Growing Number of COVID-19 Workers’ Compensation Claim Denials Vary Widely Among States with No Fed Protection
COVID-19 claims by workers across the US during the pandemic are waffling in dramatic ways, depending upon where claimants reside. Numerous states deny workers’ COVID-19 claims even as more than 500,000 deaths have occurred due to the deadly virus.
As the pandemic infects all people of every income group, some states don’t offer automatic eligibility to specific categories of workers. The impact of this legal, sweeping discrepancy of health care assistance is taking a toll on millions of Americans.
How can workers during a pandemic be denied legitimate claims? Two main reasons put forward by specific states and insurers have resulted in daunting denials of insurance claims by workers suffering from the virus.
There is no national database created for the number of COVID-19 workers’ compensation claims made by workers or the number of denials by insurers. Only three states have released this data: California, Texas, and Florida.
In the US, insurers in each state determine what constitutes eligibility for claims. At the same time, some states do not have an automatic presumption of eligibility of COVID-19.
A state-by-state difference of what entails legitimate claims is the confusing insurer determination of where, when, and which category of worker contracts the virus.
Looking at sheer numbers, specific states and insurers in those states show gaping holes in the claimant’s ability to receive assistance after contracting COVID-19.
Claims in California due to COVID-19 were 93,740 by December 2020. Yet, due to specific rules about workers' particular types of jobs, insurers denied 24,367 claims.
Workers filed over 32,000 claims in Texas as of early December 2020. But in Texas, there is no automatic eligibility for COVID-19. In total, out of 32,000 workers’ claims field by early December, insurers denied claims of 14,400 people diagnosed with COVID-19.
Insurers denied thousands of workers’ compensation claims partly because they can’t prove where the infection occurred.
In Chicago, attorney Jose Rivero told the Journal he filed thirty workers’ compensation cases that were all denied, including ten workers who died from COVID-19.
In New York, an attorney told the Journal she filed about twenty workers' compensation claims due to COVID-19, and they were all denied. Among her claims were those from medical workers.
Across the US, workers are being denied by insurance companies because they can’t prove where they contracted COVID-19.
Last September, Connecticut corrections officer Virginia Ligi contracted the virus and said she believed she would be reimbursed when her claim was approved. She was wrong. Instead, she said she heard nothing back from the state workers’ compensation organization for her medical costs and claim while out sick with COVID-19.
In Massachusetts, about one-third of all claims made by spring 2020 were denied by workers who contracted COVID-19.
Over the past decade, states have been reducing workers’ compensation rights steadily. Workers' compensation began about a century ago when workers gave up with the right to sue employers even in negligence cases for job injuries. In exchange, workers would get medical coverage and wage replacement for job-related illness or injury.
Since 2014, about thirty-five states have chipped away at workers’ compensation, backed by insurance companies reducing benefits. As early as 2007, workers’ compensation was considered so low it would pay less than about one-third of medical costs.
In states such as Florida and Alabama, the workers’ compensation benefits are drastically low, and courts ruled them unconstitutional.
Long considered a safety net for workers, the pandemic has outed a lack of coverage for many thousands of Americans who had the poor luck to contract COVID-19 while working at their jobs.
The Families First Coronavirus Relief Act (FFCRA) offers a voluntary tax-credit for employers and payback for owners who want to pay sick leave in the US, up to specific limits based upon worker category. However, since this is a voluntary and not mandatory requirement for employers, there is no legal requirement to pay workers during their COVID-19 illness.
Though the new Biden executive order for protecting health and safety is offering mandates for pandemic education in the workplace, there are currently no national COVID-19 workers’ claims protections in the US.
