MONTANA SELF INSURERS’ ASSOCIATION - MSIA
COVID-19 Coverage Presumptions
Current Montana law requires that when an injury occurs and a claim for benefits is filed, the injured worker demonstrates the injury happened as a result of work. This is a relatively common requirement across the country. Most claims are obvious or are witnessed by the employer and therefore meet the standard.
To say COVID-19 has turned our world upside down is an understatement.
There are those who would like to provide a presumption in our workers’ compensation system, that if a medical provider, first responder or “essential” worker contracts COVID-19 they be presumed to have gotten the disease at work. Some states have mandated the presumption either by Executive Order or by statute. Those states that have made such an order have seen significant increases in their costs of claims, and therefore their overall system rates.
Most states, including Montana, have let their workers’ compensation systems work. If the disease is contracted as a result of work, benefits are provided. Fortunately, most cases clear up within about 2 weeks and require some medical treatment, home isolation and rest. Some cases are significantly more severe, requiring hospitalization and potentially death. The workers’ compensation system is built to address both.
This disease is obviously spread very easily. As a result, demonstrating the disease was contracted as a result of work is often difficult. Some employers and insurers are paying for testing, regardless of how the disease was contracted. Some are providing medical benefits, again regardless of how the disease was contracted. And the Federal CARES Act provides benefits to those who are made ill by the disease – in addition to any health insurance or workers’ compensation benefits.
Those claims that have been accepted within the Montana workers’ compensation system, are being paid. Most have come from health care employers. Most of the claims have been denied, because it is impossible to know that work was the primary cause of contracting the disease. As discussed above, even denied, some of those claims are getting medical benefits.
MSIA opposes adding a COVID-19 presumption to our law. Providing a presumption in the Montana workers’ compensation law is a solution looking for a problem. If enacted, we will have problems that will require more costs and real solutions.