Though the case detailed below is specific to the first year of the COVID pandemic, and the uncertain, existential threat that accompanied it, the case highlights a lesser known but crucial existing legal precedent that applies in certain circumstances. Can vulnerability to life-threatening illnesses be considered a disability, even if the individual isn’t currently suffering disabling symptoms?

Unique circumstances

In Downs v. Unum Life Ins. Co. of Am., the plaintiff, a 70-year-old practicing pediatrician, was forced to undergo surgery to remove her uterus and a precancerous tumor. She also had a history of cancer, heart disease, diabetes and asthma. During her post-surgical recovery, the COVID-19 pandemic washed over the planet, causing unprecedented shutdowns and the threat of severe illness or death, even to those who were young and healthy.

Considering her overall health, age, and her occupation involving exposure to sick children, the plaintiff determined that exposure to COVID was an unacceptable risk to her health and life, so she applied for long-term disability benefits. Unum disagreed about this risk and the case went to court.

In the first COVID-related decision of its kind, the court had to weigh “whether a present condition that puts a beneficiary at high risk of COVID-19 but would not otherwise prevent them from completing their usual occupational responsibilities constitutes a disability.” The court ruled in the affirmative, siding with the plaintiff.

How precedent played a role

While considering his decision, the judge reviewed several previous non-COVID-related cases where courts concluded that the mere risk of a life-altering or life-threatening relapse could constitute a disability. This applied even in situations when the subject was not presently disabled.

The circumstances in the case above were unquestionably exceptional, but pandemics notwithstanding, a significant number of people live with severe autoimmune disorders and similar conditions that drastically limit their actions and activities. People who receive such transformational diagnoses should be aware that long-term disability benefits may be available to them.

Of course, profit-minded insurance companies may push back on these claims. People who believe that continuing to work poses a legitimate risk to their survival should gather the requisite supporting medical evidence and apply for benefits. If the insurance provider denies the claim, they may still find salvation in the courts.