Can I Get Social Security Disability or SSI for Long COVID?

Long COVID, or "long-haul COVID," is a term to describe the long-term effects of a coronavirus infection. Long COVID is generally defined as symptoms or conditions that continue or develop after a COVID-19 infection. Researchers have found that patients who've had COVID-19 can develop long COVID whether their initial illness was serious or not.

Generally, researchers define chronic COVID-19 as extending beyond 12 weeks, but the symptoms can, in fact, last many months or even years. Long COVID is sometimes also referred to as post-COVID syndrome, post-acute COVID syndrome (PACS), or post-acute sequelae of COVID-19 (PASC).

And it's more common than you might think. Based on the Household Pulse Survey conducted by the National Center for Health Statistics (NCHS), it's estimated that more than a quarter (28.8%) of the adults in the United States who've had COVID also developed long COVID symptoms.

Long COVID is recognized as a condition that could result in a disability under the Americans with Disabilities Act (ADA). But can you qualify for Social Security disability for long COVID? That depends on several factors, including your symptoms and how the syndrome affects your ability to work.

What Are Symptoms of Long COVID?

Long COVID doesn't affect everyone the same way. Symptoms can vary widely. According to the CDC, those who experience long COVID most commonly report the following symptoms:

• respiratory and heart symptoms
• shortness of breath or breathing difficulty
• coughing
• chest pain
• rapid heartbeat or pounding heart (also known as heart palpitations)
• neurological symptoms
• difficulty thinking or concentrating ("brain fog")
• headaches
• insomnia
• dizziness when standing (lightheadedness)
• pins-and-needles feelings
• loss of smell or taste
• depression or anxiety
• digestive symptoms
• diarrhea
• stomach pain
• other symptoms
• tiredness or fatigue that interferes with daily life
• symptoms that get worse after physical or mental effort (also known as "post-exertional malaise")
• fever
• joint or muscle pain
• rash, and
• changes in menstrual cycles.

Can You Get Social Security Disability for Long COVID?

Some long-haulers can't work because of the severity of their symptoms and limitations and have applied for disability benefits.

Getting Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) disability benefits because of long COVID symptoms can be extremely difficult, partly because of the way Social Security defines disability.

The Social Security Administration (SSA) hasn't added COVID, long COVID, or post-COVID syndrome to its list of impairments that can automatically qualify for disability. To get disability benefits for a condition that's not listed, both of the following must be true:

1. You must have a "medically determinable impairment," and
2. You must be unable to work any job for at least 12 months.

And for Social Security to recognize your impairment as long COVID, you must have evidence of a past coronavirus infection such as a record of a positive COVID test, a doctor's diagnosis of COVID, or a record of hospitalization for COVID.

Most tests that show you have COVID antibodies won't satisfy this requirement because antibodies can develop as the result of receiving a COVID vaccine.

For certain lingering symptoms, but not all, there are diagnostic tests that can indicate past infection. But many of the symptoms of long COVID don't show up on tests like X-rays or blood panels.

Social Security has provided some guidance on this point (and the CDC has released guidelines saying that lab tests aren't required to establish post-COVID syndrome).

Guidance From Social Security on Post-COVID Syndrome

In August 2022, Social Security released an emergency message (EM-21032 REV) updating its earlier guidance on how its employees should handle applications that allege "post-COVID conditions" and specifically addressing long COVID.

The emergency message also acknowledges the existence of post-COVID conditions in children, specifically, Multisystem Inflammatory Syndrome in Children (MIS-C), a rare and sometimes severe condition some children develop after having COVID. MIS-C can affect the child's:

• heart
• lungs
• kidneys
• brain
• skin
• eyes, or
• gastrointestinal tract.

The message recognizes that MIS-C symptoms can be chronic and long-term and instructs that it should be evaluated using existing policies for unlisted conditions.

This message isn't a medical ruling, but it does include some discussion on how the agency determines whether someone who can't work due to long COVID is eligible for benefits. (For the most part, the agency says it will use its current listings and rules to analyze the condition.) But the updated guidance says that, to find your post-COVID symptoms disabling, Social Security representatives must first answer whether you have a medically determinable impairment (MDI) that's kept you from working for at least 12 months?

An MDI must be established by "medical signs" and laboratory findings rather than a patient's subjective complaints alone. According to the message, to find that long COVID is a medically determinable impairment, Social Security needs to see one of the following:

• a positive viral test for SAR-CoV-2 (not an antibody test)
• a diagnostic test consistent with COVID (for example, a chest x-ray), or
• a diagnosis of COVID with signs consistent with COVID (for example, fever and cough).

If the evidence indicates a false positive viral test, Social Security won't count it.

In addition to the MDI criteria, your COVID-related impairment must also prevent you from working for 12 months. But again, Social Security will consider more than just long COVID symptoms in determining the duration of your impairment(s). If COVID causes a new impairment, such as kidney disease, or worsens an existing impairment, such as COPD, that could help you meet the 12-month requirement.

Unfortunately, if it's unclear when your long COVID symptoms will resolve, Social Security could defer a decision on your claim for several months.

Social Security might release additional directives or a "policy interpretation ruling" as the CDC learns more about post-COVID syndrome, but it's unlikely to create a listing for the condition. For example, Social Security released guidance on chronic fatigue syndrome in its ruling SSR 14-1p in 2014, but the agency still hasn't added a listing for the condition.

In some cases, however, Social Security will create a listing for a syndrome after studying it in depth; for example, after years of relying on a ruling for guidance, Social Security created a listing for post-polio syndrome, a post-viral syndrome to which many studying long-term COVID have drawn parallels.

How Will Social Security Decide If You're Disabled by Long Covid?

