The Takeaways:
- There is no universal answer to the title question, coverage depends on where you live and your particular conditions.
- If you are a federal employee, you are mostly in luck as The American Rescue Plan Act of 2021 (ARPA) makes it much easier for federal workers diagnosed with COVID-19 to establish coverage under the Federal Employees Compensation Act (FECA).
- In California, all workers, not just essential workers, will extend workers compensation coverage to include COVID-19 as a work-related illness.
- Some employers are required by law to provide paid sick leave or other benefits for COVID-19-related absences, regardless of whether the infection is deemed work-related or not.
What Does It Mean I’m Covered for Covid-19?
If COVID-19 becomes coverable in Workers Compensation insurance, it means that workers who contract the virus in the course of their employment may be eligible for compensation benefits.
According to National Conference of State Legislatures or NCSL on January 24, 2022,
“Beyond providing medical treatment at no cost to the employee, workers’ compensation also provides wage replacement benefits for lost wages resulting from time away from work. If a worker dies due to a qualifying condition, the worker’s family could be eligible for financial death benefits.”
In addition, “Most states have a dedicated workers’ compensation court system where judges make the final decision on claims and benefits awarded.”
Am I Qualified for Covid-19 Coverage?
The criterion for eligibility varies depending on the state and the specific insurance policy. In some states, such as Washington, COVID-19 claims are generally denied unless the worker can demonstrate that their contraction of the disease was not incidental to the workplace or common to all employment.
In other cases, such as under the Federal Employees’ Compensation Act (FECA), compensation is payable if the worker can demonstrate they have COVID-19 via a positive test result or a medical professional’s diagnosis, excluding home tests and exposure without a COVID-19 diagnosis.
Some states have amended their policies to include a presumption that COVID-19 infections in certain workers are work-related and therefore covered under workers compensation, making it easier for those workers to file successful claims.
A common approach is to amend state policy so that COVID-19 infections in certain workers are presumed to be work-related and covered under workers compensation. This presumption places the burden on the employer and insurer to prove that the infection was not work-related making it easier for those workers to file successful claims.
Some employers and insurers have raised concerns that these presumption policies will increase insurance costs for employers at a time when businesses are already facing significant financial challenges.
National Conference of State Legislatures or NCSL summarized on January 24, 2022,
“Every state has its own unique workers’ compensation policy landscape. States apply varying coverage requirements and standards based on industry, occupation, and the size and structure of a business.”
Generally, workers’ compensation does not cover routine community-spread illnesses like a cold or the flu because they usually cannot be directly tied to the workplace. Some states have made exceptions for certain workers who develop chronic illnesses, like cancer, resulting from repeated exposure to harmful materials and environments.
According to the National Council on Compensation Insurance, prior to the COVID-19, at least 19 states had policies stating that when firefighters and other first responders develop lung and respiratory illnesses, those conditions are presumed to be work-related and covered under workers’ compensation. It is unclear if those existing policies would include COVID-19 illnesses.
The Unique Challenge of Covid-19
The COVID-19 pandemic presents a unique circumstance where the many jobs that are not typically considered hazardous have suddenly become very dangerous for the workers. Workers deemed essential including health care workers, mass transit operators and grocery store workers are at a high risk of exposure to the virus while at work.
States are taking action to extend workers’ compensation coverage to include first responders and health care workers impacted by COVID-19.
In total, 28 states and Puerto Rico have taken action to extend workers compensation coverage to include COVID-19 as a work-related illness. 11 states have enacted legislation creating a presumption of coverage for various types of workers. Utah and Wisconsin limit the coverage to first responders and health care workers.
Illinois, New Jersey and Vermont cover all essential workers while California and Wyoming cover all workers, which is unsurprisingly more generous than other states. States have also used executive branch authority to implement presumption policies for first responders and health care workers as a part of their COVID-19 emergency responses. However, many of those executive orders have expired following the end of the state of emergency in certain states.