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Although many people with COVID-19 get better within weeks, some people continue to experience symptoms that can last months after first being infected, or may have new or recurring symptoms at a later time. This can happen to anyone who has had COVID-19, even if the initial illness was mild. People with this condition are sometimes called “long-haulers.” This condition is known as “long COVID.”
In light of the rise of long COVID as a persistent and significant health issue, the Office for Civil Rights of the Department of Health and Human Services and the Civil Rights Division of the Department of Justice have joined together to provide this guidance.
This guidance explains that long COVID can be a disability under Titles II (state and local government) and III (public accommodations) of the Americans with Disabilities Act (ADA),3 Section 504 of the Rehabilitation Act of 1973 (Section 504), and Section 1557 of the Patient Protection and Affordable Care Act (Section 1557).
Each of these federal laws protects people with disabilities from discrimination. This guidance also provides resources for additional information and best practices. This document focuses solely on long COVID, and does not address when COVID-19 may meet the legal definition of disability.
The civil rights protections and responsibilities of these federal laws apply even during emergencies.
They cannot be waived.
According to the Centers for Disease Control and Prevention (CDC), people with long COVID have a range of new or ongoing symptoms that can last weeks or months after they are infected with the virus that causes COVID-19 and that can worsen with physical or mental activity.
Examples of common symptoms of long COVID include:
Tiredness or fatigue
Difficulty thinking or concentrating (sometimes called “brain fog”)
Shortness of breath or difficulty breathing
Dizziness on standing
Fast-beating or pounding heart (known as heart palpitations)
Joint or muscle pain
Depression or anxiety
Loss of taste or smell
This list is not exhaustive.
Some people also experience damage to multiple organs including:
Long COVID is a physiological condition affecting one or more body systems. For example, some people with long COVID experience:
Heart damage, (including inflammation of the heart muscle)
Damage to the circulatory system resulting in poor blood flow
Lingering emotional illness and other mental health conditions
Accordingly, long COVID is a physical or mental impairment under the ADA, Section 504, and Section 1557.
Is long COVID always a disability?
An individualized assessment is necessary to determine whether a person’s long COVID condition or any of its symptoms substantially limits a major life activity. The CDC and health experts are working to better understand long COVID.
This guidance addresses the “actual disability” part of the disability definition. The definition also covers individuals with a “record of” a substantially limiting impairment or those “regarded as” having a physical impairment (whether substantially limiting or not). This document does not address the “record of” or “regarded as” parts of the disability definition, which may also be relevant to claims regarding long COVID.
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