Say you’ve had COVID-19. After your quarantine has finished and you’re no longer deemed infectious, it’s time to return to work.

But after a few weeks, you haven’t bounced back to fighting form. You’re more tired than you can ever recall, with chest pains and headaches. You’re struggling with brain fog and memory lapses, and when you’re distracted, it’s nearly impossible to drag your mind back to the task. Something is wrong that you can’t seem to fix with sleep, hydration, food or exercise. But when you visit the doctor, scans and test results seem to be normal. Based on your descriptions and your medical history, your doctor diagnoses you with post-acute sequelae of SARS-CoV-2 infection (PASC), aka long COVID.

As detailed in a report by Washington Post journalist Christopher Rowland, long COVID is a widespread and baffling condition whose debilitating symptoms can pop up out of nowhere, weeks after the infection has run its course. Symptoms can be physical (lung, heart and digestive problems, pain, extreme fatigue), neurological (headaches, short-term memory loss, brain fog and other cognitive deficits) or emotional (depression, anxiety).

These symptoms can interfere with your ability to perform your job. Before that becomes a problem with your boss, here are options to consider.

If you’re lucky, you may still have paid sick leave available through your employer or because you live in a state or locality that has adopted its own COVID relief mandates. Short-term disability is also an option, although it involves eligibility criteria and waiting periods to qualify, during which you may not have income.

Or maybe you can and want to keep working, although your long COVID hinders you from carrying a 40-hour workload. In that case, you can ask your employer about an accommodation.

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Notify your employer

The Equal Employment Opportunity Commission issued guidance in December 2021 clarifying that long COVID may qualify as a disability under the Americans With Disabilities Act. An employee with long COVID is entitled to an accommodation that would enable them to perform essential functions of their job unless the employer can show it would present an “undue burden.”

Terri Rhodes is CEO of the Disability Management Employer Coalition. To put your employer on notice that you need an ADA accommodation, Rhodes recommends telling your employer, essentially: “‘I need help doing my job; here’s things I think I can do; here’s what I can’t do. I don’t know how long it will last. I want to get back to work, and I need help to do it.'”

At that point, the employer is obligated to engage in a dialogue with you to determine what accommodations, if any, are possible: telework, reduced hours, a designated break area, flexible scheduling, special equipment, etc.

Long-COVID brain fog may make this a challenge, so having support from an advocate is ideal. Becki Harris, an advanced-practice nurse in Banfield, Colorado, was grateful for the union representative who went to bat for her when she needed reduced hours while enduring long COVID. “Having a person to advocate for me was just amazing. I really appreciated having someone who was invested in me as a person,” she said.

In a best-case scenario, human resources may even be able to help you work out a plan.

A sales director from Annapolis, Maryland, who asked to be identified only as “R” to protect his privacy, said that when he needed extended recovery time after getting COVID at the end of 2020, his boss’s response was, “You decide when you are ready to come in.”

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When R was finally able to return to the office in April, “I was welcomed with open arms and again was assured to take it as slow as I needed,” he said.

Consult your doctor

Some employers may be skeptical about symptoms that can’t be detected through scans or tests. “COVID brain fog, cognitive difficulty, fatigue — people think those are subjective complaints,” says Rhodes. “It’s very difficult to get some kind of diagnostic certainty that someone is suffering” when the only evidence available is the patient’s word.

To make a credible case for accommodation, request documentation from a reliable medical professional, preferably one specializing in long COVID who is current on the latest research. Charles Glassman, associate medical director for insurance and disability provider The Standard, notes that many major medical centers have established long COVID clinics with special expertise. He recommends consulting them, rather than “pop-up clinics” that may be prescribing inappropriate therapies.

Try to stay in consistent contact with that professional, in case your condition changes or the science on long COVID evolves. “You can have a case where it doesn’t present right off the bat as a disability, but two weeks later, the doctor says, ‘Actually, I do think it’s a disability, and all those absences [the employee] took earlier are part of that,’ ” says Lori Welty, an employment law compliance attorney with insurance software provider FINEOS.

Prepare for attitudes to shift as the situation evolves

Not all employers remain accommodating while long COVID symptoms persist, and not all accommodations may be adequate.

Joy Barnes, a supply chain inventory manager in Phoenix, said in an email that her managers were supportive and willing to reduce her hours at work during her recovery. However, she ran into bureaucratic roadblocks with her HR department, which, she said, seemed reluctant to view her long COVID as a disability requiring accommodation. (This was a year before the EEOC guidance update.)

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Harris, the Colorado nurse, was granted reduced hours at her job, but her patient load within those hours was still overwhelming. Harris finally applied for short-term disability, worried that her COVID-induced memory and focus problems would cause harm: “I would go to work afraid of making a medical mistake … The fear of hurting one of my patients by missing or forgetting something just became unbearable.”

“It’s frustrating to me that it became an either/or,” Harris said in an interview.

Pro tip: The National Institutes of Health has launched a nationwide research initiative on long COVID and is inviting long-COVID sufferers to participate in studies. Visit recovercovid.org to learn more.

Karla L. Miller offers advice on workplace dramas and traumas. Send questions to work.advice.wapo@gmail.com.