COVID & Mental Health/PTSD Presumptions

Injured workers and COVIDThe COVID-19 pandemic had a significant impact on workers’ compensation in 2020 and 2021. A majority of states considered expanding coverage to first responders, essential and frontline workers, and the general workforce through presumption bills in their respective legislatures. Most states focused on passing presumption bills allowing COVID to be a compensable injury under workers’ compensation. However, considering the stress from the pandemic, some states expanded mental health benefits for first responders and other frontline workers suffering from mental health impairments and PTSD.


COVID-19 Presumptions


In 2020, nine states enacted legislation allowing COVID to be compensable under workers’ compensation. Over nineteen states have proposed similar legislation so far in 2021. While most of these proposals and enacted legislation are allowed to be rebutted by employers, the requirements for doing so vary from state to state. Most of the time, employers must prove that employees engaged in significant risk behavior outside of the workplace to make employees ineligible.


Each state that is proposing or has enacted a presumption did so in its own unique way. States such as Minnesota, Utah, and Wisconsin limit coverage to first responders and health care workers. Meanwhile, Illinois, New Jersey, and Vermont cover all essential workers, and legislation in California and Wyoming covers the general workforce.


A large number of states have expiration dates for their COVID presumptions. However, some states have begun considering legislation past COVID. They are looking to the future in the case of another potential pandemic. Over 12 states introduced legislation for future pandemics similar or equivalent to COVID and other higher-risk infectious diseases.


Mental Health/PTSD Presumptions


Over 80% of health care workers reported physical/emotional exhaustion in 2020. The stress put on essential and frontline workers during the pandemic was unprecedented, and many legislatures responded in the 2021 session.


Similar to COVID presumption bills, mental health/PTSD presumptions vary by state. Certain states like Massachusetts, Vermont, California, and Oregon may provide more comprehensive legislation that includes a wider variety of frontline occupations to be eligible, while other states, such as Wisconsin and New Hampshire, limit mental health coverage to only first responders.


States also have strict or broad interpretations on the subject. For example, a state may require a formal diagnosis from a specialist, and others may need a physical injury to be present to become eligible. On the other hand, a small number of states have little to no requirements to qualify.


In 2020, five states enacted legislation to ensure mental health/PTSD was compensable under workers’ compensation statutes. Colorado, Nebraska, Virginia, Washington, and Wyoming all passed bills to expand mental health coverage referencing the pandemic as a core reason for doing so. In addition, as of May 2021, Ohio, West Virginia, and Wisconsin enacted legislation allowing primarily first responders to become eligible for workers’ compensation benefits. North and South Carolina passed similar legislation through their lower legislative chambers, as well. While many states are considering mental health/PTSD presumptions, legislators cite costs as a deciding factor for not enacting such legislation.


Although COVID vaccines are allowing many to get back to work safely, the effects of the pandemic remain fresh in the minds of policymakers. Workers’ compensation systems have come out stronger than expected from COVID-19. Yet, with economic uncertainty, many employers, legislators, and other stakeholders must closely monitor rates and premiums as more of our society begins to re-open its doors. For now, states will have to continue to weigh the balance between economic risk and the risk essential and frontline workers took on throughout the pandemic to keep public services open and economic activity afloat.

COVID-19 & Mental Health Presumptions White Paper


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