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
FDA approves first COVID-19 treatment for intravenous (IV) use in hospitals or other controlled clinical settings
October 26, 2020 · Clinical Team
Veklury® (remdesivir) is the first medication to be approved for the treatment of coronavirus disease 2019 (COVID-19) by the U.S. Food and Drug Administration (FDA) on October 22, 2020. Read more...
September 03, 2020 · Public Policy & Regulatory Affairs Team
In the late hours of the legislative session, the California Assembly and Senate reached a compromise and passed a COVID-19 workers’ compensation presumption bill. After considering several various pieces of presumption legislation, the Legislature passed SB 1159, which creates a presumption and addresses the impact of COVID-19 on the workers’ compensation system. It is expected to be signed by the governor. Read more...
Montana and New York delay workers’ comp drug formularies for legacy claims and prescriptions due to COVID-19
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...
State-by-state covid-19 policy updates
COVID-19 presumptions for first responders and healthcare workers
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
External Covid-19 related resources
|*Additional presumption language for this state is provided below|
Alaska – House Bill 76 (5.1.21)
Extends the governor’s declaration of a public health emergency in response to the novel corona virus disease pandemic.
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.
Arkansas – House Bill 1488 (3.15.21)
Will allow workers to file a workers’ compensation claim for COVID-19 if they can prove the contracted the virus while at work.
Is retroactive to March 11, 2020 and remains in effect until May 1, 2023.
California – SB 1159 (9.17.20)
Creates a rebuttable presumption for first responders, healthcare workers and other essential employers running through 2022. The presumption is applicable to those deemed by existing statue as “essential employees” in both the public and private sectors. Requires a positive test or diagnosis within 14 days that the employee performed labor or services at the employee’s place of employment at the employer’s direction. Permits employers to rebut the presumption by measures which include, but are not limited to, evidence of measurers in place to prevent transmission of COVID-19 and evidence of the employee’s non-occupational exposure to COVID-19.
Connecticut – Senate Bill 660 (6.30.21)
Expands current workers’ compensation benefits and presumptions for certain frontline and healthcare workers who suffered emotional impairments or developed PTSD as a result of providing care in connection with the COVID-19 pandemic.
DC – B58 (3.9.2021)
Creates a presumption for COVID-19 to be considered a compensable injury if contract in the course and scope of employment
Illinois – House Bill 4276 (3.2.21)
Extends previous COVID-19 presumption which expired at the end of 2020 till June 30, 2021.
Illinois - House Bill 2455 (6.5.20)
Creates a COVID-19 related rebuttable presumption for first responders, healthcare providers and other essential employees. Contains substantial rebuttal provisions
Indiana – SF 232 (4.29.21)
Adds COVID-19, to the list of diseases considered an exposure risk disease for purposes of emergency and public safety employee death and disability presumed in the line of duty. Provides, for any employee who is diagnosed after June 30, 2021, with a health condition caused by any variant of SARS, including COVID-19, that if the health condition results in disability or death and the employee wishes to have a presumption of disability or death incurred in the line of duty apply to the employee, the employee shall, by written affidavit executed before death, provide verification that the employee has not, outside the scope of the employee's current employment, been exposed to another individual known to have any variant of SARS, including COVID-19.
Minnesota – HF 2253 (5.1.21)
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). Extends through the end of the year the COVID-19 presumption that was set to expire as of May 1, 2021. The presumption applies to doctors, nurses, paramedics, firefighters, police, correctional officers and child care workers.
Minnesota - HB 4537 (04.8.20)
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.
New Jersey – Senate Bill 2380 (9.14.20)
Creates a workers’ compensation presumption related to COVID-19 exposure. Covers first responders, health care for workers and others who have contact with the public. The rebuttable presumption covers COVID related claims retroactively from March 9, 2020 and stops when the governor’s declaration of a public health emergency comes to an end. The legislation bars insurers from counting COVID claims in an employers’ experience modification ratings and employees of the state who are offered the option of working from home but refuse will not be eligible for coverage and benefits.
Tennessee – Senate Bill 995 (4.13.21)
Adds to the list of acquired infectious diseases for which a classified emergency rescue worker is given a presumption to have a disability suffered in the line of duty, such virus or other communicable disease for which a pandemic has been declared by the World Health Organization or federal Center for Disease Control and Prevention, and for which the Governor has declared a state of emergency.
Texas - SB 22 (6.14.21)
Provides a COVID-19 presumption for various first responders, EMTs, peace officers, firefighters and other detention officers
Utah – HB 3007 (6.22.20)
Clarifies the definition of First Responder under the Act and adds certain healthcare workers to the definition related to the COVID-19 Presumption
Provides a Workers' compensation presumption for first responders.
(1) A first responder who claims to have contracted COVID-19 during the performance of the first responder's duties as a first responder, is presumed to have contracted COVID-19 during the course of performing the first responder's duties as a first responder if the first responder is diagnosed with COVID-19:
- while employed or serving as a first responder; or
- if the first responder's employment or service as a first responder terminates, within two weeks after the day on which the first responder's employment or service terminates.
