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The COVID-19 information you need for workers’ comp claims

The COVID-19 pandemic has most likely impacted you in some way, from the way you work, to how you live. And while this has been stressful for most of us, those who are also recovering from a work-related injury, or, like you, are helping them navigate care through recovery, face additional challenges and have additional questions.

So, with newsfeeds filled with projections and opinions, Optum has compiled the latest workers’ compensation focused COVID-19 information. Optum is working with our clients, our providers and injured persons to make sure they continue to receive the treatment they need when they need it.

This information will be updated frequently, so please bookmark this page so you are always one click away from the information you need. 

The facts, the impact and the response to COVID-19 on the Workers’ Comp and Auto No-fault industry webinar
Hosted by David Young, President and CEO


Recent Covid-19 posts

April 09, 2020 · Policy Matters team
Montana requests insurers delay formulary implementation for legacy claims until COVID-19 crisis passes. And New York modifies formulary to extend implementation date for legacy scripts until January 1, 2021. Read more...
April 03, 2020 · Policy Matters team
Amid the coronavirus (COVID-19) outbreak, state governors, regulators and legislatures have initiated a range of urgent policy changes or directives to facilitate response and mitigation efforts, including at the workers’ compensation level. This heightened focus has diverted some attention away from other policy developments. Read more...
April 02, 2020 · From the desk of David W. Young
While there are many unknowns, Optum Workers’ Compensation and Auto No-Fault is committed to our customers, claimants and our team members. We remain fully staffed and operational and continue to ensure that the injured person is receiving the right treatment at the right time for the right duration and for the most appropriate cost. Read more...
March 23, 2020 · Policy Matters team
Amid the coronavirus (COVID-19) outbreak, state governors, regulators and legislatures have initiated a range of urgent policy changes or directives to facilitate response and mitigation efforts, including at the workers’ compensation level. This heightened focus has diverted some attention away from other policy developments. Read more...
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Daily State-by-state
covid-19 policy updates

COVID-19 presumptions for first responders and healthcare workers

Interactive Covid-19 Policy Map

Emotional support

If you or your claimants are experiencing anxiety or stress related to COVID-19, download the mobile app Sanvello, or call our free Emotional Support Help Line: 1-866-342-6892

"Optum stands strong and ready to serve our clients and their injured persons"

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David W. Young, President & CEO
Optum Workers' Comp and Auto No-fault

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External Covid-19 related resources

COVID-19 presumptions for first responders and healthcare workers

 
Updated every Friday
*Additional presumption language for this state is provided below
 

Legislation

Alaska

Alaska - Senate Bill 241 (3.23.20)

Creates a conclusive presumption that COVID-19 arose out of employment for specified workers. The presumption, which can’t be rebutted, applies retroactively to anyone diagnosed with the disease since March 11. The presumption in SB 241 applies to firefighters, emergency medical technicians, paramedics, police officers and health care providers. Workers must be diagnosed by a physician, receive a presumptive positive test or receive a laboratory-confirmed diagnosis to trigger the presumption.

Minnesota

Minnesota - HB 4537 (04.6.20)

An employee who contracts COVID-19 is presumed to have an occupational disease arising out of and in the course of employment if the employee satisfies the requirements of clauses (1) and (2).

(1) The employee was employed as a licensed peace officer under section 626.84, subdivision 1; firefighter; paramedic; nurse or health care worker, correctional officer, or security counselor employed by the state or a political subdivision at a corrections, detention, or secure treatment facility; emergency medical technician; a health care provider, nurse, or assistive employee employed in a health care, home care, or long-term care setting, with direct COVID-19 patient care or ancillary work in COVID-19 patient units; and workers required to provide child care to first responders and health care workers under Executive Order 20-02 and Executive Order 20-19.

(2) The employee's contraction of COVID-19 must be confirmed by a positive laboratory test or, if a laboratory test was not available for the employee, as diagnosed and documented by the employee's licensed physician, licensed physician's assistant, or licensed advanced practice registered nurse (APRN), based on the employee's symptoms. A copy of the positive laboratory test or the written documentation of the physician's, physician assistant's, or APRN's diagnosis shall be provided to the employer or insurer.

