During this pandemic, many workers (nurses, police, grocery store clerks, transit professionals, etc.) are considered essential, potentially putting them at heightened risk for contracting COVID-19. A key question, of course, is whether a worker who contracts COVID-19 is compensated under workers’ compensation for income loss and medical expenses.
Below are some frequently asked questions that get posed to me as president and CEO of the Workers Compensation Research Institute (WCRI). We’re an independent, not-for-profit research organization that provides high-quality, objective research and statistical information about public policy issues involving the various state workers' compensation insurance systems in the U.S.
Q1: Is COVID-19 covered under workers' compensation and, if not, why not?
A1: Historically, communicable diseases, like the flu, have generally not been covered. Workers’ compensation covers injuries and illnesses that arise out of and in the course of employment. It is generally difficult to establish work-relationship for a disease that could be contracted anywhere. Indeed, some states’ statutes bar compensation for communicable diseases. In the past few weeks, though, a number of states have taken steps to expand workers’ compensation coverage to include COVID-19 for certain groups of workers.
Q2: What is the course of action for states seeking to cover essential workers affected by COVID-19?
A2: Some states consider that their current laws, regulations and procedures are sufficient to provide compensation for workers who demonstrate that they contracted COVID-19 at work. Other states have changed their rules, either by executive order or legislation, to increase the likelihood that a worker who contracts COVID-19 may be eligible for workers’ compensation. The states vary in terms of the scope of workers covered and in terms of the burden of proof required by an ill worker to establish work-relatedness. A number of states’ laws and orders cover only first responders or healthcare workers. Others expand coverage to include other groups of workers deemed to be essential, e.g., grocery workers. In some states, the worker may be eligible for workers’ compensation if the worker can demonstrate that the illness was the result of his employment or occupation. In other states, for the workers covered, there is a presumption that their illness arose from work, though that presumption can be rebutted.
Q3: Is this the first time coverage has been expanded for conditions that may arise outside of work?
A3: No. For example, we have seen workers’ compensation coverage expanded to include those, particularly first responders, who witness a traumatic experience and as a result have post-traumatic stress disorder (PTSD) and can no longer perform their duties.
Q4: Is workers' compensation administered at the state or federal level?
A4: Individuals injured on the job while employed by private companies or state and local government agencies are covered by workers’ compensation programs administered by the states. The essential features of the states’ workers’ compensation systems are similar, but they may vary in terms of the compensability of some conditions, the amount of benefits paid and other features. Federal and some other workers are covered by four disability compensation programs administered by the U.S. Department of Labor.
See also: Impact of COVID-19 on Workers’ Comp
Q5: What does workers' compensation cover, and are the benefits across the country the same?
A5: Workers’ compensation covers all medical benefits and wages lost while off work due to the injury. It covers the first dollar of medical care, and there are statutory formulas for the income benefits that replace lost wages. WCRI’s workers’ compensation laws reports are a great resource to identify the similarities and differences across workers’ compensation systems in U.S. states and Canadian provinces.
Q6: Is WCRI working on any research that will help us better understand the impact of COVID-19 on state workers’ compensation systems?
A6: WCRI has a wealth of studies that provide a pre-COVID baseline for evaluating the impact of the virus on workers’ compensation claims. This includes WCRI’s CompScope Benchmarks studies, which compare a range of workers’ compensation performance metrics across 18 states. In the future, we will evaluate the impact of the virus on the composition of claims and their costs, how the virus may have affected the delivery of care to workers and the impact of that on worker and claims outcomes, including duration of disability.
To learn more about WCRI, visit www.wcrinet.org.
