COVID-19 – Workers’ Compensation Coverage

Originally Posted: March 13, 2020

Updated: April 7, 2021

 

With the World Health Organization (WHO) declaring the novel coronavirus (COVID-19) a pandemic, Canadian employers should prepare for the worst and plan how to respond to various employment-related issues that could arise if the virus continues to spread.

Employers are raising many questions about workers’ compensation coverage and reporting responsibilities.

Throughout Canada, the various provincial workers’ compensation boards have provided guidelines relating to the coverage of benefits for COVID-19 cases. While most cases of COVID-19 aren’t work-related, you are encouraged to report cases to your workers’ compensation board if the worker indicates that they may have been exposed at work – even if you disagree – or if the nature of their employment puts them at a greater risk of exposure than the general public.

In every case, the various provincial compensation boards will adjudicate work relatedness and benefit entitlement based on the specific circumstances of each case.

TeksMed Services Inc. has outlined general answers to some of the questions its clients are asking during this pandemic.

The following pages address questions regarding COVID-19 and workers’ compensation.

 

Questions and Answers

 

When is COVID-19 considered to be work-related?

When a worker contracts COVID-19 as a direct result of their employment, they are likely to be entitled to compensation providing certain criteria relating to the nature of their employment and the extent of their work-related exposure are met. WCB Alberta has outlined that the following conditions must be met:

  • The nature of employment involves sufficient exposure to the source of infection,

and

  • The nature of employment creates a greater risk of exposure for the worker.

 

When do I report a case of COVID-19 to provincial workers’ compensation board (WCB)?

When a worker tells you that they have COVID-19 and they suspect it was contracted at work, you should report the illness to the workers’ compensation board. In some provinces, such as Ontario, it is required to report COVID-19 claims if a worker believes they contracted it in the workplace even if you disagree. It is up to the board to determine whether or not the claim will be allowed; each claim is evaluated on a case-by-case basis.

In order to be accepted, evidence must show that a person’s risk of contracting the disease through their employment is greater than the risk to which the public at large is exposed, and that work significantly contributed to the person’s illness.

 

What is an outbreak at work?

An outbreak is a sudden rise of the number of cases of a disease; multiple cases in a workplace may lead to the declaration of an outbreak (five or more cases). COVID-19 is highly contagious and an outbreak can occur very quickly.

 

Should I submit a claim if I suspect an outbreak?

You should always be reporting illness due to COVID-19 when there is reason to believe the exposure occurred at work, including when there are several cases in a workplace. Report to WCB when multiple workers at your facility have symptoms or have a confirmed COVID-19 diagnosis.

 

Are workers covered when quarantined, self-isolated or practicing social distancing?

No, the provincial workers’ compensation boards do not provide coverage for workers who are symptom-free when quarantined, self-isolated, practicing social distancing or sent home on a precautionary basis.

 

If I believe my staff is at greater risk than the general public of exposure at work, do I need to report all exposures?

No, if there is no illness, there is no claim. You only need to report lost-time claims of occupational disease exposure to the provincial WCB. If workers were exposed to the virus but develop no symptoms, the incident should be recorded in your records but you do not need to report it to the provincial WCB.

 

I’m an employer whose staff is at greater risk of exposure at work than the general public. I sent my worker home because there’s a high risk of exposure. Do I need to report it to the provincial WCB?

No, if there is no illness, there is no claim. There’s no need to report this to the provincial WCB.

 

What happens if an employee is exposed to COVID-19 while travelling?

Employees will likely be able to claim benefits if symptoms follow exposure during any work-related travel. Entitlement to benefits extends to people traveling in the course of employment. As such, if an employee is required to travel for business and in the course of that travel is suspected to have contracted COVID-19, the employee could likely claim benefits.

 

What happens when I submit a COVID-19 claim?

Like any other claim, the provincial WCB must determine whether exposure to the disease arose out of the course of employment and was caused by an employment hazard (in this case, workplace exposure to the virus).

 

Will my staff continue to receive benefits if we shut down operations due to COVID-19?

Certain provincial workers’ compensation boards, for example Ontario’s Workplace Safety Insurance Board (WSIB) have specified that employees will continue to receive the same wage-loss benefits, full or partial, that were being received at the time of the employer’s shut down. If no wage-loss benefits were received at the time of shut down, for example in case where modified duties are being performed, then no wage-loss benefits would be provided. However, WorkSafeBC has recently announced that in the event a worker is on modified duties and the worksite shuts down, wage-loss benefits to the worker will resume if the employer is not paying the worker during the shutdown. In addition, wage-loss benefits may be payable to workers who are unable to return to modified duties due to quarantine/self-isolation; relief of costs may be considered for this period so as to avoid unfairness to the employer.

