Evan W. Wolfson: Social Security benefits and long covid
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The article “People with long covid face barriers to government disability benefits” (Nov. 10, TribLIVE) suggests it is difficult to obtain Social Security benefits on the basis of disability. This is certainly true, as a majority of applicants are denied at the initial determination level.
What is misleading is that the article implies the Social Security Administration has not issued any useful guidance in how to evaluate impairment from “long covid.”
Much like the impairment of fibromyalgia that was treated inconsistently and without substantial guidance by the Social Security Administration for years until the diagnosis was thoroughly addressed a decade ago by Social Security Ruling 12-2p, there will undoubtedly be difficulty in assessing “long covid” until similar guidance is issued and adjudicators gain more experience in dealing with claimants who have this condition.
The Social Security Administration recently issued an “Emergency Message,” EM-21032, which specifically addresses covid-19 and how the disability claims involving this impairment should be evaluated.
It provides what medical evidence an initial diagnosis of covid-19 needs to be based upon (a positive antibody test is insufficient as such could be an indicator of infection with a different coronavirus or receipt of a vaccination for covid-19). It cites CDC publications for reviewing long-term effects associated with infection. It further discusses long-term symptoms which can be variable in presentation. It also discusses the multisystem inflammatory syndrome found in children, which has been associated with covid-19 infection.
As a practical matter, unlike fibromyalgia, “long covid” cases will frequently involve medical tests showing damage to particular organs or organ systems. If there are co-occurring diagnoses such as COPD or heart or kidney damage, such conditions are amenable to diagnostic testing which can often show the degree of damage and at least some range of likely associated limitations. Reports of symptoms such as fatigue will be given greater weight and credibility with the existence of other medical evidence, and should still be considered even without much in the way of medical evidence of physical impairment.
As medical professionals continue to learn more about this relatively new illness, I expect the Social Security Administration will provide additional guidance and clarity in the form of rulings for agency adjudicators, disability representatives and the general public. In the meantime, we at least have a path down which to proceed.
Evan W. Wolfson is a Pittsburgh Social Security disability benefits attorney.