Rice Law Office Blog

COVID-19 Related PTSD May be Covered Under Workers’ Compensation

The toll of COVID-19 on workers is not just physical or economic. For many, there is an emotional impact that for some, rises to such a level that it requires treatment or time away from work. This is especially true for frontline workers who face increased risk of illness for themselves and their families by virtue of their work keeping others fed, safe and healthy.

In the last few months, and perhaps in those to come, some in our community have experienced long periods of isolation away from family and friends, interrupted only by arduous shifts at work, where the weight of responsibility and the despair at the numbers and size of the problem take a tremendous toll. Fortunately, workers’ compensation coverage is available for those who have taken on this burden and who have suffered with not just physical symptoms of COVID-19, but with the mental manifestations of emotional distress as a result of this work.

In the case of emergency responders, New Hampshire workers’ compensation laws allow employees to recover benefits for disabling mental injury suffered as a result of workplace events. However, there are numerous obstacles and challenges in making these claims. Many employees are not aware of their right to bring these claims, and for those that are, the concern of stigma or impact to an employee’s career can be a daunting obstacle to making a claim. Furthermore, when a claim is made, the chance of denial is high, and the process of appeal is in itself stressful and frequently invasive.

Too often the requirement of proof becomes a point of contention that requires the worker to open up their life and health records to inspection in order to meet the burden of proof required. Employees seeking coverage for PTSD, ASD, and other stress or mental health symptoms caused by work often face layers of opposition to their claim. In some instances, they must not only prove that the symptoms they are experiencing are work related, but to do so, they are often compelled to show that their stress is not caused by other life stressors.  This process of meeting the burden of proof in a stress injury claim can serve to make the symptoms of stress worse and discourage claims altogether. 

New legislation passed in July of 2019 seeks to address these obstacles for some of New Hampshire’s workers with the implementation of a series of amendments aimed at easing the burden of proving a mental injury claim for emergency responders/public safety workers.

RSA 281-A:2 XI, which is now in effect, amends the definition of “injury” or “personal injury” under the workers’ compensation statute, to include acute “stress disorder and posttraumatic stress disorder” if an employee meets the definition of an “emergency response/public safety worker.” This legislation also expands the definition of emergency response/public safety worker found at RSA 281-A:2 V-c, to now include “emergency communication’s dispatcher” a group of employees often overlooked but who are also deeply connected to this work. With this legislation comes the acknowledgment that the risk of mental stress injuries to these workers is real and must be met with proper opportunity for treatment and time to heal without stigmas or undue added stress associated with making these claims.

PROTECTIONS FOR FIRST RESPONDERS WHO CONTRACT COVID-19 IN NH

Executive Order for First Responders:

In the case of first responders, the burden of establishing causation with respect to COVID-19 has been made easier for the time being by Governor Sununu’s Emergency Order #36. This Order establishes that “Notwithstanding the provisions of RSA 281-a:2, XI and XIII, 16 and 27, in any proceeding before the New Hampshire Department of Labor or the administratively attached Compensation Appeals Board, there shall exist a prima facie presumption that the first responder’s COVID-19 exposure and infection were occupationally related.”

For purposes of the order, “First Responder” includes any individual covered by the definition of “Emergency response/public safety worker” as set forth in RSA 281-A:2V-c, which includes call, volunteer, or regular firefighters; certified law enforcement officers, county corrections officers; emergency communication dispatchers (incongruously, given the isolated nature of the work); and rescue or emergency medical personnel. The Order does not cover healthcare workers or any other employees who have been identified as essential workers during the emergency order. To be eligible for the protections of this Order, a “first responder” must have tested positive for COVID -19 and the case must have been reported to the Department of Health and Human Services.

It is important to note this is not new legislation, but an Order which is in effect only for the duration of the COVID-19 state of emergency in the New Hampshire. As such, unless there is a change, this Order and the presumption it provides is temporary and is only set to last as long as the state of emergency is in place. When this Order expires, the presumption will lapse and in order to be covered for workers’ compensation from contracting COVID-19, first responders will be required to prove more probably than not, that they contracted the illness in and during the course of their work by applying the increased risk test or perhaps under the theory of occupational disease.

Learn more about COVID-19 laws regarding unemployment and workers' compensation in New Hampshire.

Is COVID-19 An Occupational Disease under New Hampshire Worker’s Compensation Law?

As addressed in previous articles, there will be worker's compensation coverage available for many employees who contract COVID-19 at work. The most likely path to this coverage will be with the understanding that the employee became ill due to a neutral risk, but that the employee faced a greater risk of getting ill due to his or her work, as compared to the general public. This is known as the increased risk test and employees who can show this will likely find coverage available for lost wages, medical bills and job protections.

However, healthcare workers who treat patients with diagnoses of COVID-19 may have more than one route to winning coverage should they contract COVID-19. Certainly, these workers should be able to show they are at increased risk of contracting the illness as compared to members of the general public due to the work they do and to the correlating increased frequency of direct exposure to illness, even if no specific transmission of the disease can be traced to a known carrier. If the healthcare worker has had to engage in care that entails unusually contagious situations, such as exposures in the process of resuscitation or intubation or without full PPE, the fact that their risk was increased due to the qualitative nature of their work is clear.

That said, there may be an argument to be made that these workers or those in similar circumstances, may alternatively be eligible for workers’ compensation benefits under NH RSA 281-A:2 XIII: Occupational Disease.

RSA 281-A:2 XIII Occupational Disease

In accordance with RSA 281-A:2 XIII “Occupational disease” is “...an injury arising out of and in the course of the employee’s employment and due to causes and conditions characteristic of and peculiar to the particular trade, occupation or employment. It shall not include other diseases or death therefrom unless they are the direct result of an accidental injury arising out of or in the course of employment...”

Workers' compensation coverage for COVID-19 in New Hampshire: Here’s what employers and employees in New Hampshire need to know about how they can limit both the spread of COVID-19 and economic loss for everyone:

Employer immunity legislation is a hot topic as politicians argue over whether our current laws are sufficient to provide coverage for employees who contract COVID-19 at work, while still reasonably limiting employer liability.

We all have an interest in worker safety. A sick employee is a sick mother, father, daughter, son, neighbor or friend. The illness of an employee and the economic impact of that illness is contagious to all those who are connected to that person. One sick employee passes the illness to another, who brings it home and then sends it to school, then on to the grocery store, to grandma and the new baby cousin and so on.

Likewise, a sick and unemployed person’s financial insecurity is also contagious. Without income or insurance and while simultaneously facing mounting medical bills, COVID-19 patients can’t help but spread the economic impact of their loss onto others in their circle. They can’t pay their bills or buy goods when their income stops and so landlords, shop owners, gas station workers, grocers, hairdressers and more suffer right along with the sick worker.

Over the last few months we have learned how connected we all are. We want employees to be safe and protected, and yet we need to reopen the economy. We want to have a safety net for those who do get sick at work, but we don’t want employers to go out of business providing this protection. As a community we face difficult choices and sometimes it feels like we face inevitable loss no matter what we do.