The Florida Division of Workers' Compensation is continuing to provide data regarding the filing of COVID-19-related notices of injury. There have been two previous reports that have been the subject of posts in this blog (COVID-19 Claims in Florida and Florida COVID-19 Claims June 2020). A critical element in all of these reports is their limitation to claims involving indemnity benefits ("this summary does not include Medical Only claims in any claim counts or benefits paid.").
The volume of such "Medical Only" claims might be significant in that this COVID-19/SARS-CoV-2 requires testing and quarantine in various instances. Some people may suffer significant hospitalization while others have minimal symptoms. That aspect of the disease suggests the implication of indemnity in many instances, however, under Florida law, "compensation is not allowed for the first 7 days of the disability, except for" medical benefits. That "seven-day wait" period can be compensated retrospectively if the period of disability later exceeds 21 days total. Section 440.12(1). Thus, some with significant symptoms might not exceed the 7 days of absence to have a claim categorized as an "indemnity claim."
Additionally, there are employer-provided benefits required by federal law in many instances. Two weeks of paid sick leave are required to be provided by many employers by the Families First Coronavirus Response Act. There is an additional two weeks for an employee caring for someone else in quarantine. This, or other available sick leave may have impacted the need for indemnity claims for some who contracted this virus but do not suffer the serious symptoms, complications, or hospitalizations. The disease is unprecedented, unpredictable, and uncertain.
COVID-19 in Florida Claims; the key takeaways noted included:
- Through May 31, 2020 - 3,807 indemnity claims were reported (notice of injury filed).
- About 55% had been accepted as compensable (1,718 denied at least in part).
- The total paid at that time was $3,431,342.
- About 64% of the total expenditures were for claims from Dade, Broward, and Palm Beach Counties.
- The second largest group geographically was "not indicated," which was 16% of the total, $535,544).
- Those three counties and the "not indicated" accounted for 80% of statewide expenditures.
The claims were distributed occupationally as follows:
- Through June 30, 2020 - 5,693 indemnity claims were reported (+50%)(notice of injury filed).
- About 54% had been accepted as compensable (2,643 denied at least in part)
- Through June 30, 2020, the total paid on claims in Florida was $7,074,389 (+106%)
- About 57% of the total expenditures were for claims from Dade, Broward, and Palm Beach Counties.
- The second largest group geographically was "not indicated," which was 24% of the total, $1,713,954).
- Those three counties and the "not indicated" accounted for 81% of statewide expenditures.
The claims were occupationally distributed as follows:
In the latest report from the Division, which encompasses the figures for July and incorporates the previous numbers, the key takeaways are:
- Through July, 31, 2020 - 11,872 indemnity claims reported (+109%)(notice of injury filed).
- About 56% had been accepted as compensable (5,176 denied at least in part)
- Through July 31, 2020, the total paid on claims in Florida was $13,120,059 (+85%)
- About 54% of the total expenditures were for claims from Dade, Broward, and Palm Beach Counties.
- The second largest group geographically was "not indicated," which was 17% of the total, $2,253,987).
- Those three counties and the "not indicated" accounted for 71% of statewide expenditures.
The claims were occupationally distributed as follows:
COVID-19 indemnity claims have been notable since the first Division report. As of May 31, COVID-19 indemnity claims accounted for 15% of
all Florida indemnity claims and 2.9% of the total indemnity cost. As of June 30, 2020, COVID-19 indemnity claims accounted for 17.2% of all indemnity claims and 4.1% of
total indemnity claim costs. As of July 31, 2020, COVID-19 indemnity claims equal
to 26.2% of all indemnity claims, and 5.3% of all indemnity costs.
Note that the
cost has increased by approximately 1.2% each month (2.9%, 4.1%, 5.3%). That growth in cost percentage is more consistent than the increase in COVID-19 indemnity claim volume, which increased
2.2% from May to June (15% to 17.2%) and increased 9% from June through July
(17.2% to 26.2%). The volume, as a percentage of overall indemnity claims, is growing more significantly and less predictably than the cost as a percentage of all indemnity claim costs.
The August report also provides a new delineation of information,
“claim count & amount paid by benefit ranges.” This divides the cases
into predominately $10,000 ranges ($0-$4,999; $5,000-$9,999; $10,000-$19,999 and upward thereafter in $10,000 increments until $50,000; then in larger ranges: $50,000-$99,999, $100,000-$249,999, 250,000-$499,999, and finally $500,000+). This parameter delineation provides an initial glance at the potential and propensity for severity in the COVID-19 indemnity claims.
The
vast majority (11,544, 97%) of the total claim count (11,872) is in the $0 to $4, 999.00 range. But, overall this 97% accounts for 59% of the reported expenditures, $7,756,631. Nine cases in the upper "ranges" (8 in the $100,000-$249,999 range and one in the $500,000+) demonstrate the potential for significant financial impact of this disease. These nine claims account for 15% of the total COVID-19 indemnity claim expenditures ($2,022,046). This delineation of the expenditures substantiates that currently, the preponderance of claims (97%) are individually in the lowest defined range, but together account for significant expenditures. The remaining 3% of claim volume accounts for 41% of the expenditures, with an illustration that some claims are of significant individual expense.
The volume of COVID-19 indemnity claims is increasing with each report issued by the Division. The rate of increase from the end of May to the end of June (+50%), was significant, but not as significant as the rate of increase from the end of June to the end of July (+109%). The volume is growing and the rate of growth appears to potentially be increasingly significant. When a vaccine becomes widely available, the growth in such claim volume would likely be expected to subside.
The associated expenditures on COVID-19 indemnity claims are similarly increasing with each report. The rate of increase from the end of May to the end of June (+106%) was significant, more significant than the rate of increase from the end of June to the end of July (+85%). While that distinction is noted, the rate of increase is nonetheless significant in each of the two most recent reports. The COVID-19 indemnity claims as of July 31, 2020, are responsible for 5.3% of the overall indemnity claim expenditures in Florida. Because of the potential for claim expense to continue in a particular case, the arrival of a vaccine or compelling treatment may slow the growth in expenditures, but it is probable expenditures will continue in some populations of such cases.
The impact of COVID-19 on workers' compensation is receiving scrutiny and analysis. Some perceive the impact as significant, while others discount the impact entirely. Still, others acknowledge the impact of these specific claims but contend that resulting changes in employment generally have effected a counteracting impact of less frequency or severity (or both) of non-COVID-19 claims. Intermingled in discussions of that nature are questions raised as to whether the severity of non-COVID claims has actually diminished or whether COVID-19-related access to medical care issues (cancellation of elective surgeries, etc.) has only delayed related expenses. Some suggest that such delays may likewise have increased expected temporary indemnity in such cases as workers are out-of-work awaiting such care. There are many variables worthy of discussion.
There are various perspectives and perceptions expressed. One point of clarity, which bears repeating, is that the Florida Division is providing timely and informative public access to pertinent data. Over time, these reports will further memorialize developments and the trends they may portend. It will be interesting to see if other states begin to publish such data.
