According to statistics published by the PA Department of Labor & Industry, 14,013 new workers’ compensation claims were filed alleging to exposure to the COVID-19 virus during 2020. As of this writing, 7,284 such claims have been filed this year.
Like any claim filed under the PA Worker’s Compensation Act, in order for the claim to be compensable, certain elements must be present:
- There must be an employment relationship;
- During which an injury occurs;
- Which arises in the course of employment; and,
- Is related to the employment.
The Act defines “injury” to include diseases caused by the employment and related thereto.
Given the spread of the coronavirus via airborne particles and droplets, which can occur virtually anywhere (i.e., at the workplace, at school, at the grocery store, at the gym, at home, etc.), must an employer simply “give in” and agree that an employee suffering from COVID-19 contracted the disease at the workplace? How does an employer show that the employee contracted the disease elsewhere?
Investigation is key. While it is unlikely that an employer will be able to prove that the virus was not contracted at the workplace, it may be possible to show that alternate places of possible exposure exist. Some of the issues to be addressed when interviewing the claimant are as follows:
- Did the claimant receive one of the recommended vaccines? If so, when and where?
- Did the clamant wear a mask or other protective shield while working (whether or not such was required)?
- Does the claimant live alone? If not, with whom does he reside? Do any of those individuals tested positive for the virus? Do any of those individuals have any of the signs or symptoms of the virus? Where do those individuals work or attend school? Are they required to wear masks while at work or school? Have they been, in any way, exposed to the virus?
- Does the claimant do his or her own grocery shopping? When was the last time that they went to the grocery store before testing positive for the virus? Did they wear a mask?
- Does the claimant belong to a gym? When was the last time that he or she went to the gym prior to testing positive for the virus? Who else was present?
- Did the claimant attend any sporting events or social functions prior within the 14-day period prior to testing positive for the virus? If so, where and when? Have any of the other attendees tested positive for the virus?
- Has the claimant recently traveled outside Pennsylvania? If so, where and when?
- Authorization should be obtained to secure the claimant’s medical records from his or her primary care physician so that the records might be reviewed for possible exposure prior to the alleged work event.
These are just some of the issues that should be investigated before a claim is accepted. As the news media reports on an almost daily basis, the coronavirus is serious and can be fatal. In addition to wage loss benefits, the medical expenses to treat the virus can be high – all to the detriment of an employer’s experience rating. If an employer suspects that his or her employee has contracted the virus somewhere other than the workplace, a thorough investigation should be conducted so as to minimize the impact on future workers’ compensation premiums if at all possible.