California Workers’ Comp COVID-19 Claim Count Tops 50,000

Below is a quick COVID update from workerscompensation.com regarding COVID claims in California. Let’s hope this downward trend continues!

Oakland, CA (WorkersCompensation.com) – The California workers’ compensation COVID-19 monthly claim count may have peaked in July, but the latest tally by the California Workers’ Compensation Institute (CWCI) shows that as of November 2, there have been 50,592 COVID-19 claims reported to the state Division of Workers’ Compensation (DWC) so far this year – including 282 death claims. That translates to 1 out of every 9 California job injury claims reported for accident year (AY) 2020.

The latest figures show that after climbing rapidly over the first 7 months of this year and hitting a record 14,453 claims in July, the number of COVID-19 workers’ compensation claims reported to the DWC began to dwindle. The updated count shows 6,710 claims with August injury dates, 3,779 claims with September injury dates, and 2,016 claims with October injury dates. A significant number of claims from September and October could still be reported, but the initial claim counts from both these months were well below the early counts from June and July, so even accounting for the reporting lag associated with COVID-19 claims, those figures suggest a significant downtrend. Using claim development factors based on historical claim development from 2019 and the fluctuating development pattern for 2020 COVID-19 claims, CWCI now projects that there could ultimately be 15,786 COVID-19 claims with July injury dates, 6,910 claims with August injury dates, 4,535 claims with September injury dates, and 5,242 claims with October injury dates, which puts the projected number of COVID-19 claims for the first 10 months of AY 2020 at 57,833. Notably, denial rates for COVID-19 claims have stabilized within a narrow range, holding between 28.7 percent and 31.3 percent from April through August, while denial data on September and October claims is still too green for analysis as many of those claims remain under investigation. The distribution by industry shows that COVID-19 claims remain heavily concentrated among a small number of industry sectors, with more than three quarters of the claims from the first 10 months of this year involving workers in health care (37.1 percent); public safety/government (15.0 percent); manufacturing (8.3 percent); retail (7.9 percent); transportation (5.1 percent), and food service (4.4 percent).

The data on claims reported through October is included in the latest update to CWCI’s COVID-19 and Non-COVID-19 Interactive Claim Application, an online tool that integrates data from CWCI, the DWC, and the Bureau of Labor and Statistics to provide detailed information on California workers’ comp claims from comparable periods of 2019 and 2020. The new version features data on 1,047,448 claims from the first 10 months of AY 2019 and AY 2020, including the 50,592 COVID-19 claims reported for AY 2020. As of November 2, the DWC had received reports on 458,941 workers’ compensation claims with January through October 2020 injury dates, which even with the COVID-19 claims, was 22 percent less than the total reported for the corresponding period of 2019, or 12.5 percent less after factoring in the projected claim development for AY 2020. The decline in the overall claim count reflects the economic slowdown and declining employment, as well as the millions of Californians who continue to work from home.

CWCI updates its COVID-19/Non-COVID 19 data app with new data every two weeks and plans to expand its features as more data on claim type and systemwide costs become available. The application is available to the public here.

More Important Information on Covid-19; CDC and Workers’ Compensation

The start of Flu Season, a potential 2nd Wave of Covid-19 and employers focusing on phased re-openings here are the latest updates and reminders for things you need to know.

CDC Redefines “Close Contact” Under COVID-19 Guidance

On Wednesday, Oct. 21, 2020, the Centers for Disease Control and Prevention (CDC) clarified what “close contact” means as it relates to COVID-19-prevention guidance.

Previously, the CDC defined close contact as spending 15 straight minutes within 6 feet of another person. Now, the organization redefined the term to mean a total of 15 minutes within a 24-hour period. That means short, repeated contacts throughout the day count toward that 15-minute threshold.

The CDC strongly encourages anyone who comes into “close contact” with a COVID-19 patient to self-quarantine for two weeks.

Employer Takeaway

This update serves as a stark notice that COVID-19 may spread more easily than formerly understood. It may even prompt more contact tracing among health departments and workplaces, especially in situations where contact was previously considered too brief for infection. Furthermore, this new definition may be most impactful in offices, factories and other facilities that have many people in close proximity for extended periods. Such locations may implement stricter mask regulations if they haven’t yet done so, per CDC recommendations. The organization stresses that wearing masks is one of the best ways to fight against COVID-19, especially since many infected patients do not exhibit symptoms.

