Is Long COVID-19 Considered a Disability Under the Americans with Disabilities Act?

Two years after COVID-19 was first detected, the global COVID-19 pandemic has infected more than 300 million people, claimed the lives of almost 5.5 million, and changed the lives of everyone in the world.

Scientists and the public are learning more about the virus, but so much more still remains a mystery. Surprisingly, long COVID-19 — also called “post-acute COVID-19” or “chronic COVID-19 — has emerged as a disease with a wide range of new, returning, or ongoing health problems experienced more than four weeks after an initial COVID-19 infection. Even asymptomatic people can later present with long COVID-19.

Dr. Devang Sanghavi, a critical care medicine specialist, breaks long COVID-19 into three categories of symptoms: direct cell damage preventing full recovery; chronic hospitalization due to being in the hospital, the ICU, or in bed for weeks, and post-recovery onset. The five most common symptoms of long COVID-19 are fatigue, headache, brain fog, hair loss, and shortness of breath. Other symptoms are related to the lungs (cough, chest discomfort, sleep apnea, and pulmonary fibrosis), the cardiovascular system (arrhythmias and myocarditis), and the nervous system (dementia, depression, anxiety, and obsessive-compulsive disorder).

In light of the rise of long COVID-19 as a significant health condition, the United States Office for Civil Rights of the Department of Health and Human Services (HHS) and the Civil Rights Division of the Department of Justice (DOJ) published a joint guidance in July 2021. The guidance explained that long COVID-19 may be considered a disability under the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act, and Section 1557 of the Affordable Care Act if it “substantially limits one or more major life activities.” It also recognized long COVID-19 as a physical or mental impairment based on a physiological condition affecting one or more body systems — given the damage it causes to multiple organs including the heart, lungs, kidneys, skin, and brain.

The guidance found that a person with long COVID-19 can be substantially limited in the following major life activities:

• Respiratory function due to shortness of breath, fatigue, and related effects.
• Gastrointestinal function due to intestinal pain, vomiting, and nausea.
• Brain function, concentrating, and/or thinking.

Consequently, people whose long COVID-19 qualifies as a disability are entitled to the same protections from discrimination as any other person with a disability under the ADA, Section 504, and Section 1557 — they are entitled to full, equal opportunities to participate in and enjoy all aspects of civic and commercial life. This means that businesses or state or local governments may sometimes need to make changes to the way they operate to accommodate the effects of a person’s long COVID, such as:

• Providing additional time on a test for a student who has difficulty concentrating.
• Modifying procedures so a customer who is too tired to stand in line can announce their presence and sit down without losing their place in line.
• Providing refueling assistance at a gas station for a customer whose joint or muscle pain prevents them from pumping their own gas.

Stay tuned for further research results on the prevalence and longevity of long COVID-19. This condition can cause a variety of long-term health effects, and it may be a disability that requires accommodations under the Americans with Disabilities Act.