When Expertise Isn’t Enough: A Doctor’s Disability Journey With Long COVID (With Guest Dr. Zeest Khan)

Welcome to Season 6, Episode 19 of Winning Isn't Easy. In this episode, we'll dive into When Expertise Isn’t Enough: A Doctor’s Disability Journey With Long COVID (With Guest Dr. Zeest Khan).

Long COVID has challenged not only medicine, but also the disability insurance system. Insurers often characterize these claims as subjective, difficult to measure, or lacking definitive proof, leaving claimants to navigate a process that can struggle to account for fluctuating symptoms and complex limitations. In this episode, attorney Nancy Cavey speaks with Dr. Zeest Khan, an anesthesiologist whose own experience with long COVID forced her transition from doctor to patient. They discuss how that perspective reshaped her understanding of chronic illness, the realities of pursuing SSDI and Long-Term Disability benefits, the challenges posed by independent medical exams, and why long COVID continues to expose gaps in the way disability claims are evaluated.

Check out Dr. Khan's website here: https://longcovidmd.com/

In this episode, we'll cover the following topics:

One - From Physician to Patient: Identity, Illness, and a New Path 

Two - Inside the Disability Maze: LTD, SSDI, and System Gaps 

Three - Advocacy and Strategy: Navigating Claims with Long COVID 

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Listen to Our Sister Podcast:

We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/


Resources Mentioned in This Episode:

LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mind

LINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefits

FREE CONSULT LINK: https://caveylaw.com/contact-us/


Need Help Today?:

Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.

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Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

Transcript

Nancy Cavey [00:00:11]:
 Insurance companies often frame Long Covid cases as uncertain, subjective and not fully understand stood by the medical community. But when I look closer as a Social Security disability and a risk of disability lawyer, I see a different pattern. And what I see is that disability carriers will often minimize complex symptoms. They will purposely misconstrue limitations, and they are basically trying to ask you to prove the unprovable in a system that wasn't really built for conditions like Long Covid. So I'm Nancy Cavie. I'm a national ERISA disability and Social Security disability attorney and I want to welcome you to this episode of Winning Isn't Easy. Before we get started, I've got to give you a legal disclaimer. This podcast isn't legal advice.
 
 Nancy Cavey [00:01:02]:
 The Florida Bar association says I have to tell you that. And now that I've done that, I want to tell you that nothing will ever prevent me from giving you an easy to understand overview of the Social Security disability system and the disability system. And I want you to understand the games that both disability carriers and Social Security will play with these types of claims and what you need to know to get the disability benefits you deserve. So. So off we go. Today my special guest is a physician who has Long Covid and unfortunately she's had to leave the practice of medicine as a result of the impacts of Long Covid. And so we're going to talk about the journey that she's gone from being a physician to a patient and how this has impacted not only her identity, but giving her a new path. So, doctor, introduce yourself please.
 
 Dr. Zeest Khan [00:01:56]:
 Sure, Nancy, thanks for having me. I'm Dr. Zeest Khan. I'm an anesthesiologist in Northern California. My specialty was adult cardiothoracic anesthesiology. It's a mouthful. Probably wins the award. It means I did extra training in open heart and lung surgery.
 
 Dr. Zeest Khan [00:02:16]:
 I took care of people who were the most critically ill in the hospital and used the most high tech equipment to them. And now I called myself a full time patient with Long Covid. I have a podcast and a newsletter where I talk about my experience and kind of like you or the equivalent of you try to share what I can about understanding healthcare.
 
 Nancy Cavey [00:02:44]:
 So can you tell us about the journey, your diagnosis and how that led you you to stop work and apply for benefits and then that transition that you've made from being a physician to being a patient?
 
 Dr. Zeest Khan [00:03:02]:
 Sure. It wasn't something that I expected. I'm sure you've seen it never really is. So we can talk later. I'm Glad I had disability insurance. I live in a part of the country that was hit very, very hard by COVID 19. If you remember those maps that the CDC created that were color coded to measure the severity of COVID We were red from the start to the time they stopped making those maps. And we had outbreaks among the hospital staff, not just our patients.
 
 Dr. Zeest Khan [00:03:44]:
 I'm an anesthesiologist, which means I work very closely in people's mouth and nose, their airway, in the operating room, in the emergency room, in the ICU on labor and delivery. These are all places that you can't really always plan or change things. You kind of have to react to the situation. So we're high exposure and I recognized that. But it was really important that I show up for my community and serve as best I can. We were so short staffed, we had so many patients and every person who showed up, whether they're a doctor, a nurse, an X ray tech, really was carrying an important load. So I, I worked. I was worried about my kids and my older parents.
 