The CDC has amended COVID-19 guidance before on several occasions, usually adopting stricter positions. With that in mind, employers can reasonably expect more updates in the future.

Workers’ Compensation Changes

Under most state workers’ compensation (WC) laws, COVID-19 may be a compensable, work-related condition only if an employee can show that:

  • He or she contracted the coronavirus while performing services growing out of and incidental to his or her employment; and
  • The disease arose out of that employment (work relatedness).

As of July 29, 2020, however, several states have made—or are in the process of making—changes that reverse this burden for certain employees. In general, these changes mean that it would be an employer’s burden to prove that an employee did not contract COVID-19 on the job, rather than the employee’s burden of proving that he or she did contract it on the job. While most of these changes apply only to certain types of workers—such as first responders, health care providers or those who are otherwise deemed “essential”—some changes apply the new presumption more broadly.

Many states have also taken actions that aim to reduce the impact of COVID-19-related claims on an employer’s WC premium rates.   

This Compliance Bulletin provides general information about the COVID-19-related changes made to state WC laws and policies.

Action Steps

Employers should follow all workplace safety guidance from the Occupational Safety and Health Administration (OSHA), the Centers for Disease Control and Prevention (CDC) and local health authorities to minimize the risk of employees contracting COVID-19 on the job. Employers should also familiarize themselves with state laws that may impact their workers’ compensation COVID-19 obligations and premiums.

Background

Workers’ compensation is a no-fault system that provides medical expenses and lost-income replacement for employees who sustain injuries or illnesses that arise out of and in the course and scope of their employment.

Each state has its own workers’ compensation law that governs of the process of determining whether an injury or illness is work related and therefore compensable.  Although workers’ compensation benefits are usually the exclusive remedy against an employer for any compensable condition, employers may also be subject to private lawsuits if they intentionally cause harm to an employee or fail to have workers’ compensation coverage as required.

COVID-19 Compensability Presumptions 

The table below provides a general overview of the changes to state workers’ compensation laws that have been enacted to provide a presumption that COVID-19 is a compensable, work-related condition for certain employees. Similar changes remain pending in other states. Employers should become familiar with (and regularly check for updates to) the detailed requirements that may affect them under all applicable laws.  

StateAffected EmployeesOrder/Change
AlaskaFirst responders and health care workers.Senate Bill 241
CaliforniaAll employees not working from home.Senate Bill 1159
ConnecticutAll essential workers.Executive Order 7JJJ
FloridaFront-line state employees.Directive 2020-05
IllinoisFirst responders and front-line workers, including essential workers who encounter members of the general public or work in a location with more than 15 employees.House Bill 2455
KentuckyAll essential workers.Executive Order 2020-277
MinnesotaFirst responders and health care workers.HF 4537
MissouriFirst responders.Emergency Rule
New HampshireEmergency response and public safety workers.Emergency Order 36
New MexicoState workers who provide direct assistance or care to COVID-19 patients or work inside a facility that provides direct assistance, care or housing to COVID-19 patients.Executive Order 2020-025
North DakotaFirst responders and health care workers.Executive Order 2020-12
UtahFirst responders and health care workers.Senate Bill 3007
VermontWorkers in jobs involving regular physical contact with known sources of COVID-19 or regular physical or close contact with patients, inmates or members of the public.Senate Bill 342
WashingtonFirst responders and health care workers.L&I Policy
WisconsinFirst responders and health care workers.Assembly Bill 1038
WyomingAll workers.House Bill 1002

Premium Calculations

The premiums an employer must pay for coverage under a workers’ compensation insurance policy is usually determined based on payroll, measures of risk associated with the jobs that workers perform and the number and type of WC claims that have been made against the employer in the past. Due to the effects the COVID-19 pandemic may have on these factors, some states (including California, for example) allow employers to reclassify employees or exclude COVID-19-related claims from their calculations.

Contact your PEO for additional information and ways to stay organized and healthy. If you are not currently benefiting from a PEO relationship contact Libertate Insurance, let us know how we can help.

