饱受“长期新冠”后遗症困扰，算工伤吗？
距离凯丽•马丁从一名假阴性患者那里感染新冠病毒，已经过去了大约10个月的时间。在此期间，她一直没有工作。
在新冠肺炎疫情爆发之前，马丁主要在新生儿重症监护病房担任呼吸治疗师。但随着越来越多的新冠肺炎患者涌入她工作的萨克拉门托医院，对她的技能的需求越来越高，马丁在重症监护室和退伍军人新冠病毒病房服务，使她站在疫情的第一线。
去年11月，她有两个晚上都在治疗一名患者。这名患者最初新冠检测呈阴性，但最终检测却变成了阳性。马丁告诉《财富》杂志：“有一天晚上我回家后就病倒了，因为我感觉不太好，头痛得厉害。第二天早上起床之后，我已经失去了嗅觉或味觉，当时我的想法是：‘坏了，我感染新冠病毒了。’”
在最严重的初期症状消失之后，马丁继续在家等待康复，她表示自己还是感觉不佳。事实上，她在12月担心自己患上了肺栓塞，曾经去医院就诊。医生没有发现栓塞，但扫描发现她的心脏有炎症。
她此后一直承受着长期新冠肺炎症状的影响，即所谓的“新冠肺炎急性期后综合症”。这意味着马丁一直在看专家、接受肺脏康复和去一家神经科诊所治疗，主要接受物理治疗、职业疗法和语言矫正，以帮助缓解脑雾和记忆问题。马丁说：“有一个很棒的团队一直在帮助我，但他们也是在不断学习。”
她希望能够在年底之前回到工作岗位，但目前她觉得自己无法胜任曾经的工作。马丁表示：“现在我对于患者而言并不安全。”她目前的收入来自劳工赔偿，包括60%的工资，以及所有医疗费用。
马丁称：“这是一笔沉重的经济负担。”但她也认为自己很幸运，不必为了争取劳工赔偿向雇主抗争，而且雇主尽快批准了所有治疗方案。
最近，像马丁这样的上班族申请劳工赔偿变得更容易，但并非所有人都如此幸运。你能否因为新冠肺炎长期症状而获得劳工赔偿，取决于你所从事的工作和你的居住地，结果存在巨大差异。
各州规定不同
马丁在美国加州工作，该州在2020年9月通过了多项法律，要求大部分雇主认定感染新冠病毒的现场员工，包括急救人员、农业工人、食品杂货店员工和仓库员工等，系在工作场所染病，因此有权获得劳工赔偿。
各州对于劳工赔偿的规定差异巨大。据美国国家赔偿保险委员会（National Council on Compensation Insurance）统计，约有16个州颁布或通过立法，认定感染新冠肺炎等传染病的员工系在工作场所染病，并允许其申领劳工赔偿。
许多法律为护士、医生、急救人员和餐厅与零售员工等必要工作者，在感染新冠肺炎之后申领劳工赔偿提供了便利。但这些法律并没有覆盖所有人。
美国国家赔偿保险委员会的高级部门主管杰夫•埃丁格告诉《财富》杂志：“各州法律规定不同，但如果员工可以证明其在雇佣期间感染新冠肺炎，他们就有权领到赔偿。”
申领新冠补助存在特殊的难度
将新冠确诊病例与工作直接关联很有挑战性。新冠病毒很容易传播，尤其是新的德尔塔变种病毒，因此要证据确凿地证明一名员工在工作中感染了病毒往往并不容易。正如埃丁格所说，员工可能是在派对、运动会或者音乐会上染病，那么他们该如何向雇主证明自己是在工作中被感染的呢？
此外，有些员工可能并没有提交初步申领表，因为他们感染之后的症状并不严重。他们在几个月后申请赔偿，是由于持续的长期新冠肺炎症状。利宝互助保险（Liberty Mutual）指出，保险公司需要经过长时间调查才能够确定是否理赔。
但在申领劳工赔偿方面，新冠肺炎感染者也是一个特例。Sedgwick Claims Management Services的首席理赔官马克思•库恩斯说：“绝大多数[劳工赔偿]索赔都与肌肉损伤有关。这类损伤有明确的治疗方案；对于使用的药物有循证用药指南，因此你对于索赔处理和药物治疗方案有明确的把握。”
