When Are Contagious Diseases Covered Under Workers’ Compensation?

News of the recent Measles cases in California and other states is just one example of how a disease outbreak can cause concern for employers. To reduce costs for medical care and lost time from work, employers usually educate their employees on healthy workplace habits.

But, exposure to disease also raises questions about workers’ compensation coverage. States address disease and illness differently, and in some states, different regulations will apply to specific types of disease exposure, such as blood borne pathogens.

When a claim is submitted for a contagious disease, your claims administrator should determine if the claim was for an exposure to a disease or for an employee who has actually contracted a disease.

Exposure to disease usually will not rise to the level of a claim. However, there could be covered benefits for preventative treatment. Side effects or reactions from preventative treatment could also be covered depending on the individual case.

If the claim was for an employee who contracted a disease, a thorough review of the circumstances should be conducted to determine if the claim is compensable. Compensability depends on whether or not the illness or exposure arose out of employment and was in the course and scope of employment. The type of worker and the workplace environment are critical factors in making this decision. For example, healthcare workers are usually more likely to be exposed to different diseases than workers in other workplace settings. Each jurisdiction has its own workers’ compensation regulations and criteria for determining compensability.

Every claim is different and should be evaluated on its own set of facts.

It’s important that claims of any kind are reported promptly in order to minimize costs. We encourage you to contact us if you have any questions or if we can assist you with your claims.