Numerous medical and legal issues have arisen from the outbreak of the COVID-19 pandemic. One issue that is currently beginning to emerge is the denial of disability benefits for people suffering from COVID or at high risk of contracting COVID by returning to work. While there are strict regulations for disability insurance providers under ERISA law, there always seems to be some way for insurance carriers to deny claims.
It is important to understand the legal landscape, so you know whether to file a claim and how to proceed.
Should I file a claim?
If you are unsure of whether your insurance provider will cover your disability claim, you should file a claim. Although you shouldn’t file your claim without careful documentation and help from an experienced ERISA lawyer, you should not hesitate simply because you’re not sure of whether you will get the benefits you’re claiming.
Is COVID considered a “disability”?
Eligibility for disability benefits depends greatly on a specific insurance company’s definition of “disability.” While there are nuances from one insurance provider to the next, the common aspect of a definition involves being unable to return to work.
An important distinction arises here. Being unable to return to work is not the same as it being unsafe for you to return to work. A denial of benefits is foreseeable to a COVID victim with mild symptoms. Even if a doctor says it is unsafe for you to return to work or that you are at increased risk of contracting COVID by returning to work, these medical conclusions do not fall under the common definition of disability. You are still able to return to work.
This is a relatively new issue, so caselaw will have to be developed to determine the answer to this problem, but justice would require that someone who has a serious medical reason to not return to work should be considered unable to return to work for purposes of determining disability benefit eligibility.
How can I get disability benefits?
The steps, generally, are pretty simple:
- Document all your lost work and other losses due to your illness.
- Get a medical opinion on whether you can or should return to work.
- Talk with a lawyer as soon as possible in the process. A skilled and experienced ERISA lawyer will help you take the steps to ensure you get the benefits you need.
- File your claim.
- Appeal your claim if it is denied.
If you are unable to return to work, or if it unsafe for you to return to work due to the risk of contracting COVID, you should do everything possible to obtain disability benefits. There is too much at stake to stall in your efforts to get benefits or to handle your case on your own without the help of an experienced disability lawyer.