Physical and mental disability claims could surge due to COVID

By Paul Russell, LegalMatters Staff • A significant increase in disability insurance claims can be expected as Canada continues to contend with the COVID-19 pandemic, predicts disability lawyer Leanne Goldstein.

“We are now seeing just a fraction of what is coming,” says Goldstein, founder and senior lawyer at Leanne Goldstein Law Professional Corporation. “With delays in the vaccine rollouts and as the lockdown eases, there will be many more cases of people filing disability claims with their insurers.”

‘Long-haulers’

She notes the medical community has coined the phrase “long-haulers” to identify those who have mostly recovered from the initial infectious process related to the virus but are left with residual problems such as fatigue, body aches, shortness of breath, difficulty concentrating and difficulty sleeping.

“With many years of experience litigating long-term disability claims, our firm has seen other cases where long-term impairments are linked to something infectious such as Lyme Disease,” Goldstein tells LegalMattersCanada.ca. “I am sure there will be an increase in COVID-related disability cases in the coming years,” she says, adding that the virus can affect a person’s physical and mental health over the longer term.

“We are already seeing dramatic levels of anxiety and depression about COVID,” she says. “The lockdowns have been especially difficult on those with pre-existing mental health issues. Everything around them is changing, compounded by the pressure of social isolation.”

A coping mechanism for some has been substance abuse, Goldstein says, which also leads to disability claims.

“People are becoming more anxious, so they are relying on alcohol and drugs as a way to cope,” she adds.

Treatments disrupted

The current restrictions on the operation of medical offices will likely also lead to more disability claims in the coming months and years, Goldstein says.

“People are not visiting their doctors for regular tests, screening and treatment as often as before,” she explains. “Many are uncomfortable seeing their doctor online, or they lack the technology or ability to engage in virtual visits.

“Treatments that they might have accessed in the past nine months now seem to be unavailable to them, so we are seeing an increase in physical health issues and mental health-related symptoms,” Goldstein says. “An inability to pursue treatment can lead to an increase in symptoms and a  decrease in functionality, which in turn leads to them being unable to maintain their jobs.”

The economic downturn further exacerbates the stress people experience, she says, with many businesses closing their doors or reducing staff.

“People are panicking about finding a way to support their families,” Goldstein adds.

She says her firm often sees an increase in disability claims when there is an economic downturn.

“In times of economic turmoil, people’s coping capacities are reduced, compromising their ability to earn a living,” Goldstein says. “As a result, they end up incredibly stressed and unable to function.”

Impact on existing claims

The lack of employment opportunities affects insurers that want to see people on disability claims finding their way back into the workforce, she says.

“Insurance companies push for treatment and rehabilitation to have claimants return people to the workforce as quickly as possible,” Goldstein says. “Because of the work closures brought on by COVID, people cannot be reintegrated back into the workforce as many people do not  have a job to reintegrate into.”

She emphasizes that “this can seriously impact claimants as they may end up with a denied disability benefits claim and no job to return to.”

The treatments insurance companies expect disability claimants to pursue have also been disrupted by the pandemic, Goldstein says, which may affect a person’s eligibility for future payments.

“If there is a requirement in an insurance policy that the claimant must seek ongoing treatment and the insurer sees that the individual is not pursuing recommended treatment, that could be a reason to end the claim,” she says. “The complexities related to access to treatment is going to become a real issue as this pandemic progresses.”

Decrease in insurance surveillance

One positive change brought about by the COVID crisis is the decreased ability of insurance companies to end a disability claim based on information they have gathered through surveillance, she says. Goldstein explains that some insurance companies hire private investigators to record claimants doing physical activities such as working in the yard, socializing or going grocery shopping.

“Insurance firms use surveillance as a tool for adjudication,” she says. “Perhaps they received a tip from a neighbour, saw something on social media or read something in a medical record and now they are trying to ensure that the person receiving insurance payments is telling the truth about their disability.”

With a general decrease in activity levels due to the COVID crisis, Goldstein says surveillance will likely be used less by insurance companies.

“This is good news”, she says, as surveillance is often used unfairly by insurance companies to deny claims.

Goldstein says she is not aware of others considering the impending increase in disability claims. “Many corporate and employment lawyers are talking about the impact of COVID, but I haven’t seen a lot of disability lawyers discussing the expected surge in claims due to the physical and mental toll of COVID.”