Social Security Disability Benefits For COVID-19 Related Illnesses

SSDI COVID-19 Related Illnesses Eligibility Guidelines

Does Your COVID-related Impairment Meet Or Equal A Social Security Listing?

Important Note: The coronavirus disease (COVID-19) is not a category of impairment on the Social Security Administration (SSA) listing of medical impairments for Social Security disability benefits. However, you may be eligible if COVID-19 has created symptoms, clinical signs and laboratory findings that meet or equal an existing SSA listing.

Unknowns And What You Can Expect
There are still many unknown factors about COVID-related claims moving forward. Some of these are:

• How many people will file COVID-related claims over the next few years?
• How will the SSA evaluate “invisible” symptoms such as chronic fatigue, migraines, brain fog, and depression brought on by COVID?
• Will the SSA adjust their rules and regulations? Will they make a COVID listing?

It is possible that the SSA will issue a Social Security Ruling (SSR) around COVID instead of a listing.

Even with all this uncertainty, here are a few things you can count on:

• You’ll need comprehensive, detailed medical documentation to prove your Long COVID or COVID-related claim.
• Allsup has already won SSDI benefits for COVID-related claims.

SSDI Eligibility Guidelines: COVID-19 Related Illnesses

1. Determine if an individual is working (engaging in substantial gainful activity) according to the SSA definition. Earning more than $1,470 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.
2. Conclude the COVID-related disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. For example:

• Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling.
• Understanding/carrying out and remembering simple instructions.
• Responding appropriately to supervision, co-workers and usual work situations.
• Dealing with changes in a routine work setting.

3. Please Note: The coronavirus disease (COVID-19) is not a category of impairment on the Social Security Administration (SSA) listing of medical impairments for Social Security disability benefits. However, you may be eligible if COVID-19 has created symptoms, clinical signs and laboratory findings that meet or equal another SSA listing.

Existing listings may include:

• Respiratory System Impairments – Medical Listing 3.03. When a respiratory impairment is episodic in nature, as can occur with exacerbations of COVID, the frequency and intensity of episodes that occur despite prescribed treatment are often the major criteria for determining the level of impairment. If any of the following are present, the individual will be found to be disabled:
• Attacks of respiratory issues that in spite of prescribed treatment and requiring physician intervention, occurring at least once every two months or at least six times a year. Each in-patient hospitalization for longer than 24 hours for control of asthma counts as two attacks, and an evaluation period of at least 12 consecutive months must be used to determine the frequency of attacks.
• Attacks of respiratory issues are defined as prolonged symptomatic episodes lasting one or more days and requiring intensive treatment, such as intravenous bronchodilator or antibiotic administration or prolonged inhalational bronchodilator therapy in a hospital, emergency room or equivalent setting. The medical evidence should include spirometric results obtained between attacks that document the presence of baseline airflow obstruction.
• Chronic kidney disease – (listed under the category of impairments known as the Genitourinary System) – Medical Listings 6.00. The following criteria have been established indicative of the inability to engage in any substantial gainful activity, i.e., if one has a diagnosis of chronic kidney disease related to COVID-19 and one of the following, a finding of disabled under the Social Security Act is warranted:
• Renal dysfunction is characterized by impairment of renal function, due to any chronic renal disease that has lasted or can be expected to last for a continuous period of at least 12 months, such as chronic glomerulonephritis, hypertensive renal vascular disease, diabetic nephropathy, chronic obstructive uropathy and hereditary nephropathies.
• Other considerations evaluated with chronic kidney disease include chronic hemodialysis or peritoneal dialysis, kidney transplantation (warrants a finding of disabled for 12 months following surgery and then further evaluation occurs), persistent elevation of serum creatinine to 4 mg per deciliter (100 ml) or greater, or reduction of creatinine clearance to 20 ml per minute or less, over at least three months, with one of the following:
• Renal osteodystropy manifested by severe bone pain and appropriate medically acceptable imaging demonstrating abnormalities such as osteitis fibrosa, significant osteoporosis, osteomalacia, or pathologic fractures, or;
• Persistent motor or sensory neuropathy; or
• Persistent fluid overload syndrome with:
• Diastolic hypertension greater than or equal to diastolic blood pressure of 110 mm Hg; or
• Persistent signs of vascular congestion despite prescribed therapy; or
• Persistent anorexia with weight loss determined by body mass index (BMI) of less than 18.0, calculated on at least two evaluations at least 30 days apart within a consecutive six-month period (medical listing 5.00G2).
• Medical evidence establishing the clinical diagnosis of nephrotic syndrome (Medical Listing 6.06) also is considered and must include a description of the extent of edema, including pretibial, periorbital or presacral edema, persisting for at least three months despite prescribed therapy with:

4. Explore the ability of an individual to perform work they have done in the past despite their long COVID or COVID-related illness(es). If the SSA finds that a person can do his or her past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.
5. Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine a person’s ability to perform other work despite a COVID-related disability, the SSA enlists medical-vocational rules, which vary according to age.

For example, if a person is:

Under age 50 and, as a result of COVID-related symptoms, unable to perform what the SSA calls sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.

Age 50 or older and, due to COVID-related symptoms, limited to performing sedentary work, but has no work-related skills that allow the person to do so, the SSA will reach a determination of disabled.

Age 55 or older and, due to the disability, limited to performing light work, but has no work-related skills that allow the person to do so, the SSA will reach a determination of disabled.

Over age 60 and, due to COVID-related symptoms, unable to perform any of the jobs he or she performed in the last 15 years, the SSA likely will reach a determination of disabled.

Any age and, because of COVID-related symptoms, has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of disabled.