An Update on Long COVID Long-Term Disability Claims

Welcome to Season 5, Episode 4 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "An Update on Long COVID Long-Term Disability Claims."

Join attorney Nancy L. Cavey, a leading expert in disability claims, for an insightful discussion on COVID and Long COVID Long-Term Disability insurance claims. Despite the passage of time, COVID remains a persistent issue, bringing new challenges to disability law. In this episode of Winning Isn't Easy, Nancy - one of the first attorneys in the U.S. to litigate a Long COVID disability claim - shares the latest updates on these cases. She explores how Long COVID contributes to other disabling conditions and exposes how insurance carriers are already wrongfully denying these claims. Don't miss this essential conversation for those navigating the complexities of Long COVID disability claims.

In this episode, we'll cover the following topics:

1 - The Common Types of Cases from Long COVID Syndrome, Aggravation of an Underlying Disease Because of COVID, and New Medical Conditions Caused by Long COVID

2 - The Seven Denial Tools That Carriers or Plans Use to Justify a Claim Denial or Termination, and How Courts View These Denial Tools

3 - The Role of Your Physician in Your Long COVID Claim and Your Post-COVID Functional Status

4 - Vocational Denial Tools

5 - Thirteen Tips for Attacking the Denial or Termination of Your Long COVID Claim

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Listen to Our Sister Podcast:

We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/


Resources Mentioned in This Episode:

LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mind

LINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefits

FREE CONSULT LINK: https://caveylaw.com/contact-us/


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Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

Transcript

Nancy Cavey [00:00:00]:
 Foreign hey, I'm Nancy Cavey, national ERISA and IDI disability attorney. Welcome to Winning Isn't Easy. Before we get started, I've got to give you a legal disclaimer. This podcast isn't legal advice. The Florida Bar association says I have to say it. And now that I've said it, nothing will ever prevent me from giving you an easy to understand overview of the disability insurance world, the games that disability carriers play, and what you need to know to get the disability benefits you deserve. So off we go. Unfortunately, the COVID virus is still with us, and so is Long Covid.
 
 Nancy Cavey [00:00:47]:
 In this episode of Winning Isn't Easy, we're going to update you on how disability carriers are handling long hauler Covid claims and the denial tools that they're using in their denial toolbox to wrongfully deny or terminate benefits. I'm going to be talking about five things today. First, the common types of cases that we see from long Covid syndrome, aggravation of underlying diseases because of COVID and new medical conditions caused by long Covid. Two, the seven denial tools that carriers or plans use to justify a claim that denial or termination and how courts have viewed these denial tools. Three, the role of your physician in your long Covid claim and your post Covid functional status. Four, vocational denial tools and five 13 tips for attacking the denial or termination of your long haul or Covid claim. Got it. We've got a lot to cover, but before we get started, we're going to take a quick break.
 
 Nancy Cavey [00:01:45]:
 Okay, see you in a minute. Welcome back to Winning Isn't Easy. Let's talk about the common types of cases that we see from Long Haul or Covid aggravation of underlying diseases because of COVID and new medical conditions we find that are being caused by Covid. When I am talking with a prospective client and listening to their story, I'm really trying to initially break down what it is I have in terms of the medical sequela of long Covid. So let's first talk about the common types of cases due to long Covid that I see that really run the gamut. And they can be individual symptoms or they can be a combination of symptoms. But I'm suing this sorting, if you will, in my head as I'm listening to my client's story. So the first common type of causes due to long Covid can run the gamut.
 
 Nancy Cavey [00:02:58]:
 I see pulmonary issues such as shortness of breath, cough, decreased exercise tolerance, cardiac issues including chest pain, palpitations and even lower extremity swelling, neurological Issues such as brain fog, memory loss, loss of taste and smell, tingling of extremities, insomnia and fatigue. I'll also see gastroenterological issues such as acid reflux, gerd, common diarrhea and even kidney issues. I'll also see psychiatric issues such as depression and anxiety, and maybe even post traumatic stress disorder. Obviously there's neurocognitive issues that can be difficulty thinking, brain fog, short term memory deficit, concentration issues, and even visual spatial difficulties. And then there's a category I call other. That's a big other category, but it can include body and joint pains, relapsing, fevers, headaches, weight loss and multi organ effects. So I'm listening to, excuse me, what's the constellation of the symptoms? Then I'm listening for conditions that my clients may have had that have been aggravated by Covid. And then I'm listening for information about new conditions arising because of long Covid.
 
