As information about prolonged covid develops, workers’ compensation experts are looking at how clinical changes and statistics may affect the ability to compensate workers who continue to struggle with the effects of the disease.
Last week, the Workers’ Compensation Insurance Rating Bureau of California released data showing that in 2020 and 2021, injury claims involving treatment for long-term covid symptoms were four times more likely to result in permanent disability benefits than other covid-19 claims.
The report also found that during a 12-month, post-acute care period, approximately 13% of covid-19 claims with medical payments included treatment for prolonged covid symptoms.
As the comp industry has struggled to define the disease, findings published May 25 in the Journal of the American Medical Association narrowed down to 1
2 the most common symptoms associated with prolonged covid.“There are still a lot of unknowns out there to see if that is the case [the AMA findings] would affect workers’ comp in a way that’s more meaningful, but I expect from a compensation perspective that it won’t change too much, especially in the states that have adopted the presumptive covid causation rules,” said Dr. Kenji Saito, Augusta, Maine-based president of the American College of Occupational and Environmental Medicine.
The AMA study had limitations, and the authors cautioned that the 12 symptoms — which include post-exercise nausea, fatigue, brain fog and dizziness — should not be considered exhaustive.
Dr. Michael Choo, chief medical officer for Walnut Creek, Calif.-based medical management services company Paradigm Corp., said that while the labor market is looking at clinical definition changes regarding long-term covid, post-infection symptoms for the virus have been around for years.
In the 1990s, chronic fatigue syndrome was diagnosed in association with infections such as mononucleosis and Lyme disease, as patients developed secondary symptoms after infection.
“This is not new in the medical industry,” said Dr. Choo. “It’s always been there where people would experience long-term symptoms. But it didn’t happen very often, so it really wasn’t known except to the specialists.”
Post-infection symptoms became more apparent with COVID-19, he said, because of the large number of people infected.
This in turn created problems and raised questions about compensation for workers who contracted the virus on the job.
“We opened the door for all of these post-infection sequelae to be considered a potential problem related to workers’ compensation claims,” said Dr. Choo.
Workers whose covid-19 diagnosis is covered as a presumptive work injury are also likely to be covered if they develop long-term covid, he said.
The compensability for long-term covid becomes problematic when insurers and employers question whether an employee was affected by covid-19 at work.
“It raises a lot of interesting questions and challenges, legally and clinically,” said Dr. Choo.
Given that COVID is now considered a disability under the federal Americans with Disabilities Act, employers must accommodate it. How it looks is equal puzzling, according to disability experts.
One suggestion is to allow a worker to telecommute if possible, said Bryon Bass, CEO of the San Diego-based Disability Management Employer Coalition.
“Recommendations were gathered from an industry think tank to help employers foster a culture of accommodation that minimizes the long-term effects of prolonged covid on the employee and employer as well as society at large,” he said.
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