 Dr. Zeest Khan [00:04:37]:
 I was worried that they were the most vulnerable. And so we sort of protected them. And I went to work. And in the spring of 2020, I got what I thought was like an allergy attack or kind of a sinus infection. I live in an agricultural area, I have allergies. I didn't think much of it. And at that time, you might remember, we didn't really have Covid tests. So what I thought was a mild, I didn't really bounce back from.
 
 Dr. Zeest Khan [00:05:14]:
 I just kept feeling more and more fatigued. I felt like I was walking, wearing cement shoes and I had to talk myself, hype myself up to walk from my car into the hospital, hype myself up to walk around the hospital. And I was like a bunny before then I was running around everywhere. So it was really different for me. Start taking the elevator up one flight of stairs because I could not physically get out. And I kept working because I didn't want to abandon others, I guess. And I. Maybe I didn't want to admit that I was as sick as I was.
 
 Dr. Zeest Khan [00:05:58]:
 But at the beginning of 2021, I. It was clear that something was wrong and it wasn't getting better and that I needed to step away. But before I could meet my own deadline of when I decided I was going to take medical leave, I collapsed outside the hospital after a shift and I couldn't even make it to my car. And that was in March 2021. And that was the last time I practiced anesthesia. So it took What I thought was going to be a short break to sort of recover from burnout, which is what I thought it was. I kept talking to myself that it was that, but it was undeniable. And all these other symptoms showed up.
 
 Dr. Zeest Khan [00:06:42]:
 And I learned what Long Covid was from another patient, not from any of my doctors, and went down this path of trying to recover or use the medical system that I served to help me.
 
 Nancy Cavey [00:06:58]:
 So thank you for sharing that story. I know it's difficult to tell that story of your journey from being a highly specialized, highly skilled medical professional to now being a patient. And I represent so many people in the Long Covid community and they share that similar story. But because of your unique background, I want to ask you some questions and about how your medical background shapes the way that you understood your illness originally and now years later, how you understand your illness. So can you share that with us, please?
 
 Dr. Zeest Khan [00:07:45]:
 Yeah, it was really interesting. I kept using that word. This is, this is so interesting. This is fascinating. I remember one time collapsing in the bathroom, staring at my floorboards, and my husband came in and like, was very, very worried and was asking me, what is wrong? And I was just saying, this is fascinating because I was experiencing symptoms that I had maybe read about. And so I think, you know, that being said, I think my medical background helped me in some ways and really hindered me in others. The way it hindered, helped me, we'll say, is that I could because I take care of, especially because I take care of the sickest of the sick people. I had some perspective that like, I wasn't about to, you know, die.
 
 Dr. Zeest Khan [00:08:41]:
 You know, it can feel very, very scary to have these symptoms. And so that already gave me, I feel like a leg up in some perspective. And two, I'm a doctor. I have friends who are doctors and I know how to talk with doctors. So that really helped. But the way that it hindered me is that it really delayed my ability to like, admit that something was really going on. I kind of, I remember thinking, well, none of these symptoms make sense to me. There isn't a condition that I have learned about or interacted with that looks like this.
 
 Dr. Zeest Khan [00:09:28]:
 And so this can't be a real problem. And that mindset reflects the fact that we in medicine, and I'm not a junior doctor, I've been, you know, practicing for a long time. We in medicine do not know, know about conditions like myalgic encephalomyelitis. We don't know what post viral illnesses are and how they present. And that is Why I had to listen to patients and had to really change my perspective on health care.
 
 Nancy Cavey [00:10:08]:
 And that that's not a unique situation because many times my clients will come to me and say, the doctor doesn't understand my symptoms. And I have to say, well, I think you need to find certainly at this point, a Long Covid clinic or specialist because there are still a segment of physicians who in the medical community who just don't get Long Covid or the multiple symptoms system presentation.
 
 Dr. Zeest Khan [00:10:40]:
 That's right.
 
 Nancy Cavey [00:10:40]:
 As you know, long Covid can impact innumerable body systems. And I've had cases where there have been all sorts of weird system involvement that doesn't necessarily make common sense, but ultimately makes medical sense. So tell me, what were the challenges that you faced in, in dealing with the physicians who may not have understood your presentation? You know, how did you learn to, in other words, how did you learn to talk as a patient to a physician when in fact you are a physician?
 