Social Security follows a specific five-step process to determine disability. After confirming you're not doing a significant amount of work and have a medically determinable impairment (MDI), Social Security will next determine if your condition is so severe that it's of "listing level" severity.

While there's no listing for post-COVID syndrome, Social Security might find that your symptoms make you just as disabled as someone who meets the requirements of a listing. The agency will compare your symptoms and limitations to the criteria of any relevant medical listings to see if your limitations rise to the same level of severity.

For example, if your COVID illness caused lung damage and you developed a chronic respiratory disorder, but you don't have the exact lung function test results you need to meet the listing for respiratory disorders, Social Security could find that your condition "equals" the listing.

If your long COVID doesn't equal a listing, Social Security will assess your residual functional capacity (RFC) to determine whether you can perform any job, considering your:

• symptoms
• stamina, and
• endurance.

If no full-time jobs exist that you can do with your limitations, the agency can grant you benefits.

How Social Security Evaluates Common Long COVID Symptoms

Let's take a look at how Social Security might assess some common long COVID symptoms.

Physical Symptoms of Long COVID

For post-COVID syndrome, there are various listings that the agency could look at, depending on your symptoms. Many long COVID sufferers have physical symptoms that fall into five categories:

• fatigue and endurance issues, very similar to what happens in myalgic encephalomyelitis (ME)—more commonly known as chronic fatigue syndrome (CFS). Viral infections can trigger ME/CFS. (Learn more about getting Social Security disability for CFS.) Many people with post-COVID symptoms also report having insomnia, which can lead to fatigue.
• malfunctioning of the autonomic nervous system, as in postural orthostatic tachycardia syndrome (POTS). POTS can cause fainting and dizziness after standing or sitting up, as well as tachycardia, a fast heartbeat. (Learn more about how Social Security determines eligibility for POTS.)
• long-term respiratory difficulties, similar to those with scar tissue from pneumonia or acute respiratory distress syndrome (ARDS). (Learn more about how other respiratory difficulties, like pneumonia, COPD, and sleep apnea, are evaluated for Social Security disability.)
• cardiovascular problems from lasting damage to the heart muscle (cardiomyopathy), potentially causing congestive heart failure (CHF) or myocarditis leading to arrhythmias or chronic pulmonary hypertension. (Learn more about how Social Security evaluates CHF and arrhythmias.)
• musculoskeletal aches and pains, such as muscle or joint pain caused by myositis (muscle inflammation), myofascial pain (pain and tenderness in muscle fascia), or "reactive" arthritis. (See our article on rheumatoid arthritis for more information.)

Cognitive and Mental Symptoms of Long COVID

The majority of COVID long-haulers report problems with memory and brain fog (difficulty thinking and concentrating), sometimes in addition to headaches or the loss of the sense of smell or taste.

Doctors think at least some of these cases are caused by encephalitis (inflammation of the brain due to viral infection). The cognitive problems of long COVID are similar to those reported after encephalitis stemming from Lyme disease, another illness with a post-viral syndrome.

Social Security could use the listing for neurocognitive disorders (12.02) to evaluate long-COVID sufferers who are experiencing cognitive difficulties. Those with physical and mental problems could try to "equal" the listing for traumatic brain injuries.

Post-Intensive Care Syndrome

Long-haulers who were ventilated or hospitalized with severe COVID can suffer from what's known as post-intensive care syndrome (PICS). Patients with PICS often suffer from some or all of the following:

• long-term muscle weakness
• fatigue
• cognitive deficits, and
• mental health issues like anxiety or depression.

And some people with PICS need long-term supplemental oxygen. Sometimes these conditions are severe enough to qualify for disability. (Note, however, that receiving supplemental oxygen alone doesn't establish "listing-level severity" of a respiratory disorder, per Social Security's emergency message.)

Can You Improve Your Chances of Getting Disability for Long Covid?

You'll need to show Social Security three main things to get disability benefits for long COVID:

• a diagnosis, with signs of your illness and a record of your symptoms
• evidence of your limitations and how they affect your ability to work, and
• documentation that your inability to work has lasted, or will likely last, 12 months or more.

Keep going to your doctor or specialists to document your symptoms and how your limitations keep you from leading a normal life or being able to work. Get a diagnosis, not just of post-COVID syndrome, but of the underlying mechanisms making you sick. For instance:

• If you have respiratory issues, get referred to a pulmonologist who can give you lung function tests.
• If you faint after prolonged sitting or standing, or you have chest pain, get a referral to a cardiologist.
• If you're exhausted after the least bit of activity (known as "post-exertional malaise"), you should probably see a rheumatologist.
• If you're having cognitive issues, be sure to get a neurological evaluation before applying for disability benefits.

It's difficult to figure out the tests you need or the specialists you should see without being a doctor yourself. So your first step should be to see your primary care doctor, who can refer you to the appropriate specialists depending on your symptoms.

Next Steps You Can Take

In the meantime, if you have a short-term disability policy through your work, consider filing for short-term disability insurance benefits; if not, check if your state is one of the few that has a state temporary disability program.

Getting disability benefits for long-haul COVID isn't going to be easy. Those with existing severe impairments that were made worse by COVID probably have the best chance of getting benefits.

Others might need a disability lawyer. An attorney knows how to propose a theory to Social Security as to how and why your condition equals a specific listing or why and how your RFC has been significantly reduced by long COVID limitations.

To succeed in this, you'll also need to ask your doctor(s) to provide supporting medical evidence to back up the theory. An experienced disability lawyer can work with your doctor to get the evidence you need.

Learn more about the kind of evidence required by Social Security.

_{Updated July 20, 2023}