Kentucky Goes Further in Guaranteeing COVID-19 Workers’ Comp Claims

Kentucky is a leader among more than a dozen states that are guaranteeing workers’ compensation payments to certain workers who have contracted the COVID-19 coronavirus while on the job.

Gov. Andy Beshear issued an executive order on April 9 that paves the way for immediate temporary total disability payments (TTD) to covered employees “removed from work by a physician due to occupational exposure to COVID-19.” Typically, a worker must be out of work for eight days before being eligible for temporary disability benefits for each lost day of work afterward.

Claims Journal, an insurance industry publication, says at least 14 states have issued administrative orders or legislation requiring that workers who claim they were sickened by COVID-19 receive a fair hearing, if not an outright presumption in their favor when it comes to workers’ compensation claims for coronavirus.

While most orders refer to healthcare workers, emergency responders and certain other front-line workers, Claims Journal declares in a separate article that, “Kentucky Gov. Andy Beshear pushed the envelope furthest” in making workers’ comp benefits available. He extended the presumption of eligibility for workers’ comp benefits related to Covid-19 to include workers in grocery stores, child care centers and domestic violence shelters and other occupations.

Under Beshear’s executive order, Kentucky’s workers’ compensation program will presume that a physician’s order that an employee not report for work is due to occupational exposure to COVID-19 if the employee is an:

• Employee of a healthcare entity
• First responder
• Corrections officer
• Grocery worker
• Postal Service worker
• Military service member
• Activated National Guard member
• Domestic violence shelter worker
• Child advocacy worker
• Rape crisis center staff member
• Department of Community Based Services worker
• Childcare worker permitted by the Cabinet for Health and Family Services to work in a limited duration center during the coronavirus state of emergency.

Essentially, if you or a loved one work in one of these occupations in Kentucky, all you may need is a doctor’s note to qualify for immediate workers’ compensation benefits. Others are to receive benefits if there is a causal connection between the conditions under which the work is performed and COVID-19 and it naturally follows that exposure to coronavirus is a result of job duties.

If your employer or its insurance company balks at paying you workers’ comp benefits you qualify to receive, an experienced workers’ compensation lawyer at Morgan, Collins, Yeast & Salyer can help. Contact us today. We can give you the Kentucky Courage you need to fight employers and insurers who try to withhold benefits provided by law.

Understanding Workers’ Compensation And Illness Benefits

Workers’ compensation is state-mandated no-fault insurance coverage that most businesses in Kentucky are required to have to protect employed full- and part-time workers in Kentucky. The primary workers’ comp benefit for a worker who has become ill on the job is payment of all medical costs and partial replacement of lost wages. Workers’ comp pays a portion of lost wages and other benefits for specific disabling illnesses or injuries.

If you suffer from an occupational illness and are employed in Kentucky, under most cases you should never see a bill or make a co-pay for medical care related to that illness. All medical payments for work-related injuries and illnesses are the responsibility of your employer and will typically be paid by a workers’ compensation insurer.

Kentucky workers receiving workers’ compensation benefits also have the right to select a doctor to care for them without input from their employer. In many states, the employer chooses the employee’s doctor or offers several approved providers to choose from. But a Kentucky worker can choose their primary care provider, and that physician may also refer the employee to additional medical care providers, if necessary.

Some employees receive medical care through a managed care program offered by their employer’s healthcare insurance program. In these cases, an ill employee receiving workers’ comp would be required to choose an in-network physician as their primary care provider. However, the employee would still be allowed to seek a second opinion from an out-of-network doctor for major recommendations, such as surgery, and workers’ comp should pay for it.

How Do You Know If You Have A Legitimate Case For Workers’ Compensation?

If you work in certain occupations in Kentucky during the coronavirus pandemic and are told by a physician to stay out of work, you are to be presumed to be out of work because of an occupational exposure to COVID-19. This makes you immediately eligible for workers’ compensation benefits.

Guidance from the Kentucky Labor Cabinet says an employer can only deny payment of benefits if the employer has evidence “forming a good faith basis for denial.” For example, the guidance says, “if a grocery worker’s spouse tests positive for COVID-19 and the worker is removed from work solely due to that exposure, the employer may deny the claim since the evidence rebuts the presumption that the exposure was occupational.”

If you are employed in another occupation not listed above and have been diagnosed with COVID-19 or directed to self-quarantine by a physician due to exposure or potential exposure to COVID-19, you will need to demonstrate an occupational connection to the exposure to qualify for workers’ comp benefits. The employer or the workers’ comp insurer is supposed to promptly investigate the claim and may deny payment if there is a good faith basis for doing so. The Labor Cabinet’s example of a deniable claim is a physician’s order that lacks an explanation for occupational exposure.

Gov. Beshear’s order greatly reduces the burden for establishing occupational exposure by requiring only a “casual connection” between your work and a COVID-19 exposure that could naturally occur due to the nature of the work. An example might be additional diagnoses of COVID-19 among your co-workers or a client or customer who could be identified and whose proximity to you or your workstation could be established.

The KY Labor Cabinet applies the expansion of workers’ compensation rights retrospectively to April 9, 2020. It should be understood that any workers’ comp benefits for lost wages may be offset by unemployment benefits received during the same period or by any money received as paid leave under the federal Families First Coronavirus Response Act.

Let Our Lexington, KY, Workers’ Comp Lawyers Help

Kentucky workers have certain rights to workers’ compensation benefits during the COVID-19 coronavirus pandemic. If your employer tries to deny the benefits that you are eligible to receive by law, an experienced workers’ compensation lawyer from Morgan, Collins, Yeast & Salyer can give you the Kentucky Courage you need to stand up and fight for the full benefits available by law.

Don’t fight alone. Contact us today to set up your free legal consultation. We will not charge you a legal fee if we do not recover money for you.

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