 Dr. Zeest Khan [00:11:19]:
 Yeah, I take my kids to see the doctor. And one recently, one of them said afterwards, you don't tell anybody you're a doctor when we come to these appointments. And I said, yeah, I don't. I, I do that because I want people, my doctors and my medical team to explain things without assuming that I know a lot. I had to learn that pretty early on. And I don't necessarily want or need special treatment, but in terms of my own care, I started talking about my symptoms. This is what I am noticing. This is what is bothering me.
 
 Dr. Zeest Khan [00:12:16]:
 This is what is limiting me, kind of giving the presentation, telling my story what I know, and then trying to toss that ball to my doctor to play catch and collaborate so that they can ask me follow up questions so that their gears start spinning. Because I, especially in those early days, I still have some cognitive deficits that are really limiting, especially when I get, when my symptoms flare, the rest of my symptoms flare. But in those early days, I couldn't understand what anybody was telling me. So I'm like, just. All I can tell you is this is what's happening to me. And even then, that was tough.
 
 Nancy Cavey [00:13:03]:
 By special treatment, you meant you didn't want to be treated differently because you were a physician?
 
 Dr. Zeest Khan [00:13:08]:
 Yeah, that's right.
 
 Nancy Cavey [00:13:10]:
 Yeah. I want to come back to the symptom issue in a minute, but before we do that, I'm fascinated as to what led you to start your podcast and you have a newsletter. Long Covid M.D.
 
 Dr. Zeest Khan [00:13:24]:
 yeah, you know, my medical practice was called Z Con, Maryland because nobody told me that was not a good Idea to name your business with your name. So I named it Z Scon md. And you know, Long Covid, like you probably know from your clients, it really impacts your identity. It's like an ego death. And I had a really hard time not being productive, not like kind of losing my career, quote unquote. And at one point I like tried to reframe it and I told my husband, well, I guess I'm not Z Scon md. I'm Long Covet md.
 
 Nancy Cavey [00:14:01]:
 You know.
 
 Dr. Zeest Khan [00:14:01]:
 And so I call my newsletter Long Covid md. And it was a way to remind myself that I have. I no longer practice clinical anesthesiology. I am still a doctor, right? And I can still help people. And so I started the the podcast initially for several reasons. One, I wanted to get over the shame that I felt for being sick. I wanted to just say it out loud for myself so that I wasn't hiding anymore. I think a lot of hide and feel ashamed.
 
 Dr. Zeest Khan [00:14:43]:
 And I wanted to see who else was out there. I wanted to connect with people. And third, I thought it would help me like use my brain a little bit more because it was so hard. But my 9 year old had to help me open GarageBand and hit record and stop for me because I couldn't even do that. She would just say, okay, now talk. So it started there and it has grown into. As my cognitive bandwidth has improved, I can write a little bit better now. You might notice, your listeners might notice my voice isn't strong.
 
 Dr. Zeest Khan [00:15:21]:
 I literally lost my voice. And so I'm working with speech therapists to strengthen that. So I'm connecting in written form and speaking and to share the background explanations of different treatments, how healthcare system actually works so that patients can set appropriate expectations and get the most out of each one of their doctor visits and not get discouraged when the system acts the way that it's supposed, it's built to act. And you probably have this experience too when people get denials. So that's what I'm trying to do. I'm just trying, I'm really just trying to serve others as best I can. It helps me and I meet so
 
 Nancy Cavey [00:16:10]:
 many cool people and thank you for your service. Because what I've experienced with my clients is that it's very hard, certainly early on in the COVID epidemic to find physicians who understood what Covid was. Its presentations, offered encouragement, offered treatment. It's improved because obviously there the medical community has become familiar with COVID but there are still segments of the medical community that is dismissive, if you will. Of medical conditions such as Long Covid. So thank you for your service.
 
 Dr. Zeest Khan [00:16:48]:
 Yeah, I think it's what people really like is that they hear from a doctor and they're validated by somebody with a medical degree. And I think that's kind of a little bit sad. Just shows how many people have been dismissed.
 
 Nancy Cavey [00:17:04]:
 Yes. So we're going to take a quick break and when we come back, I'm going to talk to the doctor about my formula for telling a patient's story and see what she thinks about that and how that might help improve the results that a person gets when they see a physician. So let's take a quick break.
 