 

Please note that the COVID-19 pandemic is an ever-changing global event which may impact the stance of the Government of Canada as well as the various provincial workers’ compensation boards, thus updates will be provided when new information is made available.

For more information on occupational disability management and workers’ compensation matters please feel free to reach out to TeksMed at info@teksmed.com.

To further assist you, please review our companion article, “COVID-19 – Short Term Disability Coverage and Sick Leave” which sets out some of the emerging questions and answers.

 

Statements from various workers’ compensation board regarding COVID-19 claims can be found below:

 

WorkSafeBC:

https://www.worksafebc.com/en/covid-19/claims/information-for-employers

When a worker contracts COVID-19 as a direct result of their employment, they are entitled to compensation if the following conditions are met:

1.  Evidence that the worker has contracted COVID-19, either:

    • a medical diagnosis in a medical report, or
    • non-medical factual evidence where other evidence establishes the existence of COVID-19.

2. The nature of the worker’s employment created a risk of contracting the disease significantly greater than the ordinary exposure risk of the public at large.

A work-related example would be an acute care hospital worker, who is treating patients who have been diagnosed with COVID-19. In these cases, they are at greater risk than the general public of contracting the disease.

Work-related examples:

Acute care hospital worker, who is treating patients who have been diagnosed with COVID-19.

A worker who is staying at employer provided accommodations that are shared with other workers who have been diagnosed with COVID-19.

A care aide in a long-term care facility, who is treating residents who have been diagnosed with COVID-19.

Staff in educational facilities where a large number of students and/or staff are present and there are students or staff diagnosed with COVID-19.

Workers in retail or hospitality who interact with a large number of customers and members of the public..

“As shown in the above examples, if your employees are at significantly greater risk than the general public of contracting the virus while at work, and an employee loses time from work after contracting the virus, you must report the claim to WorkSafeBC. If in doubt or the employee or WorkSafeBC asks you to, you must submit a report immediately.

“Claims submitted for COVID-19 contracted through a work-related exposure are adjudicated on a case-by-case basis. WorkSafeBC will look at details such as whether the worker has a diagnosis of COVID-19, their symptoms, and their employment activities. A presumption in favour of an accepted claim may apply if there is evidence to establish that a worker has COVID-19 and the risk in the workplace was significantly greater than the ordinary exposure risk.”

 

WCB Alberta:

https://www.wcb.ab.ca/assets/pdfs/employers/EFS_COVID-19_at_work.pdf

“When a worker contracts COVID-19 as a direct result of their employment, they are entitled to compensation if the following conditions are met:

The nature of employment involves sufficient exposure to the source of infection, -and-

The nature of employment creates a greater risk of exposure for the worker.”

A claim is likely to be accepted if a worker contracts the illness and is performing what the province deems to be an essential service that puts them in regular contact with the general public. All essential services cases should be reported to WCB, unless:

  1. The employee was on vacation or away from work at the time of infection.
  2. The employee is not ill but must quarantine due to suspected or confirmed exposure.

“A worker will likely be covered in the event of a widespread outbreak at their place of work.

All outbreak cases should be reported to WCB for investigation.

When multiple employees in the workplace have a confirmed diagnosis of the disease, workers at that site may have a greater risk of contracting the infectious disease than the general public.

These cases need to be reported so WCB can investigate work relatedness. As an outbreak in the workplace may put workers at greater risk of contracting the disease than the general public, the condition may be covered through the workers’ compensation system.”

 

WCB Saskatchewan:

https://www.wcbsask.com/news/information-employers-covid-19

https://www.wcbsask.com/frequently-asked-questions-employers-covid-19

“A worker may be entitled to compensation should they contract COVID-19 as a direct result of their employment. Generally the employment would need to put the employee at greater risk of contracting COVID-19 than the general public. Based on WCB policy, Injuries – Communicable Disease (POL 02/2010), the following conditions must be met:

There is confirmed exposure to the disease in the workplace.

PLUS

The time period that the illness is contracted is in close proximity to the confirmed workplace exposure.

