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Tuesday, August 8, 2023

The Long Legacy of COVID-19 Disability

The legacy of the COVID-19 pandemic persists. There exists a continuing need for long-term treatment and disability. While state benefit systems such as workers’ compensation have made an admirable attempt in many jurisdictions to provide benefits, a significant gap and non-uniform delivery of benefits continue to exist among jurisdictions. Federal efforts are expanding to provide necessary research and treatment protocol resources. 


COVID-19 is a worldwide issue not constrained to state or national boundaries. The limited resources of state-based workers’ compensation systems are too fiscally restrictive to embrace the long-term treatment and disability benefits that will emerge from successive infectious disease outbreaks.

In October 2021, the World Health Organization recognized Long-COVID as a disabling medical condition. An ICD-10 Code (U9.0) Post-Acute Sequelae of COVID-19 (PASC) has been adopted by the Centers for Medicare and Medicaid Services (CMS).


The COVID-19 pandemic emerged in early 2020 and forced widespread business closings. Workers’ Compensation benefit programs provided an inconsistent approach nationally to meet the demands that occupationally induced COVID-19 presented. Over the three years that have transpired, judicial and administrative law systems were interrupted, and the processing of workers’ compensation claims was suspended and delayed. Governmental agencies declared public health emergencies on Federal and state levels that further interrupted the claims process. The reported decisions of hearings and appeals have been very limited to date.

The mandated shutdown of non-essential businesses to diminish transmittal and disease so that the healthcare system would not be overwhelmed will not be repeated. The social and economic consequences were far too severe, and the efforts for pandemic preparedness have since been ramped up. Businesses will remain open, and infectious virus mutations will result in continued occupational exposure and disease transmission.


COVID-19 has not gone away, and the threat persists. The Federal government has continued to active monitoring COVID-19.  Hospitalization is rising, greater than 10%, for both vaccinated and unvaccinated individuals in the US based on wastewater surveillance that the Federal government is monitoring.

The Food and Drug Administration, which issued 72 guidance documents during the pandemic, kept some documents, including Telehealth, active after the Federal Public Health Emergency ended in May 2023. The Centers for Disease Control [CDC] continues to direct vaccine production and, in August 2023, authorized a monovalent vaccine booster to combat the XBB.1.5 variant. 

The proposed fall 2023 booster, now delayed in production, does not address the newer variants. EG.5.1 is now the dominant variety in the U.S. Also, researchers report that the upcoming Flip Combo Mutation in Brazil and Spain is emerging, expressing mutations in the spike 455 and 456 positions.


The U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra released the following statement applauding the formation of the Office of Long COVID Research and Practice to lead the Long COVID response and coordination across the federal government and, in addition, the National Institutes of Health (NIH) launch of the Long COVID clinical trials through the RECOVER Initiative.

“As our nation continues to make strides in combating COVID-19, it is crucial that we address the impact of Long COVID and provide resources to those in need,” said HHS Secretary Becerra. “Last year, President Biden called on HHS to coordinate the response to Long COVID. The Official establishment of the Long COVID Coordinating office and the launch of the RECOVER clinical trials solidifies this issue as an ongoing priority.”

“The Office of Long COVID Research and Practice will enhance efforts being undertaken across the U.S. government to improve the lives of those who continue to experience the long-term impacts of the worst public health crisis in a century,” said Adm Rachel Levine, M.D. “Bringing together the resources and expertise of federal, state, and local partners, patients, providers, researchers, and the business sector to answer the American people's most urgent calls to action.”


The Office of Long COVID Research will be located within HHS’s Office of the Assistant Secretary for Health under the leadership of the HHS Assistant Secretary for Health, Admiral Rachel Levine. 

The Office is charged with ongoing coordination of the whole-of-government response to the longer-term effects of COVID-19, including Long COVID and associated conditions and the implementation of the National Research Action Plan on Long COVID - PDF and the Services and Supports for Longer-Term Impacts of COVID-19 - PDF. 

Currently, 14 federal departments engage on Long COVID, including over a dozen HHS Operating and Staff Divisions with a goal to reduce the impacts of Long COVID by improving quality of life for people living with Long COVID and reducing disparities related to Long COVID. 


The NIH RECOVER Initiative is a $1.15 billion nationwide research program designed to understand, treat, and prevent long COVID, which describes long-term symptoms following infection by SARS-Cov-2, the virus that causes COVID-19. Over 200 symptoms are associated with long COVID, and the condition can cause problems throughout the body, affecting nearly all body systems, including the nervous, cardiovascular, gastrointestinal, pulmonary, autonomic, and immune systems.

Launched in 2021, RECOVER established one of the largest, most diverse study group of patients with Long COVID in the world. The initial stage of the initiative involved launching large observational multi-site studies examining and following people through their experience with COVID-19 to learn why some people develop long-term symptoms while others recover completely. 

These studies are ongoing and have recruited more than 24,000 participants to date. Researchers also are analyzing 60 million electronic health records and conducting more than 40 pathobiology studies on how COVID-19 affects different body tissues and organs.  This study cohort participated in RECOVER observational studies that allowed researchers to characterize the condition in great detail, which is critical for informing the development of clinical trials to test interventions. 

The clinical trials are designed to study multiple treatments and therapies across five focus areas. Platform protocols for two of these areas were posted July 31, 2023, with enrollment for these trials beginning at the end of July 2023, and throughout the summer. To learn more about the RECOVER clinical trials, visit: external-link.

Through collaboration with federal partners, researchers, clinicians, patient advocacy organizations, and the business sector, the Biden-Harris Administration remains committed to addressing the longer-term impacts of the worst public health crisis in a century. The Federal government will continue to listen and learn from patients, caregivers, frontline workers, and those with lived experience to accelerate understanding and breakthroughs together.


The Federal government has emerged as a resource for continued research and treatment of the long-term effects of COVID. Those efforts will be of immense assistance in battling Long Covid. An appropriate next step would be to determine what Federal program(s) can be implemented to provide lifelong disability benefits and medical treatment for the victims of occupational Long COVID that will fill the gap of the fragmented, inconsistent, and litigious patchwork of workers’ compensation programs. 

Suggested Citation: Gelman, Jon L., The Long Legacy of COVID-19 Disability (August 9, 2023). Workers' Compensation August 8, 2023, Available at SSRN: or


Jon L. Gelman  |  Attorney at Law 

Wayne NJ 07470-2805 |

(973) 696-7900

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Author: "Workers' Compensation Law" West-Thomson-Reuters