 Speaker C [00:17:28]:
 Have you been robbed of your peace of mind by your disability insurance carrier? You owe it to yourself to get a copy of robbed of your peace of mind, which provides you with everything you need to know about the long term disability claims process. Request your free copy of the book@kvlaw.com today.
 
 Nancy Cavey [00:17:47]:
 Foreign welcome back to Winning isn't easy. And I'm here with my special guest, the long Covid doctor. So in my practice, I have long Covid clients who have multiple system presentations. So in other words, they may have cognitive issues, they may have pulmonary issues, they may have pulmonary issues, and they have neurological issues. I see all sorts of system involvement. I also see new presentations like pots or I will see people who have me CFS whose condition has gotten worse. And so I see all sorts of combinations. But what I've tried to do is to give my clients a formula in which to tell their story to their physician.
 
 Nancy Cavey [00:18:46]:
 So I want your thoughts about this. This is how I tell them. I want you to get out a piece of paper and I want you to write out like pulmonary issues. And on the left hand side of the column, I want you to write the word symptoms. And I want you to write all the symptoms that you have. And then the next column I want you to write, this is the duration of these symptoms. Next column I want frequency. And then in the last column I want an example of how that impacts your ability to function.
 
 Nancy Cavey [00:19:22]:
 So, for example, if you have pulmonary issues, you might have shortness of breath with exertion, shortness of breath without exertion. And so the question is, well, how often do you have that? And then the question becomes, how long does that particular episode last? Write it down. And then give me an example like, I can't even walk from my bed to the, to the bathroom. And I know that's not the typical history of symptoms that you were trained to get. If you will but how do you think that works in terms of telling a patient's story to a physician so that the, that the file, the medical chart is well documented?
 
 Dr. Zeest Khan [00:20:05]:
 I actually think that's really close to how we do a medical interview in the office. We're trained to understand the body by organ system and sometimes it's hard for, you know, part of our medical training is learning what organ systems do. So even if so, I think your suggestion is spot on. What is bothering me? How long does it last? How does it impact me? What makes it better? What makes it worse? Those are the, the things that I recommend patients bring to their doctor too.
 
 Nancy Cavey [00:20:44]:
 So what I find is, especially in, in the, these days of electronic medical records, that it's really hard and because physicians are so busy, it's really hard to get them to hear, hear the history of all the symptoms by body systems. You know, they need to do their thing and move on, unfortunately to the next patient. So I tell my clients, I want you to write this all down for me. I want you to keep a copy, but I want you to take it to the doctor's office, give it to the nurse, ask that it be made part of the chart and kind of quickly go through it as fast as you can with the physician. Is that an effective way to not only give a medical history but to make sure that it's part of the chart?
 
 Dr. Zeest Khan [00:21:31]:
 I think it depends on who you're seeing, who the doctor is and why you're seeing them. I think it's great to bring all of it to your primary care doctor, especially during your annual physical. Those appointments are built in to be longer than the 15 minute follow up. So I recommend to people like, make use of that physical, that annual physical, it's almost always covered by insurance and you can not only go through all of your symptoms, but also make sure you're not missing any preventive care things. When it comes to going to specialists, I think it's important to clarify why you're going to see them. Which problem is this person going to be, is an, is going to be an expert about.
 
 Nancy Cavey [00:22:25]:
 Right.
 
 Dr. Zeest Khan [00:22:26]:
 And so to get really clear on that and present that and then let them ask follow up questions because as you mentioned, our medical system is, you know, divided by organ systems and so those organs are connected and those, you know, those pulmonary specialists, for instance, instance a pulmonologist is going to ask you questions about your heart rate or is going to ask you questions about tingling or you know, how much you can walk because that is related to the lungs. Especially if the symptoms that you're presenting start trigger triggering ideas in their mind.
 
 Nancy Cavey [00:23:10]:
 I know that you've applied for Social Security disability and long term disability and successful for the with those claims and congratulations. However, from my perspective as an attorney who deals with this every day, what I see is both the disability insurance company and the Social Security administration is looking at not only the hard medical findings, the physical exam findings, the diagnostic studies, the treatment plan, the response to treatment, but they're looking for that history of symptoms and functionality. And if they don't see that little bells go off in their mind. Social Security is looking for that consistency. Which is why I say to my clients, bring the blasted symptoms and functionality worksheet that I've given you and give it to the doctor's office so that even though it may not be part of the quote unquote history or presentation, it's part of the chart. And I know that sort of contradicts what it is you just said, but does that make sense as helping the doctor to become an advocate for the patient?
 
