Long-Term Disability, ERISA, and COVID-19 (the Coronavirus)
Disability claims during the Corona virus era are certain to rise over the coming weeks and months. Claims for worker's compensation benefits, Social Security disability benefits, and claims under Short-Term Disability (STD) and Long-Term Disability (LTD) plans provided to an employee through a group insurance plan will become common during this era. Claims may arise for injuries such as lung problems, comas, deaths, or even Post Traumatic Stress Disorder (PTSD).
Employers and insurers are likely to deny or dispute coronaviruses disability claims as not being work-related, for Workers’ Compensation claims. However, in Missouri if work exposes the person to the disease or illness and made it much more likely that the worker would contract the disease or illness due to a greater risk of exposure at work, such claims are traditionally compensable for both Long-Term Disability purposes and for Workers’ Compensation purposes.
For example, in the Workers’ Compensation context, industrial disease claims include asbestos exposure (and possibly corona virus claims). If the person has to remove insulation from pipes, resulting in the infiltration of asbestos fibers the lungs, and the person develops a lung disease, such claim is compensable under Missouri workers compensation statutes if work is the prevailing factor in causing the illness. If the person does not have exposure to asbestos outside of work, such claim should be compensable.
Similarly if the person is exposed to the coronavirus due to having to work in the emergency room or work in the ICU unit, or work in a nursing home, by treating patients and placing medical devices upon patients, and if the healthcare facility has a shortage of PPE's (personal protective equipment), then it is likely that work would be the prevailing factor in causing the healthcare employee’s illness from coronavirus. While it is also possible the person was exposed to coronavirus outside of work, if work put them in this position and made it much more likely that they would obtain the coronavirus, it should be compensable. It is important to contact an attorney knowledgeable in Workers’ Compensation matters on such a claim.
ERISA STD & LTD CLAIMS
In the ERISA long-term disability and short-term disability context, such claims are likely to be disputed by companies like Cigna Insurance Company, Hartford Insurance Company, New York Life, Lincoln Financial, etc., and a number of other companies providing short-term and long-term disability benefits. Insurance companies often look for exclusions or exceptions to coverage to deny workers their disability claims. Insurance companies often deny the workers claims saying the injury or illness lacks objective evidence to support the severity of symptoms complained of and therefore the employee is not disabled. However, in this rapidly changing environment, if an individual has a short-term disability or long-term disability policy provided to them through their employer, corona virus disability claims would fall under Federal ERISA Law. The plan would be strictly construed by a court. If there is coverage for an illness like pneumonia or corona virus it would be examined according to the terms of the disability plan. If the corona virus causes severe fatigue, respiratory problems, the inability to do physical tasks or maintain a full work day, the disability policy should provide coverage. If the person can not perform the essential duties of their job, due the severe distress they are feeling due to the corona virus, they are eligible to obtain STD and LTD disability benefits. When exposed to the corona virus, this could cause permanent injuries to the person and result in the inability to work. It is important to hire an attorney knowledgeable in ERISA litigation that works in federal court because this is a very specialized area.
FIRST RESPONDERS IN MISSOURI COVERED BY WORKER'S COMPENSATION
Many of Missouri's first responders, such as police officers, firemen, paramedics and ambulance drivers are responding to emergencies in which they contract the corona virus. This can cause a loss of income and disabling conditions or even death. Missouri worker's compensation law discussed in the first part of the article still applies to all workers. However, Governor Parsons just this week passed an emergency rule in Missouri that allows any first responder who is quarantined or contracts COVID-19 to receive worker's compensation benefits. Thus, if a fireman or policeman or ambulance driver who must be quarantined or even hospitalized due to the virus, they can apply for an receive benefits under the law, The emergency rule creates an assumption that the first responder received the corona virus in the line of duty and therefore, benefits shall be allowed for an injury from the corona virus occurring on the job. The insurers may still dispute the degree of permanent disability so it is important for the first responders to consult with an attorney if the suffer long term impact and injuries from the corona virus.
Mr. Tatlow has worked on behalf of individual working men and women, doctors, dentists, accountants and other professionals in fighting big insurance companies to obtain their Workers’ Compensation and Long-Term Disability benefits against corporations and insurance companies around the country. Mr. Tatlow has tried in excess of 100 Social Security disability cases and has handled hundreds of workers compensation and ERISA disability benefit cases. Mr. Tatlow is a frequent lecturer on ERISA disability, workers compensation and the interaction between long-term disability statutes, workers compensation statutes and Social Security disability. He has lectured in front of many attorneys at Washington University on such topics and has also lectured through NBI and the Missouri bar Association. He has also lectured on such topics to the Eighth Circuit Annual Social Security conference. Mr. Tatlow’s partner, Mrs. Jill Bollwerk, has also fought for years in representing many men and women successfully on Workers’ Compensation injuries and diseases. She and Mr Tatlow together, frequently handle both Long-Term Disability and Workers’ Compensation claims for diseases, injuries, and trauma.Choosing an attorney is an important decision and researching the attorney’s success on ERISA, Workers’ Compensation, and disability cases is part of the process. Please see Bollwerk & Tatlow, LLC.’s blogs on ERISA, disability, and Workers’ Compensation claims for more information.
As coronavirus impacts our health care workers, it is important to protect them as the big companies and the insurance companies may not be there to protect the workers and insureds and to provide them with the benefits they promised them when they first became employed. Bollwerk & Tatlow are committed to fighting for the rights of workers and insureds who rights are impacted by the corona virus
Stay tuned for another blog post on the psychological impact of the corona virus and how it impacts Workers' Compensation claims.
Article written by Phillip Tatlow.