PLUS

The nature of employment creates a greater risk of exposure for the worker than to the general population.”

Examples of claims that may be accepted

Outbreak in the workplace: A worker, whose place of employment has had other employees test positive for COVID-19, is at a greater risk of contracting the virus and may have an acceptable claim.

Acute care hospital worker:  A worker providing treatment to patients for COVID-19. As this worker is at greater risk than the general public, they may have an acceptable claim.

Retail worker: A worker, working with the general public, interacts with a customer who has been confirmed as having contracted COVID-19, may have an acceptable claim.”

“If a situation meets the criteria listed above, such as a worker who is at greater risk of contracting the virus than the general public, and they lose time from work after contracting the virus, a claim should be submitted. If the claims is accepted as a confirmed work-related COVID-19 claim, you will receive cost relief for all costs associated with the claim.”

 

WCB Manitoba:

https://www.wcb.mb.ca/how-the-wcb-is-responding-to-covid-19

“You are required to report workplace injuries resulting in time missed from work or a medical treatment within five business days of being made aware of them.

Work-related injuries and illnesses, including in some cases COVID-19, have always been and continue to be covered by the WCB and determined on a case-by-case basis.”

“Most instances of COVID-19 are not work-related. However, the nature and type of work your workers do may put them at greater risk of contracting the virus than the general public. Nurses, health care aides and other direct care providers in hospitals and long-term care facilities are some examples of workers who may be at greater risk.”

“For a COVID-19 claim to be accepted, the WCB must determine that a worker contracted the virus as a result of an exposure arising out of and in the course of employment.

To determine the work-relatedness of COVID-19 claims, the WCB looks at details such as the person’s employment activities, their symptoms and whether they have a diagnosis of COVID-19.”

 

WSIB Ontario:

https://www.wsib.ca/en/faqs-about-claims-and-covid-19

https://www.wsib.ca/sites/default/files/2020-03/adjudicativeapproachnovelcoronavirus.pdf

“In determining the work-relatedness of COVID-19 claims, the decision-maker will consider whether:

  1. the nature of the worker’s employment created a risk of contracting the disease to which the public at large is not normally exposed; and
  2. the WSIB is satisfied that the worker’s COVID-19 condition has been confirmed.

If established, the above will generally be considered persuasive evidence that the worker’s employment made a significant contribution to the worker’s illness. Claims which do not meet these guidelines will be reviewed on their own merit, having regard to circumstances of the individual case.”

“While the nature of some people’s work may put them at greater risk of contracting the virus, for example those treating someone with COVID-19, this is a constantly evolving situation and any claims received by the WSIB will need to be adjudicated on a case-by-case basis, taking into consideration the facts and circumstances.

Please note: The WSIB does not provide coverage for people who are symptom-free even when quarantined or sent home on a precautionary basis. However, should someone who is symptom-free develop symptoms or illness while on quarantine, they may be eligible for WSIB coverage.”

“If an employee has had a COVID-19 test, the WSIB considers that they have received health care.

  • If the employee tests positive for COVID-19 and tells you that they believe they contracted COVID-19 in the workplace, you are required to report the illness to the WSIB, even if you feel that the employee did not contract it at work.
  • If the employee tests negative for COVID-19, you are not required to report the illness to the WSIB.”

“You also have an obligation to report an employee’s COVID-19 (they have a diagnosis/positive test or symptoms of COVID-19) when you have reason to believe there was a potential workplace exposure. For example:

  • other employees in the workplace have tested positive for COVID-19; or
  • there was a known or suspected contact source for COVID-19 from whom the employee could have contracted it

Additionally, you are required to report the illness if the WSIB has informed you that a claim has been set up based on a Form 6 (Worker’s Report of Injury/Disease) or a Form 8 (Health Professional’s Report).”

 

COVID-19 contracted in the workplace is considered an occupational illness, and in Ontario must be reported to the Ministry of Labour, Training and Skills Development in addition to the WSIB. You are obligated to give notice to the Ministry if you are informed that the worker has contracted an occupational illness or if a claim has been submitted to WSIB for an occupational illness – even in the event that you believe it may not be work-related.

https://www.ontario.ca/page/reporting-workplace-incidents-or-structural-hazards#section-3

“If you are advised that a worker (current or former) has an occupational illness, or that a claim for an occupational illness has been filed with the Workplace Safety and Insurance Board, you must notify, in writing, within 4 days of being advised:

  1. a director of the Ministry of Labour, Training and Skills Development
  2. your joint health and safety committee or health and safety representative
  3. the union (if there is one)”

 

CNESST Quebec:

https://www.cnesst.gouv.qc.ca/salle-de-presse/Pages/coronavirus.aspx

“21. Un travailleur qui aurait contracté le coronavirus (COVID-19) par une exposition dans son milieu de travail peut-il être indemnisé?

