Commentary

3 Different Disability Claims Available to COVID-19 Victims in Pa.

COVID-19 has been a destructive force to our lives, livelihood and our families. The last thing a person who is suffering from COVID-19 needs to fear while battling this condition is for their financial well-being. They need to be able to focus on fighting the potentially deadly virus.

May 21, 2020 at 01:59 PM

5 minute read


Michael J. Parker of Pond Lehocky Stern Giordano. Michael J. Parker of Pond Lehocky Giordano LLP.

COVID-19 has been a destructive force to our lives, livelihood and our families. The last thing a person who is suffering from COVID-19 needs to fear while battling this condition is for their financial well-being. They need to be able to focus on fighting the potentially deadly virus. I am grateful to have the opportunity to assist in educating individuals on whether they can file a disability claim if they do get infected with COVID-19.

I have personally known two individuals who have been infected with COVID-19. COVID-19 infected one of my acquaintances and he showed no symptoms. He tested positive after a family member tested also positive for the virus. At this juncture, he is being quarantined, but the virus has had no impact on his ability to function. The mandatory quarantine has certainly prevented him from working, but the issue remains whether he could perform his occupation during the mandatory quarantine. The next individual I personally knew who was infected by the virus was my grandmother. She succumbed to the coronavirus five days after being diagnosed. I mention these two individuals to illustrate the extremes to which COVID-19 can affect an individual. Clearly, the virus can be deadly; however, it also could have limited to no impact on an individual's ability to function.

In Pennsylvania, there are three disability benefits that could be available to an individual who is suffering from COVID-19. The benefits are: Social Security disability (SSD), long-term disability (LTD) and short-term disability (STD). The commonwealth of Pennsylvania does not have a state disability program that it offers to its citizens.

Short-term disability and LTD benefits are benefits offered under an insurance policy. That policy could be through your employment or through a policy purchased on your own. The insurance will define the terms of the policy; namely, the definition of disability, the rate of compensation, the term of compensation and the waiting period before the policy begins. Every insurance policy is not created equal, so it is important for you to become familiar with the terms of the policy.

Most LTD and STD policies (at least initially) define disability as "the inability to perform the material and substantial duties of your regular occupation due to your sickness or injury." However, some policies may have a more stringent definition of disability to require a showing that you cannot perform any occupation. If the COVID-19 infection is so severe that the individual is on a respirator, then an insurance company should find disability under either definition, at least during the time when they are on a respirator and the recovery period thereafter. The glaring issue for a disability claim based upon a COVID-19 infection is whether the functional limitations associated with the virus meet the duration requirements under the policy. The policy will define the specific duration or waiting period for the claim. In most STD claims, the waiting period is seven to 14 days; consequently, it is likely that short-term disability claims will be the most prevalent disability claims associated with COVID-19.

In most LTD claims, the waiting period is six months. If an individual is infected with COVID-19, but is symptomatic for less than the waiting period, then they would not be eligible for benefits. At this point in time, we do not know the long-term effects of COVID-19 exposure. If COVID-19 caused cardiomyopathy or permanent scarring of the lungs, then clearly the virus caused a long-standing effect on the individual. An individual with health issues following a COVID-19 infection could qualify for the longer term disability benefits such as LTD and SSD.

The Social Security Administration (SSA) defines disability as the inability to engage in substantial gainful activity for a period of 12 months or more or have a condition that is expected to result in death. The SSA also has a five-month waiting period before benefits become payable. It is my judgment that COVID-19 will only be relevant to a Social Security disability claim if we see claimants who survived the initial infection of COVID-19, but are dealing with the long-term effects of the virus, such as damage to their lungs and cardiomyopathy, when addressing a Social Security disability claim based upon COVID-19.  However, as our country struggles to come to terms with the virus, so will insurance companies and the Social Security Administration. Our office provides a free consultation on all disability claims, and we can explain clients' rights under their insurance policies. We also file Social Security disability applications for our clients. For attorneys who have clients with disability issues, we are also helping with those cases. Finally, we provide free representation to essential workers who contract COVID-19 while on the job and pass away from the virus. We are a law firm who represent hard-working Americans and are proud to continue fighting for those fighting the hardest battles during this pandemic.

Michael J. Parkeran attorney at Pond Lehocky Giordano LLP focuses his practice on advocating for the disabled for almost 15 years. In addition, he spearheaded the formation of the firm's long-term disability department. Contact him at [email protected].

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