This information is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice.

Lifting Travel Restrictions

As the country slowly starts to reopen and travel restrictions begin to be lifted, it reminds me of how hard the travel industry has been impacted by COVID-19. Finding workers compensation coverage for this industry can be difficult due to the exposures associated with these risks. Libertate Insurance Services works closely with Beacon Aviation in placing coverage for this industry.  Beacon Aviation Insurance Services knows the ins-and-outs and provides workers compensation coverage for general aviation businesses.

Beacon’s Program offers the following:

Payment Options

  • Pay As You Owe
  • Carrier Direct Bill
  • Carrier Direct Debit
  • Credit Card

Endorsement Options

  • Foreign Voluntary Compensation
  • Voluntary Compensation
  • Waiver of Subrogation
  • Defense Base Act (DBA) Coverage
  • Employer Liability Coverage “Stop GAP”

If you need help placing your workers compensation with your travel or aviation risk, contact Jenny Bush, at jbush@libertateins.com. Click the link below for more details on Beacon’s Program.

Beacon Aviation Program Appetite

 

Report: COVID-19 Accounts for 1-in-9 California Workers’ Comp Claims in 2020

Wow — We are seeing a depletion of capacity/increased costs for health care and other “client-facing” industries.  The why —

“CWCI says that brings the total for the year to 41,861 claims, or 11.2% of all California job injury claims reported for accident year 2020. Those claims included 224 death claims, up from 160 reported as of Aug. 10.”

.005 of all claims in California are a COVID19 fatality year to date.  The unknowns are the reopens, adjusted reserves and longevity of the severe and critical patients.  Still much unknown –

September 28, 2020

The California workers’ compensation COVID-19 claim count continued to grow in August, albeit at a much slower rate than in July, with new data showing that as of Sept. 21, the state had recorded 5,130 COVID-19 claims with August injury dates, according to data compiled by the California Workers’ Compensation Institute.

CWCI says that brings the total for the year to 41,861 claims, or 11.2% of all California job injury claims reported for accident year 2020. Those claims included 224 death claims, up from 160 reported as of Aug. 10.

The latest claim count shows that the number of COVID-19 claims reported to the Division of Workers’ Compensation doubled from May to June, then increased another 16% in July. The numbers reported for August, however, fell sharply, even accounting for the lag in the reporting of COVID-19 claims, according to CWCI.

The CWCI projects there could ultimately be 8,208 COVID-19 claims with August injury dates. Given that the latest tally suggests COVID-19 claim volume may have peaked in July, CWCI is now projecting 48,086 COVID-19 claims with January through August injury dates, which is less than the January through July projection from last month.

CWCI reports that the distribution by industry shows health care workers continue to account for the largest share of California’s COVID-19 claims, filing 38.1% of the claims recorded for the first 8 months of this year, followed by public safety/government workers who accounted for 15.8%. Rounding out the top five industries based on COVID-19 claim volume were retail trade (7.6%), manufacturing (7.6%), and transportation (5.0%). In addition, the percentage of denied COVID-19 claims declined to 28.6% from CWCI’s May report of 35.5%.

Related:

How much time is an Employer required to give Employees under the FFCRA?

The Florida United Businesses Association (FUBA) released a great Q&A for Employers.  The quick answer is 2 weeks/80 hours, but with everything COVID, we realize that there is generally more behind the scenes.   Here is FUBA’s look into the small print. Great 2 minute read!

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FUBA COVID-19 Update: Can An Employee Get More Than 2 Weeks Of Paid Leave?

Here are the 3 most common questions we get from our small business members about paid leave under the Families First Coronavirus Response Act (FFCRA):

1) One of my employees has already used their 2 weeks/80 hours of paid FFCRA leave but now they can’t work because they have COVID-19. Do I have to give them another 2 weeks of paid leave?