(2) A first responder who makes a claim under this part shall provide written documentation of a COVID-19 diagnosis to the first responder's employer or insurer.
Failure to be tested – Rebuttable presumption.
(1) A first responder who refuses examination for COVID-19 or fails to be diagnosed with COVID-19 is not entitled to the presumption established under this part.
(2) The presumption established under this part may be rebutted by a preponderance of the evidence.
Vermont – Senate Bill 9 (2.5.21)
Extends the previously approved COVID-19 presumption which expired at the end of 2020 until 30 days after the state lifts the emergency declaration.
Vermont – Senate Bill 9 (2.3.21)
Extends the rebuttable presumption supported by legislation and Executive Order from the original expiration date of January 15, 2021 to now the 30th day following the termination of the state of emergency declared in response to COVID-19.
Vermont – Senate Bill 342 (7.16.20)
Provides a rebuttable presumption for a wide range of workers who fall ill from the coronavirus contracted it through work duties. The presumption is rebuttable by the employer. The bill applies to first responders, health workers, correctional officers and other essential workers and employees the state Workers’’ Compensation Commission determines are at an elevated risk of exposure. Those non-frontline workers will have to show occupational exposure, or employers can rebut the claim by showing that the business followed coronavirus guidelines published by Vermont health authorities and the U.S. Centers of Disease Control and Prevention. The presumption and requirements of the bill applies to virus claims on or after March 1, 2020.
Virginia – HB 2207 (4.8.21)
Extends the period during which COVID-19 would be presumed compensable for first responders, police, firefighters and correctional workers. The period now covered would be extended until the end of 2021.
Virginia – Senate Bill 1375 (4.7.21)
Creates a presumption of compensability for COVID-19 that causes death or disability for firefighters, emergency medical services personnel, law-enforcement officers and correctional officers is an occupational disease under the Workers’ Compensation Act. The COVID-19 virus must be established with a positive diagnostic test for COVID-19. Provisions of this bill will be effective retroactively to March 1, 2020.
Virginia – House Bill 1985 (4.1.21)
Provides a COVID-19 rebuttable presumption for certain healthcare workers - retroactive to March 12, 2020 – who either exhibits (i) a presumptive positive test or a laboratory-confirmed test for COVID-19 and presenting with signs and symptoms of COVID-19 that required medical treatment or (ii) presenting with signs and symptoms of COVID-19 that required medical treatment absent a presumptive positive test or a laboratory-confirmed test for COVID-19
The presumptions shall not apply to any person offered by their employer a vaccine for the prevention of COVID-19, unless the person is immunized by their private physician or their private physician determines in writing that the immunization would pose a significant risk to the person’s health.
Washington – SB 5115 (5.11.21)
Establishes a presumption covered under workers’ compensation for frontline employees that are exposed to any infectious or contagious diseases that are transmitted through respiratory droplets or aerosols or through contact with contaminated surfaces that are subject of a public health emergency.
Washington – SB 5190 (5.11.21)
Establishes that for health care employees who are covered under workers’ compensation a presumption for any infectious or contagious diseases which are the subject of a public health emergency. The presumption is that the health care employee contracted or was exposed to the disease at the health care facility.
Wisconsin - Assembly Bill 1038 (4.17.20)
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 – SB 19 (4.7.21)
Extends the original legislative COVID-19 presumption expiration date to March 31, 2022. Original bill was SB 1002.
|Emergency Declaration by Governor, DOI or WC Agency|
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 - Executive Order – 10.16.20
Creates a presumption – that is rebuttable – under existing Labor Code for a “COVID-19 first response employee” who is confirmed as COVID-19 positive on or after March 18, 2020. Confirmation can be either by physician or by test and these employees shall be presumed to have suffered a “personal injury” as defined by existing law in the Workers’ Compensation Disability Compensation Act of 1969.
A COVID-19 first response employee shall be inclusive of healthcare providers, law enforcement officers, first responders and other individuals defined to be required to work in the provision of medical care, civil defense and law enforcement as correction officers.
The emergency order shall be retroactive to March 18, 2020 and shall unless rescinded be effective until March 2021.
Missouri – Regulation (1.15.21)
Adoption of Emergency Rule to extend previous COVID-19 presumption which expired at the end of 2020 until July 30, 2021
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 Hampshire – Executive Order – (4.24.20)
“First Responder” shall include any individual covered by the definition of “Emergency response/public safety worker” as set forth under existing law.
To be eligible for this order and approved presumption a First Responder must have tested positive for COVID-19 and the case must have been reported to the Department of Health and Humans Services. In any subsequent proceeding before the New Hampshire Department of Labor or the administratively attached Compensation Appeals Board, there shall exist a prima facie presumption that the First Responders COVID-19 exposure and infection were occupationally related.
New Mexico (4.23.20)
As Governor, I hereby direct and order as follows:
- 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.
- 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.
- 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 - 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.
|WC Agency Bulletin regarding existing exposure requirements|
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|