Worker’s compensation law is primarily state-based, although most jurisdictions share certain common elements. The information below is general in nature and may not apply in every jurisdiction. Individuals must review the provisions in their own state to determine whether and to what extent the information below is applicable to them.
Generally, an employee may file a workers’ compensation claim when they have suffered an injury “in the course of” and “arising out of” their employment. This means that the injury or illness occurred while the employee was working, and the injury or illness was caused by work. An independent contractor is not eligible to file a workers’ compensation claim.
COVID-19: Injury or Occupational Disease?
Some illnesses occur in an instant, and others develop over time. Where COVID-19 infection can be tied to a specific incident, proof of a compensable claim should be straightforward. The incident that caused the infection should be identified on the application for the workers’ compensation claim). If the infection occurred in the course of work and because of work, the employee may be eligible to participate in the workers’ compensation system. Medical conditions that occur over time are commonly referred to as “occupational diseases.” It will likely be very difficult to pinpoint the exact moment of infection with COVID-19 for most social workers. For that reason, most of their workers’ compensation claims are likely to be evaluated under the criteria for evaluating occupational diseases.
Proof of an Occupational Disease
An employee typically must show that the occupational disease was contracted in the course of employment, that the conditions of employment present a hazard different from employment generally, and that the employment creates a risk of contracting the disease in a greater degree and different manner than the public generally.
Each case would require a factual analysis regarding exposure levels and risk on the job. Note that first responders, or those providing direct medical care, would likely have a greater chance of obtaining an allowable claim.
The argument is that social workers, especially those working in the health care environment (or working in hospital discharge), could be more apt to contract COVID-19 because they have a greater likelihood of exposure due to infected patients being in their workplace (e.g. hospital, community clinic, etc.), and an inability to social distance or telework, particularly when other workers have been ordered to stay home due to COVID-19 and staff coverage is needed for those employees. The employee should seek a medical opinion stating that it is medically probable that the infection occurred at work. It might also be helpful for social workers to submit their hours worked in the weeks prior to their diagnosis, and information on how many COVID-19 positive patients the social worker cared for or was proximate to during that time. If that data is not immediately available, it can usually be obtained from the employer during the administrative hearing process.
Workers’ Compensation During Quarantine
Where a social worker is placed under quarantine, then tests positive for COVID-19, and has an allowed workers’ compensation claim, the time under quarantine may be compensable under the workers’ compensation system. Temporary total disability payments may provide replacement for income lost when a workers’ compensation claimant is temporarily and totally disabled from work due to their work injury or illness. If the social worker took paid time off (PTO) for time that was later awarded as temporary total disability compensation, the PTO might be retroactively credited back to the social worker.
Where a social worker is placed under quarantine but then tests negative, or tests positive but does not have an allowed workers’ compensation claim, the time in quarantine generally would not be compensable under the workers’ compensation system. An injury or illness must occur in the course of work and be caused by work in order to have a compensable workers’ compensation claim. This means that if a social worker is forced to take PTO during quarantine but does not test positive for COVID-19 and have an allowed workers’ compensation claim, there will be no method of recovering that PTO under workers’ compensation law.