No. The FFCRA requires employers give employees 2 weeks (80 hours) of paid leave only if the employee cannot work because of one of these reasons:

  1. The employee has been told to quarantine by a health care provider or by a government order.
  2. The employee has COVID-19 symptoms and is seeking a diagnosis (i.e., they are getting a COVID-19 test and are waiting on the results).
  3. The employee must stay home to care for someone who has been quarantined by a health care provider or by a government order.
  4. The employee must stay home to care for a child under 18 whose school or childcare is unavailable due to COVID-19. These employees are also eligible for an additional 10 weeks of paid leave, for a total of 12 weeks’ paid leave.

Employers are only required to give the 2 weeks paid leave one time. Once an employee has used their 2 weeks of paid leave, they don’t get another two weeks even if they meet one of the reasons above.

If one of your employees has used their 2 weeks of paid leave and then gets sick with COVID-19 or has to quarantine because they were exposed to someone with COVID-19, you can decide whether to allow the employee to take unpaid leave or to use any vacation/sick time the employee has. But you do not have to provide another 2 weeks of paid leave under the FFCRA.

The only time employees may get additional paid leave is for reason #4 above: if an employee has to stay home to care for a minor child whose school or daycare is closed due to COVID-19, they may be entitled to an additional 10 weeks of paid leave.

2) One of my employees took 4 days of paid FFCRA leave last month because he had a COVID-19 test and was waiting on the test results. He returned to work when the test was negative, and we paid him for the 4 days he was out. Now we need him to quarantine because his wife has COVID-19 and we do not want him coming to work for 14 days. Can he now use the 6 remaining days of paid leave?

Yes. The employee is entitled to take the remaining hours of paid leave (6 work days in this example). The rest of the leave can either be unpaid or vacation/sick leave at the employer’s discretion.

3) One of my employees took their 2 weeks (80 hours) of paid FFCRA leave and then was furloughed. We’ve now rehired her and she’s back at work. Does she get another two weeks of paid leave?

No. Employees are only entitled to 80 total hours of paid sick leave under the FFCRA.

If you are a FUBA member and have questions about paid leave in your business, call FUBA’s team of experts at 800-262-4483 or email us with your questions.

For more information about paid leave under the FFCRA, including documentation you should get from your employees who take this leave as well as tax credits for businesses who provide this paid leave, please visit FUBA’s Coronavirus Resources for small businesses:

Should You Partner with A PEO? Can a PEO help your small business?

Understand the Importance of What PEOs are Doing for Their Clients; Consider what a PEO can offer your small business; Having a business relationship that benefits you!

Check out the article below to see how PEOs work to protect small business clients

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THE EXPANDING PEO WHEELHOUSE: HELPING SMALL BUSINESSES SURVIVE

COVID-19: STORIES OF ADAPTATION: HOW SERVICE & DELIVERY CHANGED

BY KATHRINA SALADRIGAS

Eighteen weeks have passed since we sent our first COVID-19 newsletter to Regis HR Group clients. Looking back, we could not have anticipated the scope of support our clients would need. In addition to inquiries about traditional human resources matters, we received an unprecedented number of questions about general business operations from employers, to the point of, “What can we do to survive?”

PEOs are uniquely positioned to help our local economies (and the country as a whole) recover from the pandemic, so here are some of things we hope all PEOs will implement to help their worksite employers overcome the challenges of the COVID-19 pandemic.

EMPLOYERS DESERVE A BETTER ANSWER THAN ‘THAT’S NOT WHAT WE DO’

Laws such as the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Families First Coronavirus Response Act(FFCRA) are being passed and subsequently changed at an extraordinary rate, so employers are reasonably overwhelmed:

  • What government-sponsored financial relief is available to our business?
  • How do layoffs and furloughs affect health benefits?
  • Is our business an “essential” business?
  • Who is eligible for sick leave under the FFCRA?
  • Do we have to close our facility if an employee tests positive? If yes, for how long?