 Dr. Zeest Khan [00:24:25]:
 Yeah, it becomes a reference. Right. Especially if you're bringing paperwork later on that you want them to fill out. You can make it easier for them. We're all physicians are all overloaded with work and you know, are cogs in a wheel at times. So you can say, look, this is what I need filled out for this purpose. This is what's going to help me. You have, I filled out some stuff in this intake form that I offered you what Nancy, you might have shared and you can refer to that or pay attention to this part of it.
 
 Dr. Zeest Khan [00:25:06]:
 So I think it is very reasonable to ask your doctor, tell your doctor this is what I'm applying for. This, this is why, this is what's going to help me if you, you know, support and focus on certain things, in this case the functionality. And I've made it easier for you by giving you this and it's already in my chart.
 
 Nancy Cavey [00:25:32]:
 I find that in the long term disability world, doctors are asked to fill out attending physician statement forms. And I'm sure you've seen them and you've had them in your own case. And in Social Security cases, we Social Security lawyers have created forms called long Covid residual functional capacity forms. I have one specifically for Social Security, but then I also try to supplement that based on the applicable form body system. So if my client, for example, has pulmonary issues, I have a long Covid form and a pulmonary form just to try to make sure I'm covering all the bases. I know that's a lot of paperwork, but can you make some suggestions to our audience about what's the best way to ask the doctor to fill out these forms? And here they are. I know they're a pain, but I can't win my case without them. What's the best suggestion for asking a physician to do that? And if they say no, what's the next option?
 
 Dr. Zeest Khan [00:26:41]:
 Yeah, you know, I can't speak for all doctors, but what I can say about all doctors is that they're all human. And doing what I suggested earlier is just saying, look, this is explaining the context. These are papers. This is what they're for. This is what I need help with from you. It would be important to me because here's exactly where I need you to sign or fill out and make that visibly clear. And if you've got cognitive issues, this is where a friend, A friend could help, or in. In your instance, your lawyer can help you get set up.
 
 Dr. Zeest Khan [00:27:22]:
 It's like, this is what I need signed. This is the evidence that I need copied or like parts of my chart copied. You're not asking them to make things up. You're not asking them, you know, a very, very heavy lift. It is, you know, an additional work. And some clinics will charge for extra work, which I think is reasonable.
 
 Nancy Cavey [00:27:46]:
 Absolutely.
 
 Dr. Zeest Khan [00:27:48]:
 But, yeah, just make it clear. This is what would help me. This is what it is. And this is what I need from you. Thank you. And this is when I need it by.
 
 Nancy Cavey [00:27:59]:
 How about sending the paperwork in advance before a doctor's visit? And what about in some doctor's office? We know it's kind of the office manager that's driving things, and sometimes it's the nurse. But how to figure out who's the best person to approach with the. That issue initially in a doctor's office,
 
 Dr. Zeest Khan [00:28:17]:
 I think that's where it comes to relationships. And in, in the. I have to make clear. I think this is. This is me speaking as a patient and someone who's gone through this on. On that end is that I think it's important to feel out your provider, build a relationship. And that could be, you know, one or two visits. Make it clear what you.
 
 Dr. Zeest Khan [00:28:42]:
 What would be helpful to you and, you know, use your intuition and the evidence you have in front of you. Everybody is short on time. So just cutting to the chase, this is what I need and, you know, kind of look at it as a favor. It's not really a favor. It's, you know, part and parcel, but, you know, approach it with that sort of grace, like can you do this for me? This would really help. I'm trying to support my disability claims, but I don't know about giving paperwork before you meet the clinician because you never know if you're going to get along with them. And their take on you is.
 
 Nancy Cavey [00:29:25]:
 I mean, I never tell my clients to walk into a doctor's office the first time they've seen the doctor, even the second time with the paperwork, because I think the initial reaction of a physician is they're here just to be certified as disabled and not really interested in treatment. So that's the caution I give to my clients. But the other caution I give is, you know, particularly in the Social Security world, if the doctor doesn't support the claim, you still have to submit that unfavorable report. For me, it's a violation of the rules of ethics if I don't. So I always kind of counsel my clients to say, feel them out, you know, see what they think. And I love that suggestion because I can't undo an unfavorable residual functional capacity form. I want to take a quick break, but then I want to come back and talk about what surprised you about the Social Security system, the long term disability system, what lessons you learned, what advice you would give now that you have been successful in your claims. Let's take a quick break.
 
