What’s the verdict on Ebola and workers’ comp? We’ve gathered a roundup of what industry leaders are saying on this topic, as well as broader insurance issues. While Ebola and workers comp claims might be a relatively negligible issue, the larger issue of protecting workers from infectious disease is always one worth considering. Plus, there are other ways that Ebola may impact the business environment in general and business insurance specifically: business travel, supply chain disruptions, business interruptions, liability, malpractice and new coverage options, to name a few considerations.
Workers at highest risk would be health care and humanitarian workers in the countries most directly affected, Here in the U.S., hospital staff, public health personnel, humanitarian workers and first responders would be on the front lines for any additional outbreaks. Other workers with potential exposure might include waste disposal workers, cleaning staff, morticians, laboratory researchers and scientists, airline workers and business travelers.
Before we look at some of the insurance and prevention considerations, a little perspective from Vox by way of a brief and compelling video.
But remember, when you scare people enough, facts don’t always matter. Case in point: A Maine teacher who was placed on leave after visiting Dallas — even though she had no contact whatsoever with anyone associated with the Ebola outbreak. Journalist Maryn McKenna logs more Ebola overreactions under the category of Ebolanoia on her blog “Further Adventures of Germ Girl.” (Her articles on Ebola at Wired at worth following.)
Ebola, Workers Comp & Other Insurance Considerations
Christopher J. Boggs of Insurance Journal takes a nuts & bolts look at the two-part litmus test of compensability under workers comp and how Ebola claims would stack up in Is Ebola Compensable Under Workers’ Compensation?
Dave DePaolo looks at Ebola & Work Comp and expresses concern about our capacity to handle an outbreak, noting that “If ever there was a situation where there should be no distinction between workers’ compensation medical treatment and general health, the current Ebola situation is it. Delivery of medical care in workers’ compensation is just fine for broken bones, even for something like black lung disease.
The way medical care in workers’ compensation is delivered creates a real, and significant, national health problem when confronted with a potential pandemic like Ebola.”
Katie Siegel of Risk & Insurance says that although risk to US health care workers remains low, an Ebola outbreak could pose a workers’ comp risk to the industry: Ebola’s Impact on the Health Care Industry
MARSH offers an overview of Six Types of Insurance Coverage That May Apply to Ebola, with workers’ comp at the top of the list.
Dr. Steven N. Weisbart, CLU discusses the insurance industry ramifications of the spread of the Ebola virus, from life/health implications to property/casualty in Insurance Information Institute: Facts and Perspectives on the Ebola Pandemic .
Logan Payne of Lockton has issued a whitepaper, Ebola Outbreak: Risk Management and Insurance Considerations. He looks at the real impact on companies with operations in the affected areas: “…oil and gas operators, mining companies, and humanitarian aid organizations as well as those who rely on the raw materials or commodities in the area. The outbreak of Ebola has caused curfews to be enforced in countries like Liberia as well as voluntary evacuation of employees by many companies, causing work sites and retail locations to completely cease operation. Global supply chains have been disrupted as ports and borders are partially or completely closed, and companies across Western Africa have closed their doors. In general, many companies have seen an abrupt halt in productivity coupled with a rise in prices for many critical services in countries like Liberia, Sierra Leone, and Guinea.”
Melissa Hillebrand of PropertyCasualty360 offers a list of what you may not know ib 30 Ebola facts that will make you cringe, plus 7 ways to manage the risk. She covers how how the Ebola virus impacts economies and supply chains, insurance issues including evacuation, exposures and policy exclusions, and what you and your companies can do to prevent and control Ebola risk.
Arthur D. Postal of Property Casualty 360 looks at what Ebola will mean for the P&C industry over the long term.
At Business Insurance, Douglas McLeod says that Ace excludes Ebola claims for some new and renewal general liability policies. Sarah Vesey discusses new insurance coverage options related to Ebola: Brokers launch business interruption cover for Ebola, other pandemics
Related: Ebola: Insurance’s new way to deal with an outbreak and Businesses wrestle with insurance in Ebola’s wake
Joe Palazzola of the Wall St Journal Lawblog explains why Ebola suits against Texas Hospital likely wouldn’t be easy to win.
