A growing number of people report serious long-lasting, debilitating effects from the COVID-19 virus weeks and months after infection. These people are known as “long-haulers”.
Long-haulers are characterized as those who have been sick with COVID-19 symptoms for one month or more and continue to experience the impact of the virus in every aspect of their daily functioning. The number of long-haulers is unknown, but in the USA, estimates are in the tens of thousands, which could translate to thousands of Canadians. By one estimate, 10 per cent of all COVID-19 patients will have lingering symptoms from “long COVID”.
Most long-haulers are previously fit and healthy women with an average age of 44. They often report having had only mild symptoms initially and may not have been tested for COVID-19 or may have tested negative for the virus, due to waiting too long to be tested or for some other cause of false-negative results.
Long-haulers report symptoms commonly associated with COVID-19, including fever, cough, and shortness of breath. They also report a growing list of other symptoms including gastrointestinal, cardiac, and neurological problems (such as hallucinations, delirium, short-term memory loss), and problems with their sympathetic nervous system (which controls unconscious processes like heartbeats and breathing). They often describe “brain fog”, intense fatigue, anxiety, or depression. Sleeping difficulties, pulmonary fibrosis, heart inflammation, and renal insufficiency are other symptoms. A recent study found that recovered patients with moderate-to-severe cases of COVID-19 had lasting liver function issues.
“This is a whole new source of disability,” according to Mary Ann McColl, academic lead for the Canadian Policy Disability Alliance and an epidemiologist at Queens University.
If they’re unable to work, will long-haulers have access to health insurance or disability benefits?
Many of the symptoms can come and go, and vary in severity, over time. Long-haulers may feel out of breath while their oxygen levels are normal, or they feel their heart racing while EKG readings are normal. Given the nature of these symptoms, long-haulers face skepticism from employers, doctors, and long-term disability (LTD) insurance companies. These variable symptoms affect long-haulers’ credibility and put them at risk of healthcare misdiagnosis and/or being denied LTD benefits by insurance companies.
The Canadian Life and Health Insurance Association currently has no data about the trends in COVID-19 claims. Being a new virus there is no history nor precedents, and no one can know what the effects will be in two years, or longer. With policies differing by insurer, there are no consistent answers as to why disability coverage might be denied.
Recent media reports have profiled Canadian long-haulers who are being denied LTD insurance. Daniel Lublin, a partner at Whitten & Lublin, says, “The amount of claims that are being denied are skyrocketing right now.” Lawyers tell of insurers who say they don’t cover long-hauler symptoms. Sivan Tumarkin of Samfiru Tumarkin LLP responds: “Put it back on [the] adjuster and ask them, ‘Where in the policy does it say that long-hauler symptoms are not covered?’”
Mark Yazdani, a disability lawyer with Yazdani Law Office, says a client’s eligibility should not be dependent on diagnosis. “The definition of disability varies from policy to policy, but it’s almost uniformly a variation of, ‘Do you suffer from either an illness or … an accident that has prevented you from carrying out your job duties?’ And if you have the symptoms and they’re severe enough that they prevent you from being able to do your specific job duties, then you should qualify for disability benefits, even if you don’t have a specific diagnosis.”
Insurance companies have long denied LTD benefit claims that have no objective evidence of disability or to support a condition’s severity (such as a blood test or X-ray). They are notorious for denying claims that are based only on subjective evidence, where no tests confirm the condition’s nature or severity and the sole basis for the LTD claim are self-reported symptoms or function. Long-haulers, particularly those without a positive COVID-19 test, can struggle when proving disability to insurers.
The fact that COVID-19 is a novel virus requires careful handling by lawyers, since very few consistent diagnoses are established medically, particularly for long-haulers. It will be crucial to emphasize the typical variability in symptom frequency and severity. Self-reported symptoms, restrictions and limitations must be confirmed and corroborated medically.
NOTE: Science is still learning about the novel coronavirus. This story is based on information available at the time of writing.
