COVID-19 Workers’ Comp Claims Difficult to Prove

The bar is high for employees who say they got infected with coronavirus at work.

February 17, 2021

CHICAGO—Determining how an employee contracted the coronavirus has proven to be a difficult thing, resulting in many COVID-19-related workers’ comp claims being dismissed, the Wall Street Journal reports. Insurance firms are regularly denying compensation claims related to COVID-19, with the carriers positing the employees probably were infected off-site.

More than a dozen states enacted laws giving some workers, such as firefighters and nurses, a presumption of eligibility, which gives them access to workers’ comp coverage without having to prove COVID-19 infections happened while at work. But data seems to show insurers are still denying numerous coronavirus claims.

During the first three quarters of last year, workers’ compensation payments and liabilities dropped 7.6% compared with the same period in 2019, according to the National Council on Compensation Insurance. The decline in payouts has led some carriers to lower employer premiums for 2021 coverage, but the industry still has concerns about long-haul COVID-19 individuals, who continue to struggle with coronavirus complications long after their initial infection.

Workers’ compensation claims because of coronavirus infections have to be decided on a case-by-case basis due to the variables for each one, according to Malcolm Crosland, a South Carolina attorney and president of the Workers’ Injury Law and Advocacy Group. “Your client needs to establish that there was no other known source of exposure other than the workplace,” he said.

For more on COVID-19 liability, listen to the Convenience Matters podcast, “Protect Your Business From COVID-19 Lawsuits,” and read “Brace for Liability Lawsuits” in the February 2021 issue of NACS Magazine.

If you're seeking insights directly from legal counsel about COVID-19, vaccines and workers comp, attend the NACS HR Forum, taking place live-virtually from March 9-11.  Virtual hiring practices, building a pipeline of leaders and diversity conversations are a taste of other topics being delivered by key HR leaders from Sheetz, Maverik, Pilot and Kum & Go.

Coronavirus Resources

NACS has compiled resources to help the convenience retail community navigate the COVID-19 crisis, including information about how to educate employees about the vaccines and other vaccine-related human resources advice. For news updates and guidance, visit our coronavirus resources page.