Second Circuit Affirms Denial of Long-Term Disability Benefits for Long COVID Claim Due to Lack of Objective Evidence of Functional Impairment

In Alexander v. Unum Life Ins. Co. of Am., No. 25-974, 2026 WL 742865 (2d Cir. Mar. 17, 2026), the Second Circuit affirmed a judgment in favor of Unum Life Insurance Company following a bench trial, concluding that the claimant failed to establish that she was “totally disabled” within the meaning of her ERISA-governed plan during the required elimination period.

The claimant, a nurse practitioner, stopped working in late December 2021 after reporting worsening symptoms she attributed to Long COVID, including fatigue, cognitive difficulties, and reduced physical stamina. She received short-term disability benefits for the maximum period allowed under the plan and then applied for long-term disability benefits. Unum denied the claim, and the district court—conducting a de novo review of the administrative record—entered judgment in Unum’s favor after determining that the claimant did not meet her burden of proof.

On appeal, the Second Circuit emphasized the applicable standards of review. Because the case was resolved through a bench trial on the administrative record, the district court’s factual findings were subject to clear-error review, even though they were based on documentary evidence rather than live testimony. The court reiterated that under this deferential standard, it must uphold the district court’s findings so long as they are plausible in light of the record, even if competing interpretations of the evidence exist.

Turning to the merits, the court focused on the plan’s definition of “total disability,” which required the claimant to demonstrate that she was unable to perform the substantial and material duties of her occupation with reasonable continuity throughout the entire elimination period. The continuity requirement was central: a claimant must show not only the existence of impairments, but that those impairments rendered her unable to work for the full duration of the qualifying period.

The court agreed with the district court that the claimant’s evidence fell short of this standard. While the record reflected consistent reports of fatigue, brain fog, and other symptoms commonly associated with Long COVID, the court noted that these complaints were largely subjective and not supported by objective evidence demonstrating functional impairment. The claimant’s treatment records included references to physical therapy and reported limitations, but they also indicated some degree of improvement over time and did not establish that she was unable to perform the physical demands of her occupation throughout the relevant period.

The court also found significant that the claimant’s psychiatric provider did not conclude that she was cognitively unable to work. To the contrary, the provider indicated that the claimant was not precluded from working from a cognitive standpoint. This undermined her contention that “brain fog” and related symptoms rendered her incapable of performing her job duties.

In addressing the claimant’s arguments, the court rejected the contention that her receipt of short-term disability benefits compelled a finding of long-term disability. The court explained that the plan treated these benefits as distinct, with separate eligibility criteria, and declined to adopt any rule that would effectively merge the two determinations. The proper inquiry remained whether the claimant had carried her burden of proving total disability during the elimination period.

The court further addressed the claimant’s argument that the district court improperly discounted her subjective symptoms. While acknowledging that conditions like Long COVID may involve symptoms that are difficult to measure directly, the court explained that functional limitations resulting from such symptoms can still be evaluated through objective means. The absence of testing, clinical findings, or other evidence demonstrating work-preclusive limitations was therefore a permissible basis for the district court to assign reduced weight to the claimant’s self-reported complaints.

Finally, the court rejected the argument that the district court overlooked evidence regarding the claimant’s mental limitations. It concluded that the district court considered this issue and reasonably found that the record did not support a finding of disabling cognitive impairment.

In sum, the Second Circuit held that the district court did not clearly err in finding that the claimant failed to prove she was totally disabled throughout the elimination period. Because the record supported at least two permissible views of the evidence, the appellate court deferred to the district court’s weighing of that evidence and affirmed the judgment in favor of Unum.