LONG COVID
It’s 2023 and COVID still prevails in the world. Many people recover from COVID-19
within a few weeks while others are not so fortunate because their symptoms last for
months or even longer. Medical professionals have been referring to these cases as
“Long COVID” or “Post COVID” among other names such as “long-haul COVID” and
“post-acute COVID”. In some cases, the symptoms of Long COVID can be severe and
debilitating making it difficult or even impossible to do their job. Studies show that 25%
of individuals with Long COVID report they cannot work due to symptoms.
The insurance industry has been tasked with sorting legitimate health claims from
fraudulent ones, and face challenges as the coronavirus pandemic drags on. There is a
flood of claims citing a post-infection syndrome that is not fully understood by the
medical community and is difficult to measure.

Definition of Long COVID
The World Health Organization, WHO, has developed a clinical case definition of post
COVID or Long COVID as individuals with a history of probable or confirmed SARS
CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that
last for at least 2 months and cannot be explained by an alternative diagnosis. Common
symptoms include fatigue, shortness of breath, cognitive dysfunction but also others
and generally have an impact on everyday functioning. Symptoms may be new onset
following initial recovery from an acute COVID-19 episode or persist from the initial
illness. Symptoms may also fluctuate or relapse over time.

This first version was developed by patients, researchers, and others, representing all
WHO regions, with the understanding that the definition may change as new evidence
emerges and our understanding of the consequences of COVID-19 continues to evolve.

Conditions of Long COVID
There is no typical Long COVID patient. The condition can affect anyone, the largest
age group affected being between 27 and 54 years. Symptoms can vary from fatigue,
fever and cough to headache, chest pain, brain fog and dizziness. Mental health is also
a concern. Studies show that within six months of being diagnosed with COVID-19, one-
third of patients are diagnosed with neurological or psychiatric conditions including
anxiety, depression, and post-traumatic stress disorder (PTSD).

There is no test that determines if your symptoms or conditions are due to COVID-19.
Long-COVID conditions are not one illness. The patient’s healthcare provider considers
a diagnosis of Long-COVID conditions based on health history, including whether the
patient had a diagnosis of COVID-19 either by a positive test or by symptoms or
exposure, as well as doing a health examination.

The Centers for Disease Control and Prevention, CDC, acknowledges gaps in medical
knowledge regarding Long COVID. It warns doctors not to rely on diagnostic tests alone
to diagnose the syndrome because the symptoms are difficult to measure. “Lack of
laboratory or imaging abnormalities does not invalidate the existence, severity, or
importance of a patient’s symptoms or conditions,” per the CDC’s official guidance.

Is Long COVID considered a disability?
The Federal Government published guidance for treating Long COVID as a disability in
July of 2021. Under the ADA guidelines, most employers must make accommodations
for employees with Long COVID who are having difficulty working. These
accommodations can include flexible work policies, more time to complete tasks,
adjustments to equipment and accessibility to buildings. An employee with a diagnosis
of Long COVID should be afforded reasonable accommodations by their employer.
However, Long COVID is not always considered a disability. An individualized
assessment is necessary to determine whether a person’s long COVID condition or any
of its symptoms substantially limits a major life activity. The CDC and health experts
are working to better understand long COVID.

How we can help
At MAPS Medical, our teams stay on top of the industry’s changes regarding COVID-19
and Long COVID. MAPS Medical works with IME and Peer Review providers to
understand and continue to learn about the potential disabling factors of Long COVID.
MAPS Medical is dedicated to exceeding industry standards and providing quality
results our customers can trust. We are here to assist you with any of your IME or Peer
Review needs. Use this referral link to submit a new case Referral Page. Or contact
one of our team members for more information.