Sunday, January 17, 2021

COVID-19 in Florida, A December Update

The Florida Division of Workers' Compensation began tracking the incidence of COVID-19/SARS-CoV-2 last spring. It provides monthly updates of the manner in which allegations of COVID-19 diagnosis or SARS-CoV-2 exposure are being made in the workplace in Florida. There are other states doing similar survey reporting, California among them. However, none is doing a better job of keeping the ongoing situation described and reported. 

This blog has striven to provide analysis and update on that data periodically. The following provides links to both the various reports (left) and the blog posts which address each (right). 


Analyzing the November Division report, I noted that the media and pundit predictions of increased prevalence had not materialized the prior month, noting the "568 new COVID-`9 work injury claims in October 2020 was the lowest since February." That result is antithetical to many, and in conversations since, I have had people express their surprise that the work-related reporting was so low that month. I also noted in COVID Update November 2020 that the reports for "exposures" that month should be expected to grow, and the December report proves that prediction. The total for October was reported in the December report as 1,316. 

The November "exposures" reported in the December report were 1,016 (note that with an "occupational disease," the exposure is used as the "date of injury," or "DOI." It is the "accident date" equivalent for disease allegations). Thus, in the next immediate month (November report), the October "accident dates" related to COVID were only 568. In the next immediate month (December report), the November "accident dates were significantly higher, 1,016, but not double that. Frequency, one might conclude, increased some in November. 

However, in the December report's most up-to-date figures, the prevalence or frequency of reporting COVID-19 diagnosis in each of September, October, and November are notably lower than in any month from March through August 2020. Any focus on November alone should include consideration of the marked decrease in prevalence since August 2020, and that this trend of moderation in work-related exposure allegations appears to persist for now. 

As an aside, the end of 2020 brought an end to some provisions of federal aid to those impacted by COVID-19, but others were extended. There are those in the workers' compensation community who suggest that there is some level of suppression in the reporting of COVID-19 diagnoses as the alternative federal benefit safety net provisions, particularly the expansion and compensation of Family Medical Leave, provide(d) supplemental welfare support in a paradigm that does not present evidentiary issues that may be present in workers' compensation. That perspective perhaps bears consideration and discussion.

The December report notes that so far, there have been 25,784 claims for Florida work-related SARS-CoV-2 exposure resulting in the diagnosis of COVID-19. The Bureau of Labor Statistics reports that there are 9,384,918 people employed in Florida. The total reported "lost time" claims, 25,784, amount to about .3% of the working population. Thankfully, though the number of diagnoses in the state continues to rise, the prevalence of workers' compensation has not kept pace. The New York Times reports 1.5 million Floridians have been diagnosed with COVID-19, out of 21.5 million residents, a frequency to date of about 7%. 

The total benefits paid on those 25,784 claims is $46,165,960, which is a significant amount of money. This total is about 7.6% of the overall total benefits paid on all 2020 workers' compensation claims in Florida through the end of November 2020 - $604,065,335. Consistent with the trend demonstrated in prior Division COVID-19 reports, and discussed previously in the blog posts linked above, the financial expenditure ratio of COVID-19 to "all" is markedly inconsistent with the total "claim count ratio" that compares the number of COVID-19 claims (25,784) to the total reported work injuries 83,259 (31%). Thus, the COVID-19 reports represent a far more significant portion of overall claims (31%) than their portion of costs/expenditures (7.6%). 

In plain English, there are a significant number of COVID-19 claims, but their overall cost is far less significant in total and on average than other work injuries occurring in 2020. 

This is also illustrated in the Division's breakout of claims into financial categories. As described in previous posts, there is a trend demonstrating the vast majority of COVID-19 claims result in expenditures of $4,999 or less. In the December report, the frequency in that category is 24,380 (94% of the 25,784 total). For those 94% of claims, the payment total has been $17,079,409, an average of about $700 per lost-time claim. With the cost associated with a single physician visit being at least $70.00, this average is notably low. 

Similarly consistent, the volume of more financially significant claims is relatively small: fifty thousand through ninety-nine thousand dollars (51, or .20%); one hundred thousand through two hundred forty-nine thousand dollars (33, or .13%); two hundred fifty thousand through four hundred ninety-nine thousand dollars (12, or .05%); and, over five hundred thousand dollars (6, or .02%). All of these expenditure-level categories combined only account for .4% (102) of the total reported COVID-19 claims. For those 102 claims, the average expenditure is about $167,332. Thus, while there are various very serious lost-time COVID-19 claims, they are a very small minority of the overall picture presented at this time. 