然而，新冠病毒是一种新型病毒，有多种症状，持续时间长度不同，而且有各种潜在治疗方案。库恩斯称：“常见的劳工索赔所涉及的损伤并不会像新冠肺炎一样出现长期症状或表现。”
《华尔街日报》（Wall Street Journal）在2月发现，大部分与新冠肺炎有关的劳工赔偿索赔被拒绝理赔，比例高达56%。韦莱韬悦（Willis Towers Watson）的报告发现，一家大型理算公司的拒赔率更低：全国新冠相关索赔的拒赔率为37%，但在新冠肺炎疫情之前的拒赔率为11%。
2020年，美国国家赔偿保险委员会的行业状况报告显示，2020年与新冠肺炎疫情有关的劳工索赔数量超过45,000件。
但埃丁格表示，绝大多数索赔的数额较小，有些病例不需要住院治疗，索赔者只是暂时离岗几天或一周时间。
他补充说，事实上只有约1%的索赔数额较高，总计超过10万美元，提起这类索赔的劳工已经罹患新冠肺炎较长时间。但这1%的索赔占了总赔偿金额的60%。
埃丁格称：“尽管有些索赔数额巨大，但由于数量较少，因此我认为这不会对劳工赔偿系统的总体成本产生影响。”
并非所有人均申领了劳工赔偿
劳工赔偿系统并没有因为劳工的索赔而崩溃，部分原因可能是有些劳工没有尝试提交申请。弗兰•希尔豪斯是宾夕法尼亚州一家残疾人护理机构的护理员。11月，包括希尔豪斯在内有多名员工感染新冠病毒。
她感染之后的初期症状非常严重，接受了住院治疗，被迫停工了约四个月。但雇主拒绝承认她是在工作场所感染了新冠病毒，甚至不支持她申领失业补助。希尔豪斯回忆说：“他们在我住院期间要我提交资料，但我随身携带的只有一部手机。在住院期间我什么也做不了。”
在《家庭和医疗假期法案》（Family and Medical Leave Act）规定的无薪假期结束之后，希尔豪斯说她不得不回到工作岗位。她表示：“他们说：‘你的假期已经结束了，回来上班，否则你将被开除，但我们非常欢迎你再次申请这个岗位。’”由于担心失业或陷入财务困境，希尔豪斯说她别无选择，只能回去上班，尽管她一直存在脑雾和疲劳等症状。
依旧是未知领域
虽然到目前为止，与新冠肺炎有关的大部分索赔金额相对较小，但随着长期新冠肺炎感染病例增多，这种情况可能会发生变化。英国发布的一份报告估计，存在长期新冠肺炎症状的患者占检测呈阳性患者的2.3%至37%。
如果存在长期新冠肺炎症状的患者比例继续提高，它可能产生广泛的影响。加利福尼亚州劳工赔偿保险费率管理局（Workers’ Compensation Insurance Rating Bureau of California ）分析了潜在成本影响，并预计假定员工在工作中感染新冠病毒，保险业将为劳工赔偿索赔支付的成本高达12亿美元。与此同时，美国国家赔偿保险委员会在去年发现，保险公司申报的因为新冠肺炎疫情而导致的总损失为2.6亿美元。
但库恩斯指出，到目前为止的数据显示劳工赔偿系统中并没有出现大量存在长期新冠肺炎症状的患者。他说：“我认为存在长期新冠肺炎症状的患者数量会有一定程度的增加，但我无法确定增长的幅度。”
新冠肺炎疫情的不确定性意味着有许多劳工很难得到急需的帮助和支持。马丁是长期新冠肺炎症状联盟（Long COVID Alliance）的成员，她表示自己曾经见过令人心碎的故事。该联盟是旨在帮助人们应对长期新冠肺炎症状的支持小组。
马丁表示：“有许多人渴望得到医疗救助，但他们没有保险，或者雇主不承认他们在工作中感染病毒。人们的遭遇很可怕。我确实非常幸运。”
她希望能够在几个月后重新回到工作岗位，但她依旧无法确定具体的时间。马丁说：“我一直在尝试做到积极乐观，因为这是一段负面的经历。”她补充说自己需要确信在黑暗尽头还有一线光芒。（财富中文网）
翻译：刘进龙
审校：汪皓
距离凯丽•马丁从一名假阴性患者那里感染新冠病毒，已经过去了大约10个月的时间。在此期间，她一直没有工作。