 Nancy Cavey [00:04:15]:
 So conditions aggravated by long Covid include gerd. They can include immunological issues that people have had. They can also include things like ebv, Epstein Barr virus. So I'm listening to that story and saying, okay, well my client had these pre existing conditions. Has there been any change as a result of having Covid and if so, what are those changes? Has that condition been aggravated? Has that aggravation ended as that aggravation continued, has it become, have the symptoms become more symptomatic or more frequent? The third thing I'm listening for are new conditions that are arising because of long Covid. Now, in addition to an aggravation of gerd, I'm also listening for diagnoses like Barrett's esophagus, which ultimately can become cancerous. I'm listening for an issue of trigeminal neuralgia, which is a chronic pain condition that affects the trigeminal nerve, nerves that carry sensation from your face to your brain. I am listening for issues with pots.
 
 Nancy Cavey [00:05:31]:
 I am listening for issues involving mast cell aggravation or syndrome. And I am also listening for the ebv. Not an aggravation of, but an actual onset of ebv. So when you are talking to your physicians, I strongly suggest that you kind of divided into those three categories. If you've had a pre existing condition that's been aggravated or accelerated by long Covid, you need to talk about those baseline symptoms you had before COVID and then how they've changed after intensity, frequency, duration, location. If you have complications from long Covid of any systemic nature, you want to talk about those symptoms. But you want to talk about them by body system, pulmonary, cardiological, urological, neurological. So you want to kind of classify them by body system and talk about the symptoms and functionality.
 
 Nancy Cavey [00:06:33]:
 And then of course, if you have something new that is post Covid new diagnoses of, as I said, something like POTS or mast cell syndrome, you need to be talking to your doctor about that. I like this discreet breakup, if you will, of these medical conditions with a history of symptoms and functionality. This is really going to be important in developing your claim or ultimately dealing with a wrongful denial or termination. Most likely you're going to be required to apply for Social Security disability benefits and obviously you should be hiring a lawyer who has a specialty in both, in my opinion. But that history is also going to be significant in the Social Security disability claim. So think about that as you are approaching how you want to apply for disability or your Social Security disability benefits. Got it? Let's take a break.
 
 Speaker B [00:07:32]:
 Have you been robbed of your peace of mind by your disability insurance carrier? You owe it to yourself to get a copy of Robbed of your peace of mind, which provides you with everything you need to know about the long term disability claims process. Request your free copy of the book@kvlaw.com today.
 
 Nancy Cavey [00:07:57]:
 Welcome back to Winning isn't Easy. Let's talk about the seven denial tools that carriers or plans use to justify a claim, denial or termination and how courts have viewed these tools. In my experience, it's not uncommon for long term disability carriers or plans to to deny long Covid claims for the following reasons or a combination of reasons. Number one, no proof of infection. Number two, no diagnosis of long Covid. Number three, no symptoms that are consistent with that long Covid long hauler diagnosis. Number four, you're not getting treatment that's reasonable and appropriate based on the severity of your claim symptoms. Number five, there's no functional restrictions, limitations that would prevent you from performing your own or any condition which is known as your post Covid functional status or pcf.
 
 Nancy Cavey [00:08:49]:
 Now number six is their argument that there's no connection between your diagnosis, your symptoms, your restrictions, and your alleged inability to perform your own or any occupation. And then one of the other common defenses I'm seeing is that your risk of exposure to people who might be infected with COVID or other medical conditions that could aggravate or accelerate your symptoms just isn't the equivalent of disability. So you may have gotten a claim denial or termination for one of these seven reasons or a combination of the reasons. The question becomes, well, how can you go about Attacking some of these bogus reasons. So let's take them one by one. One attacking the no proof of infection or diagnosis of long Covid denial tolls. Now, at the beginning of the COVID epidemic, carriers and plans were insisting that a disabled policyholder or plan beneficiary had to prove that they had a COVID infection. They would complain that you didn't have a positive COVID test or that one was performed by a physician or a medical facility.
 
