Can COVID-19 Claims Convince Commissions to Compensate? An Overview of Workers’ Comp and the CoronavirusIf you get COVID-19 at work, is it covered by workers’ compensation? Maybe. In Tallahassee, Florida, a school district denied a high school teacher’s COVID-19-related workers’ compensation claim. The reason? The district says he cannot prove he caught the virus while working. Meanwhile, it has been reported that thousands of federal employees have filed workers’ compensation claims with the U.S. Labor Department due to COVID-19.

As the COVID-19 pandemic progresses, workers’ compensation will be an area of law to watch, as there are sure to be new precedents established both federally and at the state level.

Workers’ compensation laws vary from state to state, however, generally to receive compensation a worker must be able to prove that an injury or accident occurred on the job. Statutes and case law have established various “occupational diseases” presumed to arise out of or in the course of employment, and those diseases are, therefore, compensable (e.g., mesothelioma or black lung disease). However, most states impose additional restrictions on “ordinary diseases of life” to which the public is exposed both at work and elsewhere. Under this line of reasoning, catching the flu is not an “injury” covered by workers’ compensation. However, there are certainly some occupations – such as healthcare or frontline workers – in which exposure to COVID-19 may be easier to trace directly to work conditions. Regardless, such claims will require high levels of proof and will inevitably lead to messy and prolonged administrative hearings.

State Guidance and Amendments Regarding COVID-19

To head off such complications, many states have issued executive orders or amended their workers’ compensation statutes to create a presumption of COVID-19 coverage for certain types of industries. To date, at least 16 states have amended laws or issued other guidance regarding COVID-19 and workers’ compensation claims. In Arkansas, Gov. Hutchison first issued an executive order easing the burden of proof on COVID-19 claims for first responders and frontline healthcare workers, and later issued an order classifying COVID-19 as an occupational disease. Illinois passed an amendment to its workers’ compensation law creating a rebuttable presumption that COVID-19 is compensable, and therefore covered, for first responders and frontline workers.  Washington state has gone even farther, changing its policy to provide additional benefits for healthcare workers and first responders who are quarantined by a physician or a public health office.

What does this mean for you?

That depends on your industry and the states in your footprint. If you receive a workers’ compensation claim from an employee who says he or she contracted COVID-19 on the job, make sure to do your homework. To start, check to see if your state has issued guidance or amended legislation. If so, make sure to read the guidance closely and follow any required procedures. If not, you may not want to deny a COVID-19 claim outright. What evidence does the employee have to show he or she contracted the disease on the job? If the evidence is reasonable, you may consider notifying your workers’ compensation insurance carrier to see if it has received (and possibly paid) similar claims.

One advantage to the workers’ compensation system is that, in most states, if an employee receives benefits under workers’ compensation, he or she cannot also sue an employer for negligence or other torts, absent egregious circumstances. This means that you should weigh your options when deciding whether to deny such a claim. Would accepting the claim prevent future liability? Or does the employee’s claim fail to produce any reasonable evidence that catching the disease was work-related?  Your best next step will depend on how you answer these and other questions.

Conclusion

Like every other aspect of the workplace, COVID-19 is throwing a wrench in workers’ compensation as we know it. The best way to make sure any claims are handled properly is to know your state’s policies, weigh your options, and make the most informed decision possible.