Long COVID: A Case Study
Some people infected with COVID-19 may go on to experience long COVID, which can cause a wide range of health issues that can last anywhere from several weeks to even years. Symptoms vary widely and can include fatigue, respiratory and heart symptoms, neurological symptoms, fever, joint pain and/or muscle pain.
Those afflicted with long COVID may find themselves unable to work and needing to file a long-term disability claim. However, it can be difficult to prevail on these types of claims, as insurers will often try to get out of paying claims based on long COVID.
One such example is the case of Abrams v. Unum.[1] Here, plaintiff William Abrams was an appellate lawyer who was experiencing “brain fog, fatigue, decreased attention and concentration, and fevers” starting in April 2020. After Unum initially denied his claim, Abrams appealed and went to seven different medical doctors, three of whom diagnosed plaintiff with long COVID with the remaining four diagnosing him as having chronic fatigue syndrome (CFS).
Unum continued to deny his claim, stating that a mental status exam did not show the necessary cognitive deficits needed to confirm the diagnosis of CFS, and that he had not submitted enough proof that he suffered from long COVID. While the Court agreed that there may be a paucity of evidence to confirm a diagnosis of long COVID, they pointed to the fact that all of Abrams’s providers confirmed that he was indeed sick and unable to meet the demands of his prior occupation.
The Court explained that “[b]eing a trial lawyer is akin to writing, directing, producing, and starring in a play simultaneously. The work is mentally and physically grueling. A reviewer must take that complexity into account when reviewing a claim.” The record shows that prior to his illness, Abrams was an avid marathon runner and worked 12-hour days. However, after his illness commenced, his primary care doctor noted that Abrams would “not be able to put together 1-2 workdays or partial workdays in a given week.” The Court further noted that if Abrams could not follow movie plots, he “cannot be expected to plan out trial strategies for multiple, complex cases.”
While Abrams was ultimately successful with his claim, the matter required costly and time-consuming litigation before the matter was resolved in his favor. This case highlights the challenges those with long COVID face when trying to collect benefits, and the need for strong medical records and supportive physicians. If you are experiencing long COVID and feel that you might need to file a claim, please feel free to reach out to one of our attorneys directly.
Every claim is unique and the discussion above is only a limited summary of the court’s ruling in this case. If you are concerned that your insurer is not evaluating your claim under the proper standard, an experienced disability insurance attorney can help you assess the situation and determine what options, if any, are available.
[1] Abrams v. Unum Life Ins. Co., C21-0980 TSC, 2022 WL 17960616 (W.D. Wash. Dec. 27, 2022).