 Nancy Cavey [00:09:58]:
 In other words, they didn't like home test results. Luckily, we don't see that argument much anymore based on the false positive test results, results that even are present in tests performed by physicians or medical facilities. But you know, the widespread availability of home testing kits and the CDC guidance on the use of those kits I think has really overcome the disability carrier plan's argument that you couldn't possibly have all these symptoms because you didn't have a positive COVID test is gone by the wayside. How about attacking the no symptoms consistent with long Covid denial tool? Now, as the starting point for this particular defense, the disability carriers and ultimately courts are going to look closely at the policyholder or plans beneficiaries medical records. They're looking for symptoms of long Covid, an aggravation of a pre existing medical condition by long Covid or the development of new medical conditions caused or contributed to by long Covid. These symptoms should be outlined in your medical records as I discussed in the first episode. So let me give you an example of how this defense unfolds. This is the 2022 case of Abrams versus Unum Life.
 
 Nancy Cavey [00:11:22]:
 And in that case, Abrams was a trial lawyer who ultimately was diagnosed with long Covid and chronic fatigue syndrome. Unum pulled out their denial toolbox and said, oh, wait a second, we're going to deny this claim because there's no formal diagnosis or a rule out diagnosis. The symptoms are subjective in nature and therefore any diagnosis is not objectively based. And his subjective symptoms didn't prevent him from performing his occupational duties as a trial lawyer. So what did the federal court end up doing with this? Well, the court said that Abrams did not have to have a compelling unifying diagnosis of the symptoms or even the correct diagnosis. The court said that the lack of diagnosis or even the correct diagnosis was not the issue in the case. The issue was whether or not Abrams was disabled as that term is defined in the policy or plan. Now, the court noted that Abrams had daily fevers, brain fog, diminished concentration, malaise, and a homebound status.
 
 Nancy Cavey [00:12:22]:
 The court contrasted his pre disability life with his post disability life, Abrams had trained and run marathons. He, like most lawyers, had worked 12, 14, 16 hour days on complex legal matters and he wasn't able to do that anymore. And the court noted that the evidence that he submitted was objective in nature. What was that proof? Well, Abrams had daily, so he actually submitted 23 video recordings on his phone with his temperature and a temperature log to document the relapsing fevers. So this was a really fantastic way of prevent, of submitting objective evidence of subjective medical conditions. Now I think that the key is a good interval history of your symptoms and functionality between visits to your doctor, keeping a journal, keeping, keeping a symptoms log, doing videos, having third party statements. You want to really develop the basis for the doctor's opinion and restrictions and limitations. Well, how about that treatment? You're not getting reasonable or appropriate treatment Denial tool.
 
 Nancy Cavey [00:13:33]:
 Obviously you should be treating with a specialist who is, you know, appropriate for the nature of your symptoms. Now there are, we're beginning to have Covid centers of excellence to treat the whole constellation of symptoms and complications. But in some areas they don't exist. And in some areas where they do exist, there's a heck of a long waiting line. So the disability carrier plan is going to expect that you're getting treatment by a specialist. So if you're having cardiological issues, they want you to see a cardiologist. If you're having lung issues, they want you to see a pulmonologist. So, you know, obviously you want to get appropriate medical treatment by a medical provider and if possible, a specialty facility.
 
 Nancy Cavey [00:14:23]:
 What I will tell you is not acceptable is functional medicine or alternative medicine treatment. I'm sorry to say that, but the courts simply just don't accept that. And most disability carriers or plans don't consider that type of treatment to be reasonable or appropriate. Well, how about attacking the no functional restrictions and limitations that would prevent you from performing your own or any occupation Denial tool. Now obviously you should be receiving testing to substantiate your long Covid symptoms and the complications. An example would be undergoing pulmonary function tests to document the nature of your pulmonary issues or cardiological testing to document the cardiac complications. Now, they're also gonna expect specialized testing to substantiate not only your long Covid symptoms in the diagnosis, but the impact of those symptoms on your inability to perform your own or any other occupation. So they're gonna be looking for things like functional capacity evaluations, cardiopulmonary exercise testing, pulmonary function testing, EEG testing, neuropsychological testing post Covid functional status, evaluation of PCFs.
 
