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According to the Workers’ Compensation Research Institute (WCRI), long COVID cases presently account for 6% of workers’ compensation claims.

But because there are variations in how the different states administer workers’ compensation, many claimants have not been able to collect benefits.

Essential workers are amongst the workers struggling to receive benefits.  Those are hospital staff, teachers, medics, and others who could not work remotely during the earliest days of the pandemic.  The ones who could not work remotely put themselves at higher risk of infection.

For all the thanks that were poured out to essential workers during the early pandemic days, some of those essential workers are finding it hard to get compensation.

There are people who live in states that have compensability rules that make only certain workers eligible and if one works in a different occupation that worker’s injury is not going to be compensable.  This was expressed by Bogdan Savych, PhD, who was an author of the WCRI report.

There are various policies and requirements amongst the different states; so there are different individual coverage rules.

Some states require an employee to prove he or she was injured or sickened on the job.  That can be hard to determine with a chronic condition or an infectious disease like long COVID.

Some states have set up programs that guarantee coverage for COVID-19 for healthcare and essential workers, and did so from early on in the pandemic because these workers’ had close contact with the public.  But not all states have created such programs.

Some states required employees to prove they were infected with COVID on the job.  Other states allow administrators to “presume” on-the-job exposure in certain jobs.  They have allowed these employees with COVID to collect for lost wages and medical bills.

“Presumed compensability” in some states has been extended to firefighters and first responders with mental health issues and cancer, and in some of those states long COVID has been added to the list.

For the new study, the CWCI analyzed 75,000 COVID claims from 31 states.  Researchers tracked them out from March 2020 to September 2021, and followed them out to March of 2022.

The study found the sicker patients who had acute COVID were more likely to file a claim for long COVID.

Long COVID rates were higher amongst workers who spent time in a hospital.

Researchers found work comp programs paid out an average of $29,000 in medical bills for people who lost work.  Higher claims were paid for those who were hospitalized.  An average of $190,000 was paid for those treated in an ICU.

The study found that workers received payment for an average of 20 weeks of lost wages.  Long COVID was more likely to strike older workers, like acute COVID.  Between 2% and 4% of workers under the age of 35 years developed long COVID.  10% to 12% of those over 55 years of age developed long COVID.

Researchers use medical and claims data from databases like Medicare.  The data are reliable and accessible because it’s a federal program.  Groups like the WCRI have spent decades developing their own sources of data from insurers and employers because work comp is a state administered program.

Researchers used the Centers for Disease Control and Prevention’s working definition of long COVID.   It came from cases where symptoms persist after 30 days as a starting point.  They tracked claims for symptoms and ailments linked to long COVID.  These included extreme fatigue, chest pain, muscle pains, headaches and brain fog.  The study data are drawn from 24 months of medical care and income benefits from before and after the COVID Delta variant surge and the introduction of vaccines.

An earlier study of long COVID and workers’ comp cases found a higher rate of cases among employees mostly working in the healthcare industry.  Using a different but overlapping set of data from states and insurers, the National Council on Compensation Insurance (NCCI) examined 7650 COVID work comp claims in about 40 states.  About 24% were long COVID clais according to the study release in October 2022.  That study also found a link between the intensity of the treatment and the likelihood of long COVID.  About 20% of those who were not treated in a hospital went on to develop long COVID.  47% of those hospitalized developed long COVID.

Hospitalized patients were slower to recover.  The average benefit for lost wages was 160 days for hospitalized patients and 95 days for nonhospitalized patients.

The difference in the two studies findings could be driven in part by the various “presumption of compensability” rules that emerged during the pandemic.  Some states have them and some don’t.

Robert Moss, an NCCI actuary and co-author of the 2022 study, said “For essential or frontline workers there are presumptions in place that say, “If you show that you had COVID we are going to assume that it arose out of the workplace.”

But that policy is not applied across the board in all states.  Experts say countless cases may not even be filed by workers because they don’t believe they will qualify for benefits.

A lawyer in Virginia settle one of the first cases in the state after lawmakers passed such a “presumption of compensability” provision for healthcare workers.  It was a case involving a physician’s outstanding medical bills.  Dozens of other cases have now been successfully settled.

Before the law was passed, the lawyer said she didn’t even bother filing for workers’ compensation for a nurse and physician’s assistant who said they contracted COVID at work.

Thanks to the presumption, she indicated she’s had the opportunity to settle numerous long COVID cases, often for considerably higher amounts than she initially anticipated.

lonce@adjustercom.com, Lonce Lamonte, writer