 Speaker C [00:30:29]:
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 Nancy Cavey [00:31:08]:
 Welcome back to Winning Isn't Easy. I love having you as a guest because I like the perspective that you give both as a. As a physician, as a patient. And I can kind of, if you will, pick your brain. So let me ask you this. What surprised you most about the Social Security disability and long term disability claims process? Because I'm sure prior to that you were asked to fill out forms and you maybe sort of had a vague idea of what you had bought and what the Social Security system was like. But what surprised you once you actually got into the process?
 
 Dr. Zeest Khan [00:31:43]:
 How intimidating it is.
 
 Nancy Cavey [00:31:46]:
 I think that's funny from a physician. Okay.
 
 Dr. Zeest Khan [00:31:49]:
 Yeah. It feels like a mountain. And it feels like, okay, I have to explain things and use language very carefully.
 
 Nancy Cavey [00:32:03]:
 Yes.
 
 Dr. Zeest Khan [00:32:04]:
 Maybe more with the long term disability than the Social Security disability where I felt like I was, they were trying to trap me a little bit and I had to be really careful. I just felt very vulnerable. Especially when you're already sick, you don't know, your language skills are poor, you're tired, you don't, you're not a lawyer, you haven't been in this before, they've already got a leg up on you. And so I found it a little intimidating. I think the second part was just how much I think I already knew it was going to be a lot of paperwork.
 
 Nancy Cavey [00:32:47]:
 Right.
 
 Dr. Zeest Khan [00:32:47]:
 But it really is quite a bit. I think a big part of the vulnerability was I appreciated that there are no biomarkers or diagnostics like an X ray or an MRI that would support my claim definitively. And it was like a project that I had to undertake and I had already paid for it. I already paid for ssdi, I already paid for my long term disability. This isn't like I, I already put in the work.
 
 Nancy Cavey [00:33:23]:
 I thought you're not asking for something you haven't contributed to.
 
 Dr. Zeest Khan [00:33:28]:
 That's right, yeah.
 
 Nancy Cavey [00:33:30]:
 From the long term disability perspective, and I represent a lot of physicians and lawyers in their claims, I always want them to get out that policy before they stop work and apply for benefits. Because there is no uniform disability policy policy. And you certainly need to understand what it is you have to prove. What's the definition of disability? What is your occupation? Is it based on what you were boarded on what it was you were doing at the time you became disabled? So from my perspective, I think there really needs to be with physicians and lawyers, a lot of pre planning to figure out what it is I need to prove. Because you're right, you're vulnerable. You've bought a policy and you think it's going to pay, but you don't really understand what it is you, you have to prove. Did that surprise you at all?
 
 Dr. Zeest Khan [00:34:15]:
 I didn't understand that policy. With my condition, I couldn't reread it. I remember I did my due diligence when I purchased it and that felt like eons ago. Now that I was sick, I had a real, real trouble reading. Like I said, I'm not a lawyer, my husband's not a lawyer. It was also, you know, the pandemic was in its, you know, peak and it was hard to like find someone who I could send this to to read. So. But that's what I ultimately did.
 
 Dr. Zeest Khan [00:34:54]:
 I reached out to, I don't remember the name of his position, but the person who basically sold Me, the policy, the agent, broker in the agent. Yeah. And he was lovely. I called him multiple times, like, can you explain this to me? And he was able to put it into words. So throughout this process, I've really relied on the help of other people. Like I, you know, people come to me for a specific skill set. I know there's other people who've trained with specific skill set, people like you. So I reached out and tried to get help understanding what was in this.
 
 Dr. Zeest Khan [00:35:32]:
 And that made me feel better about being like, okay, I know a little bit better what the steps are here.
 
 Nancy Cavey [00:35:39]:
 So as you've probably figured out, the definition of disability in a ERISA disability or IDI disability policy is not the same definition of disability in Social Security. Did that surprise you at all or did you think that they were going to be equivalent definitions of disability?
 
