Filing workers’ compensation claims can be difficult, even in the best times. That’s why we recommend hiring an attorney who knows the business rather than struggle with it on your own.
Unsurprisingly, the COVID-19 pandemic is making the process even more difficult as workers’ comp insurers are seemingly denying the majority of the claims they receive.
Recently, the Wall Street Journal reported on the number of workers’ comp claims being denied. Mack Babcock, renowned Colorado work injury attorney and founder of The Babcock Law Firm, was interviewed for this article, which discussed why injured workers and their families face unique challenges when it comes to securing workers’ comp benefits during the pandemic.
Workers’ comp claims for COVID-19 denied
Typically, when someone files a workers’ comp claim, it stems from a worker being physically injured in an accident at work. Illnesses are generally only covered when they come from long-term exposure to something capable of causing lasting effects. This is known as an occupational disease.
There is still some debate over whether COVID-19 should be considered occupational for essential workers like healthcare employees and factory workers. It’s this ongoing debate—as well as the need to handle each claim on a case-by-case basis—that seems to be slowing down the claims process.
Many workers’ compensation insurance carriers are claiming that workers have a larger likelihood of being infected by COVID-19 while they are away from their job, and therefore the illness is not occupational or work-related. However, plaintiffs attorneys like Mack Babcock are fighting back by arguing that their exposure to COVID-19 is due to unsafe work environments.
When the pandemic began, there were fears among insurers that infection rates would lead to a flood of COVID-19-related workers’ comp claims. These fears intensified as states began to pass laws allowing frontline workers—like healthcare workers and first responders—presumptive eligibility without being able to prove where they contracted COVID-19.
As it turns out, these fears were unfounded.
During the first 3 quarters of 2020, the number of workers’ comp payments and liabilities was less than those seen during the same period in 2019. In fact, there were 7.6 percent fewer claims.
The National Council on Compensation Insurance concluded that the part of the reason for the decrease in claims is due to there being less than expected numbers of COVID-19-related claims. This has also led to a reduction in premiums for the year.
These findings should be taken with a grain of salt, however, because, to date, there hasn’t been a national comprehensive data collection on how many acceptances, claims, denials and payouts insurers have processed for COVID-19 patients.
In states that have crunched the numbers though, the claims that have been paid out have been less expensive for insurance companies than they feared.
Families impacted by workers’ comp claim denials
The WSJ article puts a human face on this ongoing issue by following the stories of 4 families that were impacted by COVID-19-related workers’ compensation denials.
Attorneys who filed claims on behalf of these families, such as Mack Babcock, feel they are eligible for compensation. Mack is currently handling several denied COVID-19 workers’ comp claims for clients. One such client is the family of Daniel Avila Loma, who died after contracting COVID-19.
During the early months of the COVID-19 pandemic, Mr. Loma contracted COVID-19. In March 2020, Mr. Avila became ill, went to the hospital, was diagnosed with COVID-19 and was quarantined for 2 weeks. Days after his release, Mr. Avila returned to the hospital where he died on April 29, with the causes being listed as COVID-19 and pneumonia.
Before his death, Mr. Avila worked as a meatpacker at the JBS USA Holdings, Inc. plant in Greeley, Colorado. He had been an employee with the company for over 25 years and planned to retire by the year’s end.
Mr. Avila’s son noted that his father’s position during his last few months was to sharpen the knives his coworkers dropped on the floor. The family believed he likely contracted the virus due to coming in contact with coworkers across different production lines.
By September 2020, the Occupational Safety and Health Administration (OSHA) cited the Greeley plant for not providing a safe environment for their employees after several died from COVID-19. Then, in November, JBS had 202 workers who were labeled as “vulnerable to COVID-19” paid full wages and benefits to stay out of work.
Since his death, the Avila family has filed for workers’ compensation on his behalf to recoup his lost wages as well as any future earning potential to support the family. JBS denied the claim and the family appealed, scheduling a hearing.
According to the WSJ:
“The Avilas’ attorney, Mack Babcock, said efforts to pass a measure in Colorado to automatically protect certain front-line workers failed in the state legislature after insurers and business groups opposed it. Of the handful of Covid-19 cases his firm is currently pursuing, all have been denied by companies or insurers, he said.”
Filing for workers’ compensation is no walk in the park. If you or a loved one have been injured while on the job or become ill due to unsafe working conditions, reach out to an experienced workers’ compensation attorney. At The Babcock Law Firm, our Colorado lawyers have the knowledge and experience you need on your side to fight for fair compensation.