Worker's Compensation & COVID-19 - What You Need to Know in 2022 - Zupnick Associates

(by Elton Mwangi)

Covering COVID-19 under workers’ compensation is a common concern for many employers trying to keep their employees safe. The consequences of not being protected from COVID-19 contraction at work are dire. Workers will experience severe symptoms like shortness of breath, chest pain, and loss of mobility or speech.

What’s worse is that there is a likelihood of death. In fact, about 115,000 nurses have died after contracting COVID-19 between January 2020 and May 2021.

On that account, companies must take precautions to reduce the risk of contraction, like providing hand sanitizers and encouraging social distancing at work. Most important is to inspire employees to take the COVID-19 vaccine.

But what happens when employees get coronavirus at work? Do they pay for their own treatment? How do they recover the lost wages? Let’s learn about COVID-19 and workers’ compensation.

Can workers get workers’ comp benefits if they get coronavirus while working?

Yes. If your employee is exposed to COVID-19 in the course of their employment, COVID-19 is considered an occupational illness. Therefore, the employee may get workers’ compensation benefits.

The New York State Workers’ Compensation Board (NYS WCB) ensures the speedy handling of claims and payment of benefits.

What happens when a worker files a claim?

The claim is reviewed by the employer’s workers’ comp insurance carrier, and the claim is only compensable if the carrier accepts the claim. But the insurance company can also dispute it, in which case a judge on the NYS WCB will decide if the claim will be payable.

Both the employee and the medical provider will testify before the judge to provide facts about:

  • The workplace
  • How the worker got exposed
  • The extent of the exposure
  • Prevalence of COVID-19 exposure in the workplace

What workers’ comp benefits do infected employees get?

According to the Workers’ Compensation Law, these are the benefits:

  • Payment for medical costs
  • Replacement of lost wages for the days they didn’t work
  • Benefits to the worker’s surviving dependents in case of death
  • Funeral cost reimbursement of up to $10,500 or $12,500 depending on the county in New York 

What kinds of workplaces can lead to COVID-19 claims?

Workplaces with significant exposure risks include hospitals, public facilities, and any other place with contact with the general public. Professionals working in these places include health care workers, transportation employees, food service workers, first responders, retail workers, and correction officers. 

How to prove that a COVID-19 claim is job-related

It’s difficult for an employee to identify the moment when they got exposed to coronavirus. But they can show the nature and extent of their job in surroundings where exposure to the virus was prevalent.

Details required include:

  • Where the employee works
  • The duties they perform
  • How often do they work?

They must get a medical report from an authorized workers’ comp physician indicating that their work caused the exposure. Workers also need to offer a positive test result. 

How to file a claim

To file a claim, employees should:

  • Inform the employer about the illness in writing. It can be handwritten or through email.
  • Fill out Form C-3 (Employee Claim), which can be accessed at wcb.ny.gov, before sending it to the NYS WCB. The form has the address.
  • See a NYS WCB-authorized physician in person or through teleconferencing.
  • Tell the doctor that they believe they got COVID-19 at work. The doctor will then send the medical report to the NYS WCB and insurance company.
  • Send the positive test result to the NYS WCB. 

The length of the procedure

After the employer is notified about the employee’s illness, they should instantly inform the insurance carrier. The insurer has 18 days to do something about the claim and pay benefits if it accepts it.

Can a claim be denied?

Yes. The insurer can deny a worker’s claim. If the coronavirus contraction is common to all employment or incidental to the workplace, like an employee who contracts COVID-19 from a colleague, a claim for contraction of the illness will be denied. 

Can an employee file a claim for a COVID-19 vaccine reaction?

Yes. An employee may file a claim for experiencing side effects of the COVID-19 vaccine. Claims are allowed for workers who have a vaccine reaction when required by the government or employer as an employment condition.

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