在新冠肺炎疫情爆发之前，马丁主要在新生儿重症监护病房担任呼吸治疗师。但随着越来越多的新冠肺炎患者涌入她工作的萨克拉门托医院，对她的技能的需求越来越高，马丁在重症监护室和退伍军人新冠病毒病房服务，使她站在疫情的第一线。
去年11月，她有两个晚上都在治疗一名患者。这名患者最初新冠检测呈阴性，但最终检测却变成了阳性。马丁告诉《财富》杂志：“有一天晚上我回家后就病倒了，因为我感觉不太好，头痛得厉害。第二天早上起床之后，我已经失去了嗅觉或味觉，当时我的想法是：‘坏了，我感染新冠病毒了。’”
在最严重的初期症状消失之后，马丁继续在家等待康复，她表示自己还是感觉不佳。事实上，她在12月担心自己患上了肺栓塞，曾经去医院就诊。医生没有发现栓塞，但扫描发现她的心脏有炎症。
她此后一直承受着长期新冠肺炎症状的影响，即所谓的“新冠肺炎急性期后综合症”。这意味着马丁一直在看专家、接受肺脏康复和去一家神经科诊所治疗，主要接受物理治疗、职业疗法和语言矫正，以帮助缓解脑雾和记忆问题。马丁说：“有一个很棒的团队一直在帮助我，但他们也是在不断学习。”
她希望能够在年底之前回到工作岗位，但目前她觉得自己无法胜任曾经的工作。马丁表示：“现在我对于患者而言并不安全。”她目前的收入来自劳工赔偿，包括60%的工资，以及所有医疗费用。
马丁称：“这是一笔沉重的经济负担。”但她也认为自己很幸运，不必为了争取劳工赔偿向雇主抗争，而且雇主尽快批准了所有治疗方案。
最近，像马丁这样的上班族申请劳工赔偿变得更容易，但并非所有人都如此幸运。你能否因为新冠肺炎长期症状而获得劳工赔偿，取决于你所从事的工作和你的居住地，结果存在巨大差异。
各州规定不同
马丁在美国加州工作，该州在2020年9月通过了多项法律，要求大部分雇主认定感染新冠病毒的现场员工，包括急救人员、农业工人、食品杂货店员工和仓库员工等，系在工作场所染病，因此有权获得劳工赔偿。
各州对于劳工赔偿的规定差异巨大。据美国国家赔偿保险委员会（National Council on Compensation Insurance）统计，约有16个州颁布或通过立法，认定感染新冠肺炎等传染病的员工系在工作场所染病，并允许其申领劳工赔偿。
许多法律为护士、医生、急救人员和餐厅与零售员工等必要工作者，在感染新冠肺炎之后申领劳工赔偿提供了便利。但这些法律并没有覆盖所有人。
美国国家赔偿保险委员会的高级部门主管杰夫•埃丁格告诉《财富》杂志：“各州法律规定不同，但如果员工可以证明其在雇佣期间感染新冠肺炎，他们就有权领到赔偿。”
申领新冠补助存在特殊的难度
将新冠确诊病例与工作直接关联很有挑战性。新冠病毒很容易传播，尤其是新的德尔塔变种病毒，因此要证据确凿地证明一名员工在工作中感染了病毒往往并不容易。正如埃丁格所说，员工可能是在派对、运动会或者音乐会上染病，那么他们该如何向雇主证明自己是在工作中被感染的呢？
此外，有些员工可能并没有提交初步申领表，因为他们感染之后的症状并不严重。他们在几个月后申请赔偿，是由于持续的长期新冠肺炎症状。利宝互助保险（Liberty Mutual）指出，保险公司需要经过长时间调查才能够确定是否理赔。
但在申领劳工赔偿方面，新冠肺炎感染者也是一个特例。Sedgwick Claims Management Services的首席理赔官马克思•库恩斯说：“绝大多数[劳工赔偿]索赔都与肌肉损伤有关。这类损伤有明确的治疗方案；对于使用的药物有循证用药指南，因此你对于索赔处理和药物治疗方案有明确的把握。”
然而，新冠病毒是一种新型病毒，有多种症状，持续时间长度不同，而且有各种潜在治疗方案。库恩斯称：“常见的劳工索赔所涉及的损伤并不会像新冠肺炎一样出现长期症状或表现。”