 Nancy Cavey [00:15:34]:
 Your records really need to be chock full of these testing modalities and results that will substantiate the basis of the restrictions and limitations. Well, how about attacking the no causal connection between the diagnosis, symptoms, restrictions and your alleged inability to do your own occupation or any occupation. Again, I think the Abrams case is a good example because he was able to objectively document the nature of the symptoms. I will tell you that when we lawyers file disability insurance claims, I think we do sort of get the Kansas City advantage, if you will, because judges know what lawyers do. Judges don't always necessarily know what other occupations are, but they can see in their own mind what the occupational duties are of a trial lawyer. And they can say, look, if this person objectively has migraines, and here's the record, here's how often they have them, here's a video of them having a migraine, here is the remitting fevers, here's the log, here's this symptom, symptom, that symptom. And it's tied together by the physician with restrictions and limitations and objective testing like FCEs and tied together with a vocational opinion. Then it gets really hard, I think, for the court to reject the evidence that we're submitting.
 
 Nancy Cavey [00:16:58]:
 And that's because you're basically building layers on layers and layers of proof and it's not speculation. So you can see that there is a rhythm and a pattern for developing this kind of evidence. Well, how about attacking the risk of exposure to Covid is not the equivalent of disability denial tool. Disability carriers like Unum really stick their nose up in the air at the possibility that a policyholder could contract Covid if they return to work. They routinely minimize the risks associated with contracting contracting Covid as a basis for ERISA disability benefits. And this in legal terms is called the risk of exposure or the risk of infection or the risk of relapse defense. And that's exactly what happened in the case of down versus unum. Now, Dr.
 
 Nancy Cavey [00:17:50]:
 Downs was a pediatrician who had practiced for over 40 years when she underwent gynecological surgery to remove her uterus and a pre cancerous growth. During her post op recovery period, COVID pandemic emerged and she ultimately filed a claim for disability benefits based on the risk of contracting Covid. And at the time she filed her claim, she was 70 years old, had a history of cardiac heart disease, asthma, diabetes, and obviously we all know she was at great risk for contracting Covid and and potentially a higher death rate because of her age and her pre morbid medical conditions. Obviously, she really couldn't practice medicine remotely because she had to examine infants and children who in my experience are little petri dishes of illness. So it really wasn't realistic for her to be in a clinical setting evaluating and treating children or being exposed to their relatives. Unum, of course, denied her claim for several reasons, saying that downs fear of contracting Covid could not possibly constitute a disability because then every health worker who was over age 65 would be deemed disabled if they made a claim for disability benefits and that such fear could open the floodgates of disability insurance claims. So the court was faced with the issue of deciding if a person with a present condition that puts them at high risk of COVID 19 but would otherwise not prevent them from completing their usual and occupational duties was disabled. And the court found in this case, based on the facts of the case, that the risk of future harm of contracting Covid did constitute a disability.
 
 Nancy Cavey [00:19:31]:
 The court noted that her occupation exposed her to Covid, that she couldn't perform her occupation remotely, and her age and underlying health conditions made it more likely that she could contract Covid and even possibly die. You can see that Unum took a extreme position in a highly sympathetic case and rightfully got slapped down. But again, the risk of exposure defense is one that we see commonly and needs to be attacked on a case by case basis. Now you've learned all about the defenses that are being routinely raised and how to go about attacking those. Hopefully you've been taking notes. We're going to give you a break. In the next segment, I'm going to talk about the role of your physician in your long haul covert Covid claim and the post Covid functional status test. Got it.
 
