The Florida Division of Workers' Compensation has done an outstanding job documenting the impact of COVID-19 on the world of workers' compensation. In five reports published June, July, August, September and October, the Division brings data regarding the volume of claims for lost time, their financial impact thus far, and ancillary issues including the blossoming of telemedicine amid this pandemic.
As an aside, there are growing signs of optimism and renaissance. In October I attended my first in-person professional presentation since spring. I am grateful to the Florida Association of Self-Insureds for producing a live educational opportunity. More recently, I attended an in-person gathering of lawyers in Pensacola, the American Inns of Court local chapter. Both events highlighted for me the significance of in-person interaction. I am hopeful that other organizations will follow their lead, with appropriate precautions of course.
The latest in the Division's series is the October Report, detailing what is known of the claims for lost time through September 30, 2020. At the end of August, the volume of claims was 17,653. By the end of September, that had increased only to 21,221 (+ 3,568). Certainly, a significant number but as certainly the figure could have been much higher. It is notable that the "curve" in Florida has been flattening overall in the same time period, with fewer reported positive tests than were seen last summer, as reported by Tallahassee Reports.
The total workers' compensation lost-time claim count thus far in calendar 2020 is 66,718, of which the COVID-19/SARS-CoV-2 claims 21,221 are a part (31.8%). Thus, it cannot be said that COVID's impact is insignificant. Any singular factor representing such a portion of the whole is significant and worth of consideration and study.
The payments made on these claims, for both medical and indemnity benefits, is $30,793,827. That represents only 7.4% of the total $418,234,254 paid this year for such benefits in the entire population of lost-time claims. That is a somewhat stark contrast. The volume of COVID-19/SARS-CoV-2 lost-time cases is 31.8% of the state's total, but the payments therefore are only 7.4%. This supports the conclusion that these claims, as yet, are not financially similar to the average lost-time claim.
Of the total 21,221, 13,901 (65.5%) are "closed" claims. That is a significant majority that is consistent with the financial reporting. It is axiomatic that the greater a time period that a claim remains open the more significant its financial expenditures are likely to be. Thus, only 7,320 (34.5%) of the overall total remains open as of the end of September. While that is noteworthy, it is important to remember that "closed" may represent a state of fallow rather than an outright conclusion. Absent the passage of sufficient time giving effect to the statute of limitations or a settlement, there remain potentials in any "closed" claim for rejuvenation.
Of that total 21,221, 20,208 (95%) have reported payments of less than $5,000.00. That is reasonably consistent with the same comparison (96%) in the September report. It is this significant portion of the COVID-19 claims remaining in this lowest payment category ($0 - $4,999) that results in the marked disparity discussed above (31.8% of lost time claims, but 7.4% of lost time costs). There are much more serious claims also.
There are 60 claims reported with expenditures in excess of $50,000. This includes 36 in the range of $50,000 to $99,999; 17 between $100,000 and $249,999; 4 between $250,000 and $4,999; and 3 with expenditures to date in excess of $500,000. The potential for COVID-19/SARS-CoV-2 to involve significant or catastrophic implications is clear. In May, I published COVID-19 Regressive Impact, and prognosticated on some categories of expenditure that were foreseeable.
There, I suggested that some volume of claims would involve only testing, quarantine, and basic medical care. With the impact of the CARES Act (federally mandated leave time), it is possible that some volume in this category would not even achieve the "lost-time" designation. Some volume of individuals who both test and miss work have anecdotally received negative test results, and thus are likely in the "denied" category. These instances may have minimal expenditure and certainly, there is a potential for them to have no "lost time."
There are also those claims that may fall within the confines of a reasonably rapid return to work. Again, anecdotally, there are reported instances of individuals with positive test results being ordered home, despite an absence of significant (in some cases any) symptoms. That fortunate group is likely to return to work rapidly following the quarantine period of perhaps two to three weeks. These likewise represent some portion of that "less than $5,000" population discussed above.
