Social Security Disability Insurance (SSDI) is a federal disability insurance program that provides benefits to disabled Americans. SSDI is administered by the Social Security Administration (SSA) and the program exists as a safety net for disabled Americans who are unable to work by providing monthly income. To be eligible for SSDI benefits, an individual must be unable to work or engage in substantial gainful activity because of their medical condition, they must be unable to perform work they have historically performed because of their medical condition, and their condition must be expected to last at least one year or until their death. Additionally, an individual must have earned a certain amount in wages from employment in the ten years preceding their disability.
Applying for SSDI is a more challenging process than applying for disability benefits under an individual or group disability insurance policy. Additionally, the eligibility criteria are more difficult to satisfy. SSDI does not provide coverage for partial or temporary disability. Individuals who are currently working are generally ineligible for SSDI, with limited exceptions. Before an individual can begin receiving SSDI benefits, they must complete a five-month waiting period. If an individual is eligible for both Medicare and SSDI benefits, they must complete a 24-month waiting period before they can begin receiving SSDI benefits.
For SSA to consider long-term symptoms of COVID-19 a “disabling impairment,” an individual must have a record of a positive viral test for SARS-CoV-2, a diagnostic test that establishes the presence of COVID-19, such as a chest x-ray, or a record of diagnosis of COVID-19 with accompanying symptoms. SSA currently does not accept antibody tests as evidence of a prior COVID-19 infection.
SSA maintains a list of disabling medical conditions the agency considers severe enough to prevent an individual from engaging in substantial gainful activity for at least one year. Unfortunately, SSA’s list currently does not include COVID-19 or long COVID, which complicates the process of applying for SSDI for patients and survivors of COVID-19. To determine eligibility, SSA will assess the individual’s medical condition and measure it against other listed medical conditions. If an individual’s medical condition has symptoms that are equivalent to another condition that is listed by the SSA and it prevents them from engaging in substantial gainful activity, SSA is more likely to consider their condition disabling. For an individual to prove to SSA that their long-term symptoms of COVID-19 should qualify them for SSDI, it may require extensive documentation of their symptoms over the course of several months. If an individual develops a Post-COVID Condition following their initial infection, that can help satisfy SSDI eligibility requirements. For example, if an individual develops diabetes following their recovery from an acute COVID-19 infection, that will help them secure eligibility for SSDI.