For some people, the effects of COVID-19 can last for a long time and may be permanent. If you are unable to work because of the toll COVID-19 has taken on your health, and you have an individual or employer-sponsored Long-Term Disability (LTD) policy, you should be covered.

Important Factors to Keep in Mind About Your Long-Term Disability Claim

  1. You must meet your policy’s Elimination Period. Check your policy – Elimination Periods are normally three or six months. You must be continuously disabled during this time. Many, but not all, companies that offer LTD plans also offer Short-Term Disability (STD) policies to cover the LTD Elimination Period.
  2. Be careful – your doctor must document, in your office visit notes, why your COVID-19 symptoms and side effects prevent you from working. COVID-19 is one of those tricky diagnoses from a disability standpoint, because “most people” get better and do not suffer long-term disabilities. The insurance company will assume you are “most people” unless your doctor explains why you are not.
  3. Be clear about the “material duties” of your job. Disability is a combination of two things: your physical condition, including any restrictions and limitations you have on your activities, and what you need to do for your job (later, according to how your policy defines “disability,” this will mean what you would need to do to perform any job you are qualified for). Disability is when the two do not overlapthat is, there are things you must do for your job that you are unable to do.

What If I Get Covid-19 and Work a Sedentary Job?

If you have a sedentary job and the effects of COVID-19 has left you chronically short of breath, your insurance company may argue you do not meet the requirements for short or long-term disability. However, if you work a physically demanding job, which requires a lot of standing, walking, lifting, and general physical activity, your shortness of breath certainly can be disabling.

Even for people with sedentary jobs, there are indications that the multi-system havoc COVID-19 can inflict on the body may be disabling for a long time, and possibly permanently. The key to an approved LTD claim will be proving to the insurance company’s satisfaction that you are one of the unfortunate ones who did not recover from COVID-19 enough to be able to return to work.

Takeaway

COVID-19 is a new disease, and people are just now meeting their policy Elimination Periods and applying for Long-Term Disability coverage. It is too soon to say whether we will see patterns emerging from how the insurance companies treat COVID-19-related LTD claims. In general, though, it is always in your best interest to present the strongest, most well-supported claim from the very beginning. Don’t rely on the insurance company to figure out why you are disabled due to COVID-19.

How BenGlassLaw Can Help

When in doubt, ask BenGlassLaw! We help people all the time understand what individual documentation they need to provide to prove their claim to the insurance company’s satisfaction.

We offer a flat fee consultation to review your policy (they are like fingerprints – many similarities but each one a little different) and your medical records. We can let you know what your doctors will need to document in order to make your claim to the insurance company as strong as possible. Our goal is that after this consultation your claim will be approved, and you will never need us again. But if your COVID-19 claim is ever denied after a consultation with us, we will credit the entire cost of the consultation to the appeal fee.

Ben Glass
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Ben Glass is a nationally recognized car accident and ERISA disability attorney in Fairfax, VA.