Insurers are hesitant to pay claims that are difficult to prove
Many Canadians have improved from COVID-19 but experience persistent, long-lasting symptoms post-recovery. As the impact of the virus remains volatile, personal injury lawyer Joshua Goldberg foresees long-term COVID disability claims becoming an imminent legal battle with insurance companies over payouts.
In 2023, Goldberg says personal injury claims will involve people unable to work because of long-term symptoms from COVID and predicts insurance companies will turn down these claims. According to the World Health Organization, the most frequently reported long-COVID symptoms are fatigue, shortness of breath, brain fog, and muscle and joint pain.
Most insurance companies dislike dealing with chronic pain cases and are reluctant to pay out claims because proving that someone is suffering from chronic pain and unable to work due to their condition can be challenging, says Goldberg. So, securing compensation will be a battle.
People are recovering from the COVID sick period and starting to face the long-term consequences, and Goldberg says that with people still not back to work, personal injury lawyers have not seen the full extent of disability claims.
Due to the long-term impact of COVID-19, he says that many people will have problems primarily in the office, and it will be difficult for employees with lingering symptoms to work regular eight-hour shifts. “Many people are still not back to work full time and are working from home remotely,” Goldberg says, “let’s say you have physical health issues and have to run into the office every day and sit at a desk for eight hours; that takes a lot of energy.”
If an employee is too sick to work, there is not much an employer can do but let the person apply for disability benefits, but Goldberg says working from home can help people with long-term COVID effects.
“If people can work with COVID accommodations like remote work, it might help them avoid staying on long-term disability,” Goldberg says. “If employers are willing to be considerate and work around their clients’ disabilities then it’ll definitely lead to fewer long-term disability claims.”
People with long-COVID unable to return to employment will have to file claims for long-term disability to receive benefits, and Goldberg says premiums increase depending on the number of employee claims in a company.
Long-term disability insurance companies allow employers to appeal rejected claims internally, but he says appeals are rarely successful and not usually required. “Our best resource is to sue the insurance company for wrongfully denying the benefits.”
Learn how to sue an insurance company and Canadian laws to know here.
Goldberg says employees affected by COVID should collect medical records dealing with their diagnosis and treatment.
With the spread of Omicron, he says many people are experiencing mild COVID-like symptoms that do not require medical visits and have no formal documentation to show they had the virus, particularly now that Polymerase Chain Reaction (PCR) tests are not readily available.
However, an employee displaying symptoms that prevent them from performing the regular duties of their occupation should be enough to file a disability claim, Goldberg says.