How to Apply For—and Receive—Your SSDI
Long COVID makes it tricky. Know the rules.
I lost my job because of long COVID
You might be in the same boat. Paying for a disability policy doesn’t mean you’ll get your payout easily, and it’s an especially tricky process when you have a condition like long COVID. Because our symptoms fluctuate, and because we don’t have reliable easy-to-measure biomarkers, disability claims for people with long COVID are often challenged or denied.
But you can get the payments you deserve. The first step is understanding the system and process you’re engaging with.
In this episode of Long Covid, MD, we’re covering the nuts and bolts of Social Security Disability Insurance (SSDI). I spoke with disability attorney Barbara Comerford of Tri-State Disability Law, who has spent more than 30 years representing people with complex chronic illnesses, including ME/CFS and now long COVID.
Barbara explains:
- how SSDI works
- why so many claims are denied initially
- and how patients can better document a complex disability like long COVID
Today, I’m sharing the most important information I learned. You can watch our full conversation on YouTube—just scroll down for the link.
You’re going to learn a lot in this post, so let’s get started.
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Is Long COVID Considered a Disability?
Yes.
Long COVID is considered a cause of disability by the Department of Health and Human Services.
“This guidance explains that long COVID can be a disability under Titles II of the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act of 1973, [and] Section 1557 of the Patient Protection and Affordable Care Act. Each of these federal laws protects people with disabilities from discrimination.”—Guidance on Long COVID as a Disability Under the ADA
The bottom line is: Long COVID can cause disability, and if you’ve paid Social Security taxes while you were working, you may be eligible for Social Security Disability Insurance payments.
Is SSDI a Type of Welfare?
No.
SSDI is not a benefit nor an entitlement. It is an insurance policy YOU PAID FOR.
The insurance premiums are pulled from most W-2 paychecks. To qualify for SSDI, you’ll have had to pay enough of of those premiums. SSA checks how much you’ve contributed, for how long, and how recently. These variables are mixed together and represented as “credits.”
If you have enough SSDI credits, you can apply for SSDI payments.
Check your credits by downloading your Social Security Statement here.
Once you confirm you have enough credits, you can start the 5-step process to qualify for payments.
If you feel awkward applying for financial assistance, my ever-encouraging Substack buddy Kira Stoops might help.. We spoke last year about ways to take the shame out of the process.
5 Steps of SSDI
Disability lawyer Barbara Comerford describes SSDI as both a medical and legal process. It follows a specific 5-step sequence:
1. Are you engaging in “Substantial Gainful Activity” (SGA)?
The Social Security Administration (SSA) considers an adult disabled if they are unable to perform substantial gainful activity (SGA) because of medical, physical, or mental impairments that last—or are expected to last—for at least 12 months.
“Substantial gainful activity” is a technical term meaning work done for pay or profit above a monthly income threshold. SGA is defined as monthly income—currently about $1690—and/or hours.
2. Does your illness significantly limit daily functioning?
Social Security evaluates whether your condition limits activities like sitting, standing, concentrating, lifting, walking, or sustaining cognitive effort throughout a workday.
Barbara points out that most physicians don’t document these limitations unless patients actively describe them. She strongly recommends symptom journaling—tracking fatigue, PEM, dysautonomia, and cognitive crashes—and bringing those to appointments so they become part of your medical chart.
3. Does your condition match a recognized disability category?
At this stage, Social Security compares your illness to official “listed impairments,” which are standardized disability categories used by the government.
Long COVID and ME/CFS don’t always fit neatly into these boxes, which is one reason our claims are difficult.
4. Can you still perform your previous job?
Social Security then looks at the actual demands of the work you used to do. This includes physical stamina, cognitive load, reliability, and the ability to sustain attention and attendance consistently.
Barbara describes how many people with long COVID can sometimes perform isolated tasks, but cannot reliably function at the level required for full-time employment.
5. Could you realistically perform ANY job in the national economy?
Finally, Social Security asks whether there is any type of work you could reasonably sustain. Barbara explains that this is where objective evidence becomes especially important.
More on that in a bit.
You should probably expect a denial at first
Initial SSDI applications are reviewed by state disability agencies. Many are denied. After a few appeals, cases proceed to a hearing before a federal judge. This is where applicants finally have the opportunity to present their case more fully.
Additional appeals can continue beyond that level, if necessary.
Denials aren’t personal, they’re business statistics
The math just isn’t in our favor the first go-round.
Roughly 32% of initial SSDI applications are approved—many of those are for what Social Security calls “compassionate allowance” cases: illnesses with extremely high morbidity and mortality. Think ALS, glioblastoma, end-stage cancer, or kidney failure.
Long COVID and ME/CFS generally do not fall into these automatic approval categories.
That means denials are extremely common for complex chronic illnesses and should not be interpreted as personal insult. A denial does not mean Social Security believes you are lying, exaggerating, or mentally unstable. In most cases, appeals are simply expected.
Your claim needs the right medical evidence
A major challenge in Long COVID and ME/CFS disability claims is the lack of straightforward laboratory evidence. Again, from the Social Security Administration’s definition:
“The medical impairment(s) must be shown to exist by means of medically acceptable clinical and laboratory findings.
Under the law, symptoms alone cannot be the basis for a finding of disability, although the effects of symptoms may be an important factor in deciding whether an individual is disabled.” —
