Program Showcase: Long COVID Claims

Jai Hooker@Work

Insights for Employers Dealing with Long COVID Claims

By Tracy Hamill, MD, AVP, Medical Director, US Clinical Claims, Sun Life

For the last few years, much of the focus in the disability claim world centered on the immediacy of learning as much about COVID-19 as possible, assessing factors such as risk of infection, rationale for self-isolation, and infection when formal testing was unavailable.

A newer trend is increased incidence of employees experiencing symptoms beyond the anticipated recovery time and when persistent symptoms rise to the level of impairment. Recognizing that a cohort of people had symptoms from COVID-19 that left them unable to return to work for three to six months or more, the best next step was to assess long COVID claims1 to provide guidance about expectations and assistance.

The Department of Health and Human Services provides a working definition of long COVID2 that includes “… signs, symptoms, and conditions that continue or develop after initial COVID-19 or SARS-CoV-2 infection. [The signs, symptoms, and conditions] are present four weeks or more after the initial phase of infection; may be multisystemic; and may present with a relapsing — remitting pattern and progression or worsening over time, with the possibility of severe and life-threatening events even months or years after infection.”

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