This is a very small sample of the questions creating uncertainty and anxiety for business owners. While some of these questions are business-specific and can only be addressed by the employer’s legal counsel and/or tax professional, there are practical steps PEOs can take to support these employers without defaulting to “that’s not what we do:”

  • We’ve learned that monitoring regulatory changes and providing brief descriptions (one to three sentences) with links to the governing body in a timely fashion reassures clients that they have a trusted partner to lean on and reduces worries about missing something.
  • Similarly, sharing a finite list of well-researched government resources that consolidate information from multiple regulatory bodies (such as the Centers for Disease Control and Prevention (CDC) Resuming Business Toolkit​) saves employers time and reduces the incidence of misinformation.
  • We’ve learned that employers appreciate live interactive webinars where they can connect with employment lawyers and tax professionals. To this end, Regis HR Group has sponsored eight webinars (at no charge to PEO clients) with topics ranging from FFCRA requirements to Payroll Protection Program (PPP) loan forgiveness, with additional webinars scheduled in the upcoming weeks.
  • Perhaps most importantly, we’ve witnessed the significance of the human connection (albeit socially distanced). Our entire team, from our payroll specialists to our president, has proactively worked to check in with our clients and ask, “How can we help?” Often, the answer is not something in our traditional scope of services, but we’re committed to do what we can.

HELPING EMPLOYERS ADJUST TO THE ‘NEW WORKPLACE’

The pandemic has created a seismic shift in our traditional workspace. Whether or not this shift is temporary remains to be seen. In the meantime, however, employers are finding it difficult to adjust to the new workplace.

To help mitigate the stress that accompanies these significant changes, we have provided several tools to educate employers and their managers about how to get the most out of their employees in remote work environments, how to maintain employee morale, and how to continue to communicate effectively as a team.

Some employers find themselves in a position to reopen, but their pre-pandemic staff is refusing to return. We are helping these employers find qualified staff, often by connecting them with employees who have been laid off by other clients.

For clients that are hiring during this ordeal, we are sharing resources on interviewing best practices and, in particular, educating them about the importance of behavioral interview questions.

While it has long been commonplace to ask behavioral interview questions to assess a candidate’s problem-solving skills, resiliency, and adaptability in demanding/high-stress work environments (such as healthcare, investment banking, and hospitality), the pandemic has demonstrated that these skills are central to the success of every business.

To that end, PEOs should be encouraging employers to ask behavioral interview questions, in addition to assessing candidates on previous experience—because past behaviors can help predict future performance. Examples of behavioral questions include:

  • “Tell me about a chaotic situation you experienced in a professional setting.”
  • “Describe a time that, despite your best efforts, things did not work out as you had envisioned.”

FACILITATING REPORTS FOR PPP FINANCING & MEANINGFUL BUSINESS CONNECTIONS

Lenders participating in the Payroll Protection Program, which helped businesses across the United States maintain their workforces during the COVID-19 crisis, required employers to submit payroll reports quickly and accurately.

In addition to producing detailed payroll reports that included employee salaries, wages, commissions, cash tips, group health benefits payments, retirement benefits payments, state or local taxes, etc., Regis HR Group was able to help small businesses connect with local, community banks participating in the Small Business Administration’s PPP loan program.

Our clients thanked us for these introductions because community bankers were often more helpful with questions about PPP loans and more responsive than their counterparts working for national banks. Similarly, the community banks were thankful for the introductions because, prior to the pandemic, many of these employers had not considered partnering with a local bank for their routine banking and financing needs.

WE ARE IN THIS TOGETHER

COVID-19 remains a clear and present danger, but we are confident that working together, our country will overcome this crisis. We are motived by the dedication of our team and inspired to work harder each day to earn the gratitude of our clients.

Moving forward with the support of PEOs across the nation, we can serve our clients in new ways and emerge stronger from this pandemic.

KATHRINA SALADRIGAS

Marketing & Talent Acquisition Director

Regis HR Group

Miami, Florida

Paid Leave for Employees if School/Daycare/Summer Camps are Closed

With the new school year fast approaching and some schools electing to delay the start date, we want to make sure employers are plugged into the requirements of FFCRA. Small businesses are required by the Families First Coronavirus Response Act (FFCRA) to give employees paid leave from wok in certain circumstances relating to COVID-19. One requirement is that the child’s school/daycare/summer camp must be unavailable because of COVID-19.

The below article from FUBA helps breakdown the requirements of FFCRA.

Small businesses are required by the Families First Coronavirus Response Act (FFCRA) to give employees paid leave from work in certain circumstances relating to COVID-19. Employees who cannot work due to very specific reasons related to COVID-19 are entitled to two weeks of paid leave, with an additional 10 weeks of paid leave if they have to stay home to care for a son or daughter whose school, daycare, or summer camp is closed due to COVID-19.

