Industrial COVID-19 Aggravates Nonindustrial Conditions

What if a worker has an underlying nonindustrial condition, contracts COVID-19 from work, and the disease causes a worsening of the condition? For example, a worker might have a heart condition that was not caused by her work. What if she caught COVID-19 at work, and her heart condition worsened? Would the aggravation of a nonindustrial condition and the subsequent need for benefits be the employer's responsibility to address under workers' compensation? Yes.

As discussed in the previous section, an employer would be liable for disability or death benefits if an employee's nonindustrial COVID-19 was aggravated or accelerated by an industrial work injury. The opposite also is true: An employer would be liable if an employee contracts COVID-19 on an industrial basis, and the disease aggravates or accelerates a nonindustrial condition. Also, as discussed in the last section, there is no apportionment of needed benefits, with the exception of permanent disability.

For example, if an employee with nonindustrial hypertension, chronic lung disease, heart disease or other condition dies as a result of COVID-19 contracted at work, his death would be compensable. If his condition deteriorated because of industrial COVID-19, prompting him to miss work, the employer would owe temporary disability. If the COVID-19 combined with underlying nonindustrial hypertension and caused a need for medical care, the employer would be fully liable. If the hypertension was permanently aggravated such that the worker's medical care for the rest of his life was caused in any part by that aggravation, the employer would be liable for lifetime medical care.

But most people who contract COVID-19 experience only minor or moderate symptoms, and fully recover. If the industrial injury or condition causes only a temporary exacerbation of a nonindustrial condition, and the employee fully recovers from the effects of the industrial problem, the employer is not liable for ongoing care of the nonindustrial condition. Accordingly, these cases are important in distinguishing a temporary exacerbation from a permanent aggravation. The difference is discussed in "Sullivan on Comp" Section 5.3 Aggravation of Pre-Existing, Nonindustrial Disease or Condition.

For example, in Reff v. Workers' Comp. Appeals Bd., the appeals board held that a nurse who contracted occupational pneumonia was not entitled to lifetime medical treatment for her pre-existing and dormant common variable immune deficiency (CVID) when it was only temporarily lit up by the occupational disease. The appeals board explained that "if it is established that the medical treatment or medication in question is required separate and apart, or independent of, an industrial injury or condition, then the employer may avoid liability." The board found that the medical evidence established that the industrial pneumonia aggravated the nonindustrial CVID condition for about two months. Consequently, it concluded that there was no legal basis for a permanent award of medical treatment for the CVID condition.

So, if an employee contracts COVID-19 on an industrial basis and it temporarily exacerbates the worker's nonindustrial condition, the employer would be required to provide treatment during the temporary exacerbation. But if the employee fully recovers from COVID-19 without any permanent aggravation of the nonindustrial condition, the employer's liability for treatment of that condition ceases. Ultimately, whether the COVID-19 temporarily exacerbates or permanently aggravates a nonindustrial condition is a medical issue.

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