Social Security Disability evaluation of COVID-19

The Social Security Administration (SSA) has issued policy guidance for evaluating adult disability cases that involve a diagnosis of COVID-19.

SSA needs objective evidence from an acceptable medical source to establish the existence of a medically determinable impairment for COVID-19, including long terms effects of COVID-19.

If a person as a medically determinable impairment of COVID-19, SSA must determine if the impairment is severe, and has lasted or is expected to last at least 12 months.  SSA will not combine two unrelated medically determinable impairments to meet the 12 month requirement.  However, if COVID-19 causes a new medically determinable impairment, or worsens an existing medically determinable impairment, SSA will consider there medically determinable impairments to be related.

If a person recovers from COVID-19 with no residual symptoms, limitations or restrictions, COVID-19 will not meet the duration requirement.  However, symptoms associated with COVID-19 that last for months or longer after recovery may meet the 12 month requirement when a person has long-term effects of COVID-19, one or more new medically determinable impairments caused by COVID-19, or any existing medically determinable impairment worsens because of COVID-19.  SSA may need to project the severity if it is unclear whether the medically determinable impairment will resolve.

Issues related to the COVID-19 pandemic, including eviction, medical facility closure, quarantine, job loss and insurance loss, may affect the ability to seek treatment.  SSA should consider whether lack of treatment is because of these issues.

COVID-19 by itself cannot meet a listing but it may equal a listing as an unlisted impairment or as part of a combination of impairments.  COVID-19 may affect respiratory, cardiovascular, renal, neurological, or other body symptoms.  In most cases, the listing relevant to a new medically determinable impairment caused by COVID-19 or any medically determinable impairment that has worsened because of COVID-19 will be the appropriate listing to consider.

COVID-19 cannot be medically equivalent to Listing 3.14, respiratory failure, because an infection cannot be a chronic impairment for purposes of that listing.

When determining residual functional capacity, SSA will consider functional limitations from any new medically determinable impairment caused by COVID-19, or any medically determinable impairment that have worsened because of COVID-19.  (EM 21032, April 16, 2021.)