Workers’ Comp & COVID-19

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On the COVID-19 resource page, DWC has an FAQ section. It offers the following guidance on if workers’ compensation covers coronavirus-related exposure illness:

Workers’ compensation is an insurance program that pays for medical bills and some lost-time income for employees who have a work-related injury or illness. To qualify, an employer must have workers’ compensation insurance, and 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. If there is a dispute over a claim and you are not able to resolve the dispute with the insurance carrier, then you may ask for dispute resolution by contacting DWC.

There is also a presumption for workers’ compensation benefits for first responders, including EMS professionals, specific to respiratory illnesses in the Government Code.

Sec. 607.054. TUBERCULOSIS OR OTHER RESPIRATORY ILLNESS. A firefighter, peace officer, or emergency medical technician who suffers from tuberculosis, or any other disease or illness of the lungs or respiratory tract that has a statistically positive correlation with service as a firefighter, peace officer, or emergency medical technician, that results in death or total or partial disability is presumed to have contracted the disease or illness during the course and scope of employment as a firefighter, peace officer, or emergency medical technician.

Most first responders have workers’ compensation coverage through municipalities such as TML, TASB, or larger self-insured cities.

An exposure only claim would generally not be covered by workers’ compensation.

Governor Abbott, at DWC’s request, has also suspended Health and Safety Code Section 81.050(j) and 28 Texas Administrative Code Section 122.3(c) regarding 10-day testing requirements.  This will remove a possible justification for a workers’ compensation insurance carrier to deny a COVID-19 claim from a first responder.  Here is a link to that notice and helpful FAQs.