If you have an employee who cannot come to work because they have to take care of a child because the child’s summer daycare – a school, camp or other program in which the employee’s child is enrolled – is closed or unavailable for a COVID-19 related reason, the employee may be entitled to paid leave.

Keep in mind that the child’s school/daycare/summer camp must be unavailable because of COVID-19. School being closed for summer vacation does not qualify an employee for paid leave because school is always closed during the summer and that closure is not related to COVID-19. If school does not reopen in the fall due to COVID-19, that may qualify employees for paid leave. However, if schools reopen but the employee’s children are attending online or digitally, the employee may not qualify for paid leave.

If an employee requests paid leave, you should get the following:

  1. The employee’s name and the dates the leave is requested
  2. A statement of the COVID-19 related reason the employee is requesting leave
  3. A statement that the employee is unable to work or telework for this reason
  4. Documentation supporting the reason for leave

The employee also needs to give you the name and age of the child they will be taking care of, the name of the daycare/summer camp that has closed, and they must provide a statement that no one else will be caring for the child while the employee is on paid leave. If the child is older than 14, the employee must show that special circumstances require them to stay home with the child during daylight hours.

Employees taking paid leave because their child’s daycare/summer camp is closed due to COVID-19 must be paid two-thirds their regular rate of pay, up to $200 per day. Learn more about calculating pay here.

You can offset the cost of their leave by keeping a portion of the quarterly federal employment taxes you would otherwise deposit with the IRS. If the cost of the leave is more than your federal employment tax bill, you can request an advance refund from the IRS using form 7200. To claim a payroll tax credit, you must retain the documentation described above and comply with any IRS procedures for claiming the tax credit. For more information about how to claim these payroll tax credits and what documentation is required, click here. For more information about form 7200, click here.

Click here to learn about other reasons that entitle employees to paid leave.

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This article was written by FUBA Workers’ Comp

How Are Employers Protected From Covid-19? Now Is The Time To Understand Your EPLI Coverage!

What can we learn from the first COVID-19 related suit filed against Walmart in March 2020? What the claim identified as Negligence.

See article below to ensure these considerations are built into your COVID-19 Returning to Work Strategy and Your Company’s Action Plan on handling everything COVID.

What does your EPLI policy cover? Important policy line items and questions ask to understand your coverage.  When does my PEO EPLI kick in, what is the WARN Act Exclusion specific to my policy, etc

Read the below to know the right questions to ask about your EPLI coverage.

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The COVID-19 pandemic has forced employers across the country to rapidly make numerous and significant decisions about how to manage their business in this unprecedented time. Employers have had to quickly develop and implement policies and procedures addressing remote work, layoffs, furloughs, pay cuts, workplace conditions, and a host of other issues. Not surprisingly, we’re already starting to see COVID-19-related lawsuits being filed against employers.

The first suit was filed against Walmart by the estate of an employee who passed away due to complications of COVID-19 on March 25, 2020. The complaint alleged that store management knew that several employees and individuals at the store were exhibiting symptoms of COVID-19. Nevertheless, the estate alleged, Walmart was negligent in the following respects:

