A Long COVID disability lawyer can help if your short-term or long-term disability benefits have been denied, delayed or cut off.
An insurer may argue that there is no objective evidence of your condition, your medical tests are normal or your ability to complete basic activities proves that you can return to work.
These arguments may overlook fluctuating symptoms, brain fog, severe fatigue and post-exertional crashes that occur hours or days after physical or mental activity.
Samfiru Tumarkin LLP represents people with denied and terminated disability claims throughout Canada, excluding Quebec.
On This Page:
- How a Lawyer Can Help
- When to Contact a Lawyer
- Why Long COVID Claims Are Denied
- Evidence for Your Claim
- What Happens Next?
- Frequently Asked Questions
How Can a Long COVID Disability Lawyer Help?
A disability lawyer can review your insurance policy, medical evidence and denial letter to determine why the insurer refused or ended your benefits.
A lawyer may help by:
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Explaining the definition of disability in your policy
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Identifying weaknesses or inconsistencies in the insurer’s decision
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Determining what medical and functional evidence is missing
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Connecting fatigue, brain fog and post-exertional symptoms to your occupation
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Addressing normal tests and the absence of a positive COVID test
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Documenting failed accommodations or return-to-work attempts
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Communicating and negotiating directly with the insurance company
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Starting legal action when appropriate
Connecting Long COVID Symptoms to Your Job
A strong disability claim should explain why your symptoms prevent you from meeting the specific requirements of your occupation.
Brain fog may affect concentration, memory, communication and decision-making. Fatigue and breathing problems may limit walking, lifting, commuting and completing a full shift.
Post-exertional malaise may cause a delayed increase in symptoms after meetings, computer work, travel or other seemingly manageable activities.
When Should You Contact a Long COVID Disability Lawyer?
Speak with a disability lawyer promptly if:
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Your short-term or long-term disability claim was denied
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Your approved benefits were later cut off
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The insurer says there is no objective evidence of Long COVID
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The insurer relies on normal bloodwork, imaging or physical examinations
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Your insurer says you can perform sedentary or remote work
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Your daily activities are being used as evidence of work capacity
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You are being pressured to return before your doctor believes you are ready
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You are considering an internal appeal
Do You Have to Appeal to the Insurance Company?
An insurer may invite you to submit an internal appeal after denying your Long COVID disability claim.
An appeal is not always the best option. The same insurance company that denied your claim will review it, and resubmitting similar evidence may produce the same result.
You may not have to complete the insurer’s appeal process before pursuing legal action. A disability lawyer can explain your options and applicable deadlines.
Why Are Long COVID Disability Claims Denied?
Long COVID claims are frequently challenged because many symptoms fluctuate and may not appear clearly on standard medical testing.
Common denial reasons include:
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There was no positive COVID-19 test
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There is no single test confirming Long COVID
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Bloodwork, imaging or examinations appear normal
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Fatigue, pain and brain fog are described as subjective
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The insurer focuses on a brief period of improvement
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Daily activities are treated as proof of work capacity
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The insurer says you can work from home
The Insurer Says There Is No Objective Evidence
There is no single test that confirms or excludes Long COVID.
The insurer should consider your history, clinical assessments, investigations, treatment and functional limitations together.
Testing may also help identify complications or exclude other possible explanations without directly measuring your fatigue, cognitive stamina or post-exertional symptoms.
The Insurer Says You Never Tested Positive
Some people did not have access to testing during their original infection or did not receive a positive result.
Your doctor should document your illness history, continuing symptoms, investigations and reasons Long COVID remains the appropriate diagnosis.
The Insurer Uses Daily Activities Against You
Shopping, preparing a meal or attending an appointment does not automatically establish full-time work capacity.
The activity may have been completed slowly, with assistance, after substantial rest or at the cost of worsened symptoms afterward.
A disability lawyer can help place isolated activities in their proper context.
The Insurer Says You Can Perform Desk Work
The ability to sit does not establish the ability to perform sedentary work.
Desk jobs still require concentration, memory, communication, pace, regular attendance and the ability to repeat cognitive activity throughout the day.
The Insurer Says You Can Work From Home
Remote work may eliminate the commute, but it does not eliminate fatigue, brain fog, headaches or delayed symptom crashes.
You may still be unable to attend meetings, meet deadlines or remain productive throughout a normal workday.
