s case, Hartford didn’t even try to verify her condition using their own physicians. Instead, Hartford had a third party send three doctors who evaluated the plaintiff and reported that she had no claim. 

“But there were terrible, glaring mistakes in their reports — the [doctors] had the wrong name and wrong dates of disability,” says Conway. “They were clearly mixing this up with another patient. But one of the doctors doubled down and said that he wasn’t going to change his report.”

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It became clear to Conway that Hartford, among other insurance companies caught in similar lawsuits, do not want to offer coverage for long COVID because they deem it to be a new risk they didn’t plan for in their contracts with employers. Insurance companies typically write a contract with an employer based on the number of employees, work hours, the physical requirements of the job and the likelihood of events like car accidents, strokes and heart attacks for that workforce; they didn’t anticipate long COVID, Conway explains. 

“Insurance companies are trying to get a handle on how many claims may be coming in, so they’re just really pushing back on this as a recognized disability classification,” he says. “COVID threw all their risk tactics out the window.”

Ultimately, it comes down to money. Insurers do not want to be financially responsible for a new wave of disabled workers, resulting in lawsuits like this one. Conway argues that this should be a straightforward case: The plaintiff has a history of great performance evaluations and was fit to do her job until COVID. But long COVID patients shouldn’t have to go to court to prove that they are deserving of the benefits legally guaranteed to them, underlines Conway. 

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He advises employees who catch COVID to get a blood test that shows the presence of the infection even after they start testing negative on standard COVID tests. It’s important that workers can prove they contracted the virus, just in case they begin experiencing long-term symptoms. As for employers, Conway encourages them to reevaluate their insurers.

“Pay attention and ask, ‘Are my insurers being helpful to their employees when they have legitimate disability claims?'” says Conway. “If you’re using an insurer that has a bad claims history, and several of them do, you’re not putting your employees in a good position.”