 Nancy Cavey [00:20:20]:
 We'll be right back. Welcome back to Winning Isn't Easy. What's the role of your physician in your long haul or Covid claim and what is your post Covid functional status? As I have discussed in earlier segments, your medical records can make or break your long Covid claim and as a result, it's important that your physician be a great historian. That means you have to be a great historian. In earlier segments I talked about the three things that I'm looking for or listening for as I'm talking to a prospective client. The first thing I'm looking at is does this person have a preexisting medical condition that was aggravated or accelerated by their Covid? And if so, I'm telling my client to write down what was their baseline set of Symptoms for this pre existing condition in terms of frequency, duration, intensity and the nature of the treatment. And then post Covid contrast, how that pre existing condition has changed, has it been aggravated, has it been accelerated? Are there more symptoms, different symptoms, are they more frequent? Has the nature of your symptoms changed? Then we have the, what I call the general Covid symptoms by system. Cardiological issues, neurological issues, pulmonary issues, whatever body systems are involved, you want to write that down and you want to explain what your symptoms are by function, pulmonary function, for example, and how those symptoms impact your ability to function.
 
 Nancy Cavey [00:22:17]:
 Then the third set of medical criteria in my mind is new conditions that are being seen as the sequela of COVID It might be pots, it might be chronic fatigue syndrome, it might be mast cell syndrome. Anything that's new, that is a known new disease, complication, if you will, of COVID should have its own piece of paper, if you will, writing down the symptoms and the functionality, because not only should you keep a copy of it, but you want to give it to your physician because what's in your medical records can make or break your claim. So again, what ultimately we want them to do is take down this information about your symptoms, make a diagnosis, and then correlate the diagnosis with objective findings and then address your functional restrictions and limitations that would impact your ability to do your own or any other occupation, depending on where you're at. Now, let's talk a moment about the post Covid Functional Status Scale manual. And I will be real frank with you. I don't like it. I have a number of issues with it. I think a better alternative is a functional capacity evaluation, a CPET exam if you're having cardiological issues.
 
 Nancy Cavey [00:23:47]:
 You know, cardiological testing that indicates the level of your cardiological functioning and even in the right cases, neuropsychological testing. I think those are better measures of a person's functionality than this post Covid Functional Status Scale manual. So now that I've sort of trashed it, let me tell you why I don't like it. It's a manual that can be used by physicians to determine your functional limitations. And according to the manual, this scale is intended to help users become aware of current functional limitations in a COVID 19 patient, whether as a result of a specific infection, and to objectively determine the degree of disability. So it really was designed to monitor the course of symptoms and the impact of symptoms on a functional status. But I don't necessarily think that the range that it uses captures the full impact of a person's symptoms because it doesn't do the analysis as I had suggested. It will focus on limitations and usual duties and activities and changes in lifestyle on a one to six scale.
 
 Nancy Cavey [00:24:58]:
 And what I'm going to pay a little bit of attention to is grade three, which is the inability to perform certain activities that have to be structurally modified, and grade four, which is reserved for patients who have severe functional limitations acquiring assistance with activities of daily living. I don't like that scale. To me that's, you know, you go arbitrarily from an inability to perform certain activities that require structural modification and then you kind of jump to severe functional limitations that require assistance. I just don't, I don't like that. I think that's quite frankly subjective. I also have a number of issues with the validity and scientific reliability of this scale, how it's applied to patients, and in particular, I really think that this is a tool that disability carriers are going to misuse, particularly as they apply the definition of occupation or any occupation. And certainly I don't like this in the context of a Social Security disability claim where the real question is whether a patient can return to their past work that they've done, the lightest job they've done or simplest job they've done in the five years before the claim is adjudicated and whether they can do other work of a sedentary nature. Again, it sounds good, I think in theory, but I don't think practically it's really the great thing for your physician to use.
 
