Insurance Companies Routinely Deny COVID-19 Claims

Workers’ compensation insurers are making it more difficult for workers who contract COVID-19 while on the job to receive benefits while they recover from the illness. Why are so many of these claims being held up or denied?

The Typical Scenario 

A worker who works in an industry where the work cannot be done remotely begins to feel symptoms of the virus. They go to their doctor who tests them and the test comes back positive. Even if their symptoms aren’t severe, they will be required to quarantine for two weeks while their body fights off the virus. Those with severe symptoms may be out for much longer.

The worker files a claim on their employer’s workers’ compensation policy, but the claim comes back denied. The insurer says that the worker didn’t catch COVID while they were on the job, they caught it somewhere else. There exists no way to “prove” where they got the disease, so the claim is held up or unfairly denied while the worker tries to figure out how they can prove where they contracted the illness.

In some cases, workers are receiving denial letters, but far more frequently, they are hearing nothing back at all. Even in cases of meatpacking workers who are forced to work side-by-side with one another or corrections officers who cannot routinely socially distance inside a poorly ventilated prison are having their claims denied. Even health care workers are having their claims denied. Why? Because there is no way to prove that their illness was a result of their employment. Over 50% of COVID-related workers’ compensation claims have been denied here in Florida.

Now What? 

The workers are upset that their claims are coming back denied, but it’s their employers who face liability when it comes to these claims. Since the workers’ compensation claim was rejected, the employee would have the option of filing a lawsuit against their employer for failing to provide them with the proper PPE or safe working conditions. In fact, filing a lawsuit will become the default way to handle a COVID-19 workers’ compensation claim. A jury would only need to find that it is more likely than not that the worker contracted the illness while on the job. The standard for a workers’ compensation claim, however, is much higher.

In reality, there are very few situations in which companies get left holding the short end of the stick. Right now, legislators are attempting to pass laws that insulate companies from liability if they are in “substantial compliance” with public health initiatives. That means that the front-line workers who were forced into a dangerous position simply to do their jobs may have no recourse whatsoever to recover wages lost during the pandemic.

Any coronavirus immunity legislation must ensure that frontline workers have recourse to recover wages for bravely preventing our society from completely shutting down during the pandemic.

Talk to a Miami Workers’ Compensation and Personal Injury Attorney 

If your workers’ compensation claim is being delayed or denied because you can’t prove where you contracted COVID-19 from, call the Miami personal injury attorneys at Payer Law today to schedule a free consultation and discuss your situation in more detail.

Resource:

theintercept.com/2020/09/07/coronavirus-workers-compensation-claims-labor/