Long-haul cases demand attention – and now ADA coverage

July 29, 2021

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Written by Beth Burry-Jackson, MA, CRC, ARM, SVP, case management, clinically integrated programs and Kimberly Culver, MSN, RN, RDMS, RT(R), director of clinical pharmacy

The mention of long-haul COVID-19 cases and their impact on the workplace has surged to the top of many discussions — even at the highest levels of government; as of this week, long COVID is now a recognized, protected condition under the Americans with Disabilities Act (ADA).

It is important for industry professionals to remain abreast of developments surrounding this condition and to understand what roles they can play as companies strive to manage workplace productivity and better meet the needs of today’s workers. To advance the conversation, we look at the definition of long-haul cases, share important statistics and figures that underscore their frequency, and outline strategies for addressing these cases moving forward.

First, “long-haul COVID-19” is an umbrella term that encompasses post-acute COVID syndrome cases. Patients with long-haul COVID tend to exhibit continued, new or reoccurring symptoms despite testing negative for the COVID-19 virus amid an initial recovery. These symptoms can be ongoing for several months or persist over a year with varying degrees of severity or complexity.

While there is much to be learned about long-haul COVID cases, their prevalence appears to be growing. Recent studies show that approximately 80% of patients who were infected with COVID-19 developed one or more of these long-term symptoms.

In a recent survey of publications and studies, the most common long-haul symptoms were identified. An estimated 50% reported fatigue, 44% described headaches, and 27% noted attention disorder. Hair loss and shortness of breath rounded out the top five, notching 27% and 25% respectively. Theories surrounding the cause of these conditions were varied with some speculating that they arose from immune activation and others projecting they were due to damage by the virus or a low-level presence of the virus.

It is easy to surmise that common symptoms such as extreme fatigue or cognitive dysfunction can have significant ramifications on an organization’s return to work initiative or overall productivity. Combine long-haul symptoms with other physical and mental health declines and the effect can be magnified — for example, physical deconditioning often accompanied the COVID-19 virus resulting from time away from work due to the illness or quarantine. Now factor in brain fog that can impede reaction time, memory or the assimilation of new information. These circumstances can delay return to work and decrease productivity significantly.

Early statistics bear this out as 45% of workers surveyed said they needed an altered work schedule compared to their pre-COVID status. Moreover, 22.3% reported they could not work at all because of illness. A study by the Disability Management Employers Coalition (DMEC) reported an increase in accommodation requests over the past year with the number one request being to work remotely.

These observations and findings have implications for both claims professionals and clinicians in terms of how they can better serve workers who have been infected by the coronavirus and may be experiencing long-haul symptoms.

  • For example, it is important for claims professionals to actively listen to workers and identify such concerns early on so that early intervention measures can take place.
  • Clinicians likewise need to monitor and manage pharmacy utilization and medical care to help ensure the whole person is treated.
  • Professionals overseeing care and claims for impacted individuals should consider both physical and mental health needs.

Employers also have a range of options and strategies available as they wrestle with long-haul COVID cases.

  • Increased awareness and understanding can help organizations be proactive in assisting employees who report these types of symptoms.
  • Organizations should help workers understand their full range of benefits and how to access their benefits plans; this includes promoting the availability of employee assistance programs (EAPs) where available.
  • It can also be helpful for employers to evaluate job functions and requirements and offer flexibility in functions and scheduling where possible.

Earlier this week, the Biden administration announced that long COVID will be considered a disability under the ADA. While the actual symptoms or conditions therein must qualify the individual as having a disability, this is a significant step in recognizing the impact that it has had or will have on individuals. Furthermore, it underscores the action employers need to consider for those with long COVID when considering reasonable accommodations under ADA.1

New information will continue to surface in the coming months related to COVID-19 and long-haul cases. Like so many other issues, it will require employers to be vigilant, agile and responsive. Our clients can rest assured we will be watching as we, too, are in it for the long haul.

Tags: ADA, Casualty, Claims, clinical approach, clinical data, coronavirus, COVID-19, COVID-19 long-haul, Long-haulers, Managed care, Post-COVID reality, Trends + Transformation