As cases of COVID-19 mount in Texas and across the U.S., some patients who test positive for the disease might file a claim under their workers’ compensation insurance if they believe they contracted COVID-19, or the coronavirus that causes the disease, as a result of their work.
Under workers compensation, injured workers must prove their infection was work-related, the Texas Division of Workers’ Compensation (DWC) notes. If they don’t, their claim may be denied. And claim denials, of course, mean those workers’ physicians may have trouble getting paid.
As DWC’s resource website on coronavirus notes, to file a successful claim for workers’ compensation, “an employee must have been injured or contracted an occupational disease as a result of their employment. Whether a workers’ compensation claim is compensable or not is a case by case determination by the insurance carrier.”
DWC also notes that a disagreement over a claim between the workers’ compensation insurance carrier and the injured worker can move to the division’s dispute resolution process. But needless to say, a worker proving a work-related contraction of COVID-19 would be difficult in many scenarios, given that the virus has proven contagious enough to cause a global pandemic. Generally, a worker would need to prove there was a heightened risk of exposure due to their employment compared to the general public.
Many health insurers in Texas are waiving patient costs associated with COVID-19, including government programs.
You can also find the latest news, resources, and government guidance on the coronavirus outbreak by visiting TMA’s COVID-19 Resource Center regularly.
Last Updated On
March 23, 2020