Lack of PCR Tests Should Not Impact Long-Term Disability Benefits for Those with Long COVID

Some with long COVID struggle to access benefits, but PCR test should not affect the process Spencer Van Dyk, CBC News
Posted: Jan 03, 2022

As more people suffer from long COVID and attempt to access disability benefits, some are being asked to show proof they had the illness, but an Ottawa lawyer says it’s their ability to work, not the disease, that ultimately matters.

The Ontario government began restricting access to PCR testing last week as a surge in COVID-19 cases put pressure on the province’s testing capacity. That means many people who are experiencing COVID-related symptoms aren’t able to access a PCR test, while some have access to rapid antigen tests.

But neither test was available to Chantal Renaud when she contracted COVID-19 in April 2020, during the first wave of the pandemic.

For nearly two years, the Clarence-Rockland woman has been suffering from shortness of breath, postural tachycardia – a rapid heart rate whenever she sits or stands – severe post-exertional malaise, and hair loss, among other symptoms all related to long COVID.

“It’s extremely debilitating,” she said.

Despite her symptoms, her former employer’s insurance company denied her long-term disability claim, which eventually forced her to to leave her job and sell her house. Renaud launched a lawsuit against the insurer last January.

“It’s a nightmare when they deny claims,” she said.

Renaud isn’t alone. Many people with long COVID symptoms have had difficulty accessing certain benefits, some because they lacked proof their illness is caused by the virus, and some because long COVID is relatively new and some insurers don’t recognize it.

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With the recent surge in cases, Renaud said she’s worried the number of people with long COVID who won’t be able to access benefits will also grow exponentially.

“Knowing what I know about long COVID, I’m one of the few people who knows what’s really coming, and that has caused me more anxiety,” she said, “Because I don’t want anyone to get as sick as I am.”

PCR test unnecessary, lawyer says

An Ottawa lawyer says it’s a common misconception someone needs a positive PCR test to have access to both short and long-term disability benefits.

“It’s not about what’s the matter with you, it’s about an objective assessment of your conditions,” said Janice Payne, an employment lawyer at Nelligan Law in Ottawa.

Many people who contract COVID-19 now likely won’t be able to access a PCR test to prove the diagnosis, but Payne said the claim process should stay the same regardless of a test.

“In order to access sick leave, or disability leave, as a first step anyway, all you need to do is establish, with the assistance of a medical professional, that you presently have conditions that are disabling you to such a degree that you cannot perform the normal duties of your occupation,” she said.

“That’s really all that matters.”

She said an insurer is entitled to medical information to confirm the existence of a disability, but not its nature.

Payne’s advice to those who contract COVID-19 now, and especially those who cannot prove the diagnosis with a PCR test, is to write everything down.

“It’s very important that they document their symptoms with their [doctor],” she said.

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