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Long-Haul COVID Claims

Long-Haul COVID Claims

Long-Haul COVID Claims

COVID-19 has drastically changed the way we live, and it will also drastically change the long-term disability claims landscape. As more Americans contract and recover from COVID-19, the CDC is learning more about the long-term effects of coronavirus. These effects exist even if a patient only had mild illness and did not require hospitalization. 

Who We Help

While most people will be able to live productive lives with many of these long-term indicators, some of these symptoms, if severe, can be debilitating. If you experience long-haul symptoms such as fatigue and difficulty with concentration that cause you to be disabled from work activities, you may be entitled to disability benefits through your employer’s disability plan. We regularly help clients in situations like these:

  • You can no longer sustain your job. Long COVID symptoms make it hard to maintain a full workday, keep regular attendance, or perform consistently. You may have tried to push through and keep working, but your body will not let you continue the way you once did.
  • You never had a positive COVID test. Your symptoms line up with Long COVID, but you never received a documented positive test at the start. Now the insurer questions whether your current disability can be tied back to that original illness.
  • A reinfection made things worse. You were managing or slowly improving from Long COVID when another COVID infection set you back. You may now be unable to work at all, even though you previously had some ability to function.
  • You developed new post-COVID conditions. After COVID, you were diagnosed with conditions such as POTS, dysautonomia, or ME/CFS. These added limitations, combined with your other symptoms and diagnoses, now make working difficult or impossible.

If you find yourself in any of these situations, it is important that you consult with an experienced ERISA long-term disability attorney to help you navigate this new terrain. Our team at Roberts Disability Law, P.C. is ready to help.

The Long-Haul COVID Claims Process in California

Roberts Disability Law, P.C. takes long-haul COVID claims very seriously. Although every claim is different, most follow a similar path. Here is a general look at how our team will help you:

  1. Review your policy. We start by reading your long-term disability policy closely. The definition of “disability,” the elimination period, and any limitations for self-reported symptoms all shape how your claim should be handled.
  2. Gather medical evidence. Long COVID claims rise and fall on documentation. We work with your treating doctors to collect records, test results, symptom logs, and statements that connect your diagnoses to your inability to work.
  3. File the claim or appeal. If you have not yet filed, we help prepare a strong application. If your claim was already denied, we prepare a detailed appeal that responds to every reason the insurer gave.
  4. Meet the deadlines. Under ERISA, which governs most employer-sponsored plans, you usually have only 180 days to appeal a denial. Missing that window can cost you the right to challenge the decision, so timing matters.
  5. Build the administrative record. During an ERISA appeal, this is your chance to add every piece of supporting evidence. A court will generally review only what is already in the file, so we work to make it as complete as possible.
  6. Pursue a lawsuit if needed. If the insurer upholds its denial after appeal, we can file suit in federal court to fight for the benefits you are owed.

We explain all of the details in plain language as we go, so nothing catches you off guard. We’ll walk you through your Long-COVID and ERISA disability claim and advocate for your rights.

Why Choose Us

Until more is known about the long-term effects of coronavirus, insurance companies will view long-haul COVID claims skeptically. This skepticism may be fueled by treating doctors who may disbelieve or lack the information to make a proper diagnosis. If your claim has been denied, a knowledgeable attorney at Roberts Disability Law, P.C. will be able to:

  • Evaluate your employer’s disability policy to determine whether any exclusions or limitations may apply to long-haul COVID claims.
  • Strategize the best way to obtain evidence demonstrating your medical impairments cause functional limitations.
  • Rebut insurance company expert opinions that discount your symptoms or treating doctor opinions.
  • Obtain vocational evidence demonstrating that you cannot perform your own occupation or any occupation for which you may be reasonably qualified.

We’ll guide you through every step of the process so that you can have peace of mind. Reach out today to see how we can help.

Talk With Us About Your Claim

Due to the complexities of ERISA, insurance policies, and long-haul COVID claims, you do not want to go at it alone. If you believe you cannot work due to the long-term effects of COVID and your long-term disability claim was denied, contact Roberts Disability Law, P.C. to schedule a consultation about your options.

FAQs About Long-Haul COVID Claims in California

Can I get long-term disability benefits for Long COVID?

Yes, many people do. Your policy does not require a specific diagnosis to qualify. What matters is whether your symptoms prevent you from working under the terms of your plan. Strong medical documentation of your condition and limitations is key.

What if I never had a positive COVID test?

You can still pursue a claim. Many people were sick before testing was widely available, or they tested at home without a record. We help connect your ongoing symptoms to a clinical picture consistent with Long COVID, even without an early positive test.

How long do I have to appeal a denial?

For most employer-provided plans governed by ERISA, you have 180 days from the date of your denial letter to file an appeal. This deadline is strict, so it is smart to contact an attorney as soon as you receive a denial.

Will suing my insurance company put my case at risk?

No. Filing an appeal or a lawsuit is your legal right under your policy and the law. The insurer cannot punish you for challenging a wrongful denial. In fact, holding them accountable is often the only way to get the benefits you are owed.

What kinds of post-COVID conditions do you handle?

We help clients with a wide range of post-COVID diagnoses, including chronic fatigue, brain fog, shortness of breath, POTS, dysautonomia, and ME/CFS. Many clients have more than one condition, and we address how they combine to limit your ability to work.

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