Episodic disability and adjustments for work: the ‘rehabilitative work’ of returning to employment with Long Covid

Abstract Long Covid is an activity-limiting condition that causes significant long-term impairment that can last up to one year or longer and impacts labour participation. ‘Episodic disability’ is an apt conceptual framework to comprehend the fluctuating impairments of those with Long Covid and the barriers they encounter when returning to employment. Drawing on 65 narrative interviews, conducted between 2021 and 2022, from three UK studies involving adults with Long Covid, this article demonstrates how participants experienced a ‘spoiled identity’, had their ‘disability’ status challenged due to existing in-between (dis)ability classifications and experienced their ‘bodies-at-odds’ with their working environment. The additional ‘adjustment’ and ‘administrative’ work of navigating disabling systems required participants to balance workloads to avoid relapse. Utilising ‘episodic disability’ demonstrates that current sickness absence, return to work and welfare policies are disabling and unfit for purpose, requiring participants to take sole responsibility for the additional ‘rehabilitative work’ involved in returning to employment. Points of interest There is very little advice for people with Long Covid on how best to return to work. Long Covid is not yet officially classified as a ‘disability’ in the UK. People with Long Covid may have symptoms others cannot see and symptoms that vary. One day symptoms may be very severe and debilitating and other times they are less severe. People with Long Covid report sadness, guilt and fear about being unable to work as well as they had done before. Because Long Covid symptoms can be invisible to others and their severity is unpredictable, some people said they felt disbelieved about how serious their symptoms were and said that people at work did not realise they needed workplace adaptations. Sickness absence policies that classify employees simply as either ‘able’ or ‘disabled’ do not work for people with unpredictable illnesses that vary in their severity, like Long Covid.