  • Failing to cleanse and sterilize the store in order to prevent infection of COVID-19;
  • Failing to implement, promote, and enforce federal and state social distancing guidelines;
  • Failing to provide the decedent and other employees with personal protective equipment such as masks, latex gloves, and other protective devices;
  • Failing to warn the decedent and other employees that various individuals were experiencing symptoms at the store and may have been infected by COVID-19, which was present and active within the store;
  • Failing to adequately address or otherwise ignoring other employees who had communicated that they were experiencing signs and symptoms of COVID-19;
  • Failing to follow Department of Labor and Occupational Safety and Health Act (OSHA) recommendations;
  • Failing to follow CDC guidelines to keep the workplace in a safe and healthy condition and to prevent employees and others within the store from contracting COVID-19;
  • Failing to develop an Infectious Disease Preparedness and Response Plan as recommended by the CDC;
  • Failing to prepare or implement basic infection prevention measures as recommended by the CDC;
  • Failing to conduct periodic inspections of the condition and cleanliness of the store as recommended by the CDC;
  • Failing to provide employees with antibacterial soaps, antibacterial wipes, and other cleaning agents as recommended by the CDC;
  • Failing to develop policies and procedures for prompt identification and isolation of sick people as recommended by the CDC;
  • Failing to develop, implement, and communicate to its employees about workplace flexibilities and protections as recommended by the CDC;
  • Failing to implement engineering controls designed to prevent COVID-19 infection including, such as installing high-efficiency air filters, increasing ventilation rates in the work environment, and installing physical barriers such as clear plastic sneeze guards, as recommended by the CDC;
  • Failing to cease operations of the store and to otherwise close the store when it knew, or should have known, that various employees and others present at the store were experiencing symptoms of COVID-19;
  • Failing to properly train personnel to implement and follow procedures designed to minimize the risk of contracting COVID-19;
  • Failing to periodically interview and/or evaluate employees for signs and symptoms of COVID-19;
  • Failing to prohibit employees who were exhibiting signs and symptoms of COVID-19 from working at the store or otherwise entering the premises; and,
  • Hiring employees via telephone and other remote means in an expedited process without personally interviewing or evaluating whether prospective employees had been exhibiting signs and symptoms of the COVID-19 prior to the commencement of their employment.

A second wrongful death lawsuit was filed in Texas state court against a meat packing company following the death of a forklift driver at the defendant’s plant. Plaintiffs alleged that the decedent was told he would be laid off if he didn’t report to work—despite exhibiting symptoms of COVID-19—and that the defendant “refused to take the pandemic seriously, and kept its functions as normal, taking no precautions and implementing no protocols for the safety of its workers.” The plaintiffs further alleged that, “[a]round April 8, 2020 it had become very clear that people in the factory were sick, and that Covid-19 was among them – factory owners and managers played the fiddle. [The decedent] contracted the disease at work, was forced to separate from his partner and children, in order to protect them, and then – became part of the statistic of over 60,000 people who have died in the USA since the pandemic took hold.” The plaintiffs asserted claims for negligence and wrongful death asserting the defendant failed to:

  • Supervise the environment, placing protocols, providing and requiring masks, gloves, and enforcing six feet social distancing as per CDC and local orders;
  • Provide safety tools and equipment that is the basis of this lawsuit;
  • Ensure company premises were maintained in a way to prevent illness and injuries to its employees;
  • Supervise the employee’s activities as per CDC and Dallas County protocols;
  • Warn employees as to the hazards of their employment post COVID-19 pandemic;
  • Install, adopt, or employ adequate safety measures to prevent COVID-19 incidents.

Undoubtedly, these lawsuits are just the tip of the iceberg. See, e.g., “2 Utah County businesses told staff to ignore COVID-19 guidelines, resulting in 68 positive cases,”Daily Herald, May 5, 2020 and “A Detroit Nurse Was Fired After Speaking Out About Her Hospital’s Handling Of The Coronavirus Outbreak. Now She’s Fighting Back,” Buzzfeed News, April 21, 2020. As more organizations attempt to reopen in the absence of a coronavirus vaccine, we will likely see a substantial wave of employment-related COVID-19 lawsuits, leading to claims under Employment Practices Liability Insurance (EPLI) policies.

We consider some of the likely EPLI coverage issues below.

COVID-19 EPLI Coverage Issues

We note at the outset that there is no standard EPLI policy, and coverage terms, conditions, and exclusions vary considerably. Accordingly, review of the precise language of the particular policy will be required. When considering COVID-19 EPLI claims, insurers should pay special attention to the following issues:

Notice

Although timely notice of a claim is a critical threshold issue under virtually every insurance policy, it can be particularly challenging in the EPLI context where verbal communications with employees could constitute notice under certain policy forms. Policy requirements for notice of claim and notice of circumstances, if applicable, should be closely considered in the context of the information provided by the insured. Since EPLI policies are typically written on a claims-made basis, it’s important to make sure the claim was reported within the timeframe specified in the policy. Prior notice issues also should be considered. Decisions concerning the disposition of notifications under EPLI policies should be consistently made, timely, and well documented.

