Covid19 News

Proving where they got it

This article was produced by FairWarning, a nonprofit news organization based in Southern California that focuses on public health, consumer, labor and environmental issues.

COVID-19 sent Sylvia LeRoy, a pregnant nurse working at a Brooklyn hospital in the earliest days of the pandemic, into a tailspin that left her barely responsive in a brain recovery center in New York City.

The coronavirus hit the 35-year-old with an array of maladies — from severe muscle spasms to stomach issues and even a dislocated jaw, likely from when she was revived from heart failure — that had to be addressed before the brain center could awaken her from a near-vegetative state.

There was another hurdle as well. LeRoy’s insurance would only cover 60 days at the brain recovery center, not enough time for her to make real progress, her sister Shirley Licin, who is caring for the healthy baby that LeRoy gave birth to while sick, told FairWarning. Nor would her insurance begin to cover the costs of her recovery once she left the center, from a $70,000 vehicle capable of moving her wheelchair to a highly specialized $4,000 shower chair.

Sylvia LeRoy.Courtesy FairWarning

It seemed obvious to her family that LeRoy got the disease at her workplace, the Brookdale University Hospital Medical Center in Brooklyn, which had been overwhelmed with COVID-19 when the outbreak started.

So they did the logical thing — they filed a workers’ compensation claim.

It was denied.

Across the United States, workers like LeRoy face wildly varying rules about whether COVID-19 is covered as a workplace injury. More than a dozen states, including Utah, Michigan and Illinois, have changed their laws or rules since the pandemic, often so that a nurse would be presumed to have contracted the virus at work, leaving it up to the employer to prove that the worker got it someplace else.

But even among the states that have created so-called “presumptions,” there are significant differences, with some extending them only to hospital or emergency response workers, while others include all of those whose jobs required them to interact with the public during the pandemic.

Still others, like New York, have not made a change, forcing workers to try to document that they contracted the disease on the job. New York legislators have introduced a couple of bills, one creating a presumption for emergency responders and another that defines COVID-19 as an occupational disease, but they remain bottled up in committees.

Full coverage of the coronavirus outbreak

That leaves workers like LeRoy with the formidable task of trying to prove they contracted the virus on the job. The workers’ comp carrier who denied LeRoy’s claim, GCG Risk Management, did not respond to a request for comment.

“Trying to prove where somebody contracted an infection is really difficult,” Bill Smith, president of the nonprofit Workers’ Injury Law & Advocacy Group, said. “You’ve got health care workers working around individuals who are positive and you would think clearly they would be covered. They may or may not, depending on what state you’re in.”

Workers’ comp systems vary considerably from state to state, but in general, employers are required to maintain workers’ comp insurance, which they most often obtain from private carriers that cover worker costs for medical treatment, lost time and permanent disabilities.

These insurers make determinations on claims based on whether they believe the injury occurred on the job, as well as what treatments are warranted. Workers whose claims are denied can appeal to hearing officers and workers’ comp boards, and eventually in court, but in complicated cases this can take years.

The stakes are high for those with serious cases. Even if they have health insurance, they can face ruinous costs if their workers’ comp claims are denied.

And for survivors of those who die, the workers’ comp system may offer the only way to make up for their loved one’s lost income.

In Greeley, Colorado, the workers’ comp administrator for the JBS USA meatpacking plant denied a claim from the family of Daniel Avila Loma, 65, who died of COVID-19 in late April. JBS did not respond to requests for comment.

Loma had worked at the plant for 30 years. When he got sick in March, he was working in the knife-sharpening shop, where workers dropped off their knives each day as their shifts ended. COVID-19 ran rampant at the JBS plant, which ultimately had almost 300 cases and six deaths.

Daniel Avila Loma.

Loma, who had five children, 16 grandchildren and a great-grandson, was on a ventilator and had several strokes before he died. His wife and one of his adult sons, both disabled, lived with him.

“My father was the sole provider for the household,” another son, Olivier, wrote in a letter supporting a Colorado bill to create workers’ comp presumptions for front-line workers.

Source Website Proving where they got it

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