Long COVID or Post-COVID Conditions (as defined by the CDC) emerged soon after the pandemic did. It was clear almost immediately that COVID didn’t affect everyone equally. When Long COVID was classified as a longer-term illness, separate from the initial COVID infection, we in our Clinical Claims Innovation Lab made sure to group the majority of our claimants with this diagnosis together so that we could learn from each case and look for trends and patterns in real time. The immediate benefit to our members by making this change is that we can have earlier and more frequent discussions between case managers and vocational rehabilitation counselors to identify accommodations that help them, our members, return to work.

Our lab found that there are no strong predictors about who will develop Long COVID. It’s not limited to individuals with pre-existing conditions or to older populations. Only 31% of members we are working with report having a pre-existing condition. While the average age in our group is 52, all age ranges are represented. In addition, a CDC study between March 2020 – November 2021 showed that Long COVID symptoms can occur in 1 in 5 COVID patients.

For people that acquire COVID-19, vaccination status has only been shown to decrease risk of Long COVID by a small percentage (~15%), however vaccines do continue to prevent hospitalizations and death from COVID-19 infections.

There is hope though. We found in our claims lab that Long COVID symptoms generally improve over time. In July 2021, it was found that Long COVID can be considered a disability under the Americans with Disabilities Act (ADA), so returning to work is possible, but may require accommodations and time.

Sun Life is committed to providing the best care and benefits for our members, and we will continue to closely follow Long COVID as it evolves in our population. Please visit our page dedicated to the Clinical Claims Innovation Lab focus on Long COVID where we have shared our findings to date and will continue to update with relevant information.