Supporting Employees with Long COVID: A Guide for Employers
This guide, developed by EARN and the Job Accommodation Network (JAN), provides information and resources to help employers support employees with Long COVID.
Introduction
Since the COVID-19 pandemic began in the spring of 2020, COVID-19 has impacted people in many ways. Government reports estimated that millions of Americans have experienced ongoing symptoms, a condition known as Long COVID, and its associated conditions. These symptoms can be severe enough to affect a person’s ability to function, including their ability to work. This publication provides information and resources to help employers support employees with Long COVID.
What is Long COVID?
Long COVID is an infection-associated chronic condition that occurs after SARS-CoV-2 infection and is present for at least three months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems. More than 200 symptoms have been associated with Long COVID. Some commonly reported symptoms associated with Long COVID include fatigue, shortness of breath, muscle pain, cough, headache, joint pain, chest pain, an altered sense of smell, diarrhea, and altered taste.
Who is impacted by Long COVID?
An estimated (PDF) 6.9% of adults in the United States have had Long COVID, and about 400,000 workers exited the labor market due to Long COVID. Long COVID symptoms are more prevalent among people with disabilities (10.8%) than among those without disabilities (6.6%). A more significant number of people from historically underserved communities are affected by Long COVID, especially people from racial and ethnic groups who experience barriers to accessing health care. People within these groups are also more likely to experience prolonged complications and pre-existing health disparities.
Supporting Employees with Long COVID
Are people with Long COVID protected from employment discrimination?
According to the Equal Employment Opportunity Commission (EEOC), Long COVID may be a disability under the Americans with Disabilities Act (ADA). Under Title I of the ADA, employers with 15 or more employees who are private, state government, or local government may have a legal obligation to provide accommodations to people with Long COVID. Subtitle A of Title II of the ADA prohibits public entities such as state and local governments, regardless of workforce size, from discriminating against people with disabilities in their employment practices.
The ADA’s nondiscrimination standards also apply to federal sector employees under Section 501 of the Rehabilitation Act (Rehab Act). Section 501 prohibits federal agencies from discriminating on the basis of disability and requires them to provide reasonable accommodations.
As a part of doing business with the Federal Government, federal contractors and subcontractors must meet certain obligations under Section 503 of the Rehab Act, including not discriminating against qualified job applicants or employees on the basis of disability. Covered federal contractors and subcontractors are also required to ensure their workforces are inclusive of disabled workers. Hiring and retaining people with Long COVID and encouraging them to self-identify is one way federal contractors can meet their obligations.
How long do symptoms of Long COVID have to last for an employee to be entitled to accommodations?
A person experiencing symptoms of Long COVID can be eligible to receive workplace accommodations from their employer before three months pass and without an official diagnosis. For example, a person experiencing brain fog, fatigue, or shortness of breath that limits their ability to work for periods of time less than three months can request and be entitled to reasonable accommodations in their workplace even though they do not yet meet the clinical definition of Long COVID.
The ADA does not specify the length of time a condition must last to be substantially limiting, and “temporary” conditions may be covered (EEOC, Question 10). The duration of an impairment is one factor that is relevant in determining whether a person is substantially limited in a major life activity, but not the only one. Conditions that last only for a short period of time are covered if they are substantially limiting. An individualized assessment is necessary to determine whether the effects of a person’s COVID-19 or Long COVID substantially limit a major life activity (EEOC, Section N). Employers can retain employees with Long COVID by providing workplace supports, resources, and accommodations.
How can employers support and retain employees with Long COVID?
A key to developing this inclusive culture is to provide a seamless accommodation process that results in effective accommodations when needed. When exploring accommodations for employees with Long COVID, start by asking the employee for suggestions—employees are often the best resource for practical accommodation ideas. If the employee does not have ideas that work, the Job Accommodation Network (JAN) can help. JAN provides confidential technical assistance on workplace accommodations and related disability employment issues at no cost, which includes offering accommodation ideas for people with Long COVID.
Another way to support employees with Long COVID is to provide workplace flexibility, such as telework and flexible scheduling, as a benefit of employment. When flexibility is built-in, employees with disabilities have less need to disclose personal medical information and request accommodations, making the workplace more inclusive. In addition to providing accommodations through a formal process, workplace flexibility is another way to help promote return to work policies.
Mental health and workplace well-being should also be at the forefront of every employer’s planning. Through collaboration, employers can create supportive, inclusive, mental health-friendly workplaces for all workers, which can be especially helpful to employees with Long COVID. The Employer Assistance and Resource Network on Disability Inclusion (EARN) Workplace Mental Health Toolkit contains information and tools that can help.
If you do not already have a paid leave policy that covers time off needed by employees with Long COVID, you might consider developing one. Paid leave can ease some of the stress associated with having Long COVID and can benefit (PDF) you as an employer. For example, paid leave policies (PDF) have improved employee retention and increased productivity for all workers.
Finally, another way to support employees with Long COVID is to refer them to available organizational resources, especially when they are undergoing treatment. If you have internal resources such as an Employee Assistance Program (EAP) or Employee Resource Group (ERG), an employer can remind employees that these options are available.
Do people with Long COVID work successfully with accommodations?
Meet Asher. Asher is a long-haul truck driver with Long COVID who experiences joint pain and the feeling of pins and needles when sitting for extended periods. The employer replaced the conventional truck seat with an ergonomic suspension seat, allowing Asher to customize settings and reduce vibration.
Meet Callie. Callie is a school cook who experiences brain fog due to Long COVID, as well as difficulty thinking and concentrating when trying to remember recipes. Callie’s employer provides a tablet as an accommodation to record recipes and quickly access conversion charts.
Meet Ishaan. Ishaan is a distribution center operations manager who experiences shortness of breath due to postural orthostatic tachycardia syndrome (POTS) resulting from Long COVID. Symptoms worsen with fatigue, as Ishaan often walks around to oversee performance management. As an accommodation, Ishaan’s employer provides a mobility scooter, accessible parking space, and an office on the first floor to reduce walking.
Meet Jaye. Jaye is a corporate attorney with anxiety and depression. Symptoms of these conditions increased after Jaye had COVID. Jaye now has Long COVID and also experiences sleep disruption. After working through options with the employer, Jaye works a flexible schedule and teleworks three days a week.