COVID-19
has been infecting, disabling, and even killing workers in the course of their
employment. Healthcare workers, first
responders, cleaners, grocery clerks and other essential workers are put at
elevated risk of COVID-19 infection because of their work. Despite precautions and COVID-19 safety
plans, work-related COVID-19 infection are a significant proportion of the
overall infection count… and may be under-represented for a variety of reasons.
Many
workers contracting COVID-19
Public health
agencies investigate the likely source of infection as part of their contact
tracing efforts to stop the chain of transmission and contain the COVID-19 virus. In British Columbia, for the period September
13 to October 26, workplace settings accounted for more than 10% of COVID-19 local
case/cluster settings. [Derived from BC CDC, COVID-19: Monthly Update November
12, 2020, Slide 9 https://news.gov.bc.ca/files/COVID19_Monthly_Update_Nov_2020.pdf]
In a recent
report, the British Columbia Centre for Disease Control states:
1 in 10 individuals who had COVID-19 identified as a health-care worker
[BC CDC, COVID-19: Monthly Update November 12, 2020, Slide 10 Https://news.gov.bc.ca/files/COVID19_Monthly_Update_Nov_2020.pdf]
While not
all those identifying as healthcare workers may have contracted the disease
because of work, there is no question that essential workers are at elevated
risk. The number of claims received from
healthcare workers alone is about 70% of
what the public health data of COVID-19 test-positive healthcare worker count suggests.
[ Based on WorkSafeBC COVID claims data by industry as of November 11, 2020 as
numerator and BC CDC, COVID-19: Monthly Update November 12, 2020, Slide 10 https://news.gov.bc.ca/files/COVID19_Monthly_Update_Nov_2020.pdf as denominator]
In another
recent report, the CBC contacted all provincial workers’ compensation boards in
Canada to determine the number of workers’ compensation claims from workers for
work-related COVID-19. As of mid-November, 26,107 claims had been submitted and
20,140 claims allowed so far this year.
Given that Canada reported 335,000 cases of COVID-19 over that same
period, just under 8% of all reported COVID-19 cases resulted in a workers’
compensation claim. [CBC, Workplace
compensation claims reflect toll COVID-19 has taken on Canada's workers,
November 23, 2020 https://www.cbc.ca/news/canada/covid-compensation-wsib-wcb-workers-1.5810305]
Workers’
compensation claims for COVID-19 lag public health data
It takes
time to consider and determine the “work-relatedness” of a workers’
compensation claim. Although nearly 80%
of claims reported have already been allowed, the ultimate acceptance rate may
well be higher.
Timing is
not the only complication. In some
cases, a claim may be submitted but with no costs for income loss, medical or
other expenses received. Depending on the jurisdiction, such a case might or
might not be considered “reportable” to the workers’ compensation or
occupational health and safety agency.
That said, the employer or the worker may want to file a claim because
of the uncertain consequences of a COVID-19 infection even if there is no
interruption in earnings, no medical expenses, and no resulting permanent
disability so there is no further action required. This sort of situation is captured in claim
statistics detail from WorkSafeBC:
Eligibility Decision by WorkSafeBC to November
11, 2020
Allowed 506
Disallowed 733
No adjudication
required 49
Pending 197
Rejected 4
Suspended 100
Total 1,589
As evident in
these data, not all reported workers’ compensation claims are accepted. Many may be disallowed (determined not to be work-related,
for example) and some rejected (not a “worker” as defined by the legislation,
for example). Even in jurisdictions with
presumptions for some categories of essential workers, there may be evidence to
rebut the presumption.
Even if all
new COVID-19 exposures were to magically end tomorrow, the number of workers’
compensation cases filed and accepted may continue to rise for years to
come. Workers have time to file claims
and contested cases may subsequently be allowed on review or appeal. In some cases, consideration is delayed while
medical records and tests are obtained.
This means that the eventual claim counts and costs related to COVID-19
occurring in 2020 may not be fully known for many years to come. It also means
that current proportions like those noted here understate the ultimate level of
workplace COVID-19 impacts.
Workers’
Compensation for COVID-19 infection are being allowed
When this
pandemic began, many questioned if workers’ compensation agencies would accept
any COVID-19 infections injury or disease claims as work-related. From data being reported in Canada, the US
and Australia, a substantial proportion of COVID-19 worker’s compensation
claims are being accepted.
In Quebec, where almost all workers are covered by workers’ compensation, submitted claims represent 10% of the provinces 133k reported cases of COVID-19; nearly 90% of claims submitted so far have been allowed in that province. Ontario, where about 70% of the working population is covered by workers’ compensation shows about 7% of cases are represented in the submitted claim category with a 76% allow rate to date.
