Covid-19 tests comp coverage

Workers’ compensation carriers in Washington state and Kentucky say they will provide benefits to healthcare workers and first responders exposed to the coronavirus. Beyond those two categories, coverage is likely to be decided on a case-by-case basis, according to industry analysts.

Typically, workers’ compensation laws exclude ordinary diseases of life, and provide compensation only for occupational diseases that arise out of and in the course of employment. Washington State’s Department of Labor and Industries recently announced it will provide benefits to healthcare workers and first responders during the period they are quarantined and cannot work. The agency has received several workers’ compensation claims related to the coronavirus.

The benefits would pay for medical testing, treatment, and provide indemnity payments. The policy decision extends wide as employers in Washington are required to purchase coverage from the government-operated insurance fund.

Kentucky Employers Mutual Insurance Co. has also said it will pay wage-replacement benefits to first responders or healthcare workers quarantined because of direct exposure to the coronavirus. Separately, the National Council on Compensation Insurance reports the pandemic has prompted nearly a dozen states to require health insurers to cover coronavirus.

slide show

“The mandates vary by state, but they include coverage for testing and visits to emergency rooms or urgent care facilities either in-network or out-of-network without deductibles or copays. These measures, if expanded to more states, could have the impact of limiting claim activity in the WC market in those cases where only testing or quarantine are necessary,” NCCI notes.

Observers note employees other than healthcare workers and first responders are likely to have a difficult time claiming workers’ compensation benefits because they would have to prove their jobs put them at greater risk of being infected. “But where there is an outbreak of the virus at a plant or facility, there may be some argument to support coverage for certain workers,” says Bob Robenalt, an attorney with Fisher Phillips in Columbus, Ohio.

For instance, he noted to SHRM, the receptionist and cleaning staff at a healthcare facility where the virus has become rampant may argue they were at a greater risk of contracting the virus. But the more widespread COVID-19 becomes, the more difficult it may be for an employee to show the disease is work-related rather than an ordinary disease of life.

States differ considerably on their rules for compensability. John Burton, a well-known workers’ compensation expert, told SHRM, a few states apply the test of whether a disease arises out of and in the course of employment, but many states instead have a list of compensable diseases.

“Surely coronavirus is not going to be on the list,” he said.