《华尔街日报》（Wall Street Journal）在2月发现，大部分与新冠肺炎有关的劳工赔偿索赔被拒绝理赔，比例高达56%。韦莱韬悦（Willis Towers Watson）的报告发现，一家大型理算公司的拒赔率更低：全国新冠相关索赔的拒赔率为37%，但在新冠肺炎疫情之前的拒赔率为11%。
2020年，美国国家赔偿保险委员会的行业状况报告显示，2020年与新冠肺炎疫情有关的劳工索赔数量超过45,000件。
但埃丁格表示，绝大多数索赔的数额较小，有些病例不需要住院治疗，索赔者只是暂时离岗几天或一周时间。
他补充说，事实上只有约1%的索赔数额较高，总计超过10万美元，提起这类索赔的劳工已经罹患新冠肺炎较长时间。但这1%的索赔占了总赔偿金额的60%。
埃丁格称：“尽管有些索赔数额巨大，但由于数量较少，因此我认为这不会对劳工赔偿系统的总体成本产生影响。”
并非所有人均申领了劳工赔偿
劳工赔偿系统并没有因为劳工的索赔而崩溃，部分原因可能是有些劳工没有尝试提交申请。弗兰•希尔豪斯是宾夕法尼亚州一家残疾人护理机构的护理员。11月，包括希尔豪斯在内有多名员工感染新冠病毒。
她感染之后的初期症状非常严重，接受了住院治疗，被迫停工了约四个月。但雇主拒绝承认她是在工作场所感染了新冠病毒，甚至不支持她申领失业补助。希尔豪斯回忆说：“他们在我住院期间要我提交资料，但我随身携带的只有一部手机。在住院期间我什么也做不了。”
在《家庭和医疗假期法案》（Family and Medical Leave Act）规定的无薪假期结束之后，希尔豪斯说她不得不回到工作岗位。她表示：“他们说：‘你的假期已经结束了，回来上班，否则你将被开除，但我们非常欢迎你再次申请这个岗位。’”由于担心失业或陷入财务困境，希尔豪斯说她别无选择，只能回去上班，尽管她一直存在脑雾和疲劳等症状。
依旧是未知领域
虽然到目前为止，与新冠肺炎有关的大部分索赔金额相对较小，但随着长期新冠肺炎感染病例增多，这种情况可能会发生变化。英国发布的一份报告估计，存在长期新冠肺炎症状的患者占检测呈阳性患者的2.3%至37%。
如果存在长期新冠肺炎症状的患者比例继续提高，它可能产生广泛的影响。加利福尼亚州劳工赔偿保险费率管理局（Workers’ Compensation Insurance Rating Bureau of California ）分析了潜在成本影响，并预计假定员工在工作中感染新冠病毒，保险业将为劳工赔偿索赔支付的成本高达12亿美元。与此同时，美国国家赔偿保险委员会在去年发现，保险公司申报的因为新冠肺炎疫情而导致的总损失为2.6亿美元。
但库恩斯指出，到目前为止的数据显示劳工赔偿系统中并没有出现大量存在长期新冠肺炎症状的患者。他说：“我认为存在长期新冠肺炎症状的患者数量会有一定程度的增加，但我无法确定增长的幅度。”
新冠肺炎疫情的不确定性意味着有许多劳工很难得到急需的帮助和支持。马丁是长期新冠肺炎症状联盟（Long COVID Alliance）的成员，她表示自己曾经见过令人心碎的故事。该联盟是旨在帮助人们应对长期新冠肺炎症状的支持小组。
马丁表示：“有许多人渴望得到医疗救助，但他们没有保险，或者雇主不承认他们在工作中感染病毒。人们的遭遇很可怕。我确实非常幸运。”
她希望能够在几个月后重新回到工作岗位，但她依旧无法确定具体的时间。马丁说：“我一直在尝试做到积极乐观，因为这是一段负面的经历。”她补充说自己需要确信在黑暗尽头还有一线光芒。（财富中文网）
翻译：刘进龙
审校：汪皓
It’s been about 10 months since Kary Martin caught COVID-19 from a patient who had a false negative. And since then, she hasn’t worked.