Thomas Benjamin Huggett of Littler looks at The Ebola Exposure: U.S. Workplace Considerations
Michael Oliver Eckard and Jean Kim of Ogletree Deakins discuss Emerging Concerns for Healthcare Facilities and Employers
General Information on Ebola
CDC: Ebola
Facts, FAQs, signs & symptoms, transmission, prevention, treatment, clinical guidance, updates & more
WHO: Ebola Virus Disease
Here’s how you can (and can’t) get Ebola
15 charts, maps, and photos that explain the Ebola outbreak
Worker Health & Safety
National Institutes on Health: Ebola Virus Disease: Information for U.S. Healthcare Workers
NYCOSH: Essential Information for Aircraft Cabin Cleaners and Cargo Handlers
NIH: Guidance for Safe Handling of Human Remains of Ebola Patients in U. S. Hospitals and Mortuaries
CDC: Health care workers: Could it be Ebola?
CDC: Detailed Hospital Checklist for Ebola Preparedness
MA Nursing Association- Ebola: Screening and Managing a Patient While Protecting Yourself
OSHA: Ebola
WHO: Ebola Virus Disease: Occupational Safety and Health – joint WHO/ILO briefing note for workers and employers
NYCOSH: Essential Information for Workers
Ebola Medical Waste Management
Travel health notices
Infectious Diseases Related To Travel
In closing, Josh Cable of EHS Today reminds us that risk is relative. He offers a gallery of Safety and Health Threats that Are Deadlier than Ebola
Posts Tagged ‘pandemic’
New Health Wonk Review posted; other noteworthy news
Thursday, October 1st, 2009For another biweekly issue of the best of the health policy blogs, Brady Augustine hosts The Boys (and Girls) of October edition of Health Wonk Review at medicaidfirstaid. Get a little baseball nostalgia with your health policy. For our neighbors in the Boston area, Brady recalls the era of Carlton Fisk, Carl Yastrzemski, Fred Lynn, Jim Rice, and Luis Tiant.
Other news notes…
ADA, RTW and the law – Failure to accommodate an injured worker as they return to the workplace can be costly. Sears is setting a $6.2 million bias case over just such an issue. Sears refused to reinstate a recovering injured worker with reasonable accommodations when he sought to return to work, and subsequently fired him. An investigation turned up more than 100 other employees who sought return to work with an accommodation, but were fired by the company.
New Mexico – “Thirty-three states, including neighboring Colorado and Arizona, already require workers’ compensation for farm workers, although some limit coverage or exempt small farms. But New Mexico’s agricultural workers fall into a job category not protected under state law.” New Mexico agricultural laborers sue for workers’ comp coverage.
Presenteeism – Is presenteeism worse than absenteeism? Roberto Ceniceros looks at new research on the issue at CompTime.
Veteran issues – Risk and Insurance has been running an excellent series on issues facing vets on their return from Iraq and Afghanistan, authored by Peter Rousmaniere. The third and most recent installment: Dealing With Scar Tissues. If you haven’t been following, catch up here:
Part 1: Wounded Back Home
Part 2: Frayed Obligations
H1N1 Virus – Jon Gelman makes the case for the urgent need for workers compensation pandemic planning, noting that in the case of emergency, the Federal government has sweeping powers under the Public Health Service Act (PHS) that could disrupt employment throughout the country. He cites a recent Harvard School of Public Health study reveals that 80% of businesses foresee severe problems in maintaining operations if there is an outbreak, and looks at what this might mean to workers comp.
Flu.gov has issued Guidance for Businesses and Employers for the Fall Flu Season. Consumer resources are available at the Consumer Insurance Blog.
Health and safety news from the blogosphere
Wednesday, August 26th, 2009Money-Driven Medicine – Maggie Mahar, one of the regular Health Wonk bloggers who we admire, is author of the book Money driven medicine: the real reason health care costs so much. Her book has been made into a documentary by Alex Gibney, the producer noted for his documentary expo Enron: The Smartest Guys in the Room. This Friday night, Bill Moyers Journal will preview excerpts of Money Driven Medicine, which Moyers cites as one of the strongest documentaries he has seen in years. It bears checking out. For more about the documentary, including a trailer, see moneydrivenmedicine.org. You can also follow Maggie’s blog posts at Health Beat.