Oui, les travailleurs atteints de la COVID-19 qui auraient été infectés au cours de leur emploi pourraient avoir droit aux prestations et aux services habituels offerts par la Loi sur les accidents du travail et les maladies professionnelles.

Pour ce faire, le travailleur doit consulter un médecin qui posera le diagnostic, aviser son employeur et remplir la réclamation du travailleur qu’il fera parvenir à la CNESST. Le travailleur devra démontrer qu’il a été en contact avec le virus par le fait ou à l’occasion de son travail. Le lien avec le travail devra être démontré de façon prépondérante.

La décision de la CNESST tiendra compte des particularités inhérentes à chaque demande.”

 

WCB PEI:

http://www.wcb.pe.ca/Information/NewsItem/495

“Most cases of COVID-19 are not work-related. If a worker’s COVID-19 is not work-related, there is no need to report it to the WCB.

If a worker contracts COVID-19 that may be a result of work, they should report it to the WCB to determine if they are eligible for compensation benefits. To have a claim accepted for COVID-19, all of the following conditions must be met:

There is medical confirmation that the worker has COVID-19.

The worker has been exposed to COVID-19 at work.

The exposure is confirmed to be work-related, that is, it arose out of and in the course of their employment.

The WCB adjudicates all claims on a case-by-case basis, including those related to COVID-19. The WCB will be in contact with the worker and their employer about the claim.”

 

WCB Nova Scotia:

https://www.wcb.ns.ca/About-Us/News-Room/News/COVID-19-Novel-Coronavirus.aspx

“As with any claim received, WCB Nova Scotia will adjudicate claims related to COVID-19 on a case-by-case basis. As set out in the Workers’ Compensation Act, compensation is only available for a work-related injury or illness. It is not provided for workers who cannot work for preventative or precautionary reasons, such as self-isolation or quarantine.”

 

WorkSafeNB:

https://www.worksafenb.ca/safety-topics/covid-19-safety-is-our-priority/covid-19-coronavirus/

“Workers’ compensation is available for a work-related injury or illness and is not provided for workers who withdraw from work for preventive reasons.

Claims submitted for a COVID-19 virus infection contracted through a work-related exposure are adjudicated on a case-by-case basis. For a claim to be accepted, evidence must show that the infection arose out of and in the course of employment and the risk of contracting the disease through the employment is greater than the risk associated with contracting it through day to day living.”

 

WorkplaceNL:

https://workplacenl.ca/workers/health-and-safety/coronavirus-disease-2019-covid-19/

“You are required to report workplace injuries or illnesses resulting in lost time or the requirement to seek medical treatment within three business days of being made aware of them. You can file your Employer’s Report of Injury (Form 7) through connect. Any claims submitted for COVID-19 will be reviewed and adjudicated on a case by case basis.”

“Most instances of COVID-19 are not work-related. However, some workers may be at a greater risk of contracting the virus due to the type of work they do including nurses, health care aides and other direct-care providers in hospitals and long-term care facilities.”

…confirmation of a positive COVID-19 diagnosis is required in order to receive benefits.

 

WCB Yukon:

https://www.wcb.yk.ca/web-0005/web-0019

“When a worker contracts COVID-19 as a direct result of their employment, they are entitled to compensation if the following conditions are met:

  • There is a causal connection between the conditions of the work required to be performed and the resulting injury.
  • The injury is linked to a worker’s employment in terms of time, place and activity consistent with the obligations and expectations of that employment.”

 

Workers’ Safety and Compensation Commission Nunavut and Northwest Territories:

https://www.wscc.nt.ca/health-safety/covid-19

“While most cases of communicable diseases are as a result of daily activities and interactions with people, if you believe that you contracted COVID-19 as a direct result of your employment, please contact 1-800-661-0792, or email our Claims Department  with a completed Worker’s Report of Injury. WSCC will determine whether the claim is related to work, and if so, what benefits will be provided based on that unique circumstance.

 

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