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Analyzing a Long Haul COVID determination


A client with long-haul COVID symptoms was recently awarded Social Security disability benefits at the initial stage of review. That was great news. But when Social Security allows a disability claim at the initial or reconsideration level of review, they don’t tell you why; they just pay the disability benefits.

I wanted to know why the claim was granted. Specifically, I wanted to know how the claim was analyzed by the disability examiner and the medical reviewer, so that I could use that information in future cases. I requested a copy of the Disability Determination Explanation from the local field office. It just arrived.

This particulary client was 61 years old at the time of his application, with past relevant work at the Medium exertional level. His long COVID symptoms included chronic fatigue, joint pain, and severe, near-daily headaches.

Social Security issued an Emergency Message last year, entitled “Evaluating Cases with Coronavirus Disease 2019 (COVID-19)” (see EM 21032). If you have a client with long-haul COVID, that Emergency Message is a good starting place when putting your case together.

I was wondering if, due to the my client’s long COVID symptoms, DDS had assessed an RFC for complete inability to do sustained work-related activity (see POMS section DI 24510.057B.2.b). To me, that would be the most appropriate resolution of the claim, and a similar finding could be made in most long-COVID cases.

But no. DDS assessed a straight Light exertional RFC and made a Medical-Vocational determination. A younger claimant, or one with sedentary or light past relavant work, would have been denied.



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