Alberta Workers’
Compensation Board reports 3,209 COVID-19 claims received, 2,164 accepted, 646
rejected and 399 are either pending or under review. Interestingly, most claims
were from the manufacturing sector, related to meat processing plants in that
province. Claims received would be just under 6%
of reported COVID-19 cases in Alberta. Nicole Stillger, “Over 3,200 COVID-19 claims made to Workers’
Compensation Board of Alberta since March, Global News, posted November 29,
2020, https://globalnews.ca/news/7491453/alberta-workers-compensation-board-covid-19/
Washington
State experienced 80,465 confirmed cases of COVID-19 by September 14,
2020. https://www.seattletimes.com/seattle-news/health/coronavirus-daily-news-updates-september-15-what-to-know-today-about-covid-19-in-the-seattle-area-washington-state-and-the-world/. The state’s safety and health research agency
report 3836 submitted claims (with an 83% allow rate) and 3488 claims as
a result of quarantine coverage covered in that state by the same date. [See https://lni.wa.gov/safety-health/safety-research/files/2020/64_20_2020_wcCOVID_Nov.pdf
]. The claims submitted represent nearly 5% of the total COVID-19 cases
reported in the state over that time frame.
SafeWork Australia reported that by July 31, 2020 533
workers’ compensation claims had been lodged with jurisdictional authorities (about
3% of all COVID-19 cases reported in Australia). Up to that date, nearly half had been accepted
(253) and a substantial number pending (185).
It should be noted, however, that claim counts reported in this context
include mental health and testing or isolation circumstances and not just test-positive
work-related claims. https://www.safeworkaustralia.gov.au/sites/default/files/2020-11/COVID-19%20Infographic%20-%20Worker%27s%20Comp%20Claims%2031%20July.pdf
Work-related
COVID-19 infection is higher than workers’ compensation accepted claims
The work-related incidence of COVID-19 may be much higher. Not all workers are covered by workers’ compensation. Others may be covered but unaware of their right to workers’ compensation. Still others may be directly or indirectly discouraged from filing a workers’ compensation claim.
The
proportion of workers contracting COVID-19 in the course of their employment
may also vary with the nature of their work.
Prison guards, food processing plant workers and long-term care aids are
among the most likely to have the disease passed to them because of the close
congregation of workers and of workers to others in frequent close
contact. This is particularly likely
when the virus is spreading in the community. If the virus is in the community,
chances are someone (worker, visitor or other person) will become infected and
introduce the virus into the workplace.
Fraser Health recently published an excellent example in this poster:
How many workers’ compensation claims arose from this real-life example? I asked the workers’ compensation authority that question and was told they were not privy to the information used by Fraser Health to develop the example. The lack of data sharing between health authorities and workers’ compensation insurers may contribute to the under-representation of work-related COVID-19 cases in statistics. I’m not saying that public health should adjudicate workers’ compensation claims. What I am saying is that the public health determination that a COVID-19 test-positive case likely occurred at work is important evidence that should be available to those adjudicating workers’ compensation claims.
Direct COVID-19 infections are only one category of workers’ compensation
claim
COVID-19
case counts should not be considered as the only work-related consequence of
this pandemic. I’ve spoken with workers
in health care; many are stressed to near the breaking point. Work-related psychological injuries are
occurring now and are likely to be a growing feature of future workers’
compensation claims experience.
Some
essential workers are exhausted. With
staff shortages, many are being called to work double shifts, longer hours, and
expanded duties. Even the simple
comforts families could offer the severely ill and dying must now be offered by
workers… and that, too, takes a toll.
Photos of chapped
and swollen faces from long hours wearing N-95 masks are common. Healthcare workers have spoken of hands
breaking down from repeated washing and sanitization. Images of medical staff in despair and reports
of suicides from their ranks are a growing concern. Dermatitis, depressive reaction
and PTSD may not be direct consequences of COVID-19 but they are real injuries;
if work-related, then workers and their families should be compensated.
Except for
the Australian data, I could not find current statistics on the incidence or
prevalence of psychological or mental health claims for workers’ compensation
related to COVID-19.
Final
comments
A few jurisdictions
such as WorkSafeBC are reporting statistical data for COVID-19 cases. Jurisdiction such as Washington State that
cover quarantine for some occupations are reporting these data separately but are
clearly tracking cases in this regard. It
is not clear which jurisdictions are comprehensively collecting and reporting data
on workers’ compensation COVID-19 claims, claim types, claim status, or costs.
What is not
being reported in most jurisdictions are the indirect COVID-19 cases. We are barely 8 months into the COVID-19 pandemic
declared by the World Health Organization on March 11, 2020. PTSD has a “delayed specification” of six
months, so, formal assessment and diagnosis can’t happen in real time. It will be years before we know the human and
financial costs of COVID-19 in the workplace.
Reporting on cases of PTSD related to COVID-19 is just one example of the
sort of data that needs to be collected, tracked, and made available as soon as possible.
This is not
just about money and who should pay for work-related case. Timely workers’ compensation data is necessary
for prevention, targeting interventions and making workplaces safer right now
and in years to come.
If we are
to ever understand the real human and financial costs of this pandemic, we need
to be identifying and tracking cases now.
We need to understand any disparities between the work-related COVID-19
cases identified by public health and the cases reported to occupational safety
and health or workers’ compensation authorities. This is not a trivial task; however, it is
essential if we are fully acknowledge these costs, learn from this pandemic… and
prepare for the next one.
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