The Insurer Focuses on a Good Day
Long COVID symptoms can disappear, return and vary in severity.
A better day or brief period of improvement does not establish that you can maintain regular attendance and performance over several weeks or months.
Your Benefits Are Cut Off After Two Years
Many LTD policies change their definition of disability after approximately two years.
The insurer may accept that you can’t perform your previous occupation but argue that you can work elsewhere.
Another occupation must be genuinely suitable given your education, experience, cognitive limitations, stamina and ability to work consistently.
What Evidence Supports a Long COVID Disability Claim?
A strong claim should document your symptoms, treatment and functional capacity over time.
Helpful evidence may include:
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Records from your family doctor and treating specialists
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Evidence of your original infection, where available
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Investigations assessing symptoms and excluding other conditions
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Specific physical, cognitive and attendance restrictions
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A symptom and activity record
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A detailed description of your occupational duties
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Failed accommodations and return-to-work attempts
Document Post-Exertional Symptom Worsening
Record the activities you attempt and any delayed increase in fatigue, pain, brain fog, headaches or breathing symptoms.
Include when symptoms begin, how long they last and what activities you are unable to complete during the resulting crash.
Explain Your Abilities Over Time
The insurer may focus on whether you can perform an activity once.
Your evidence should address whether you can repeat that activity throughout a workday and return the next morning without a significant decline.
Document Failed Returns to Work
A brief or part-time return does not necessarily prove sustained capacity.
Document the hours and duties attempted, the symptoms that increased and why the arrangement was reduced or stopped.
What Happens After You Contact a Long COVID Disability Lawyer?
During an initial consultation, a disability lawyer may ask about your symptoms, occupation, treatment and the insurer’s reason for denying or ending your benefits.
The lawyer may review:
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Your denial or termination letter
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The definition of disability in your policy
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Your medical evidence and functional limitations
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Your symptom and activity records
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Your job duties and return-to-work history
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Important dates and potential legal deadlines
The lawyer can then explain whether the insurer’s decision may be challenged and what evidence could strengthen your case.
How Can a Long COVID Disability Claim Be Resolved?
Depending on the circumstances, a denied claim may be resolved through reinstatement of monthly benefits, payment of benefits previously withheld or a negotiated settlement.
There is no standard Long COVID disability settlement. The outcome depends on the policy, monthly benefit, medical evidence, prognosis, age and other circumstances.
Is There a Fee to Speak With a Disability Lawyer?
Samfiru Tumarkin LLP offers a free initial consultation for denied short-term and long-term disability claims.
There are no upfront legal fees. You only pay if we successfully resolve your disability claim.
Frequently Asked Questions About Long COVID Disability Lawyers
What does a Long COVID disability lawyer do?
A disability lawyer reviews your policy, medical evidence and denial letter and helps challenge the insurer’s refusal to pay benefits.
Can an insurer deny a claim because medical tests are normal?
An insurer may raise that argument, but normal testing does not necessarily establish that fatigue, brain fog or post-exertional symptoms have resolved.
Do you need a positive COVID test?
Not necessarily. Some people with Long COVID never received a positive test. Consistent medical and functional evidence remains important.
Can Long COVID qualify if symptoms fluctuate?
Yes. The insurer should consider whether fluctuating symptoms allow you to maintain regular attendance and performance over time.
Does a failed return to work hurt your claim?
Not necessarily. A medically supported but unsuccessful return may help demonstrate that you can’t sustain the required hours or duties.
Do you have to appeal to the insurer first?
Not necessarily. An internal appeal is only one option. Speak with a disability lawyer before deciding how to challenge the denial.
How long do you have to challenge a denial?
Legal deadlines apply and vary by province, policy and circumstances. Get legal advice promptly to protect your options.
Speak With a Long COVID Disability Lawyer
Managing fatigue, cognitive problems and unpredictable crashes is difficult enough. You should not have to fight an insurer alone while facing financial uncertainty.
Samfiru Tumarkin LLP represents people with denied and terminated disability claims throughout Canada, excluding Quebec.
Some members of our legal team previously worked for insurance companies. We understand why chronic and medically complex claims are challenged and what evidence may be needed to dispute a denial.
For more information about eligibility and available benefits, read our guide to Long COVID disability claims in Canada.
Contact us for a free consultation if your short-term or long-term disability claim has been denied or cut off.