New CDC Guidelines and Disability Lawsuits: Navigating Long COVID's Impact on the Workplace
The Centers for Disease Control and Prevention (CDC) issued new guidelines that relax isolation requirements for most people testing positive. However, this move coincides with mounting legal battles over whether insurers must cover long COVID disabilities under employee benefits plans.
The New Normal
Under the updated CDC recommendations, individuals with improving COVID symptoms who have been fever-free for 24 hours without medication can return to work, school, or public settings. This guidance acknowledges the evolving landscape, including waning severity due to vaccines, treatments, and growing immunity levels. Experts estimate 98% of the U.S. population now has some COVID immunity from vaccination or prior infection.
Yet respiratory viruses remain a threat, particularly for older adults, those with weakened immune systems and individuals with chronic conditions. While annual COVID-19 deaths declined from 245,000 in 2022 to 76,000 last year, influenza still causes up to 51,000 U.S. deaths annually.
Long COVID Challenges
As COVID case rates persist and societal risk tolerance shifts, another serious issue has emerged, namely long COVID disabilities. The CDC estimates that 18 million Americans currently suffer or have suffered from longterm COVID-19, defined as symptoms lasting three months or more after infection. These can include debilitating fatigue, cognitive impairment, heart issues, and mobility problems.
A Brookings Institution analysis suggests around 500,000 workers were out of the labor force due to long COVID in 2022 alone. Legal experts warn this emerging phenomenon could significantly strain workforce productivity and employee benefits in the years ahead.
Legal Battles Over Coverage
Lawsuits are mounting as some insurers deny long COVID disability claims, deeming it an unforeseen risk outside existing contracts with employers. In one high-profile case, an attorney represents a client whose longtime disability insurer rejected her claim after a COVID infection caused seizures, memory loss, and digestive issues.
The insurer allegedly based the denial on flawed third-party medical reviews containing obvious errors like incorrect patient details. Legal experts contend some insurers are disputing long COVID disability recognition to avoid increased claims costs they failed to anticipate when developing premiums for existing policies.
Legal professionals argue insurers are trying to curb rising long COVID claims that disrupted standard risk-assessment practices used when originally drafting employer contracts. COVID's emergence as an unexpected event upended typical tactics for evaluating potential disabilities and associated costs.
Proving Long COVID Impact
For employees with lingering COVID-19 effects, experts recommend proactively documenting infection histories. Obtaining blood tests confirming the presence of the virus, even after negative diagnostic results, can help substantiate later disability claims.
With long COVID's full scope still unfolding, a key question is whether current health plans and disability policies will adequately cover associated chronic illnesses and workforce impacts. Employers are urged to examine insurers' history of claims handling and be cautious of carriers denying seemingly valid long COVID disability cases.
Legal professionals advise employers to examine if their insurers have a track record of disallowing what turn out to be legitimate disability claims. Using an insurer with a poor claims history could disadvantage workers seeking long COVID disability coverage.
Adapting Employee Benefits
The CDC's evolving recommendations allowing more COVID-positive individuals to return to workplaces aim to balance health protections with restoring economic activities. However, implementing such policies requires proactive measures from employers.
Experts advise providing flexible paid leave, remote work options, and COVID testing resources to support employees recovering from infections. Masking, distancing, and hygiene protocols should be implemented for workers returning after positive tests to limit viral transmission risks.
The relaxed CDC stance underscores COVID's transition from an acute emergency to an endemic health issue requiring ongoing management strategies akin to influenza. As risks evolve, maintaining updated vaccination coverage will be crucial for employees.
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