Clinical Claims Innovation Lab focus: Long COVID

Long COVID is a result of the novel coronavirus impacting our world since the start of 2020

People who experience COVID-19 symptoms for four weeks or more may be diagnosed as having long COVID. According to an article published by the CDC, “[Long COVID] symptoms can happen to anyone who has had COVID-19, even if the illness was mild, or if they had no initial symptoms.”  

Sun Life’s Clinical Claims Innovation Lab focused on members who are on long-term disability for reason of long COVID. 

It’s important to understand as much as possible about Long COVID

The severity of long COVID can vary from person to person and result in some individuals being unable to work as a result of their symptoms. 

The unique nature of long COVID meant that we needed to learn about the emerging symptoms and their impact on a members' ability to do their job, and adjust our case management practices to meet the needs of members who have this still-new and complex diagnosis.

Read trends and observations of our long COVID Clinical Claims Innovation Lab 

The work done by Sun Life’s Clinical Claims Innovation Lab allowed us to:

  • Learn about the wide-ranging complex symptoms of Long COVID and their impact on a member’s ability to return to work;
  • Analyze treatments;
  • Understand recovery trends;
  • Train our case managers on each of these factors to help them best engage members, employers and treating providers.

The majority of members with long COVID are case managed by the Clinical Claims Innovation Lab team

This change to our disability management practice means members are partnered with case managers knowledgeable about long COVID symptoms and experienced in discussing treatment plans and clinical interventions with treating physicians.

In addition, members benefit from:

  • Early clinical collaboration to understand functional ability and prognosis for improvement, which facilitates a timely benefit decision;
  • More frequent telephone contact to monitor for symptoms changes that may signal a readiness for return to work;
  • Holistic discussions that include both physical and mental wellness, with help obtaining neuropsychological testing as needed;
  • Earlier and more frequent discussions between case managers and vocational rehabilitation counselors to identify accommodations that help members return to work.

Our focus on long COVID provides a better experience for members. 

We use what we learned to create processes for timely decisions and an environment to identify clinical intervention opportunities that improve recovery.

  • How employers can help

    Long COVID is a new, medically accepted diagnosis. It can be scary and it’s important for employees to feel supported. Employers can remind employees about services provided by their employee assistance program. Further, employers can help employees with long COVID by allowing transitional return to work and workplace accommodations. There are many no-cost and easy-to-implement solutions that can help an employee recovering from long COVID be more productive at work.

The content on this page is not approved for use in New Mexico.

Group insurance policies are underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) in all states, except New York, under Policy Form Series 93P-LH, 15-GP-01, 12-DI-C-01, 12-GPPort-P-01, 12-STDPort-C-01, 16-DI-C-01, TDBPOLICY-2006, and TDI-POLICY. In New York, group insurance policies are underwritten by Sun Life and Health Insurance Company (U.S.) (Lansing, MI) under Policy Form Series 15-GP-01, 13-GP-LH-01, 13-LTD-C-01, 13-STD-C-01, 06P-NY-DBL, 12-GPPort-01, and 12-STDPort-C-01. Product offerings may not be available in all states and may vary depending on state laws and regulations. The group insurance policies described in this advertisement provide disability income insurance only. They do NOT provide basic hospital, basic medical, or major medical insurance as defined by the New York State Department of Financial Services.

SLPC 31678 6/22 (Exp 6/24)