Lost time: COVID‐19 indemnity claim reporting and results in the Wisconsin workers' compensation system from March 12 to December 31, 2020

Abstract

Background: The COVID-19 pandemic introduced a new compensable infectious disease to workplaces. Methods: This was a descriptive analysis of Wisconsin COVID workers' compensation (WC) claims between March 12 and December 31, 2020. The impact of the presumption law (March 12 to June 10, 2020) was also evaluated. Results: Less than 1% of working-age residents with COVID-19 filed a claim. COVID-19 WC claim rates (per 100,000 FTE) were notably low for frontline industry sectors such as Retail Trade (n = 115), Manufacturing (n = 88), and Wholesale Trade (n = 31). Healthcare workers (764 claims per 100,000 FTE) comprised 73.2% of COVID-19 claims. Most claims (52.8%) were denied and the proportion of denied claims increased significantly after the presumption period for both first responders and other occupations. Conclusion:The presumption law made benefits accessible primarily to first responders. Further changes to WC systems are needed to offset the individual and collective costs of infectious diseases.

Industry-Specific Profile of COVID-19–Related Workers' Compensation Claims in New York State

“…54 In Washington, 1 of 2 states with an infectious disease presumption for frontline workers during a declared public health emergency, nearly 90% ( n = 17,792) of the 19,996 State Fund and self-insured COVID-19 claims submitted between February 2020 and August 2022 were accepted. 55 In an analysis of Wisconsin's COVID-19 WC claim denial rates during (March–June 2020) and after (June–December 2020) a presumption period in Wisconsin, Modji et al 50 found that the proportion of lost work time claims among first responders who were denied more than doubled from 18.4% to 43.8% when the presumption law was no longer in effect. Also, in an analysis of accepted COVID-19 claims from 11 states in the Midwest United States submitted to a large, private insurance carrier before August 31, 2020, Bernacki et al 56 found that the likelihood of filing a COVID-19 WC claim in a presumption state was significantly higher than in a nonpresumption state.…”

Why presumptions are important in occupational health: The example of COVID‐19 infection as an occupational disease

“…42,59,60 In states with a presumption, COVID-19 claims accounted for 38% and 33% of total claims in Minnesota and Alaska during 2020, 31% of paid lost time claims in Michigan (2020-2021), and 19% of total lost time claims in Wisconsin during 2020. 45,50,54,61 This contrasts with nonpresumption states, where COVID-19 claims accounted for 10%, 9%, and 4% of total claims in Louisiana, New York, and Montana, respectively, during 2020. 41,44,55 Further, according to an analysis of over Washington, Alaska, and California awarded 89%, 79%, and 66% of all filed COVID-19 claims, respectively, and Michigan awarded 72% of COVID-19 indemnity claims with ≥7 days of lost work, despite differences in details of presumptive coverage.…”

“…Summaries are available 1,2 and state-based results have been described in individual state reports, [41][42][43][44][45][46][47][48][49][50] select multistate reports, [51][52][53] and a handful of peer-reviewed papers. [54][55][56][57][58] Without detailed analyses, state to state comparisons are difficult to make and limited in their interpretation given stark differences across states in economic responses to the pandemic, industry mix, presumption eligibility criteria, and presumption expiration dates. Keeping these limitations in mind, we identified several patterns that emerged from the patchwork of approaches to providing WC coverage for COVID-19.…”

“…In Wisconsin, for example, among first responders, the COVID-19 claim denial rate rose from 18.4% during the time period when presumptions were active to 44% after the presumptions expired. 54 In Michigan, the proportion of awarded COVID-19 claims dropped below the proportion of unpaid claims for the first time since the beginning of the pandemic in April 2021, the same month that their COVID-19 presumption expired. 61 A possible alternative or complementary explanation for the decrease in the proportion of awarded COVID-19 claims is a change in the profile of occupational SARS-CoV-2 exposure risk during the course of the pandemic, although the evidence to support this explanation is limited.…”

Global Trends in Occupational Lung Disease

“…The most prominent in recent years are SARS-CoV-2 and influenza viruses, especially among health care workers. 16 17 Tuberculosis is reported to have an occupational burden of 2.3 and 1% in silica-exposed workers and health care workers, respectively. 4 Community-acquired pneumonia among welders and zoonoses among workers with animal contacts also contribute to the burden of work-related infections.…”