For Essential Workers, COVID-19 Treatment Covered Under Workers’ Compensation Benefits
The law described below is effective in accordance with the declaration and redeclaration of New Jersey's public health emergency period. This means law was effective and the rebuttable presumption applies for claims with dates of service March 9, 2020 through June 4, 2021, and from January 11, 2022 through March 7, 2022.
With the expiration of the law, the rebuttable presumption will only apply for claims with dates of service March 9, 2020 through June 4, 2021, and January 11, 2022 through March 7, 2022, although essential workers may still be eligible for Workers' Compensation after the expiration date. In such cases, the burden of proof for establishing compensability for a COVID-19 infection will return to the higher standard of establishing that the illness was contracted in the workplace and was work-related.
On September 14, 2020, a new law went into effect affecting workers' compensation (WC) benefits in New Jersey. The law created a rebuttable presumption that “essential workers” who contract COVID-19 during the public health emergency, contracted it in the workplace. As a result, essential workers' treatment of COVID-19 may be under their WC benefits. This law was retroactively effective March 9, 2020.
Who is considered an essential worker under this new state law?
Under this law, “essential workers” include employees who, during the Governor-declared State of Emergency, are:
- Public safety workers/first responders (for example, fire, police or other emergency responders);
- Workers providing medical/health care services, emergency transportation or social services, including services in health care facilities, residential facilities or homes; and
- Workers performing services in physical proximity to members of the public and who are essential to the public's health, safety and welfare, including transportation services, hotel and other residential services, financial services, and the production, preparation, storage, sale and distribution of essential goods such as food, beverages, medicine, fuel and supplies for conducting essential business and work at home.
Why is this Workers' Compensation law important for essential workers?
For essential workers diagnosed with COVID-19, it's beneficial to have treatment handled as a WC claim because WC covers 100% of medical costs, without copays or deductibles, from the first date of injury or illness to the date that maximum medical improvement is achieved. Under WC, this period may extend for one day or a lifetime. This is important since many COVID-19 cases appear to have long-lasting medical implications.
In addition, under WC benefits, partial wage replacement is also available.
What you need to do
We want you to be aware of this new law so that your patients who are essential workers diagnosed with COVID-19 can have their cases covered according to this new law. When appropriate, please ask your patients for their WC carrier information and submit claims accordingly.