More than two years into the coronavirus pandemic, millions of people who have contracted COVID-19 are not recovering fully. Labeled “post-acute COVID-19 syndrome” or “long COVID,” the Centers for Disease Control and Prevention (CDC) estimates that nearly one in 5 American adults who develop COVID-19 may experience symptoms ranging from cough and chest pain to severe fatigue, brain fog, and dizziness that last for weeks, months, or years after infection.
People who have had severe COVID can also develop autoimmune conditions or complications due to multiorgan damage, which may make them more likely to develop chronic health complications like diabetes, heart conditions, or neurological conditions. For some people, long COVID may amount to a life-changing disability.
Indeed, surveys show a staggering increase in the number of Americans who identify as newly disabled. In 2021, an additional 1.2 million more Americans identified as having a disability compared to the same time in 2020. Healthcare experts say that COVID-19 is most likely to blame.
Long COVID and the labor force
The massive number of newly disabled people in the United States has spearheaded urgent conversations about worker accommodation and disability. An estimated 3.3 million adults are out of work full-time because of long COVID, amounting to 2.4% of full-time workers in the United States. An additional 2.6 million workers afflicted with long COVID have had to reduce their work hours by 25%.
One thing is certain: long COVID isn’t going anywhere. As the number of people who develop COVID-19 continues to increase, so too will the number of people who experience long-term complications.
In the United States and around the world, workplaces are being called to proactively accommodate the needs of an increasingly disabled workforce by decreasing the barriers that make it difficult for them to apply, obtain, and maintain employment.
Here are some steps employers can take:
Educate yourself on the ways long COVID affects people
Long COVID syndrome may affect people’s daily lives (and consequently, their careers) in various ways. Understanding the kaleidoscope of symptoms faced by COVID “long haulers” is an important first step in supporting them.
While some people experience mild post-COVID symptoms, others are plagued by debilitating exhaustion, chronic pain, and cognitive dysfunction. Some people are able to return to work, while others experience ongoing impairments that make them unable to perform their jobs at all.
Common long COVID symptoms like tiredness and fatigue may make it difficult for employees to perform work duties or get through an 8-hour workday without rest.
Post-exertional malaise, which refers to symptoms that get worse after a person exerts physical or mental effort, can be debilitating for employees who occupy high-intensity roles. Brain fog, one of the most commonly reported symptoms of long COVID, can seriously hinder productivity and communication, making it difficult for employees to perform “basic” job tasks.
There are also immense psychological effects. Previously healthy people who developed long COVID describe an overwhelming mental health burden and a profound sense of helplessness. Due to the wide range of symptoms, lack of documentation, and no easy way to test for it, many people experiencing long COVID have trouble proving their disability and are thus unable to secure disability benefits.
“Depression and anxiety are how the brain responds to limitations brought on by a new health condition. The longer someone experiences a health challenge, the more a person’s mental health can decline,” says Jordan Anderson, D.O., an assistant professor of psychiatry and neurology at the Oregon Health and Science University School of Medicine. “Having long COVID itself is a new form of trauma that’s prolonged, and hasn’t stopped for two-plus years for some patients.”
Employers must also recognize that symptoms of long COVID can come and go. An employee might appear to be doing well one day but have worsening symptoms and reduced functionality the next.
Ensure that employers understand the full range of benefits available
Employers must ensure that their employees are aware of and able to access any benefits that might aid in their recovery and ease their return to work.
Examples of these benefits include workers’ compensation, healthcare (including emotional and mental health benefits), paid time off (PTO), leave of absence, and resources offered by employee assistance programs (EAP).
Employees should be reminded and instructed to reach out to medical plan administrators who can help them locate the right specialists to treat long COVID symptoms, and employers should be prepared to grant employees time off to receive proper treatment.
Additionally, employers should re-evaluate their leave policies and ensure that they are sensitive to the realities of people who have long COVID.
“Most companies’ current leave policies require extensive documentation, which may be a roadblock for people with long COVID, because they often face doubt from clinicians and are sometimes unable to provide proof of infection,” writes Fiona Lowenstein, the founder of health justice organization, Body Politic, in an article for MIT Sloan Management Review. “In addition, sick leave policies that allow for only a certain number of “episodes” are less likely to be useful to long COVID patients than policies that renew.”
Above all else, employers are responsible for creating work cultures that actually encourage employees to take advantage of benefits like PTO or flexible work setups. Importantly, people who have long COVID may prefer remote work set-ups which can allow them to pace themselves, conserve energy used to travel to work, and mitigate the chances of re-infection.
“Employees who come forward and ask for time off, accommodations, or professional help due to long COVID should be taken seriously and treated with empathy, rather than suspected of abusing the system,” Teresa Bartlett, M.D., managing director, and senior medical officer at Sedgwick wrote for BenefitsPro.com. “For individuals suffering from long COVID whose reports of impairment may be dismissed by those unaware of its significant impact, employer support is especially critical to their physical and emotional well-being.”
Prepare for an increase in ADA accommodation requests
In January 2021, the Biden administration announced that long-term symptoms of COVID-19 could be considered a disability under the Americans with Disabilities Act (ADA). As the number of people who develop long COVID increases (and cases will keep increasing,) so too will the number of ADA accommodation requests fielded by employers.
Even if a person’s long COVID is temporary, it may still meet the ADA’s definition of a disability. For that reason, employers must consider reasonable accommodation requests for long COVID in the same ways that they would other mental and physical disabilities.
Examples of accommodation requests relevant to employees with long COVID may include:
- part-time or modified work schedules
- reassignment to open positions
- job restructuring
- extended work break
- experimenting with new software or apps to aid employee organization/productivity
Encourage employees to apply for Social Security Disability Insurance (SSDI)
Employers should encourage employees who have long COVID and are unable to work to apply for SSDI, which provides benefits to disabled workers and their dependents, either through their own employment or that of a spouse or partner.
While long COVID is not technically a category of impairment for Social Security disability benefits, the SSA has started to track data on long COVID-related claims and recognize the following conditions when awarding benefits:
- Lung, heart, kidney, neurological, and circulatory damage
- Worsening impact on pre-existing physical and mental impairments
- Respiratory, cognitive, circulatory, and other chronic disorders resulting from COVID-19 infection
Applying for SSDI can be a lengthy process, but encouraging employees to begin collecting medical documentation of their disability as soon as they experience symptoms of long COVID can help increase their chances of qualifying.
If a person receives SSDI, they can participate in the Trial Work Period (TWP), an incentive of the Social Security Administration’s Ticket to Work program designed to help people gradually return to work while still receiving SSDI benefits. The program allows employees to test out returning to work over a period of nine months and still receive full benefits, regardless of how much they make on the job.
Long COVID has the potential to be a “mass deterioration event,” and employers need to ensure that their workplaces are properly prepared to support an increasingly disabled workforce. Leading with empathy, prioritizing disability education and benefits relevant to people who are disabled, and creating workplaces that value employee wellbeing are all good places to start.
“Long COVID marks a transitional period for disability awareness and support,” Ted Drake, global accessibility leader at Intuit told Time Magazine. “Even beyond long COVID, we’re seeing more employees talking openly and honestly with their teams and their managers about their mental, emotional, and physical needs. This open dialogue creates opportunities for companies to better their policies.”
Lia Tabackman is a freelance journalist, copywriter, and social media strategist based in Richmond, Virginia. Her writing has appeared in the Washington Post, CBS 6 News, the Los Angeles Times, and Arlington Magazine, among others. She writes weekly nonprofit-specific content for 501c.com.