Industrial COVID-19 Aggravates Nonindustrial Conditions

What if a worker has an underlying non-industrial condition, and then contracts COVID-19 from work? And the disease causes a worsening of the condition? For example, a worker might have heart condition which was not caused by work. But what if that same worker caught COVID-19 at work, and as a result that heart condition worsened? Would that aggravation of a non-industrial condition and the according need for benefits be the employer's responsibility under workers' compensation? Yes.

As discussed in the prior chapter, an employer would be liable for disability or death if an employee's nonindustrial COVID-19 was aggravated or accelerated by an industrial work injury. The opposite is also true. An employer would be liable if an employee contracts COVID-19 on an industrial basis, and the disease aggravates or accelerates a nonindustrial condition. Also as discussed in the last section, there is no apportionment of needed benefits, with the exception of permanent disability.

For example, if an employee with non-industrial hypertension, chronic lung disease, heart disease, or other condition dies as a result of COVID-19 which was contracted at work, then the employee's death would be compensable. If that same employee had a worsening condition because of industrial COVID-19, and had to miss work, the employer would owe temporary disability. If the COVID-19 combined with underlying non-industrial hypertension and caused the need for medical care, the employer would be fully liable. If the hypertension was permanently aggravated such that the worker's medical care for the rest of his or her life was caused in any part by that aggravation, the employer would be liable for lifetime medical care.

However, the majority of people who contract COVID-19 only experience minor symptoms and fully recover. If the industrial injury or condition causes only a temporary exacerbation of a nonindustrial condition, and the employee fully recovers from the effects of the industrial, the employer is not liable for ongoing care of the nonindustrial condition. Accordingly, it is these cases important to distinguish between a temporary exacerbation and a permanent aggravation. This is discussed in depth in Sullivan On Comp 5.3 Aggravation of Pre-Existing, Nonindustrial Disease or Condition.

For example, in Reff v. Workers' Comp. Appeals Bd., the appeals board held that a nurse who contracted occupational pneumonia was not entitled to lifetime medical treatment for her pre-existing and dormant common variable immune deficiency (CVID) when it was only temporarily lit up by the occupational disease. The board explained that "if it is established that the medical treatment or medication in question is required separate and apart, or independent of, an industrial injury or condition, then the employer may avoid liability." The board found the medical evidence established the industrial pneumonia temporary aggravated or lit up the non-industrial CVID condition for about two months. Consequently, it concluded there was no legal basis for a permanent award of medical treatment for the CVID condition.

Therefore, if an employee contracts COVID-19 on an industrial basis and it temporarily exacerbates a non-industrial condition, the employer would be required to provide treatment during the temporary exacerbation. However, if the employee fully recovers from COVID-19 without any permanent aggravation of the non-industrial condition, the employer's liability for treatment of the non-industrial condition ceases. Ultimately, whether the COVID-19 temporarily exacerbates or permanently aggravates a non-industrial condition will be a medical issue.

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