Utah

Utah – HB 3007 (4.22.20)

A first responder – an emergency responder or healthcare provider – who claims to have contracted COVID-19 during the performance of duties, is presumed to have contracted COVID-19 by accident during the course of duties if the first responder is diagnosed with COVID-19. A claim under this part requires a copy of the positive laboratory test or the written documentation of a physician’s diagnoses to the first responders employer or insurer.

Wisconsin

Wisconsin - Assembly Bill 1038 (4.15.20)

Rebuttable presumption that injury caused to first responders during current public health emergency is caused by employment

For the purposes of worker's compensation, an injury caused to a first responder, during any public health emergency declared by the governor on March 12, 2020, by executive order 72 and ending 30 days after the termination of the order, is presumed to be caused by the individual's employment. The presumption requires a diagnosis or positive test for COVID-19, and may be rebutted by specific evidence that the injury was caused outside of employment. 

Wyoming

Wyoming - SB 1002 (5.18.20)

For the period beginning January 1, 2020 through December 30, 2020, if any employee in an employment sector for which coverage is provided by this Act, is infected with the COVID-19 Coronavirus, it shall be presumed that the risk of contracting the illness or disease was increased by the nature of their employment.

 
Emergency Declaration by Governor, DOI or WC Agency
Arkansas

Arkansas - Governor Executive Order (4.15.20)

  • Suspension of Ark. Code that currently requires a contagious or infectious disease be contracted in or in immediate connection to a hospital or sanatorium to allow first responders and front-line healthcare workers to seek workers’ compensation for exposure to COVID-19 in the line of duty outside those settings
  • Suspension of ARK. Code that currently bars compensation for exposure to a disease to which the general public is exposed to allow first responders and front-line healthcare workers to seek workers’ compensation for exposure to COVID-19 in the line of duty
California

California - (5.6.20)

  • Any COVID-19-related illness of an employee shall be presumed to arise out of and in the course of the employment for purposes of awarding workers’ compensation benefits if requirements are met:
    • The employee tested positive for or was diagnosed with COVID19 within 14 days after a day the employee performed labor or services at employee’s place of employment at employer’s direction
    • The day referenced above was on or after March 19, 2020
    • The employee’s place of employment referenced above was not the employee’s home or residence
    • The positive test and diagnosis was done by a physician who holds a physician and surgeon license issued by the California Medical Board and diagnosis is confirmed by further testing within 30 days from date of diagnosis.
  • The presumption may be controverted by other evidence and the presumption shall only apply to dates of injury occurring through 60 days following the date of this Order.
Kentucky

Kentucky - Executive Order (3.6.20)

Kentucky Gov. Andy Beshear executive order notes that health care workers, first responders, corrections officers, domestic violence shelter workers, child advocacy workers, rape crisis staff, grocery workers, some child care workers and even postal workers should receive wage-replacement benefits if kept away from work by a physician.

Michigan

Michigan - WCA Emergency Rules 2020 MR 5 (4.1.20)

Rule 1.
(1) These rules apply to first response employees that are exposed to COVID-19.
(2) A first response employee suffers a personal injury that arises out of and in the course of employment if the first response employee meets 1 of the following criteria:
(a) Is quarantined at the direction of the employer due to confirmed or suspected COVID-19 exposure. (b) Receives a COVID-19 diagnosis from a physician. (c) Receives a presumptive positive COVID-19 test. (d) Receives a laboratory-confirmed COVID-19 diagnosis.

Rule 2.
(1) As used in these rules, "first response employee" means any of the following: (a) A person working in a health facility or agency as defined in the public health code, 1978 PA 368, MCL 333.1101 to 333.25211. (b) A person working in a health care organization as defined in R 418.10108(x). (c) A person working in an industrial medicine clinic as defined in R 418.10108(bb). (d) A person working as a practitioner as defined in R 418.10109(l). (e) A person working in a capacity described in section 161(1)(c) to (j) of the worker's disability compensation act of 1969, 1969 PA 317, MCL 418.161(1)(c) to (j). (f) A member of the state police or an officer of the motor carrier enforcement division of the department of the state police.

