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Feb 24, 2021

"Long-Hauler" Disability Claims Start To Trickle In

      From National Public Radio:

When COVID-19 first arrived in the U.S., Jodee Pineau-Chaisson was working as the director of social services for a nursing home in western Massachusetts called Center for Extended Care in Amherst. By the middle of April, residents were getting sick.

In early May, Pineau-Chaisson was tapped for a particular duty: "I was asked to go on to the COVID-19 units to do FaceTime calls, so they could say goodbye to their family members," she recalls. "I was very scared."

She was worried about contracting the virus, but also felt like she owed it to her residents. So, at 55 years old and with no pre-existing conditions, Pineau-Chaisson put on an N95 mask, a white jumpsuit, and she entered the units to help. Three days later, she had COVID-19. ...

It's now been almost ten months since Pineau-Chaisson got sick, yet she is still dealing with a series of devastating ailments. She says she has memory problems, body pain, heart palpitations, depression and chronic fatigue. ...

Pineau-Chaisson is a so-called long-hauler. These are people who survive COVID-19 but have symptoms – sometimes debilitating symptoms – many months later. As scientists scramble to explain what is going on and figure out how to help, disability advocates are also scrambling: They are trying to figure out whether long-haulers will qualify for disability benefits.

Disability advocates and lawmakers are calling on the Social Security Administration or SSA to study the issue, update their policies and offer guidance for applicants.

"If we end up with a million people with ongoing symptoms that are debilitating, that is a tremendous burden for each of those individuals, but also for our healthcare system and our society," says Dr. Steven Martin, a physician and professor of family medicine and community health at UMass Medical School.

"We know what's coming. So, we have to make sure that we're on top of this," says U.S. Rep John Larson, a Democrat from Connecticut, who joined with another member of Congress to write a letter asking the SSA to work with scientists to understand what support long-haulers might need. ...

In a statement, the SSA told NPR that the current disability policy rules should be sufficient for evaluating COVID-related applicants, though the agency did not rule out taking additional action in the future. "Researchers are still learning about the disease and we will continue to look at our policies as research evolves," the statement said. ...

     As I've said before, it's easy for me to predict what Social Security will do with post-Covid "long hauler" cases. They'll delay and delay and delay doing anything with the claims. They'll then deny virtually every one of them but many will be approved after a hearing. Meanwhile, the agency will release a vague Ruling that will give no criteria whatsoever that could be interpreted as a standard by which a claim could be approved or, for that matter, denied. The Ruling will say that all evidence must be considered, blah, blah, blah. The agency is quite experienced in issuing such Rulings that seem to say something but which actually say nothing. If you refuse to say what the standard is, no one can blame you for not following the standard.

     By the way, I have my first post-Covid long hauler case now. Other attorneys tell me that they're starting to see a trickle of these cases. No one has any idea whether this will stay a trickle or become a flood but there's evidence that a significant percentage of those who suffer even mild cases of Covid-19 are still having symptoms six months later so the flood scenario is quite real.

8 comments:

  1. I have been representing claimants since the mid 2000s. I also suffer from chronic fatigue syndrome. I suspect Covid will be something like this after getting over the horrible breathing issues. ALJs will probably handle it like fibromyalgia or chronic fatigue where they know it exists but some do not buy it because it is nebulous. We will see.

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  2. I don't see the problem with evaluating long-term COVID symptoms like SSA does with a number of other impairments that don't have their own listings or SSRs with specific diagnostic, etc. criteria (in terms of establishing as an MDI or finding disability).

    COVID appears to potentially effect multiple body systems for long periods. Simply evaluate the COVID symptoms in terms of those affected body systems. Sure, you're limited to only medically equals or a disabling RFC, but that's the situation with a number of other impairments.

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  3. @12;12. agreed. Not sure why anyone is making an issue of this. There are lots of impairments that affect multiple body systems and are hard to diagnose...yet cause real functional limitations. Nothing new here

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  4. Latest addition to the disability lotto, cant define it, tests dont show it, i must have it.

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  5. @8:13 AM

    The public perceives it as a game of chance because it functions like a game of chance. And yes, it can be difficult to deal with an illness whose effects can't all be measured in clear objective terms. But that's true of most illnesses. And it's precisely why ruling 16-3p sets forth a wholistic set of criteria to be viewed when evaluating claimants' symptoms. If you're not capable of going further than throwing up your hands and saying "if I can't see it, it ain't real," then you're not up for this kind of work.

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  6. Keep in mind that HIV had been around for over a decade when SSA finally posted HIV infection listings in 1993. The listing was based on 1987 AIDS-defining illnesses identified by the Centers for Disease Control and Prevention. Prior to the listing, however, there was guidance on how to allow claims, also looking at multiple body systems, and using the CDC info for guidance.

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  7. SSD wasn't designed for these ill defined impairments. It started out as a program for worn out manual laborers who couldn't carry 50 pounds anymore. The claimant pool and reps and particularly public assistance agencies have flooded the program with different cases, including the notable subcategory of physically strapping men in their 30s and 40s with criminal records and substance abuse and old diagnoses of schizoaffective disorders. The system wasn't designed for this and was slow to adjust.

    DDS exists to deny 80% so these COVID cases will be alien to them. The ALJs will grant most, until themselves replaced by career Appeals Council attorneys who've never spent a day in court in their lives and will be forced in just to create a uniform 80% denial rate at all agency levels.

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  8. DDS will likely deny these cases because it’s going to be difficult to assume every long hauler will have symptoms that will last at least 12 months since there is variance in that duration, and they’ll most likely be looking at the record far less than 12 months after the Covid diagnosis. By the time it gets to OHO, there’s a better chance of having 12+ months of records related to the condition to evaluate, do I would naturally suspect a higher approval rate.

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