The COVID 19 pandemic is an unwelcome visitor into our daily lives. For some individuals, it will cause mild symptoms and pass quickly, but for others there can be severe long term affects. This post attempts to address how SSA will evaluate a claim for Social Security based on COVID 19.
Social Security Disability Benefit Overview
Social Security Disability has two types of benefits (generally): Social Security Disability Insurance Benefits (SSDI) and Supplemental Security Income (SSI). SSDI is based on the credits from the work that you have done in your life while SSI is a need based program. You must be found disabled by SSA before you are entitled to either benefit.
SSA evaluates all claims for SSDI and SSI under a Five Step Sequential Evaluation:
- Step 1 – Are You Working (engaging in substantial gainful activity)?
- Step 2 – Is Your Condition “Severe”?
- Step 3 – Is Your Condition on the List of Disabling Conditions?
- Step 4 – Can You Do the Work You Did Previously?
- Step 5 – Can You Do Any Other Type of Work?
For a detailed discussion of the above five steps look here.
SSA also has a duration requirement:
To meet the duration requirement, you must have a medically determinable physical or mental impairment which can be expected to result in death, or which has lasted or can be expected to last for at least 12 months in a row.
There are several levels to a Social Security Disability case: initial, reconsideration, a hearing before an administrative law judge, the appeals council and even district court. Your disability claim can be approved at any level, but the hearing is where you have your best chance of being approved.
While the CARES Act has helped with stimulus money (economic income payments), to date (January 2021), SSA has not changed the duration requirement or issued any other special instructions for handling COVID 19 disability cases to SSA employees (publicly).
Because of COVID 19, all Social Security Offices, including hearing offices, are currently (January 2021) closed to the public. This means that SSA is conducting telephone hearings for disability cases. Video hearing capabilities are on the horizon according to SSA.
What is COVID 19?
COVID 19 (or Corona Virus Disease 2019) is an infectious disease that causes mild to moderate respiratory illness in most people. However, in the at risk population, more serious illness can develop because of COVID 19, including death from complications. The at risk population includes those with cancer, chronic kidney disease, obesity, down syndrome, COPD, a weakened immune system and pregnant women to name a few.
Human coronavirus itself is not new and was first identified in the mid-1960s. The coronavirus’ known previously caused the common cold. However, the particular virus that causes COVID 19 is new (novel) and can result in chronic severe illness.
The virus can spread by human contact when a person coughs, sneezes, sings, talks or breathes. COVID 19 can be spread by infected people who do not have symptoms. The CDC and WHO have recommended the use of masks, hand washing and social distancing as a means of preventing the spread of COVID 19.
According to the CDC,
The most commonly reported long-term symptoms include:
- Shortness of breath
- Joint pain
- Chest pain
Other reported long-term symptoms include:
- Difficulty with thinking and concentration (sometimes referred to as “brain fog”)
- Muscle pain
- Intermittent fever
- Fast-beating or pounding heart (also known as heart palpitations)
More serious long-term complications appear to be less common but have been reported. These have been noted to affect different organ systems in the body. These include:
- Cardiovascular: inflammation of the heart muscle
- Respiratory: lung function abnormalities
- Renal: acute kidney injury
- Dermatologic: rash, hair loss
- Neurological: smell and taste problems, sleep issues, difficulty with concentration, memory problems
- Psychiatric: depression, anxiety, changes in mood
COVID 19 & Social Security Disability
When it comes to evaluating a claim for Social Security Disability, the name of your impairment is not as important as the severity of your symptoms. SSA can generally use three ways to find you disabled: the listings, the grid rules (Medical Vocation Guidelines) or on the combination of your impairments.
To date, there is not a listing specifically for COVID 19. However, other listings may be helpful such as 3.00 Respiratory, 4.00 Cardiovascular or 11.00 Neurological. It should be noted that most listings are very difficult to meet.
The Medical Vocational Guidelines (Grid Rules) can help someone over the age of 50 that is reduced to sedentary work from their COVID residuals.
Also, if you have been diagnosed with several impairments and also have COVID residuals (which is common in the at-risk population), you may be found disabled based on the combination of your impairments.
However, as noted above, SSA does have a 12 month duration requirement. If you acquire COVID 19, recover and are able to return to work within 12 months, you would not be eligible for Social Security Disability benefits.
If you have been diagnosed with COVID, are unable to work and it appears that your symptoms are going to last for 12 months or more, you should file a claim for SSDI or SSI as soon as possible. If you recover within 12 months, you can withdraw your claim for disability benefits.
The Bishop Law Firm represents disabled clients in Raleigh, Cary, Durham, Fayetteville, Smithfield, Rocky Mount, Wilson, Chapel Hill, Roanoke Rapids, Louisburg and other areas in North Carolina. We do not get paid unless you win and we offer free case reviews at (919) 615-3095. We wish you or your loved one a speedy recovery and hope we all can be free from COVID 19 soon!