Missouri

Missouri - DL&I/DWC Emergency Rule (4.7.20)

Presumption of Occupational Disease for First Responders. An emergency rule under the workers’ compensation statute to provide a presumption that first responders contracting COVID-19 were infected in the course of their employment.

New Mexico

New Mexico (4.23.20)

As Governor, I hereby direct and order as follows:

  1. In processing or responding to WC claims, I direct all state executive agencies to employ a presumption that certain agency employees and eligible volunteers who contracted COVID-19 suffered a compensable occupational disease under existing law.
  2. The presumption should be applied to all agency employees and eligible volunteers who contract COVID-19 within two weeks of providing direct assistance or care to COVID-19 patients, or within two weeks of working in any capacity inside a facility that provides direct assistance, care or housing to COVID-19 patients.
  3. Some examples of employees who should be afforded this presumption include but are not limited to EMT’s and other first responders, volunteer and paid medical personnel, administrative and custodial staff at COVID-19 specific care centers and law enforcement officers.
North Dakota

North Dakota - Exec Order 2020-12 (3.13.20)

First Responders health care workers and all occupations included under NDCC 65-01-02 (11)(b)(1) who are exposed to COVID 19 in the course of employment may file for workers compensation coverage and may be eligible for up to fourteen days of wage replacement and medical coverage if quarantined.

Texas

Texas - TDWC Commissioner's Bulletin (3.27.20)

In order to ensure that public safety employees of governmental entities are able to be reimbursed by their employer for reasonable medical expenses related to COVID-19, Governor Abbott has suspended Texas Government Code Sections 607.002(1) and (2) to the extent necessary to allow public safety employees, who were likely to have been exposed to COVID-19 while in the course of their employment, to be entitled to the reimbursements set forth in Section 607.002 of the Government Code. This suspension is in effect until terminated by the Office of the Governor or until the March 13, 2020, disaster declaration is lifted or expires.

SUSPENDED:
Sec. 607.002. REIMBURSEMENT. A public safety employee who is exposed to a contagious disease is entitled to reimbursement from the employing governmental entity for reasonable medical expenses incurred in treatment for the prevention of the disease if:
(1) the disease is not an "ordinary disease of life" as that term is used in the context of a workers' compensation claim;
(2) the exposure to the disease occurs during the course of the employment; and
(3) the employee requires preventative medical treatment because of exposure to the disease.

Washington

Washington - (3.5.20)

Pursuant to an order by Governor Jay Inslee, the WA DL&I is making policy changes around WC coverage for health care workers and first responders who are quarantined by a physician or public health officer.  WC coverage will be extended for medical testing, treatment expenses if the worker becomes ill or injured and provide loss-time payments for those who cannot work if they are sick or quarantined.  These benefits will cover workers during the time of quarantined after being exposed to COVID-19 on the job.  Workers’ can file a WC claim up to two years after being exposed to a disease at work.  The expanded coverage takes effect immediately.  

 
WC Agency Bulletin regarding existing exposure requirements
Florida

Florida - DWC Informational Memorandum (4.6.20)

All Regulated Entities are reminded that section 440.09, Florida Statutes, requires an employer to provide workers’ compensation coverage if the employee suffers a compensable injury arising out of work performed in the course and scope of employment. First responders, health care workers, and others that contract COVID-19 due to work-related exposure would be eligible for workers’ compensation benefits under Florida law. Insurers licensed to provide workers’ compensation coverage in Florida are reminded of this statutory requirement, which must be applied on a non-discriminatory basis. The OIR expects workers’ compensation insurers to comply with all of the provisions of Florida’s Workers’ Compensation Law and will take appropriate action in the event of non-compliance.

 
No action to date
Illinois

Illinois - 

Initial presumption rule repealed by the IWCC on 4.28.20.