The Institutes

Is It Compensable? A COVID-19 Workers Compensation Q&A

 Wednesday, June 24, 2020

 CLM Magazine

The COVID-19 pandemic has sent reverberations through every industry and has the potential to take a heavy economic toll on workers compensation insurers and self-insurers in particular.

The current environment creates many questions. Here are answers to those being most frequently asked. How do you analyze compensability of a COVID-19 workers compensation claim?

The determination of compensability of an alleged COVID-19 workers compensation claim will, of course, vary state-to-state depending on the particular laws of that jurisdiction.

Within most states, compensability will likely be decided on a case-by-case basis, rather than a uniform rule, given the fact-intensive nature of the analysis process.

In most states, the employee will bear the burden of proving compensability. In general, the foundation of your compensability analysis boils down to whether a COVID-19 diagnosis arises out of and in the course of employment. Many state statutes exclude diseases of “ordinary life,” such as the common cold or the flu. However, most states are treating COVID-19 as an occupational disease.
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