Presumption laws for significant workers acquiring COVID-19 may have less impact than expected on workers 'compensation systems, but whether it will lead to an increase in workers' compensation payments is up for debate, a group of panelists said Thursday Affärsförsäkring 's webinar, Workers Compensation: Presumption & COVID-19.
Laws of Assumption of Workers' Compensation, which assume that a worker's injury or illness has been acquired during the course and extent of employment. has usually been limited to occupational cancer in firefighters or post-traumatic stress disorder in the first responders. However, California, Illinois and Vermont have extended executive or legislative assumptions to necessary workers using COVID-1
The question is whether these laws are to the benefit of the worker, the employer and the insurer or an obstacle, and whether they will lead to an increase in the claims of coronavirus workers.
On June 5, Illinois Gov. The JB Pritzker law provides a returnable assumption for customers facing customers who acquire COVID-19.
"(The presumption) was a concession, at least in our state, to incredibly strong unions," says Rich Lenkov, capital member and head of workers' compensation practices at Bryce Downey & Lenkov LLC in Chicago. "We already have a foundation for workers to prove their case – it's called the Illinois Workers' Compensation Act. We do not need to create a separate class of people, especially given the basic understanding of how difficult it is to prove causation. I do not think an acceptable assumption is necessary. "
"Much of the presumption is really an attempt to dampen society's conscience in many ways by providing easily accessible benefits," said John Hanson, an Atlanta-based senior consultant with Willis Towers' Watson PLC. "They are designed for the right reasons just so as not to be the right methodology for providing a solution."
California Govin Gavin Newsom was the first to create a reprehensible assumption for 16 classes of workers deemed necessary by an executive order issued May 6 The order, which was retroactively applied to workers who acquired coronavirus on March 19 or later, expired on May 5. July. Several bills that re-established that assumption have been proposed in the state legislature.
The state was also one of the first to take up occupational disease in connection with an occupational injury in 1920 around the acquisition of the Spanish flu by a hospital worker in San Francisco v. Industrial Accident Commission stated Jeff Adelson, Newport Beach, California -based partner with workers comp defense company Adelson McLean PC
“They wanted to determine if illness could really be a source of injury and come within the scope of industrial injury … (and) if not a person who got the disease had a greater risk than the public, he said. "Probably, if you are a significant worker, you have greater exposure."
In Illinois, however, case law for refuting a presumption claim requires "the absolute minimum" of evidence from employers, which will make it very difficult for workers to succeed in claiming COVID-19, Lenkov said, noting that many of his Clients stated that they do not intend to pay these claims even if the trial costs more.
"Yes, it may cost a bit of money to justify them, but you have to decide whether to fight the case is of value because you can be guaranteed for every case you accept that you will also see some others," he said.
more expensive, and choosing not to accept COVID-19 comp claims from workers may be more risky for employers due to higher litigation costs and the potential consequences if a worker ends up in a serious case of coronavirus requiring hospitalization, he said. Adelson.  "A year later they go to file an application and compensation is assumed, he said." Not only are you facing the probably compensable claim, but suddenly you could suffer an extremely large pension right from the hospital, the doctor , the state. "
As science continues to evolve the long-term effects of COVID-19, Mr. Adelson also predicts that workers' claims will see body parts added, e.g. damage to the lungs, respiratory system, circulatory system, and psychological claims.
"It's really up to the employer and carrier to get started on each of these cases quickly," he said. "We have the benefit in California of evaluating use and have the ability to put the brakes on potential medical costs.
Even with the contradictory assumption in his condition, Mr. Lenkov recommends the opposite approach and notes that many of the plaintiffs' lawyers are not interested in taking these cases because most COVID -19 claims are small, and their payments will be minimal.
To date, COVID claims have not had a dramatic impact on workers' compensation systems due to their short duration and relatively inexpensive medical costs for most claims, says John Hanson, an Atlanta-based senior consultant with Willis Towers Watson PLC.
However, he claims that these cases – along with reprehensible ant agendas for occupational cancers and mental health claims – do not belong in the workers' compensation system in the first place.
"Trial cases for presumptive cases are relatively high … there is a lot to learn from other assumptions in both the legal system and the comp system," Hanson said. “The question is, is workers' compensation the right place to handle COVID claims? (States can) try to decide if there is a better way to handle these claims without having to push them … to the comp system.
Louise Esola, Assistant Editor of Business Insurance moderated the webinar.
A recording of the full webinar is available here.
More insurance and labor news about the coronavirus crisis here .