Key Takeaways

• The New York State Workers’ Compensation Board has released a Q&A on workers’ compensation and COVID-19 issues for claimants

The New York State Workers’ Compensation Board has released a Q&A-style guide to workers’ compensation and COVID-19 issues. The document is intended “to provide the public a general framework about viral exposure and contraction claims.” This presents some valuable insight into the board’s perspective on COVID-19 workers’ compensation claims.

Read: COVID-19 & Workers’ Compensation Q&A

WORK ENVIRONMENTS: RISK AND COMPENSABILITY

Notably, the Q&A identified work environments that are “more likely to result in COVID-19 claims.” Employees associated with these work environments include:

• Health care workers
• First responders
• Transportation workers
• Correction officers
• Food service workers
• Other workers with direct dealings with the public

INFORMATION NEEDED: DEMONSTRATING “SIGNIFICANTLY ELEVATED RISK”

The Q&A also identified the “information needed to show that a COVID-19 claim is work-related.” The document states that “[m]ost workers will never be able to point to the moment or method of exposure to COVID-19, but workers can demonstrate the significantly elevated risk in their workplace by demonstrating the nature and extent of their work in an environment where exposure to COVID-19 was prevalent.” The board encourages claimants to provide details surrounding:

• Where you work
• How often you work
• Types of duties performed (especially involving contact with the public)

Regarding documentation, the board indicated that “[a] positive test result is best,” but “a medical report, from an authorized workers’ compensation provider, showing a diagnosis via PCR test, or by virtue of examination by a treating physician, may be used.”

FILING INSTRUCTIONS TO CLAIMANTS

The Q&A closes with information regarding the process of filing a claim, the timeline, and additional help available to claimants. The Q&A instructs claimants with COVID-19 claims to:

1. Inform the employer as soon as possible
2. Fill out the Employee Claim (Form C-3)
3. See a doctor authorized to treat workers’ compensation patients
4. Tell the doctor of a suspected case of COVID-19
5. In the case of a positive test result, submit the result to the board with the claim form

ANALYSIS

The decision to accept or deny a claim involves looking at the facts and applying them to the law. The information in the Q&A for claimants, taken together with the board’s prior letter to carriers, offers insight into how the board will handle COVID-19 claims.

Notably, the sections of the Q&A pertaining to the work environment and claim documentation include language similar to that found in S8427, the legislation signed by Gov. Andrew Cuomo on May 30, 2020, establishing accidental death benefits for front-line workers and enhanced benefits for state and local government employees.

FURTHER INFORMATION

For a complete list of high-level guidance and updates from the New York State Workers’ Compensation Board, please see our New York State Workers’ Compensation Board COVID-19 Initiative Overview.

For more information or immediate guidance, contact:

• Christina M. Hassler
• Damon M. Gruber
• Sean J. McKinley
• Or another member of our Workers’ Compensation practice