Employment Wrongful Act

Another threshold issue to be examined is whether the claim falls within the policy’s definition of an “employment wrongful act.” Keep in mind that many EPLI policies contain manuscripted provisions, so it will be important to carefully review the entire policy and endorsements. The impact of COVID-19-related governmental orders may also need to be evaluated in connection with any claim. When considering claims brought against the insured by non-employees—such as customers, clients, and vendors—it will be important to ascertain whether the policy extends coverage to third-party employment practices.

Bodily Injury Exclusion

Bodily injury claims are typically excluded under EPLI policies, although such exclusions often contain an exception for emotional distress or mental anguish claims. Distinctions between exclusions for claims “for bodily injury” versus claims “arising out of bodily injury” could be important in some instances.

OSHA and FMLA Violations

COVID-19 claims for actual or alleged OSHA and Family and Medical Leave Act (FMLA) violations may be subject to OSHA and FMLA exclusions. Those exclusions typically will have a carve-out for related retaliation claims, such as an allegation that an employee was impermissibly laid off after exercising OSHA or FMLA rights, so careful review of the claim is imperative.

Wage and Hour and FLSA Claims

Most employers have instituted new work routines for their employees as result of COVID-19 and related government orders, including work from home, self-quarantine requests, procedures concerning time capture, and new work schedules. This could lead to compensation disputes giving rise to Wage and Hour and Fair Labor Standard Act (FLSA) claims. Depending on the terms of the policy, such claims may be excluded entirely, covered only for defense costs, or fully covered.

WARN Act Exclusion

In light of widespread COVID-19 layoffs and furloughs, employers are likely to face wrongful termination lawsuits. While EPLI policies generally cover claims for wrongful termination, retaliation, and discrimination, claims for Worker Adjustment and Retraining Notification (WARN) Act violations typically are excluded. The policy, however, may contain “employment events” coverage, which is triggered by terminations affecting a specified percentage of the workforce, i.e. 10-15% of employees.

Criminal and Fraudulent Acts Exclusion

Depending on the particular facts giving rise to a claim, a policy exclusion for malicious, fraudulent, and criminal acts or omissions may apply. The exclusion should be carefully reviewed with regard to the timing of its application; many exclusions are not be triggered until there is an adjudication of the deliberate act or omission. The exclusion may also have a carve-out for defense costs. An insurer’s reservation of rights concerning these issues should be carefully considered in light of the allegations at issue, the precise policy language, and the applicable law. Insurers should also check for potentially relevant exclusions for punitive and exemplary damages.

Issues Arising from PEOs

A growing number of today’s companies utilize the services of professional employer organizations (PEOs) to manage certain human resources functions and related administrative functions. Depending on the services provided by the PEO (for example, whether the PEO is the employer of record or a co-employer) and the legal relationship between the insured company and the PEO, a variety of issues impacting coverage under an EPLI policy may arise. Coverage for any given claim may also implicate the PEO’s EPLI policy, so insurers should review their policy’s “other insurance” provision, which may need to be addressed when considering its defense obligation and reserving rights.

Injunctive and Equitable Relief

Employers should anticipate lawsuits demanding they implement certain actions and/or make accommodations to remedy alleged unsafe employment practices and workplace conditions, including for employees who are members of a protected status. Typically, EPLI policies do not cover costs to comply with injunctive relief, costs of accommodations associated with disabilities, or other protected status, benefits due, or salary obligations. Front pay and back pay, however, are often covered in the policy’s definition of “loss.” These issues should be kept in mind when evaluating coverage and reserving rights.

Final Thoughts

EPL insurers should anticipate an increasing number of COVID-19-related claims , particularly as many companies are taking steps to reopen their businesses. In this regard, it’s worth noting that as an added benefit to policyholders, some EPLI policies provide access to pre-claim legal advice services from qualified employment counsel. Given the wide range and high stakes of COVID-19 risks confronting employers, some insurers have reminded their policyholders about taking advantage of this service.

credit to original article: https://www.jdsupra.com/legalnews/early-covid-19-liability-suits-raise-31472

written by: Hinshaw & Culbertson – Insights for Insurers