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kotak: many long-haulers not yet recognized as eligible for disability benefits

insurance companies that don't recognize the debilitating symptoms after covid infection are leaving people with long-haul covid out in the cold.

by nainesh kotak

feb 9 2022

3 minute read

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kotak: long-haulers not recognized as eligible for disability benefits

unfortunately, long-haul covid is likely a phenomenon that will be around for years to come. getty

there’s a cruel twist to the devastation of covid-19 for too many canadians. not only did they suffer through the initial illness, but sometimes, weeks or months later, they find themselves still experiencing symptoms — or worse, they develop new ones that are debilitating, disabling and life-changing.

many canadians, have applied for disability benefits while they manage long-haul covid, but this can be fraught with difficulties. first of all, without a recognized pcr or other medical test, a diagnosis of the virus can’t be proven. with little research around long-term impacts of covid, some insurance companies don’t recognize it as a disease, dismissing disability claims due to “insufficient medical evidence.” unfortunately, once denied long-term benefits, some canadians have turned to government programs for help, only to see the financial support run out, and have had to sell their vehicles or homes to survive financially.

helping long-haul covid sufferers is no different than managing a chronic fatigue case or even a chronic pain case — what is more difficult, though, is the newness of the ongoing symptoms.

what exactly is long-haul covid?

even the world health organization (who) struggles to define long-haul covid. in october 2021, it published a study defining it as: “occurring in individuals with a history of probable or confirmed sars-cov-2 infection, usually three months from the onset of covid-19, with symptoms that last for at least two months and cannot be explained by an alternative diagnosis.” the report goes on to describe common symptoms as “fatigue, shortness of breath, cognitive dysfunction, but also others and generally have an impact on everyday functioning,” and that “symptoms may be new onset following initial recovery from an acute covid-19 episode or persist from the initial illness… they may also fluctuate or relapse over time.”

many years ago, chronic fatigue syndrome and fibromyalgia were not recognized the way they are now. but over time, these disabilities have been established, diagnosed by medical professionals and accepted by insurance companies. i suspect long-haul covid will go through the same process, but because it’s new right now, insurers will find ways to deny claims based on insufficient medical evidence until there is more research and decisions made in court.

if you are a long-hauler, you need evidence

it’s important for long-haul covid sufferers to build medical evidence by relying on their family physician to record their symptoms and provide referrals to specialists, as needed. the important thing, of course, is to have your physician as an ally.

if you don’t have a family doctor, long-haulers should use the same clinic for appointments — continuity of treatment makes it easier to gather evidence. every time you see a physician, they take notes of what you say, which will then be given to the insurance company, and could help you get approval for your disability claim.

what if your claim is denied?

since disability policies are really about function, with most having provisions for being totally disabled or unable to perform functions of a job, when our firm gets an insurance benefits denial case, we ask the treating physician— or an expert — how covid-19 continues to affect a patient’s abilities to work and live. the impact can be devastating.

a pan-canadian long covid impact survey from may 2021 of more than 1,000 covid-19 long-haulers in canada, found that 60 per cent of respondents had to take time off from work because of long-term symptoms, while 69 per cent had to reduce their workload; the public health agency of canada says 10 per cent of those with long covid-19 are left unable to return to work in the long term; and a september 2021 ontario covid-19 science advisory table briefing said a conservative estimate suggests between 57,000 and 78,000 ontarians had — or are currently experiencing — long-haul covid symptoms.

unfortunately, long-haul covid is likely a phenomenon that will be around for years to come — and we find that what makes insurance companies listen is litigation.

nainesh kotak , is the founder of kotak personal injury law, a firm focusing on protecting their client’s rights to justice and obtaining the compensation their clients deserve. he also serves as the chair of the long-term disability section of the ontario trial lawyers’ association.

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kotak: many long-haulers not yet recognized as eligible for disability benefits

insurance companies that don't recognize the debilitating symptoms after covid infection are leaving people with long-haul covid out in the cold.

what exactly is long-haul covid?

nainesh kotak: disability benefits reduce risk while providing peace of mind

my disability claim has been denied. now what?

if you are a long-hauler, you need evidence

what if your claim is denied?

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kotak: many long-haulers not yet recognized as eligible for disability benefits

insurance companies that don't recognize the debilitating symptoms after covid infection are leaving people with long-haul covid out in the cold.

what exactly is long-haul covid?

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nainesh kotak: disability benefits reduce risk while providing peace of mind

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if you are a long-hauler, you need evidence

what if your claim is denied?

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