Monday, March 15, 2021
Many in the workers’ compensation insurance industry have been trying to predict what costs COVID-19 will ultimately impose. One line of thought is that most claims will be of short duration, with those found compensable perhaps only lasting weeks, and with de minimis medical expense. Other claims analyzed in such projections, of course, are more costly occurrences. Those are the ones featuring death.
Insurance industry commentators, however, are now recognizing another potentially expensive type of claim, that is, those COVID cases that become chronic. The term for the condition is “Long COVID.” The victims, meanwhile, have been called “long haulers.”
In a new article, which I highly recommend, the author interviews a number of Long COVID patients with an eye towards determining their typical symptoms, determining how they are treated by the medical field and, pertinently for our purposes, how they are to survive from an economic point of view. Alexander Zaitchik, The Forever Disease: How COVID-19 Became a Chronic Condition, The New Republic, p.32 (March 2021), https://newrepublic.com/article/161102/covid-19-long-haulers-chronic-disease-health-care.
All of this is of interest to the workers’ compensation professional because it is chronic cases that can be the most challenging for the system. And, notably, the author here compares Long COVID to a long-recognized condition we encounter in workers’ compensation, “chronic fatigue syndrome” (CFS). Here the author refers to CFS in its full modern articulation, or Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, or ME/CFS. ME/CFS is like another sometimes-chronic condition, Lyme Disease, encountered in workers’ compensation.
Both CE/CFS and chronic Lyme said to be are diagnoses with “no clear markers.” In this article, the author assigns Long COVID to this this group of ailments: “Those who live with ME/CFS know full well the consequences of living in a medical no-man’s land. Like Long COVID, ME/CFS usually has no clear biological markers. There are no on-label treatments. Patients are often undiagnosed, misdiagnosed, or altogether dismissed by doctors.”
What are the symptoms of Long COVID? The author identifies them as “headaches, nerve pain, cognitive dysfunction, hair loss, constipation, and extreme weight loss.” A key symptom, however, is indeed like CFS – the same persistent fatigue that afflicted the COVID-19 victim in the first place.
The author reports that researchers have long known that virus sufferers do not all have the same illness experience. Some, indeed, develop a chronic condition. The author remarks, “research on post-viral illnesses suggest that as many as half or more of those who survive the virus could suffer one or more symptoms for months or years. Whatever the final number, the pandemic’s mortality rate will continue to be dwarfed by the long-hauler population.” This fact leads to an issue pertinent to our field; a key issue as the population of chronic sufferers “is how to support and care for a new cohort of chronically ill Americans, possibly numbering in the millions.”
The remedy of workers’ compensation is not mentioned in the article, and none of the individuals interviewed alleges that they contracted the virus from a work exposure. Thus, as one might expect, Social Security Disability is identified as the obvious remedy for the true long haulers. “Most,” the author states, “will likely turn to their earned Social Security Disability insurance benefits….” But will this really happen? The author reports that, as of 2017, SSA reported that only about 13,000 individuals received this key benefit for the similar diagnosis of ME/CFS.
Of course, the author points out that SSD is an imperfect remedy for most, given the waiting period for both benefits and the accompanying Medicare card. On this point, Social Security expert Nancy Altman told the author, “the mounting number of long haulers makes eliminating both waiting periods even more important.” She adds, “in the meantime, some people found medically eligible may end up on SSI [Supplemental Security Income] and Medicaid, but that requires having virtually no income at all.”