“Can I file an injury claim related to coronavirus?” For Georgians who catch COVID-19, that seemingly simple question is actually very complicated. Below, our attorneys walk through the issues that determine whether you have a claim worth pursuing after a diagnosis.
1.Damages
According to reports at the time, up to 80% of people who contract COVID-19 have only mild, cold-like symptoms. That’s good news for your health — but it also means you likely don’t have enough damages to justify a personal injury lawsuit. Lawsuits are expensive, and involving an attorney will probably cost more than you can recover unless you were hospitalized with bills exceeding roughly $50,000. And if your only “injury” was being exposed without a diagnosis, you probably don’t have a claim. The rest of this discussion assumes an actual doctor’s diagnosis and significant medical bills.
2.Workers’ Compensation
If you caught COVID-19 and think it was at work, do you have a good workers’ compensation claim? For most people, the answer is no — but you might have an even better personal injury claim.
In Georgia, workers’ compensation is the “exclusive remedy” for people hurt at work: you usually can’t sue your employer or a co-worker, even if their negligence — or recklessness — caused your injury. (If a co-worker accidentally breaks your leg with a forklift, your only claim is typically workers’ comp.) Some “occupational diseases” are covered, but there’s a demanding five-part test under O.C.G.A. § 34-9-280(2). The sick employee must prove to the State Board of Workers’ Compensation all of the following:
- A direct causal connection between the conditions under which the work is performed and the disease;
- That the disease followed as a natural incident of exposure by reason of the employment;
- That the disease is not of a character to which the employee may have had substantial exposure outside the employment;
- That the disease is not an ordinary disease of life to which the general public is exposed;
- That the disease must appear to have originated in a risk connected with the employment, and to have flowed from that source as a natural consequence.
As more Georgians are diagnosed, these requirements get harder to meet. Once a disease spreads like the flu, it’s difficult to prove you caught it at work rather than the grocery store — and in Georgia you can’t get workers’ comp for catching the flu, because it’s everywhere.
3.Personal Injury
Since most employees can’t get workers’ comp for COVID-19, can they sue instead? The virus is new and the law doesn’t address this directly — but the answer may turn on whether your employer intentionally or recklessly put you in harm’s way by ignoring government quarantine or shelter-in-place orders. An employer that (1) defies a government quarantine order and (2) knowingly or negligently places healthy workers alongside sick ones risks a finding of “negligence per se” — that it violated a law, causing your infection.
Employers in “essential industries” may be exempt — a hospital isn’t negligent for exposing doctors and nurses to COVID-19, which is exactly why those workers are more likely covered by workers’ comp instead. But most employers aren’t essential and are expected to follow normal quarantine procedures. Similarly, if you’re a customer who caught the virus at a store that defied a lockdown order — and you can prove it — the owner may be liable. Proving these cases turns on many factors, so call us right away to discuss what evidence to preserve.
4.Health Insurance
If you have Group Health or ACA (“Obamacare”) coverage, it should cover much of your COVID-related care — though every plan differs and some have important exclusions. Call your insurer to confirm coverage and get pre-approval for recommended treatment. Note that having health insurance pay for your care does not affect your ability to make an injury claim. If your entire claim is based on a denial of health-insurance benefits, though, you may need an “ERISA” lawyer — Morrison & Hughes doesn’t handle health-insurance claims, but we can refer you to an experienced one.
5.Disability, Life & AD&D Insurance
Several kinds of insurance may cover sick or disabled Georgians. If COVID-19 leaves you totally disabled for three months or more, you may be able to collect under a long-term disability or accidental death and dismemberment plan; if a family member with life insurance dies, the insurer should pay the proceeds. Unfortunately, many insurers deny claims on flimsy grounds. Because appeal deadlines can be very short, contact experienced counsel immediately if your benefits are denied — we’re happy to connect you with an attorney who handles these claims.
6.Social Security Disability (SSDI)
Those hit hardest by COVID-19 often have pre-existing conditions and comorbidities like diabetes, heart disease, and COPD. If you’re between roughly 19 and 67 and the virus causes you to both lose your job and become disabled, consider filing for Social Security Disability. To qualify, you must have worked and paid taxes for enough quarters before your disability, and the disability must last (or be expected to last) at least one year. (If you’re still working, or have already reached Social Security retirement age, SSDI won’t apply.)