Long COVID: A Guide for Health Professionals on Providing Medical
Evidence for Social Security Disability Claims
(over)
SSA.gov
Long COVID: A Guide for Health Professionals
on Providing Medical Evidence for
Social Security Disability Claims
Contents
Definition of Disability 1
What We Need from You 2
Evaluating Disability for Individuals with Long COVID 3
Contacting Social Security 3
This guide for health professionals describes the kinds
of medical evidence the Social Security Administration
(SSA) needs to evaluate disability claims led by
individuals with long-term health effects of COVID-19,
known as Long COVID or Post-COVID Conditions
(PCC).
1
1 - Long COVID is a lay term for the technical term post-COVID conditions (PCC), a subset of which are termed Post-Acute
Sequalae of SARS CoV2 infection (PASC). These conditions are sometimes referred to as long-haul COVID, post-acute COVID-19,
or chronic COVID. For more information, see the COVID.gov page About Long COVID.
We appreciate you providing us timely medical
and laboratory reports and other medical records.
2
2 - An individual applying for disability benets must inform SSA about, or submit all evidence known to them that relates to, whether
or not they are disabled. See 20 CFR 404.1512, et seq., and 20 CFR 416.912, et seq. By providing us with all medical evidence,
you are helping individuals fulll their duty to provide all known evidence relating to whether they are disabled.
You
may send us medical records electronically, on our
secure website, or by fax, or by mail.
Denition of Disability
Federal Social Security law sets out a specic denition
of disability. While some programs provide partial
disability or short-term disability payments, SSA’s
disability programs do not. We consider an adult
disabled if the individual is unable to do any substantial
gainful work activity because of any medically
determinable physical or mental impairment(s) that
has lasted, or can be expected to last, for a continuous
period of at least 12 months, or that is expected to
result in death. We consider a child under the age of
18 disabled if the child has a medically determinable
physical or mental impairment(s) that causes marked
and severe functional limitations, and that has lasted,
or can be expected to last, for a continuous period of at
least 12 months or that is expected to result in death.
2
Long COVID: A Guide for Health Professionals on Providing Medical
Evidence for Social Security Disability Claims
(over)
The medical impairment(s) must be shown to exist by
means of medically acceptable clinical and laboratory
ndings. Under the law, symptoms alone cannot
be the basis for a nding of disability, although the
effects of symptoms may be an important factor in
deciding whether an individual is disabled. In some
adult disability claims, we also consider other factors,
such as age, education, work background, and
functional capacity in light of the individual’s medical
impairment(s). If a child claimant under age 18 has
a functional limitation because of the child’s medical
impairment(s), we consider the child’s functioning in
relation to other children of the same age who do not
have the medical impairment(s). You can nd more
detailed information about our disability evaluation
process on the Disability Evaluation Under Social
Security page on the Medical/Professional Relations
section of our website.
What We Need from You
We need information from you that will help us
determine the existence, severity, and duration of the
individual’s medical condition(s).
Medical reports you provide to us should include a
thorough description of the individual’s medical history,
with information on the diagnosis, onset, duration,
and prognosis of the individual’s COVID-19; Long
COVID; conditions that might be associated with,
exacerbated by, or consistent with Long COVID; and
any other conditions. Longitudinal clinical records and
detailed historical notes discussing the course of the
condition(s), including any treatment prescribed and
the individual’s response to treatment, are very useful
for us because we are interested in the impact of the
illness over time.
Include in your reports all clinical ndings (such as
results of physical examinations and mental status
examinations) and laboratory ndings (such as blood
tests, magnetic resonance imaging, or any other
clinically accepted form of testing), both positive and
negative, including any ndings used to support a
diagnosis of COVID-19 or Long COVID. A positive
viral test result for SARS-CoV-2 is not necessary
for a diagnosis of COVID-19 or Long COVID. It is
essential that you submit all available objective ndings
concerning your patient’s condition, even if the ndings
may relate to another disorder or establish that the
individual has a co-occurring condition.
Please report any medical signs you have observed.
Examples include:
• Difculty breathing or shortness of breath;
• Cough or abnormal auscultation of the lungs;
• Fever;
• Heart palpitations or other cardiovascular
abnormalities;
• Coagulopathy;
• Orthostatic intolerance (symptoms worsen on
maintaining upright posture and improve by lying
down);
• Weight loss or malnutrition;
• Edema; and
• Newly developed diabetes or abnormalities in serum
glucose.
Also, please include in your reports any additional
signs and any symptoms or other effects of Long
COVID, such as:
• Persistent or relapsing fatigue resulting in reduction
or impairment in ability to carry out daily or work-
related activities;
• Post-exertional malaise (worsening of symptoms
after physical, cognitive, or emotional effort);
• Exercise intolerance;
• Respiratory difculties, such as labored breathing or
sudden breathlessness;
• Muscle or joint pain or tenderness;
• Weakness;
• Chest tightness, pain, or tenderness;
• Cognitive impairment(s) such as having difculty
with information processing, memory, or
concentration and attention;
• Headaches of a new type, pattern, or severity;
• Changes in taste or smell;
• Gastrointestinal disturbances, discomfort, diarrhea,
or constipation;
• Dizziness when standing up;
• Paresthesia (numbness, tingling, or pins-and-
needles sensation);
• Sleep problems;
• Tinnitus; or
• Mood changes and new or worsening depression or
anxiety.
3
3 - For more information on potential symptoms of Long COVID, see the CDC’s Long COVID webpage.
3
Your descriptions of any functional limitations you
noted throughout the time you examined or treated the
patient are very important. If possible, please provide
your opinion of the individual’s ability to do daily
activities or work-related physical and mental activities.
Tell us your opinions about both the individual’s
physical and mental functions and, to the extent
possible, the reasons for your opinions, such as the
clinical ndings and your observations of the individual.
Examples of work-related functions include:
• Physical functions: The ability to walk, stand, sit, lift,
push, pull, reach, carry, and handle.
• Mental functions: The ability to understand,
remember, and carry out simple instructions; the
ability to use appropriate judgment; and the ability
to respond appropriately to supervision, co-workers,
and usual work situations, including changes in a
routine work setting.
Evaluating Disability for Individuals
with Long COVID
State agencies called Disability Determination Services
(DDS) perform initial evaluation of disability claims for
SSA. The DDS uses an adjudication team that consists
of a physician or psychologist and a specially trained
disability examiner to decide whether an individual
is disabled under Social Security law. In evaluating
disability for individuals with Long COVID, the team
looks at all the available evidence, including the clinical
course from the onset of the illness, and considers the
impact of the illness on each affected body system.
If the team determines there is not enough information
to make a determination, they may call or write you to
nd out if you have the needed information. If you do
not, they may ask you or, in some circumstances, an
independent medical source, to provide the information
by performing tests or an examination paid for by the
DDS.
For more information on how we evaluate disability
cases with Long COVID or COVID-19 involvement,
see SSA Emergency Message EM-21032 REV,
Evaluating cases with Coronavirus Disease 2019
(COVID-19).
Contacting Social Security
The most convenient way to contact us anytime,
anywhere, is to visit www.ssa.gov, where you can
also access many of our services with an online my
Social Security account.
We look forward to serving you.
SSA.gov
Social Security Administration
Publication No. 64-128
June 2023
Office of Disability Policy – Long COVID Fact Sheet
Produced and published at U.S. taxpayer expense
