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Tuesday, August 4, 2020

Florida COVID Claims June 2020

In June, the Florida Division of Workers' Compensation (DWC) released a report regarding filings related to COVID-19. A new report issued in July updated those statistics. The June report was summarized in a post COVID-19 in Florida Claims (June 2020). I followed soon after with an analysis of the volume of petitions for COVID and related issues in Florida COVID-19 Litigation (June 2020). A main takeaway is that there is far less litigation over COVID than there is reporting of it to the Division. That may change in time, but the future is for soothsayers and fortune tellers. 

Much has occurred in the meantime. Various states have created legislative or executive presumptions for workers who test positive for COVID-19. One of the broadest was an executive action in California that drew significant attention. That burst on the scene in May, but was limited by a July 5, 2020 expiration date. It was among the broadest, but also the briefest. Thus, it has now come and gone; the California legislature may enact a statutory presumption, or the Governor there may step in yet again. California illustrates both extraordinary COVID presumption process and uncertainty. 

Most recently a New Jersey legislative committee moved forward with a bill (A3999) to create a legislative compensability presumption for COVID-19 claims. The National Council on Compensation Insurance (NCCI) has an excellent overview of compensability considerations and questions. Since the first Division report, Sedgwick has striven to deliver analysis also. There is a plan for a series of analytical papers on the subject of occupational disease and presumptions. I was proud to be involved in the first paper in the series and a podcast that is related to it. On August 5, 2020 I will present a "View from the Bench" program on presumptions for WCCP. There may still be some availability at that link. 

In the vein of interpretations, a recent post on Occupational Disease and the 1918 Flu (June 2020) might be of interest. That was a much more deadly pandemic than we are currently experiencing (at least thus far). The decision discussed in that post illustrates an evolution to some or a mere interpretation to others. In the end, the Court concluded that the flu was a compensable event under the circumstances described there. Some will see the interpretation as strict construction and others will see activism. The decision occurred when American workers' compensation was in it infancy. It may be that the stricter treatment of "ordinary diseases of life" across the country owe some homage to this early California Court decision.

Also, in the last few weeks, there has been a national increase in diagnoses. As of June 1, 2020, there were "1.8 million cases reported" in the United States, with "at least 105,099 people" killed, according to CNN. As of July 30, 2020, the confirmed diagnoses are about 4.4 million Americans. So the diagnosis volume has roughly doubled in two months. No one ever talks about the recovery rate though. That is curious. Of that 4.4 million, how many are over the virus now and back to their lives as before? Also as of July 30, 2020, the U.S. death total is 150,716. So, while the diagnosis has more than doubled, the deaths have increased by about 43%. Perhaps the doctor's efforts are bringing notable success? 

Focusing on the deaths, I originally wrote about the tragic side of this pandemic on April 2, 2020. I noted that:
"Unfortunately, some of us will know and perhaps love someone who it kills. If we are lucky enough not to know someone, well, . . . we will be connected somehow to someone that dies."
I remain personally fortunate. I now know several people who have tested positive, but none that even have been hospitalized to my knowledge. I do not know anyone who has passed away from it. However, I now know people who have had friends or relatives pass away. The disease is hitting closer to home. It will likely profoundly and directly affect someone I know eventually. I am dreading that day. 

The report that DWC issued in July updated the reporting trends as of June 30, 2020. The previous information posted by the DWC in early June reflected a total of 3,807 total reported COVID-19 workers' compensation claims in Florida, with dates of accident between January and May. The figures in the new July report indicate that through the end of June (an added 30 days) claims then totaled 5,693, an increase of 1,886 (+50% approx.). That may be significant. 

The total paid on the 5,693 claims as of June 30 is $7,074,039 (this includes $4,509,064 paid on claims that remain open and another $2,565,235 that was paid on claims that are now closed). The predominant portion of that, $4,998,070 (approx. 71%) has been paid by self-insured entities. In a corresponding statistic, some 2,617 claims have been denied, more by insurance carriers than self-insured employers. That point has been the cause of questions by some. Why is there that disparity? Some might suggest that more first responders and healthcare workers are employed by self-insured businesses? 

The June report documented $3,431,342 paid on COVID-19 claims as of that time (through May 31, 2020). Thus, in the thirty days of June, total payments ($7,074,389) increased by $3,643,047, which is 106%. Keeping in mind that the June report covered claims for the period January through May 2020 (5 months), it is interesting that the expenditures in one month, June, resulted in that notable increase. It suggests that expenditures continue and have the potential to be significant. 

A large portion of the payments are in Dade ($2,774,428), Broward ($713,931), and Palm Beach ($568,750) counties. These three account for $4,057,109, which is 57% of the statewide total ($7,074,389). That area is also where Florida has been hardest hit with diagnoses. A sizable portion (24%) of $1,713,954 is reflected in the report as "not indicated," meaning that at this stage the state is not certain in which counties the funds were paid. This likely illustrates challenges in record keeping and data reporting. Thus, the three highest counties and the "not indicated" account for about 81.5% of the total payments to date in Florida. 

The latest report continues to categorize the claims based upon occupation. Roughly 1% are airline workers, 34% are healthcare workers, 33% are protective services ("first responders"), 23% are service industry, and 8% are office workers. The large portion in these may explain in part the self-insured/insurance differences noted above. The service industry percentage has changed markedly since the June report; now at 23%, that category was only 9% in the initial report. Some would suggest that this is no surprise as those occupations all have significant potential for person-to-person interaction with the public. Office workers, perhaps not so much, but overall that is likely a fair conclusion to suggest. 

According to the Employee Assistance Office, the Ombudsmen have assisted with advice on the Petition for Benefits Process. The DSC identified petitions as filed in 10 claims. There have been more than that filed, and a later post will address current OJCC data on petition filing. In the post regarding Petitions through May the total was at least 14. 

The DWC report also supports that the new processes of telemedicine continue to be utilized. The cumulative volume of bills for telemedicine in 2020 is now 20,747 (up 71% from the 12,156 reported as of May 31). The vast majority of the telemedicine in both bills and payments has been the medical doctors (bills = 49% of total, paid = 45% of total). The second largest group is physical therapists (bills = 26% of the total, paid = 27% of total), followed by osteopathic physicians (bills = 7% of the total, paid = 6% of total). These three account for about 82% of the telemedicine bills and 80% of the total paid for telemedicine. However, there are payments to podiatrists, dentists, family therapists, and dieticians. Overall, the trend is seemingly to broader acceptance of telemedicine by payers and patients. 

A nod to the Florida Division of Workers' Compensation. The periodic reporting is informative and useful. It is also, seemingly, unprecedented. If the DWC can produce this kind of timely and helpful data on a month-to-month basis, it would seem that national data of this kind could be similarly produced.