Long Covid and LTD Claims

December 13, 2022 | J. Price McNamara
Long Covid and LTD Claims
Long Covid and LTD Claims

​While it seems the Covid-19 pandemic is nearing a close, there are still high case numbers and lasting effects of the disease. Those who survived Covid often have lingering effects, and many think it is all in their head. Previously coronavirus sufferers were told the lingering symptoms they experienced were related to something else. It is important to know about long covid and LTD claims. A similar situation occurred after the influenza pandemic of 1918-19, where those who survived suffered from depression, tremors, and nervous system complications. For more information, reach out to a long-term disability lawyer.

Long Covid Research and Clinics

However, after some research and recurring symptoms in Covid survivors, long Covid clinics are opening up. Sadly, there are delays in getting into these clinics, and frontline medical workers do not have the training and resources they need to treat long Covid. It is the third year of the pandemic, and those suffering from long Covid need and deserve answers. Aside from the medical repercussions that people are suffering, there are also financial burdens because long Covid prevents people from working, resulting in them losing their health insurance and other benefits. While we do not have the solution for your medical concerns, we have options for your financial losses.

What Is Long Covid?

The definition of long Covid is broad, making it challenging to determine who has the condition and the proper treatment plan. The CDC defines long Covid as persistent symptoms lasting more than four weeks, while WHO sets the bar at symptoms lasting over two months. They also state that the symptoms cannot result from another illness or disease. The two agencies do agree on some long Covid symptoms including:
  • Brain fog
  • Digestive symptoms
  • Cognitive dysfunction
  • Shortness of breath
  • Fatigue
  • Depression
  • Anxiety
  • Headaches
  • Cough
  • Sleep disturbances
The CDC only requires you have one symptom on the list lasting over four weeks to fall into the long Covid category. Sufferers of long Covid have reported experiencing severe fatigue. They are bedbound after doing daily tasks like brushing their teeth. There is some pushback, as other respiratory diseases can have similar symptoms. The elderly are more susceptible to experiencing long Covid because they are already in frail health. It is essential to include all symptoms of long Covid but also have stricter guidelines, so there are better treatment plans and accurate reporting.

Medical professionals throw their hands up

While the research and clinical trials are in motion, they don’t have sufficient participants, and those suffering from long Covid are losing patience. Sufferers are becoming so desperate they are looking for alternative treatment options to get through the day. They want answers and to get back to their daily life sooner rather than later. Currently, medical professionals are left using trial and error and creativity to treat sufferers, which is dangerous. Some doctors do not know where to begin, and they are becoming so frustrated from being unable to help the patients they see daily. The people in charge of these studies ask for patience because they say finding a solution is complex. Antiviral infections require the analysis of:
  • The immune system
  • Autoimmune conditions
  • Cardiovascular mechanisms
  • Neuropsychiatry
  • Metabolic symptoms
  • Viruses
These studies require teams of people and many volunteers to break ground. While long Covid sufferers understand these hurdles, their conditions are not improving, and they do not have time to sit around waiting for these teams to get it right. Officials say that help is on the way, and when it gets here, it will be life-changing.

Surviving Covid but not getting better

Over seven million people have been infected with coronavirus over the last few years, and while there have been countless deaths, there has also been a myriad of survivors. You might think being a survivor is the best thing to happen to you, except long Covid is plaguing many survivors with debilitating symptoms. Imagine surviving the illness but being stuck at home for months, out of breath, and visiting the hospital every month, begging for answers. That is precisely what long haulers are dealing with, and they not only need long-term medical attention but a way to supplement the income they are no longer getting after losing their jobs.

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From active to inactive

One woman in Los Angeles was an extremely active person before she suffered from the coronavirus. After falling ill, she cannot do any physical activity without suffering more harm. Her previous hobbies of kayaking, hiking, and white water rafting are no more. Even showering is difficult for her, and not having answers only worsens it. Another woman from Atlanta experiences daily chest pain, dizzy spells, and internal shaking. There are days when she cannot speak and sleeps on a recliner because she cannot lie flat. Her job requires her to speak for her entire shift, and since she can only talk for fifteen minutes at a time, her career options are slim. One man from Las Vegas describes post-Covid as worse than when he had the infection. He now struggles to get up the stairs and is always dizzy. His ride-share business is nearly shutting down because he cannot drive. When he sees his doctors, they have blatantly told him, “it’s just in your head.” When professionals tell people it is in their heads, it is difficult to get proper care and be taken seriously, especially when seeking benefits. While many are in disbelief and denial of long Covid, steps are being taken to address the condition. You can file for long term disability to address some of the financial burdens of being a long hauler.

Long term disability

Long Covid and LTD ClaimsLong term disability is a benefit that employees receive when they suffer an injury or illness that leaves them unable to work. Covid might fall into the category of a disease that leaves a person unable to work for an extended time. Unfortunately, long-term disability companies are keen on denying valid claims, making it more stressful for people trying to get better. The insurance policy favors the insurer, making it challenging for policyholders to obtain the benefits they are paying for. You need a long-term disability attorney to fight for you and ensure you can access the benefits you invested in.