 Dr. Zeest Khan [00:35:54]:
 Honestly, I. All I knew was that I couldn't function, I could not work at all. And so I applied admit, I had to admit that, yeah, I was disabled and I qualify for this. So for me, it wasn't a. I didn't need that clarification.
 
 Nancy Cavey [00:36:17]:
 Okay. For me as a lawyer, it's like, well, there's a big difference and you need to understand that difference because the proof can be, can be different. So one of the things that has evolved, at least in the world of disability insurance litigation since COVID began, was in the beginning there were companies like Unum, who I sue all the time, who really required proof. They wanted that positive COVID test. And if you didn't have it, you couldn't have Covid. We've kind of, we've evolved past that point. Now it's not so much we want the objective basis of the diagnosis. We want the objective basis of the functional, physical, cognitive, psychological restrictions and limitations to prove that you can't perform your own or any occupation.
 
 Nancy Cavey [00:37:09]:
 The same sort of holds true in the Social Security world. They want to see objective evidence of restrictions and limitations. So based on your perspective as a physician, what are your suggestions for people who have long Covid who are applying for Social Security and long term disability benefits to obtain that objective evidence of functional restrictions and limitations?
 
 Dr. Zeest Khan [00:37:37]:
 So again, I can't speak as a doctor as I don't know, I have never had to fill out paperwork to support someone else's claim claim. But I will tell you what I have found. When you don't have biomarkers like a blood test or an X ray, it is really important, as you've emphasized, to rely on the symptoms that are limiting your function. What Are you able to do if you can't get a diagnosis? You still connecting all of your symptoms? Those symptoms are still there.
 
 Nancy Cavey [00:38:09]:
 Right.
 
 Dr. Zeest Khan [00:38:10]:
 So I have shortness of breath, and for whatever reason, I have shortness of breath and I can't, I can't walk very far. I have restricted exercise capacity. Shortness of breath is a symptom, not a diagnosis. Reduced exercise capacity is a symptom, not a diagnosis. I have. My heart rate goes up really high, shoots up when I stand up, I get dizzy when I change positions. That's not a diagnosis, that's a symptom. But those things limit my function.
 
 Dr. Zeest Khan [00:38:45]:
 And, you know, and I, you know, I have a hard time reading, I have a hard time following instructions. I have a hard time understanding what people are telling me. Again, in a complex condition like long Covid, that can be really challenging to diagnose. Absolutely. These symptoms is what I went back to. So I didn't apply, I think I remember I didn't apply as like long. I have a diagnosis of long Covid because that was kind of still evolving at the time. But I did have asthma, I did have orthostatic intolerance.
 
 Dr. Zeest Khan [00:39:24]:
 I did, you know, have all these other things. And in my case, because I so consistently presented with that to multiple doctors over time, the judge noted that in his opinion, that this keeps coming up. So, yeah, I don't have, you know, a cytokine panel that'll prove that I have a certain condition, but I have the eyes, ears and exams of these, these doctors that I keep going to.
 
 Nancy Cavey [00:39:59]:
 And that's why I keep on harping on that history of symptoms and functionality, because it's the story in the medical records that will help document the nature, frequency and duration of the symptoms that gives you the patient credibility and gives information to the physician with which to fill out the forms. Let me ask you this. I take a systems based approach to this. So if my client presents, for example, with pulmonary system involvement, I've got the underlying diagnosis of long Covid. But I always want the objective testing from a pulmonary standpoint. If I have problems from a neurocognitive standpoint, I want the neurocognitive testing. If I have a client who has issues with fatigue, I want the CPET testing. If I have a patient or client, rather, who's presenting with orthostatic hypertension, known commonly as pots, I want that positive tilt table test.
 
 Nancy Cavey [00:40:59]:
 So I think that it's important not only that we have the subjective complaints documented and in the form of the history of symptoms and functionality. But I really also do think that it's important to kind of tie all of this together with objective testing. Would you agree with me as both as a physician and as a, as a person who has been through the Social Security system and the long term disability system?
 
 Dr. Zeest Khan [00:41:29]:
 Yeah, I mean, I wish we didn't have to rely on those things. They, they exhaust patients. But, you know, they are important in this disability realm. You know, I wish they were less invasive. I wish they were more clinically helpful to track disease progress. So, you know, I think patients have to collaborate with, you know, understand their claim and under. Make a, make a very intentional decision to have some of these tests done in order to, to support their claim if they need it, recognizing that they're going to have to deal with the aftermath.
 
