Submitting a COVID-19 Workers’ Compensation Claim 

The Office of the Advocate for Injured Workers released a comprehensive video that explains the necessary steps to file a Workers’ Compensation claim in the event that a worker contracted COVID-19 while working. The video reviews what benefits are covered under Workers’ Compensation and what steps you should take if you contract COVID-19 at your place of work.

Since 1914, the workers’ comp board has covered outbreaks and chronic injuries by providing benefits that are paid to those affected such as diseases like tuberculosis and asbestosis, the disease, injuries and fatalities of 9/11 and even the opioid crisis. This history of coverage provides case law to support future benefits for employees.

Depending on the details of your workers’ compensation COVID claim the benefits covered could be:

  • Medical care for your work-related illness
  • Wage replacement benefits if your illness prevents you from working
  • Benefits to surviving family members in the event of death from the illness
  • Reimbursement of funeral expenses

What do I do if I get COVID-19 at work?

Unfortunately, you most likely won’t be able to pinpoint the exact moment and method you came into contact with someone who is COVID positive. Workers can show the nature and extent that their job puts them at for an elevated risk due to increased exposure due to their employment. Those that work in environments where COVID is prevalent and risks are elevated are more likely to have compensable COVID claims. Some of these occupations include:

  • Healthcare Workers
  • First Responders
  • Transportation Workers
  • Correction Officers
  • Food Service Workers
  • Retail Workers

Any worker that contracted COVID-19 due to employment should file a claim, especially those who come into contact with the public regularly.

What information is needed to prove my COVID claim is work-related?

Details on your employment and exposure are key to demonstrating that you contracted the virus at your place of employment. Important details to provide are:

  • Where do you work?
  • How often do you work?
  • The type of job duties you perform (especially those involving contact with the public)
  • A medical report from an authorized workers’ comp medical provider stating your work caused your illness
  • A positive test result
  • A medical report showing a diagnosis via PCR test, or by examination of a treating physician may be used

How do I file a claim?

STEP 1: Tell your employer, as soon as possible, that you are sick. Tell your employer in writing: via email or handwritten or typed letter. Do not send a text message, it can be difficult to obtain

Step 2: Complete an Employee Claim Form (Form C-3), submit this quickly electronically or print and mail to the Board

Step 3: You can see any doctor in an emergency; if it is not an emergency you should see an authorized workers’ comp provider. Send in your positive COVID-19 test result. If the doctor has your results, they should send it in. If you have your results, either give them to your doctor to submit or send a copy to the Board with your claim form. Tell your treating doctor you believe you contracted COVID while at work and share the details of your work environment. Your doctor will send the report to your employer’s Workers’ compensation insurance carrier and the Workers’ Compensation Board.

Finding an authorized provider

You can find workers’ compensation authorized providers on the New York WCB website.  Currently telemedicine is now an available treatment option when appropriate. It is important to choose an authorized provider as rules for treating injured workers and payments are complicated and different from your regular doctors and health insurance billing system.

What happens once I file a workers’ compensation claim?

Once you submit your claim and you or your doctor submit all the needed paperwork, your employer’s workers’ compensation insurance carrier will review your claim. If it’s accepted your COVID-19 claim will be compensable.

If there is a claim dispute, a Board judge will decide if the claim should be paid. The judge will listen to testimony from you and your provider. Testimony should include: where your work, whether you were exposed to COVID-19 and the extent, and whether COVID was prevalent in your work environment.

How long does the process take?

Once you tell your employer that you are ill due to your employment, they should immediately inform their insurance carrier. The insurance carrier has 18 days to act on the claim and begin paying benefits if accepted. The Board makes an effort to move claims as quick as possible. If there are disputes The Board holds hearings on claims when needed to expedite benefits to affected workers.

MDASR is here to help you with your Workers’ Compensation claim

The process of submitting a workers’ compensation claim can be confusing and stressful. Hiring a skilled and experienced workers’ compensation attorney, such as our attorneys, will give you your best chance of a successful compensable claim. MDASR attorneys know all the ins and outs of filing a workers’ compensation claim and understand how the system works. If you are struggling to establish your COVID-19 Workers’ Compensation claim, call all our offices at (866) 557-7500