There are more serious implications though. There is some probability of hospitalization being required, and those costs can be significant. Still more serious are the patients that require intensive care and even ventilators or other assistive care. The implications for these patients is more significant in terms of both the medical care costs and the duration of disability. Some would suggest that the long-term implications of the disease is perhaps more potentially significant as well.
It is possible that any COVID-19/SARS-CoV-2 exposure could remain medical only, progress to lost time, serious, or even catastrophic proportions.
Thus, today we view the statistics and the patients through the lens of the present. However, there remains a great deal of unknown about this virus, its effects, and implications in the long term. As reported by CNBC, there is a term now being bantered, the "long COVID." This is being used to describe "people who recover from coronavirus but continue to suffer from a wide range of symptoms." That seems oxymoronic, as "recover" by definition means "back to normal" and normal cannot mean continued symptoms that are related to the disease.
Perhaps in this regard it would be more apt to say that "long COVID" is "a wide range of symptoms" suffered by those who were infected but presently test negative for the virus? The scientists are documenting patients who are virus-free but who continue to report things such as "shortness of breath, migraines, and chronic fatigue." They complain of symptoms that preclude us from saying they are "back to normal," or are "recovered."
The British Broadcasting Corporation (BBC) reports that "long COVID" sufferers are not only those whose initial suffering was sufficient to justify hospitalization. It cites examples in which patients have suffered months of ongoing complaints and symptomatology. In other instances, BBC has reported on patients that "recovered" and were discharged from hospital, but who suffered "long COVID" and even passed away. The use of "back to normal" or "recovered" is perhaps too strong in some settings.
There are implications for this "long-COVID," as various symptoms, complaints, treatments, and disability remain a part of the potential future of each of those 21,221 "lost-time" patients documented thus far in Florida workers' compensation. To a lesser extent perhaps, those potentials remain even for patients whose experience was less severe and as yet remain "medical only." In some regard, it may be too soon to predict the outcome of this pandemic generally, and the future health of various individuals specifically?
Of the 21,221, 9,365 are reported by the Division to be either total (9,322) or partial (43) denials. Those instances are not necessarily concluded, as litigation could ensue to prove compensability and entitlement to benefits at some point. The remaining population, that has not been denied, some suggest are worthy of noting the application of Florida's so-called "120-day rule" and the potential that future developments such as the "long-COVID" could represent a variety of claim potentials for which carrier denial might be foreclosed by the law.
Most of the COVID-19 lost-time claims continue to be clustered in Florida's southeast. Dade County has 6,751; Broward is 1,803; and West Palm Beach is 1,258. These three counties account for 9,812 (46% of the 21,221). The only other population to exceed 1,000 is the 1280 lost-time cases for which no county has been indicated.
Beyond the predominance of the southeast, which is also admittedly Florida's population center, other urban areas are significant. This includes Duval (834), Orange (778), Pinellas (741), Hillsborough (692), Lee (645), and Polk (508), which each exceed 500 lost-time cases. This is 4,198 (20%). Two-thirds (66%) of the lost-time cases noted by the Division report are in less than ten of Florida's 67 counties.
The Division report provides details on the demographics such as age and gender. Females are notably more represented than males in the population of lost-time claims. There are also details on the representation of various industry segments in the totals. As of the end of September, the main segments are Health Care (26.9%), Office Workers (10.6%), Protective Services (32.1%) and Service Industry (29.4%). Airline Workers are distinguished in the report but now represent only 1% of these claims.
The conclusions remain. COVID-19/SARS-CoV-2 has impacted the workers' compensation community in terms of direct effect (workers infected), and tangentially (the pivot to telecommuting, challenges with obtaining medical appointments, social isolation, etc.). The population of infections is continuing to grow and most claims are being accepted. The present exposure on those appears to be concentrated in the bracket below $5,000 total cost, but there are potentials of lurking long-term exposures that are being discussed.
In all, the Division report is comprehensive and interesting. Those engaged in the workers' compensation community would be well served to review it in full and consider the implications that it may portend.