Prior to the COVID-19 pandemic, Martin served primarily as a respiratory therapist in a newborn intensive care unit. But with her skills in high demand as more and more COVID patients flooded the Sacramento-based hospital where she worked, Martin served in intensive care and step-down COVID units, putting her on the front lines of the pandemic.
Last November, she spent a couple of nights working with a patient who initially tested negative for COVID, but eventually tested positive. “I ended up going home sick one night because I just was not feeling good—I had this massive headache. The next morning I woke up, and I couldn’t smell anything or taste anything, and I’m like, ‘Shit, I’ve got COVID,’” Martin told Fortune.
Even once the worst of her initial COVID symptoms had passed while she convalesced at home, Martin said she still didn’t feel right. In fact, she went to the hospital in December worried she had a pulmonary embolism. While they didn’t find an embolism, scans showed heart inflammation.
Since then, Martin has been dealing with the effects of long COVID, also known as post-acute COVID-19 syndrome. That means Martin has been doing everything from seeing specialists to attending pulmonary rehab and a neuro clinic, which focus on physical therapy, occupational therapy, and speech therapy to help relieve some of the brain fog and memory issues. “I have a great team that’s helping me, but they’re all learning,” Martin said.
She’s hopeful that she’ll be back to work by the end of this year, but right now, she doesn’t feel she can do her job. “Right now I’m not safe with patients,” Martin said. Instead, she’s on workers’ compensation, which pays about 60% of her salary and takes care of the medical expenses.
“It is a financial burden,” Martin said, but added that she’s lucky—she didn’t have to fight with her employer to provide workers’ comp, and it has approved every treatment without pushback.
It’s recently become easier for workers like Martin to file for workers’ comp, but not everyone is so fortunate. Whether you can get workers’ comp for long COVID varies widely, depending on your job and where you live.
Different states, different rules
Martin works in California, which passed laws in September 2020 that require most employers to presume an in-person worker who contracts COVID-19—including first responders, farmworkers, grocery store employees, and warehouse workers—did so in the workplace and is therefore covered by workers’ comp.
Workers’ comp rules vary dramatically state by state. About 16 states have introduced or passed legislation that would allow employees who suffer from a communicable disease like COVID-19 to file workers’ compensation claims presuming they contracted their illness at work, according to the National Council on Compensation Insurance.
Many of these laws have made it easier for essential workers—nurses, doctors, first responders, and restaurant and retail employees—to receive workers’ comp after falling ill with COVID-19. But not everyone is covered.
“State laws do differ, but if an employee can show that they contracted COVID In the course of their employment, then their claim will be paid,” Jeff Eddinger, NCCI’s senior division executive, told Fortune.
COVID claims can present unique challenges
Tying a case of COVID-19 directly to work can be challenging. Because this virus is contracted so easily, especially the new Delta variant, proving beyond a shadow of a doubt that an employee caught it at work can often be tricky. As Eddinger noted, workers can potentially catch it anywhere—at a party, a sporting event, or a concert—so how do they prove to their employer that they caught it on the job?
Additionally, some employees may not have filed an initial claim form because they didn’t get a severe case when they contracted COVID. Instead, they file a claim months later because of ongoing symptoms of long COVID. Liberty Mutual notes that deciding whether or not to accept these types of claims may involve extended investigation.
