If you believe that you contracted COVID-19 because of exposure to the coronavirus on the job or while traveling for work, you may be wondering if you qualify for workers' compensation benefits (including wage-loss benefits when you're in quarantine).
The short answer is that in most states, it will probably be difficult to get these benefits unless you're a healthcare provider or first responder who treated an infected person.
The longer answer is that it will depend on the nature of your job, the circumstances in your case, and the rules in your state—including changes to those rules that may make it easier for some employees to qualify when they get COVID-19 during the pandemic.
Workers' compensation generally covers diseases that employees contract because of their work—or in legal jargon, occupational diseases "arising out of and in the course of employment" (AOE/COE). Although common infectious diseases like the flu aren't considered occupational illnesses, COVID-19 might be treated differently in some cases.
Specific eligibility requirements for occupational diseases vary from state to state, but you typically need to demonstrate that:
When an infectious disease becomes widespread in the community, as in the case of the coronavirus pandemic, it can be particularly difficult to meet both of those requirements.
Speaking to the situation in most states, Will Peterson, a workers' comp attorney at Wood, Cooper & Peterson in Neosho, Missouri, commented: "Even if the claimant could establish successfully that COVID-19 was contracted at work, which seems unlikely, the claimant would still be required to prove that there was something specific about their work that increased their risk of contracting COVID-19."
According to Peterson, Missouri law "does not compensate individuals just because they are hurt or injured while working. Work has to be the prevailing cause of why the individual contracted COVID-19."
Peterson believes that in most states, "the vast majority of COVID-19 claims will be unsuccessful because the disease is a general hazard to everyone worldwide, irrespective of employment. Individuals are exposed to it both at work and everywhere else."
In a few states, you still might be able to qualify even if your job isn't considered particularly high risk, as long as you have strong medical evidence of workplace exposure. And, as discussed below, several states have made it easier for certain employees to qualify for benefits when they get COVID-19 during the pandemic.
In contrast, other states like South Carolina rule out workers' comp coverage when employees contract a contagious disease from coworkers or when they would've been equally exposed outside of work (S.C. Code § 42-11-10 (2022)).
Clearly, first responders and healthcare workers face a particular danger of being exposed to COVID-19, especially in the midst of a pandemic. But workers in other occupations—like correctional officers, bus drivers, and grocery workers—might also be able to show that the nature of their work put them at higher risk than the general population.
Several states have extended special protection to certain employees working on the front lines of the pandemic by presuming that they qualify for workers' comp when they come down with COVID-19, unless the employer or its insurer proves otherwise. For example:
The Division of Federal Employees' Compensation (DFEC), part of the U.S. Department of Labor, created special procedures for handling workers' comp claims by federal employees who say they contracted COVID-19 while performing their job duties.
Given how difficult it is to know exactly when or how anyone gets this disease, DFEC explained that it will consider certain federal workers at higher risk of infection—such as law enforcement, first responders, frontline medical and public health personnel, and others whose jobs require frequent, close, in-person interactions with the public—and will treat their COVID workers' comp claims differently.
If you file a claim for COVID-19 as a high-risk federal employee, DFEC will accept that your job caused your exposure to the coronavirus. You can still file a claim if your job isn't considered high risk.
But you'll need to provide evidence about your on-the-job exposure to the virus, along with medical evidence showing that work-related activities directly caused or aggravated your diagnosed case of the disease. (Learn more about the federal workers' compensation system and the required evidence and claim procedures for COVID-19 under that system.)
In addition to the federal workers' comp system, another federal program (the Public Safety Officers' Benefit Program) provides benefits to certain federal workers who are permanently and totally disabled as a direct result of an injury sustained in the line of duty, as well as death benefits to their survivors when they die as a result of such an injury.
These "public safety officers" include firefighters and law enforcement officers who work for a public agency, as well as members of authorized ambulance crews who provide emergency medical services.
A federal law enacted in August 2020, the "Safeguarding America's First Responders Act," makes it easier for these first responders to get permanent total disability benefits when they contract COVID-19—and for their survivors to get death benefits if the workers die of the disease.
The law presumes that COVID-19 was an injury sustained in the line of duty if the employee was diagnosed with the disease during the 45-day period after the worker's last day of duty during 2020 and 2021 (P.L. 116-157 (S. 3607); 34 U.S.C. § 10281, 10284 (2020)).
What if you believe that you were exposed to the coronavirus because of dangerous conditions at your workplace rather than the nature of your occupation? For instance, you might work at a shipping facility or a meat processing plant that hasn't provided face masks or instituted social distancing measures for employees. Can you get workers' comp benefits if you contracted COVID-19 after being exposed to an infected coworker?
Although laws haven't addressed this question directly, existing statutes and court opinions indicate that states may take varying approaches. Under New Jersey law, for example, workers' comp may cover occupational diseases that are materially caused by conditions that are particular to their place of employment, in addition to their trade of occupation.
And New Jersey courts have held that the sick employees only need to show a probable link between the workplace conditions and the occupational disease. (N.J. Stats. § 34:15-31 (2020); Magaw v. Middletown Bd. of Educ., 731 A.2d 1196 (N.J. Sup. Ct. App. 1999).)
However, courts in other states have held that employees must show a link between the distinctive nature of their jobs rather than conditions at a particular workplace (see, for example, Demers v. St. Lawrence Psychiatric Center, 271 A.D.2d 857 (N.Y. App. Div. 2000)).
Employers and their insurance companies will probably fight hard against workers' comp claims for COVID-19—at least for anyone other than employees in particularly high-risk occupations with clear evidence that they were exposed to an infected person on the job.
If you file a claim and are denied at first, you should speak with a qualified workers' comp attorney who can evaluate your claim, explain how the current rules apply to your situation, and help you with an appeal if that's appropriate.
An experienced employment lawyer should also be able to explain whether you might be able to sue your employer outside of the workers' comp system for failing to protect you from the coronavirus.
Meanwhile, however, you have other options for getting more immediate benefits, including sick leave and paid medical leave or short-term disability benefits (available in a few states).