April 28, 2020

FAQs about COVID-19’s Impact on Workers’ Comp

FAQs about COVID-19’s Impact on Workers’ Comp

Dr. John W. Ruser, President and CEO of the Workers’ Compensation Research Institute (WCRI), contributed this Q&A about the role workers’ compensation insurance plays in the coronavirus pandemic.

Dr. John Ruser

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), which is 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 United States.

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

Q2: What is the course of action for
states seeking to cover essential workers impacted 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 by 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 health care 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 they can demonstrate that their illness was the result of their
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

Q3: Is this is the first time coverage
has been expanded for conditions that may arise outside of work and how are
workers’ compensation laws changed?

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 US Department of Labor.

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 injured workers and the impact of
that on worker and claims outcomes, including duration of disability.

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