Washington State, like many states across the nation, continues to grapple with COVID-19. Here are some key things to know about how the Department of Labor and Industries is attempting to protect the states’ workers in the midst of this crisis.
Who can file a claim for Coronavirus workplace exposure/quarantine
The Industrial Insurance Act allows for treatment of COVID-19 when work-related activity has resulted in probable exposure to the virus and certain criteria are met. In these cases, the worker’s occupation must have a greater likelihood of contracting the disease because of the job (examples include first responders or health care workers). There must also be a documented or probable work-related exposure, and an employee/employer relationship.
Health care workers and first responders will receive wage-replacement benefits (timeloss compensation and loss of earning power benefits) and have all related health care expenses covered under the state’s workers’ compensation program when quarantined by a physician. Other essential workers in Washington who test positive for COVID-19 will be considered on a case-by-case basis.
Workers do not need to be examined by a physician for a COVID-19 exposure claim to be submitted when they are quarantined. L&I is handling medical documentation for these claims differently than other workers’ compensation claims. However, the Department does require a positive test to allow a claim for the disease when a worker has actually contracted the virus.
Criteria for claim allowance
The state has established three criteria for evaluating COVID-19 claims:
- Was there an increased risk or greater likelihood of contracting the condition due to the worker’s occupation (such as a first responder or health care worker)?
- If not for their job, would the worker have been exposed to the virus or contracted the condition?
- Can the worker identify a specific source or event during the performance of his or her employment that resulted in exposure to the new coronavirus (examples include a first responder or health care worker who has treated a patient with the virus)?
When will a claim likely be denied?
When the contraction of COVID-19 is incidental to the workplace or common to all employment (such as an office worker who contracts the condition from a fellow employee), a claim for exposure to and contraction of the disease will be denied.
For allowed claims, time-loss payments for lost wages during a quarantine period may be available for up to 14 days. As with all wage replacement benefits under the Industrial Insurance Act, the first 3 days are not paid unless the worker is medically required to remain off work on the 14th day following exposure.
Once a claim is allowed, the insurer will pay for treatment of COVID-19. Currently, the only treatment for this new coronavirus is supportive care to help relieve symptoms.
The Industrial Insurance Act allows the insurer to pay for testing before someone is ill when there has been a documented, work-related exposure. If the diagnosed condition on the original accident report form is contraction of COVID-19 and the 3 criteria under when to file a claim are satisfied, the claim will be allowed, and treatment authorized. When a claim is filed for probable exposure and the criteria under when to file a claim are satisfied, the claim will be allowed for the quarantine period regardless of whether the worker actually contracted COVID-19.
Let us know how we can help
The situation with the pandemic continues to develop. If you would like to know more about how we can assist you in filing or navigating your claim for coronavirus exposure, please Contact Us and let us know how we can lift the weight off your shoulders!