Long-Term Disability Claims for Long COVID (PASC)
You survived the infection, but you never got better. Now, you’re left with crushing fatigue, “brain fog,” and a dozen other symptoms. Why is your insurer treating your Long-COVID claim like it isn’t real?
Long-COVID, officially known as Post-Acute Sequelae of SARS-CoV-2 (PASC), is a new and devastatingly complex medical condition. You may have been a high-functioning professional before your infection, but you are now left with a cluster of “invisible” symptoms that make work impossible. Your condition is real, and it is recognized by the CDC and NIH as a serious medical issue.
However, insurance companies are in uncharted territory, and their default response is to **deny.** They are treating Long-COVID claims just like they have treated Fibromyalgia and Chronic Fatigue Syndrome (ME/CFS) for decades: with extreme skepticism and a playbook designed to reject “subjective” illnesses. At Uscher, Quiat, Uscher & Russo, P.C., we are on the front lines of this new legal battle. We are applying our decades of experience with “invisible illness” claims to fight for Long-COVID sufferers.
Why Long-COVID Is a Genuinely Disabling Condition
An insurance adjuster cannot see your “brain fog” or feel your “crash.” They will try to deny your claim because your symptoms are “self-reported.” We know that these symptoms are very real and make a 40-hour work week impossible.
Long-COVID is a multi-systemic disease that can include:
- Severe Cognitive Dysfunction (“Brain Fog”): This is one of the most common and disabling symptoms. It includes memory loss, an inability to concentrate, difficulty with word-finding, and slow processing speed. For a professional, this is a career-ending impairment.
- Debilitating, Pervasive Fatigue: Similar to ME/CFS, this is a profound, “bone-deep” exhaustion that is not relieved by sleep.
- Post-Exertional Malaise (PEM): This is the “crash” that follows even minor physical or mental activity. A single important meeting or a trip to the grocery store can leave you in bed for days, making a consistent work schedule impossible.
- Postural Orthostatic Tachycardia Syndrome (POTS): Many Long-COVID patients develop POTS, a blood circulation disorder that causes dizziness, fainting, and a racing heart upon standing. This can make it impossible to even sit at a desk for long periods.
- Other Symptoms: A constellation of other issues, including chronic pain, shortness of breath, and severe headaches, can make work a daily, painful struggle.
How & Why They Deny Long-COVID Claims
The insurance company’s entire strategy is based on one word: “objective.”
Tactic 1: “No Objective Evidence” (The Primary Weapon)
Because Long-COVID is new and its mechanisms are still being studied, there is no single “test” for it. Your basic bloodwork and chest X-ray may come back “normal.” The insurer will seize on this, claiming there is no “objective” medical proof of your condition or your limitations. They will dismiss your very real symptoms as “subjective” or “anxiety.”
Tactic 2: Attacking the Diagnosis
The insurer’s “paper-only” doctor will review your file and claim your symptoms are “non-specific.” They will say that since there is no “official” diagnostic criteria, your doctor’s diagnosis of Long-COVID is just a guess. They will try to create doubt around the very existence of your condition.
Tactic 3: The “Mental Health” Limitation
This is a cynical and dangerous tactic. The insurer will argue that your fatigue and “brain fog” are “all in your head” or are “caused by” the stress and anxiety of the pandemic. Why? Because many policies have a 24-month cap on benefits for “mental/nervous” conditions. By re-characterizing your neuro-immune illness as a mental one, they try to limit their financial payout.
How We Build a Winning Appeal for Long-COVID (The ERISA Trap)
When your insurer denies your claim, you have one chance to appeal. This appeal, governed by a federal law called ERISA, is your one and only opportunity to build your case. You cannot add new evidence later. This is why it is critical to build a fortress of evidence *now*.
So, how do you “objectify” a new and “invisible” illness? You use every tool available.
1. We Objectify Your “Brain Fog”
This is the most critical piece of evidence. We will send you for a **Neuropsychological Evaluation.** This is an extensive, multi-hour series of tests that provides hard, objective data on your memory, processing speed, and concentration. When this report shows your cognitive function is in the “impaired” range, the insurer can no longer claim your “brain fog” is just “subjective.”
2. We Objectify Your Physical Limitations
We may commission a **2-day Cardiopulmonary Exercise Test (CPET)** to get objective evidence of post-exertional malaise. We can also use a **Functional Capacity Evaluation (FCE)** for physical data. If you have POTS, we get clear documentation from a Tilt-Table Test. We gather every piece of objective data that exists.
3. We Get Medical Opinions That Matter
We work with your Long-COVID clinic, your pulmonologist, your cardiologist, and your primary care doctor to write detailed narrative reports. These reports tie all your symptoms together, explain the diagnosis, and state unequivocally why your constellation of symptoms prevents you from performing the duties of your job on a reliable, full-time basis.
4. We Prove Your “True” Occupation
We hire a vocational expert to write a report on the *actual* cognitive and stamina demands of your job. This report proves that your career required 100% reliability and concentration—things your Long-COVID has made impossible.
Long-COVID Is Real. Your Disability Is Real.
We are at the forefront of this new and complex area of disability law. We are fighting for Long-COVID patients every day, and we are applying our decades of experience to win these challenging cases. You are not a test case. You are a person with a real illness who deserves to be protected.
If your long-term disability claim for Long-COVID (PASC) has been denied, contact us today for a free, confidential consultation. Let us take on this fight for you.
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