The insurance company

The insurance company with your long-term disability policy is a for-profit business and doesn’t intend to pay benefits whether it is a valid claim. The way they maximize profits is by collecting premiums and minimizing payments in claims. If you become disabled, you cannot work, and your policy is supposed to step in and provide benefits during your time away. When there is a legitimate claim that is undeniable, they will approve short-term disability benefits while they find evidence to deny future compensation. Policyholders will often take what they can get and not fight back out of fear. Do not fear these companies and instead work with a long-term disability attorney.

The definition of disability

The key to getting a benefit approval is your condition meeting the disability definition of the insurance company. Unfortunately, there is no blanket definition, and each insurance company has its definition. If you are unsure what constitutes a disability under your policy, review it and speak to a long-term disability attorney.

Denials

Insurance Companies will issue denials on technicalities and use medical consultants against your regular physician’s diagnosis. Of course, the insurance company will accept the diagnosis of the paid medical consultant on their team over your physician. These tactics are how you will receive a claim denial. Another tactic they will use is to have you sign waivers authorizing them to access all of your medical documents. You think this is protocol; of course, you want them to see that you have a disability and cannot work. The truth is they want to review your medical documents to find another reason why you have a disability. Suppose you are suffering anxiety and shortness of breath from long Covid; they will review past medical records that show you had a respiratory infection ten years prior and cite that as the reason for your current issues. The insurance company will look as far back as they legally can to find any way to deny your valid claim. They don’t care that these records far precede your disability date; they care they are saving money. It will feel like an invasion of privacy, and to some degree, it is, but since you gave them written authorization, they are within their legal right to access these documents. Don’t let them get the upper hand, and avoid signing anything without first discussing it with your ERISA attorney. Lastly, the insurance company will hire a private investigator to take videos of your activities that your disability should prevent you from. The activity might be simply walking around the block to build your stamina. Some of these activities are authorized by your doctor, but the insurance company will still argue that if you are genuinely disabled, you should not be participating in these activities.

Seeking benefits

The process for seeking benefits will rely on your employer since this is an employer-sponsored program. Full-time employees can access health, life, dental, vision, and disability insurance. You will first review your disability benefits; if you do not have the benefit plan handy, you can request it from your human resources department. Refrain from assuming that your short-term benefits will roll into long-term benefits. You must take action to seek both types of disability benefits.
  • Step one: Request the forms.  Speak to the human resources department to get all documentation you need to seek benefits such as forms, instructions, and more. If the employer refuses to provide these documents, contact the insurance company.
  • Step two: Complete and submit the forms. Once you have all the applicable forms, you must fill them out. They will require personal information like your name, date of birth, social security number, the last date worked, and the date of onset of your illness. You will also need to state your reason for disability.
  • Step three: Get your employer’s statement. Your employer needs to provide a statement to the insurance company regarding your disability and general employment information.
  • Step four: Get your doctor’s statement. Your regular physician must also provide a statement regarding your condition and future prognosis. It is best if you take the forms directly to your doctor and have them complete them while you are in the office to avoid discrepancies.
  • Step five: Submit supporting documentation. You must submit all documentation the insurance company requires and any additional information you deem fit. You need evidence when seeking benefits, and doctors and employers are not on top of collecting and providing these elements.

Long Covid and long term disability

Long Covid is a debilitating condition that can impair a person for months or years. Short-term disability benefits are not enough for you to live and recover. You require additional assistance and are paying a premium for LTD. it is your right to access these benefits when needed. Some long Covid cases resolve within the year and leave sufferers with restrictions, but they are okay to return to work. Other cases are grim and require additional assistance. Speak with a long-term disability lawyer to discuss your benefits.

Why you need a long-term disability attorney

Long Term Disability Lawyer, J. Price McNamara
Coronavirus is still an unknown and challenging virus, and everyone experiences something different. Recovery is different for every case, and what works for some won’t for others. Mild and severe designations make no difference in whether or not you will be a long hauler. Age and pre-existing conditions also do not indicate whether you will have lingering symptoms. There is no way to know which patients will be long haulers and which will recover fully. We know that victims of long Covid have an uphill battle. You need to hire a long-term disability attorney because insurance companies are not paying our claims for long Covid, and many doctors deny the existence of these conditions. If you seek benefits and receive a denial, you must immediately speak with a long-term disability lawyer before you seek an administrative appeal. Contact us for more information,
J. Price McNamara Author Image

J. Price McNamara

Attorney

Losing my own brother, then my father and sister after long, disabling illnesses just a few months apart drove a career change for me. Before that experience, I never truly understood the place you’re in. I never understood the dramatic impact that receiving (or not receiving) the disability and life insurance benefits you paid for and counted on can have on your life especially when you need to focus on family and healing. What I experienced with my own family now drives the way I view my clients and my work, and I will never forget it!

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