Employers in most states are required to carry workers’ compensation insurance to provide wage replacement benefits for injuries sustained by employees during the course of their employment. Workers’ compensation is the exclusive remedy for most workplace injuries, which means that employees cannot typically pursue a separate personal injury claim against their employer for an injury covered by workers’ compensation. A worker’s compensation plan typically includes coverage for:
- Lost wages due to the injury;
- Medical treatment for the injury;
- Ongoing medical costs; and
- Funeral expenses.
Some workers’ compensation policies may also include payments for injuries that cause disability or death.
Each state has their own laws that govern workers’ compensation. Generally, to file a claim, an employee will need to first notify their employer of the injury, preferably in writing. Employees should notify their employer as quickly as possible following their injury because most states require claims to be filed within a certain amount of time of the injury. For example, Connecticut requires an employee to immediately notify their employer of the injury. Conn. Gen. Stat. Sec. 31-294(b). In contrast, Kansas provides employees thirty calendar days to report their injury to their employer. Kan. Stat. Ann. Sec. 44-520. A workers’ compensation claim will have a greater likelihood of success if the employer is notified promptly. This will minimize any disputes that may arise about whether the employee’s injury occurred during the course of their employment.
Filing a workers’ compensation claim for COVID-19 may be more challenging than a claim for a physical injury because the employee will need to prove they contracted COVID-19 at work. Many states have amended their workers’ compensation laws to establish presumptions that COVID-19 infections occurred during the course of employment for certain categories of professionals at high risk for occupational exposure, including health care workers and first responders. Workers’ compensation presumption laws have the effect of shifting the burden of proof from the employee to the employer. Instead of requiring the employee to prove they contracted COVID-19 at work, employers are required to prove that the employee did not contract COVID-19 at work. A person who only spends time around other people while they are at work will have an easier time establishing that the infection occurred during the course of their employment, compared to someone who is very socially engaged outside of work.
Unfortunately, even if a COVID-19 infection is associated with a person’s employment, some workers’ compensation laws exclude coverage for infectious diseases like COVID-19. For example, South Carolina excludes coverage for injuries caused by a “contagious disease resulting from exposure to fellow employees or from a hazard to which the workman would have been equally exposed outside of his employment.” S.C. Code Ann. Sec. 42-11-10. South Carolina does not provide workers’ compensation coverage unless the infectious disease causes a disability.
Workers’ compensation for federal employees is slightly different than state programs. If a federal employee tests positive for COVID-19, the employee needs to secure a positive test result (excluding home tests) and file the workers’ compensation claim paperwork within 30 days of exposure. A federal employee is not required to specifically track when and how they may have been exposed to COVID-19 in the workplace, only that their duties include a risk of exposure.
If an employee’s workers’ compensation claim is denied, claimants will typically be able to appeal the decision within a set number of days. For example, in Texas, an employee has 15 days to file an appeal with the state’s Appeals Panel, which is comprised of neutral third-party judges.
Filing a claim for workers’ compensation for a COVID-19 infection requires swift action and attention to detail. If you are exposed to COVID-19 and you suspect that it may have happened at work, you should record the activities you engaged in around the time of the exposure, notify your employer of the exposure, and gather information about your state’s workers’ compensation program. You may need help from an attorney to file or appeal your workers’ compensation claim. If you are unsure about your eligibility for workers’ compensation benefits or if you need help from an attorney, you can request assistance through the Pandemic Legal Assistance Network (PLAN).