Rice Law Office Blog

COVID-19 Related PTSD May be Covered Under Workers’ Compensation

The toll of COVID-19 on workers is not just physical or economic. For many, there is an emotional impact that for some, rises to such a level that it requires treatment or time away from work. This is especially true for frontline workers who face increased risk of illness for themselves and their families by virtue of their work keeping others fed, safe and healthy.

In the last few months, and perhaps in those to come, some in our community have experienced long periods of isolation away from family and friends, interrupted only by arduous shifts at work, where the weight of responsibility and the despair at the numbers and size of the problem take a tremendous toll. Fortunately, workers’ compensation coverage is available for those who have taken on this burden and who have suffered with not just physical symptoms of COVID-19, but with the mental manifestations of emotional distress as a result of this work.

In the case of emergency responders, New Hampshire workers’ compensation laws allow employees to recover benefits for disabling mental injury suffered as a result of workplace events. However, there are numerous obstacles and challenges in making these claims. Many employees are not aware of their right to bring these claims, and for those that are, the concern of stigma or impact to an employee’s career can be a daunting obstacle to making a claim. Furthermore, when a claim is made, the chance of denial is high, and the process of appeal is in itself stressful and frequently invasive.

Too often the requirement of proof becomes a point of contention that requires the worker to open up their life and health records to inspection in order to meet the burden of proof required. Employees seeking coverage for PTSD, ASD, and other stress or mental health symptoms caused by work often face layers of opposition to their claim. In some instances, they must not only prove that the symptoms they are experiencing are work related, but to do so, they are often compelled to show that their stress is not caused by other life stressors.  This process of meeting the burden of proof in a stress injury claim can serve to make the symptoms of stress worse and discourage claims altogether. 

New legislation passed in July of 2019 seeks to address these obstacles for some of New Hampshire’s workers with the implementation of a series of amendments aimed at easing the burden of proving a mental injury claim for emergency responders/public safety workers.

RSA 281-A:2 XI, which is now in effect, amends the definition of “injury” or “personal injury” under the workers’ compensation statute, to include acute “stress disorder and posttraumatic stress disorder” if an employee meets the definition of an “emergency response/public safety worker.” This legislation also expands the definition of emergency response/public safety worker found at RSA 281-A:2 V-c, to now include “emergency communication’s dispatcher” a group of employees often overlooked but who are also deeply connected to this work. With this legislation comes the acknowledgment that the risk of mental stress injuries to these workers is real and must be met with proper opportunity for treatment and time to heal without stigmas or undue added stress associated with making these claims.

Is COVID-19 An Occupational Disease under New Hampshire Worker’s Compensation Law?

As addressed in previous articles, there will be worker's compensation coverage available for many employees who contract COVID-19 at work. The most likely path to this coverage will be with the understanding that the employee became ill due to a neutral risk, but that the employee faced a greater risk of getting ill due to his or her work, as compared to the general public. This is known as the increased risk test and employees who can show this will likely find coverage available for lost wages, medical bills and job protections.

However, healthcare workers who treat patients with diagnoses of COVID-19 may have more than one route to winning coverage should they contract COVID-19. Certainly, these workers should be able to show they are at increased risk of contracting the illness as compared to members of the general public due to the work they do and to the correlating increased frequency of direct exposure to illness, even if no specific transmission of the disease can be traced to a known carrier. If the healthcare worker has had to engage in care that entails unusually contagious situations, such as exposures in the process of resuscitation or intubation or without full PPE, the fact that their risk was increased due to the qualitative nature of their work is clear.

That said, there may be an argument to be made that these workers or those in similar circumstances, may alternatively be eligible for workers’ compensation benefits under NH RSA 281-A:2 XIII: Occupational Disease.

RSA 281-A:2 XIII Occupational Disease

In accordance with RSA 281-A:2 XIII “Occupational disease” is “...an injury arising out of and in the course of the employee’s employment and due to causes and conditions characteristic of and peculiar to the particular trade, occupation or employment. It shall not include other diseases or death therefrom unless they are the direct result of an accidental injury arising out of or in the course of employment...”

In New Hampshire, there is coverage for employees who contract COVID-19 at work and there is also limitation of liability on the employer side. What’s more, there is insurance for the benefit of both the employee and employer in the event of exposure.

All this together is good for people and business alike, as it provides a safety net for COVID-19 loss, a means for paying for associated health care and a path back to work that will support the economy.

The primary question regarding workers’ compensation coverage, as related to the contraction of COVID-19, will hinge on whether the employee contracted COVID-19 in and during the course of work. In accordance with the law, and as interpreted and applied by the courts, the burden of proof to establish this necessary causal connection, and thus to establish eligibility for workers’ compensation benefits, is on the employee.

To meet this burden, the law requires that an employee prove more probably than not, “that the injury occurred within the boundaries of time and space created by the terms of employment,” and that it “occurred in the performance of an activity related to employment.” Both prongs of the burden must be met to prevail in a claim for benefits.

At first glance it seems it would be difficult, if not impossible to prove an employee contracted COVID-19 at work. After all, given the widespread incidence of COVID-19 in virtually every New Hampshire county, the risk of infection exists at work, but also in the community and even at home. However, this is not fatal to coverage under our law.

An employee may recover from an illness under workers’ compensation even if the cause of contraction is unknown and the risk of illness is not distinct to work, as long as the employee can show the illness results from a “risk greater than that to which the general public is exposed.” This is referred to as the increase risk test.

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With the phased lifting of the stay at home order and the ensuing return to business and work, questions about employer and employee rights have begun to surface in increasing numbers. The problem is, all too often the speed, breadth, and impact of the COVID-19 outbreak has outpaced the ability to predict or even respond to the myriad legal questions raised as a result of this pandemic.

The Governor has issued emergency orders to establish protections for some workers and to offer guidance for employers as they begin to reopen. The Federal government has also responded with the CARES ACT, the First Families Corona Virus Recovery Act (FFCRA) and other pieces of legislation aimed at easing the economic impact of this health crisis.

In addition to new laws, orders and regulations, there are existing laws that can provide answers and protection as we all work together to forge a new path forward. Employees and employers can and should still look to the Family Medical Leave Act (FMLA) and sick leave policies as well as collective bargaining agreements to find guidance about leave time related to COVID-19. State and federal laws regarding disability rights and accommodations such as the ADA and New Hampshire RSA 354-A will offer clarity as to rights and responsibilities for employees who have disabilities due to COVID-19 or health complications due to the increased risk of contracting COVID-19. 

For employees who contract COVID-19 at work, there is protection in the form of payments for medical bills and lost wages under our state workers’ compensation laws and between the state and federal government. Many employees will have the right to increased benefits for unemployment.

There are many options, rights and benefits for employees and employers impacted by COVID-19, but the challenge has been in getting that information out to the public and then combing through the options to find the best combination of protections and benefits for each circumstance.

For some employees, workers’ compensation will be the best route to recovery for lost time from work due to illness, but for others, they may find an easier path and better coverage for lost wages by using accrued sick time. Employees with complications that will keep them out of work, but who can still perform their duties remotely, may be able to stay employed by requesting accommodations. These last few months have shown that many businesses can still function with remote workers and thus accommodations that would have been considered a hardship in January, may be perfectly reasonable now. If an employee is ill or vulnerable to becoming ill due to an underlying disability and remote work isn’t an option, it may be possible for the employee to access short- or long-term disability. Some employees who are let go or have to leave work due to COVID-19 will be eligible for unemployment benefits.