 Nancy Cavey [00:42:19]:
 So as a physician now, having been through the process, what are the, and now understanding Social Security and long term disability, what do you think are some of the common mistakes that people should avoid or may encounter and not really think that they're a mistake? In other words, they don't know, but then they make a mistake.
 
 Dr. Zeest Khan [00:42:46]:
 What I see in the long Covid space and the chronic illness space is getting very, very discouraged when they get a denial and taking it personally and letting that impact their, you know, emotion, emotional resilience. I think it's important that patients understand the steps, the system that they're engaging with and, you know, just whittle it down to the practicalities. I'm doing X for Y. Whoever stamps an approval or denial for your case in disability is not making a moral judgment on you. This is a game. You know, not to be crude about it, but this has a set of rules and you just got to follow those rules. If you know what you're getting into, then you're going to be less prone to that, like real anger and grief that comes with a denial. Because a lot of people are like, the government doesn't believe me.
 
 Dr. Zeest Khan [00:43:58]:
 They think I'm lying. And when you've already been dismissed by people in authority, that triggers, you know, something deep in your heart too.
 
 Nancy Cavey [00:44:08]:
 A lot of emotion. Yeah. So in the Social Security world, I tell clients, look, in a Covid case, you know, you're probably going to get that initial denial unless the claim is really well developed with that history of symptoms and functionality, and you're going to have to have that residual functional capacity for them, but expect a denial. And I say the same thing in the long term disability world and I sort of have a, it's not a joke, but let me Tell you, this is the golden rule. Social Security, sorry, long term disability carriers are more than happy to collect your gold in the form of premium, but they're also very happy to rule that you're not entitled to the benefits. And so I try to tell my client that's the golden rule from the disability perspective. And as you said this, you should anticipate unfortunately being dismissed because they are not interested in providing you the benefits that you paid for. So I think we're coming from the same perspective.
 
 Nancy Cavey [00:45:11]:
 I find it really disheartening to have to explain to my clients the golden rule and say, this is the way it needs to go, this is what we need to do. I believe you, your doctors believe you, but we're going to have a fight potentially with the Social Security administration or the disability carrier. In closing, for someone who's just starting this journey, what do you want them to know? And what role, if any, do you think a lawyer like myself would play in this process?
 
 Dr. Zeest Khan [00:45:47]:
 So what I want people who are struggling with their health to know, especially if you've had a viral infection and are dealing with unexplained symptoms afterwards, is to trust your instincts. Carve out time for yourself. Don't wait too long because you're probably going to. So expect that it's already later than it should be. The time is now. If you're starting to think, hey, I think I need some time off, you need time off. Engage with these systems, both healthcare and legal, in a way that you're prepared and understand what the system is built to do and how it functions. I love relying on experts, people who have been in fields in medicine to get information from.
 
 Dr. Zeest Khan [00:46:42]:
 I am not a lawyer even in medicine. I'm an anesthesiologist. I know a lot about different organ systems. I'm not a heart surgeon. We ask each other questions. I run into special, like kidney specialists in the break room. Be like, hey, I had a question for you, right? It's really great to collaborate and I've been so touched by, by the generosity of people like you, people in the legal space, especially when they're dealing with disability for complex illness like me and Long Covid, just the generosity of spirit and being like, no, you deserve what you are entitled to. Here's a little bit how I can help you.
 
 Dr. Zeest Khan [00:47:24]:
 So I think it's, you know, especially with SSDI where the payment is coming from, you know, you're not, you're never really going to see it and it's capped and it's fair, it's not a It's an easy decision to get help from a lawyer and call, you know, call people, ask questions.
 
 Nancy Cavey [00:47:44]:
 Dr. Khan has been fantastic. I love having you on on the show and I'd like to have you back again talking about different issues because there are a number of things that I wanted to talk with you about today that we didn't even get to. But thank you for being a voice for the Long Covid community and letting people know that they've been heard and heard by someone like you, a physician and who is a patient who can bring the perspective of both worlds. So thank you for being a guest.
 
 Dr. Zeest Khan [00:48:13]:
 Thank you for having me, Nancy. Thank you for your work. This is not going to be the last time that we talk.
 
 Nancy Cavey [00:48:18]:
 Great. So this is going to wrap up this episode of Winning Isn't Easy. If you've liked this show, please give us a five star, subscribe to it and I look forward to talking with you in our next episode of Winning Isn't Easy. Thanks.