COVID-19 and the Effect on the Illinois Workers’ Compensation Industry

By: Jordan Lejcar

The First Quarter of 2020 was full of surprises and challenges!  While we were busy preparing for how medical and recreational marijuana was going to shake up our daily grind, COVID-19 snuck in and hit the headlines, becoming a major concern in the work comp industry and in our everyday lives.  As always, ASA was at the forefront of the industry and immediately began addressing the emergent issues and challenges of COVID-19 on the industry.  In March, ASA presented COVID-19 Webinars in both California and Illinois* and circulated a written COVID-19 update to all our clients. The key take-aways from these initiatives are:

• ILLINOIS:

  COVID-19 FACTS:

• Rapidly evolving due to more and more data and studies as time and infections rise.

• A respiratory illness that is primarily spread through contact with an infected person who coughs or sneezes. It is secondarily spread by touching a surface or object that has the virus on it followed by touching a person’s mouth, nose, or possibly eyes.

• Incubation period of 14 days, with most occurring at 4-5 days.

• Symptoms include fever, tiredness, shortness of breath, dry cough and pneumonia,

• Test results vary in timing, most commonly taking 4 days.

  PROVING COVID-19 CASES:

• Under the ODA, an employee has to prove exposure, causation, a disabling condition and that the disease (here, coronavirus) has its origin in a risk connect with employment.

• Ultimately, whether compensable under workers’ compensation will be determined by a factual analysis and on a case by case basis.

• Widespread infection rates will make it more difficult for most employees to prove exposure was work-related (i.e. “no greater exposure than the general public).

• If reported, ask specific and detailed investigation interview questions regarding public and personal exposure, past and current medical history and supporting documentation, preventative measures and safety instructions.

• Degree of exposure compared to the general public will become key:

           • Essential Business

           • Healthcare workers

           • First Responders

           • Grocery/Restaurant/Delivery workers

           • Airport workers (from janitor to flight attendants, etc.)

           • Exposure from treatment for an open workers’ compensation claim (treater, therapy, FCE, IME)

  CONTINUING SECTION 12 EXAMS VIA TELEHEALTH OR RECORDS REVIEW, WHERE AVAILABLE

• Using specific key language to ensure attendance or timely rescheduling of appointments due to COVID-19.

• Causation opinions based on medical records and report of accident.

• Utilizing FCEs to assess work restrictions, if any.

  CONTINUING MEDICAL TREATMENT

• Utilizing telehealth appointments with providers, both treaters and therapy.

• Utilizing Nurse Case Managers to monitor telehealth appointments, proper treatment notes, recommendations, and restrictions.

*   If you missed the IL and CA Webinars, please feel to contact one of ASA’s team members with questions or to discuss additional current issues relating to COVID-19.  You can also find the webinars streaming at:  www.asalawgroup.net/news

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