These November conclusions in the December report are likewise generally consistent with the trends demonstrated in the prior reports. The preponderance of such COVID-19 claims (11,186, or 43%) were identified as from Dade, Broward, and Palm Beach counties. If the "not indicated" (no county reported to the Division) are included, those four designations account for 12,796, or 49% of the statewide total (25,784). There is support for the conclusion that the work-related allegations are predominantly in southeast Florida. 

A similar conclusion can be supported regarding the propensity in more urban areas. Including Duval (1,055), Hillsborough (879), Pinellas (856), and Orange (1,037) in that calculation with the four designations above (Dade, Broward, Palm Beach and "not indicated"), results in a total for the eight designations of almost 65%, two-thirds, of the Florida totals. The other 59 Florida counties simply do not illustrate the volumes seen in these urban areas such as Miami (Dade), Ft. Lauderdale (Broward), West Palm Beach (Palm Beach), Jacksonville (Duval), Tampa (Hillsborough), St. Petersburg (Pinellas), and Orlando (Orange). 

The total frequency of lost-time claims in the lower half of the list of Florida counties (the 34 of 67, or 51% of counties), totals only 1,805 of that 25,784, or about 7%. The lower two-thirds (45 of 67, or 67% of counties), total 3,812, or about 15%. The distinction between rural and urban is notable and distinct. 

The news, in a nutshell, is that the December report does not bring indicia of significant change in the COVID-19 picture in Florida workers' compensation. The data suggests that the financial implications remain consistent, as do the moderate frequency of reported claims in the three months ending with November. The time is currently ripe for the Division's January report, which will provide better edification of the most current status. That this post has awaited its turn through the holiday season is attributable to distraction and relaxation at the end of a long calendar year. 

How the reported frequency for October and November may have changed through more recent reporting will be pertinent to review when the next report is issued. Whether the December reports in the "next immediate month (January) remain generally consistent with the overall trend of frequency moderation will likewise be of interest. 

The issue on the horizon may be the impact of various vaccinations as they become more widely available. In the current phase of deployment, their primary effect will be in the "first responder" populations. There were early reports of less than pervasive participation rates in some populations. There have been some anecdotal stories of vaccine fears or anxieties. People are striving to make individual decisions about their willingness to vaccinate. However, the vaccination impact on the workplace will be muted in the first phase, as it is limited in some degree to these first responders and older workers. 

Other than the medical community and first responders, the other eligible workers in this first phase will be those over 65 years old. The volume of Florida residents over 65 (the current vaccine parameter) is only 20%. The vast majority of Florida's working population will thus continue to await their turn for the vaccines. Until the time arrives when the vaccine is more widely available to working Floridians, their impacts will perhaps not be apparent. It may take several months of vaccination in broader occupational and chronological categories to illustrate the impact on the prevalence of COVID-19 in workers' compensation. 

Perhaps another issue to be observed will be the potential for work claims related, instead, to the vaccine itself. Some marketplace pundits are already expressing opinions as to whether an employee reaction to such a vaccine would itself be a compensable workplace injury. There are some who believe that this question will turn to some degree on whether such vaccination is or is not employer-mandated. There is also discussion in that regard of the "reasonable accommodation" of the Americans with Disabilities Act and other such laws in the event an employee demurs the offer of inoculation. And, there is a discussion of the employer's liability for the cost of the vaccine and missed work for that shot, should they elect to require inoculation.  

What is certain, perhaps, is that interesting times continue to lie ahead. The reader is reminded of the potential for "long COVID" discussed in COVID-19 in Comp - October Update, and  COVID Update November 2020. The evolution and progression of the impacts of this virus have many potentialities worthy of monitoring. Furthermore, the recent appearance of "variant" strains demonstrates perhaps that the virus itself has yet to complete its cycle of evolution. There are those who felt 2021 would bring closure; mine will be a voice of caution - there may remain much to require our attention this year. The world of workers' compensation and safety may need to continue to devote significant time and resources to COVID-19/SARS-CoV-2 as we progress through this new year.