But COVID cases are also a different breed when it comes to navigating the workers’ comp system. “The vast majority of [workers’ comp] claims are really muscular type injuries,” said Max Koonce, chief claims officer with Sedgwick Claims Management Services. “When you look at those injuries, they have a very established protocol as to how they’re treated; they have evidence-based medicine guidelines that they use, so you have a pretty good idea of the way the claim is going to go as far as with medical treatment,” Koonce noted.
With COVID, however, it’s a brand-new virus with multiple symptoms, varying lengths, and a whole host of potential treatment options. “Your typical workers’ compensation injuries don’t have these long-term symptoms or conditions that you’re seeing creep up within the COVID environment,” added Koonce.
The Wall Street Journal found in February that a significant number of workers’ comp claims related to COVID-19 have been denied—up to 56% in some instances. A report from Willis Towers Watson found that the denial rate at one major claims adjuster was much lower: 37% COVID-only claims were denied nationwide, compared with denial rates of 11% prior to the pandemic.
Overall, workers filed more than 45,000 COVID-related claims in 2020, according to NCCI’s State of the Line report.
Yet the vast majority of those COVID-19 claims are very small, Eddinger said, noting that those cases are ones that don’t require hospitalization in which workers are only out of work for a few days or a week.
In fact, only about 1% of claims turned into expensive claims totaling over $100,000 where a worker was sick with COVID-19 for a very long time, he added. But those 1% of claims accounted for 60% of the total payouts.
“Even though there are some claims that ended up being very expensive, because there’s so few of them, I wouldn’t expect there to be a measurable impact on the total workers’ comp system costs,” Eddinger said.
Not everyone files for workers’ comp
Part of the reason that these COVID claims aren’t overwhelming the system could be that some workers aren’t even bothering to attempt to file. Fran Highhouse works as a caregiver at a Pennsylvania-based facility for those with disabilities. In November, a few workers came down with COVID-19, including Highhouse.
Her initial infection was so bad that she was hospitalized and ended up out of work for about four months. But her employer refused to admit she contracted COVID at work and even fought her unemployment claim. “They were demanding documentation while I was still in the hospital, and the only thing on me was a cell phone. I wasn’t capable of doing anything while I was in there,” Highhouse recalled.
Once she had used up her unpaid time off through the Family and Medical Leave Act, Highhouse said she had to return to work. “They said, ‘Your FMLA is up, you come back to work or you’re terminated, but you’re more than welcome to apply again,’” Highhouse said. Worried she wouldn’t get unemployment or disability, Highhouse said financially, she had no option but to go back, despite lingering brain fog and fatigue.
Still in uncharted territory
While most of the COVID claims have been relatively small so far, there’s a chance that could change as long COVID cases develop. Estimates of the number of patients who suffer from long COVID range from 2.3% to 37% of those who test positive, according to a report published in the U.K.
If the percentage of patients who suffer from long COVID ends up on the higher side, it could have widespread consequences. The Workers’ Compensation Insurance Rating Bureau of California examined the potential cost impact and estimated that presuming employees contracted COVID at work could cost the industry $1.2 billion in workers’ comp claims. Meanwhile, NCCI found that last year, carriers reported $260 million in total COVID-19 incurred losses.
But so far, Koonce says that the data doesn’t show an overwhelming number of long COVID cases in the workers’ comp system. “I think inevitably there will be some type of uptick," he said, "and how big it is, I don’t know.”
Yet the uncertainty of COVID means there are many workers out there who are struggling to get the help and support they need. A member of the Long COVID Alliance, a support group for those navigating the effects of long COVID, Martin says she’s seen heartbreaking stories.
“There are so many people that are just desperate for medical help, and they don’t have insurance or their job does not acknowledge their exposure for work. There are horror stories. I’m really blessed,” Martin said.
She hopes to be back to work in a few months, but she’s still unsure of that timeline. “I’m trying to be really positive because this has been such a negative experience,” Martin said, adding she needs to believe there’s a light at the end of the tunnel.
