|School leaders, faculty members, coaches, and paraprofessionals have put in an extraordinary amount of time and planning in preparation for reopening their doors and welcoming students to a new school year. In classrooms across the state, these dedicated employees work diligently to keep themselves and their students safe. Yet, for many of these employees, the question remains, “What happens if I become sick with COVID-19 after being exposed at work?”|
The impact of this evolving environment on employee workers’ compensation insurance claim benefits has become an increasingly salient topic. We want you to know that we’re in this together, and CIRMA’s Claim professionals will continue to work closely with our members and their employees with the care and compassion they have come to expect from CIRMA. In addition, as students and teachers adapt to their new routine, we will continue to keep our Boards of Education (BOE) members abreast of emerging insurance and risk exposures so that they can focus on keeping their schools in session.
We want you to know that we’re here to help. Each COVID-19 claim has been and will continue to be a top priority for our Claim professionals. In addition, we’ve established proven workflows and expedited the COVID-19 claim process to serve you and your employees better.
We know you have questions. So here’s a collection of answers to questions that our members have asked regarding COVID-19 and BOE employee workers’ compensation claims:
|Q. Who is eligible for workers’ compensation claim benefits?|
A. All paid BOE employees are eligible for workers’ compensation claim benefits.
Q. Will CIRMA provide workers’ compensation claim benefits to BOE employees (e.g., teachers, paraprofessionals, bus drivers, school nurses, coaches, custodians) if they test positive for COVID-19 after being exposed to a student or fellow employee who has tested positive for COVID-19?
A. Yes. CIRMA will provide workers’ compensation claim benefits to BOE employees who have contracted COVID-19 if it is determined that the illness arose out of and in the course and scope of their employment. A copy of the positive laboratory test or written diagnosis must be provided to the employer and CIRMA.
Example: A student attends school and is diagnosed with COVID-19. The student’s teacher is subsequently diagnosed with COVID-19 the following week.
Q. If an employee reacts to the COVID-19 vaccine that requires medical treatment and/or lost time from work, could they be covered under workers’ compensation?
If an employer mandates that their employees must be fully vaccinated for COVID-19 and the employee experiences a reaction to the vaccine that would interfere with the performance of their duties, the employee could be entitled to workers’ compensation benefits, just as they would be for any other work-related illness or injury.
As with any claim, CIRMA Claim professionals will work closely with critical parties to gather pertinent information and specific claim-related details. The culmination of this information will help determine whether a workers’ compensation claim is compensable. Compensability determinations are made on a case-by-case basis, given the unique facts pertaining to each claim.
Q. If a BOE employee chooses not to wear a mask and then contracts COVID-19 after being exposed to someone at work, which has tested positive for COVID-19, are they eligible for workers’ compensation claim benefits?
A. Yes. Workers’ compensation is a no-fault insurance compensation policy. Therefore, injured employees are entitled to benefits, even if it was due to their negligence.
Example: Despite understanding that it is mandatory to wear a mask at all times, a BOE employee who believes that they are alone in a classroom takes off their mask. A student walks into the classroom to retrieve an assignment they left behind. Later that week, the student tests positive for COVID-19. The following week, the employee contracts COVID-19.
Q. Are BOE employees eligible to receive workers’ compensation claim benefits from CIRMA if they have not been diagnosed with COVID-19, however, have been quarantined due to exposure during the course and scope of employment?
A. No. The employee must have a positive diagnosis of COVID-19 from a positive laboratory test or a written diagnosis of COVID-19 from a physician. BOE employees who are quarantined and do not have a positive COVID-19 diagnosis may be eligible to receive benefits under the Families First Coronavirus Response Act (FFCRA).
Example: A BOE employee is exposed to a student who has been diagnosed with COVID-19. The employee is immediately tested, sent home, and advised to quarantine. During quarantine, the BOE employee’s COVID-19 test is determined to be negative.
Q. Are BOE employees eligible for workers’ compensation claim benefits if they are injured while working from home?
A. Yes, if a BOE employee sustains an injury due to their work duties while working from home, they are eligible for workers’ compensation claim benefits.
Q. I am unsure that I have a workers’ compensation claim. What should I do?
A. Contact CIRMA right away—we’re here to help. Especially during these difficult times, you may not be confident that you should file a workers’ compensation claim. It’s good to err on the side of caution—the faster we know that you have a potential claim, the faster we can help.
We understand that with COVID-19 comes a great deal of uncertainty. We’re here to help. If you have questions, please reach out to your CIRMA Claim Representative.
Visit CIRMAClaim.org to report a claim.
For more information on COVID-19’s impact on your insurance, be sure to check out CIRMACOVID.com.
The information contained within this document should be solely interpreted as preliminary guidance regarding the impact of COVID-19 on workers’ compensation. As with all workers’ compensation claims, CIRMA will continue to make compensability determinations on a claim-by-claim basis.
This material is intended for informational purposes only, and descriptions of insurance coverage are general in nature and are not to be construed as actual policy language. This material does not amend, extend, or otherwise affect the provisions or coverages of any insurance policy issued by the Connecticut Interlocal Risk Management Agency (CIRMA), nor is it a representation that coverage does or does not exist. Coverage depends on the facts and circumstances of each claim or loss, all relevant policy provisions, and applicable law. The availability of any coverage referenced in this document depends on underwriting qualifications and Connecticut State and Federal regulations.