 Nancy Cavey [00:26:34]:
 I really want your doctor to complete what we call long Covid residual functional capacity forms in combination with the applicable system based residual functional capacity form. So in English, what that means is we lawyers, Social Security lawyers, have developed sort of an overview long hauler Covid generic form RSC form. But then if my client, for example, has cardiological complications, I want to use the cardiological rfc. If they have neurocognitive complications, I want to use that residual functional capacity form. So there are many times in a case that I'm using multiple residual functional capacity forms to get at, in fact what my client's functional restrictions and limitations are at the own occupation stage, as that term is defined own occupation, and at the any occupation stage as that term is defined, I will modify or use these forms as an addendum to the carrier or plans attending physician statement form. They don't ask the right questions. And these Social Security forms do ask the right questions. And of course, because you're probably required to apply for Social Security disability benefits, I will also use them when I'm assisting my client in applying not only for their long term disability benefits, but for their Social Security disability benefits.
 
 Nancy Cavey [00:27:57]:
 You can see medical records are key and in combination with the strategic use of residual functional capacity forms, you can, I think, really improve your chances of getting your benefits and staying on claim. Got it. Let's take a break, but in the next segment I'm going to talk about the vocational denial tools that disability carriers use. Got it. We'll be back in a second.
 
 Speaker B [00:28:24]:
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 Nancy Cavey [00:29:04]:
 Welcome back to Winning Isn't Easy. Let's talk about the vocational denial tools in the Disability Carriers toolbox. Now, disability carriers or plans often take the position that notwithstanding your restrictions and limitations, you can perform your own or any occupation. It's really crucial to understand how those terms are defined in your disability policy or plan because what the disability carrier or plan is going to do is to hire an in house vocational evaluator to address your occupational duties and then they're going to apply the restrictions and limitations as found by the carrier's peer review physicians to determine whether you are capable of performing your own or any occupation. So you need to understand that this is the game that's going to be played. What I often find is that the disability carrier plan makes mistakes in understanding what in fact your occupation is. They will generally use the outdated dictionary of Occupational titles to try to pigeonhole you into an occupation. Now they may be able to do that based on the terms of the disability policy or plan.
 
 Nancy Cavey [00:30:13]:
 Occupation can be defined as how the job is performed for your employer, how the job might be performed in the local economy, how the job might be performed in the national economy, or how the job might be performed pursuant to the Dictionary of Occupational Titles. So you need to understand what this definition of occupation is because ultimately you want your physician to understand that and address your restrictions and limitations in the context of your occupation. If you're at that stage now, the definition of disability is going to change at some point from own occupation to any occupation. And again, you need to understand the definition of any occupation. It could be doing the material and substantial duties of any occupation that you might be allegedly able to perform in view of your education, your transferable skills, and whatever your restrictions are, that's going to be the measure of your entitlement to benefits. And again, your doctor needs to understand what is that definition so that they can adequately address the restrictions and limitations. If the claim is ultimately denied, as most are going to be denied, they will use this vocational rehabilitation person to analyze your own occupation, determine if you're able to do, in quotes, your own occupation. And if you're at the any occupation stage, they're going to do what's called a transferable skills analysis to understand what skills you may have learned in your past work.
 
 Nancy Cavey [00:31:46]:
 Well, if they get your past work wrong, your occupation, they're going to get the analysis wrong. And they're also going to get the analysis wrong when they apply the wrong restrictions and limitations to determining whether or not you have transferable skills. And on top of it, they may get the labor market surveys wrong or the wage calculations for the occupations they identify wrong. It's really crucial that you understand this, because I will tell you, as part of our appeals, we routinely get functional capacity evaluations or doctors to comment on restrictions, and then we try to rebut the carrier's vocational evaluator's opinion based on the correct analysis of your occupation, your restrictions, transferable skills, job numbers. So we're there knowing from the very beginning we're going to have to rebut this, and we want to set it up properly from the beginning. So how does this work? Well, in the Abrams case that I've talked about, Abrams was a trial lawyer who had complications of COVID including recurrent fevers that he documented. The case ended up in front of a federal judge. And.
 
 Nancy Cavey [00:32:57]:
 And the court noted that the court is intimately familiar with trial work and its complexity. For being a trial lawyer is akin to writing, directing, producing, and starring in a play. Simultaneously, the work is mentally and physically grueling. And a reviewer has to take that complexity into account when reviewing the claim. You can see that the judge understood what the occupational duties were of a trial lawyer, understood the restrictions and limitations, and was able to say, look, there's this causal connection. He's got these symptoms. They're severe. I know what his occupational duties are, and I understand why he can't do these occupational duties.
 
 Nancy Cavey [00:33:37]:
 So you can see that you need to be prepared from the very beginning for a vocational denial, either at the any occupation stage or the own occupation stage. Got it. Let's take a break. And in our final segment, I'm going to give you a number of tips for attacking the denial or termination of your long haul or Covid claim. See you in a second foreign welcome back to Winning Isn't Easy. Let's talk about the 13 tips for attacking the denial or termination of your long Covid claim. As a nationwide ERISA and IDI disability attorney who routinely handles long haul or Covid claims, I will tell you that These are my 13 tips that I use in attacking a wrongful denial or termination. And I'm going to riff a little bit, if you will, on each of these as I have in earlier segments of this episode.
 
 Nancy Cavey [00:34:54]:
 But let's run through them. Number one, documentation of exposure. If you've got a positive COVID test, that would be fantastic. Two, we want documentation of the diagnosis in your medical records. Number three, we want documentation of symptoms. And you've heard me talk about the three categories pre existing condition, aggravation and acceleration, pure Covid complications, if you will, based on body system new diseases or medical conditions that we are seeing as a result of COVID So we want documentation of those symptoms and functionality. Number four, we want to make sure that you're getting appropriate treatment that's consistent with the severity of your complaints and dysfunction. We want to see at Number five, documentation of restrictions and limitations by objective testing, be it a functional capacity evaluation, be it a CPET exam, be it neuropsychological testing, be it cardiological testing or pulmonary testing or whatever testing is appropriate to the system involvement.
 
 Nancy Cavey [00:36:03]:
 We also want, number six, corroborating statements from from you about your condition. Number seven, we want journals and symptom logs. Now I'm not necessarily a big fan of day to day minute by minute logs. I like more of the generic type of log that's done on a weekly basis that doesn't, you know, set alarms off in the carrier or plan's mind that you're exaggerating but which is consistent with your medical records. I like those journals and symptom logs to be made part of my client's medical records. Number eight, photos of readings. If, for example, you're having recurrent fevers or you're having recurrent some things that can be measured. Take pictures of it.
 
 Nancy Cavey [00:36:55]:
 Keep that in the form of a picture log. Number nine, third party witness statements. Now certainly disability carriers may consider your family members to be biased. They probably are because they're your loved ones. But those statements need to be objective. If you've got witness statements of co employees or colleagues that can attest to your functionality before and after. That's consistent with what you've complained of. That's great.
 
 Nancy Cavey [00:37:25]:
 Obviously at number 10, you want physicians confirming the diagnosis, testing restrictions, and being willing to help you attack any opinion from the carrier or their liar. For higher peer review, doctors number 11 as appropriate, you might want to get your own independent medical evaluation of a physician who is sympathetic to a Covid case. Number 12 FCEs, CPETs. Whatever the appropriate exam is that's going to measure your functionality, you need to get that, and you want the provider to corroborate the level and nature of your symptoms. Ultimately, that FCE or the CPET is going to be given to number 13, a vocational evaluator, and that vocational evaluator is going to take these restrictions and limitations, either documented by the objective testing end or endorsed by your IME or treating physician, and then render the vocational analysis. Got it? So that's my 13 tools or tips that I use in attacking a denial or termination of your claim. Got it? I hope that you've enjoyed this week's episode of Winning Isn't Easy. If you've enjoyed this, please like the page, leave a review or share it with your friends or family or even your long haul or COVID support group.
 
 Nancy Cavey [00:38:46]:
 Please subscribe to this podcast. That way you're going to be notified every time a new episode comes out. And by the way, we welcome questions from our listeners. And at the start of each episode description where you have been listening, there's going to be a link where you can text us comments or questions send them to us because I'm going to address them in future episodes. I want you to be educated about your rights to your long term disability benefits and the games that disability carriers play. Got it? Please tune in next week for another insightful episode of Winning Isn't Easy. Thanks.