Meanwhile, in Business Insurance, Joanne Wojcik writes that two surveys project that healthcare benefit costs will increase by more than 10% in 2010. Aon Consulting projects an average 10.5% increase, while Segal Co. sees cost increases ranging between 10.2% and 10.8% for managed care plans.
Nanoparticles – the NIOSH Science Blog highlights recent research related to occupational disease and nanoparticles. Nanotechnology is the discipline of technology that works at a molecular level with particles that are less than 100 nanometers in size. Earlier this year, the CDC released Approaches to Safe Nanotechnology (PDF), which offers recommendations for specific precautions to protect workers who are exposed to any level of nanoparticles. Learn more about research and risk management at the NIOSH Nanotechnology site.
Fatal Sunshine – Time recently featured an article on the plight of California farm workers, who frequently do not have adequate protection from heat stroke and basic precautions to prevent heat-related illness. While California state law mandates heat stress standards, many employers do not adhere to those standards. The ACLU and the law firm Munger, Tolles & Olson are suing California’s occupational health and safety agency on behalf of the United Farm Workers, workers who became sick, and relatives of workers who died from heatstroke.
Employer Pandemic Planning – While there are dueling projections for the potential impact of the H1N1 flu this fall and winter, it pays to be prepared. Safety Daily Advisor offers an abbreviated workplace pandemic planning checklist based on CDC recommendations. For more detailed planning information for work and home, see Flu.gov.
More on work suicides – We noted last week that a recent Bureau of Labor Statistics report showed that workplace suicides increased by 28% in 2008. At Comp Time, Roberto Ceniceros looks at the issue of workplace suicide in light of a recent Indiana appeals court ruling in which a widow was denied benefits related to her husband’s suicide.
Taking the job home – Jon Gelman blogs about a recent CDC study showing that workers who are exposed to lead can transport it home. The CDC suggests certain precentive measures to minimize risk to other family members.
Fitness for Duty – Fred Hosier of SafetyNewsAlert posts about how to deal with employees who are consistently unsafe through a comprehensive fitness for duty program.
OSHA – Is OSHA back in the business of enforcement? The Safety Duck thinks that issuance of 142 citations and $576,000 in penalties against Sims Bark Co. and Sims Stone Co. signifies that it is.
New Health Wonk Review; other news notes
Thursday, July 9th, 2009If you find the task of following breaking news developments on the health care reform front a trifle daunting, we have a solution: let the health policy blogosphere’s best braniacs dish up and dissect the news for you in bite size portions in the bi-weekly compendium of the best of heath care policy posts. Check out the fresh edition of Health Wonk Review: Crunch Time For Health Reform hosted by Ken Terry at BNET Healthcare Blog.
And in other news:
MHSA – The Pump Handle tells us that Joe Main has been nominated for Assistant Secretary of Labor for Mine Safety and Health and posts some info on his background.
Taking the industry economic pulse – With another quarter in the year under our belt, several industry watchers have taken the pulse of the industry’s health. In Business Insurance, Roberto Ceniceros reports that a tough climate is shaping up for workers comp. Among the many problems he notes, he reports that sources have told him that “…rising bankruptcies have insurers concerned that defunct businesses may not pay all their premiums and leave their insurer stuck with claims that should have been paid by the company.” Risk and Insurance features an article on a report from Fitch Ratings which discusses the challenges that the workers compensation market is facing in 2009. According to the report, underwriting performance is expected to worsen in 2009 as rate reductions persist. And we’ve recently noted grim news in the industry at large: first quarter of 2009 was the worst on record for property casualty insurers since quarterly results were first compiled in 1986.
Training – Eric at The Safety Blog reports that OSHA is targeting fraudulent trainers in construction and general industries and is working to strengthen their trainer authorization program. They will be conducting more surprise visits to independent training centers to check for compliance with program requirements. Trainers are authorized to teach and to do outreach training only after completion of a one-week course in an OSHA Training Institute Education Center. Learn more about training certifcation: OSHA Outreach Training Program.
H1N1 – Lloyd’s warns that pandemics continue to pose a threat to companies – Many feel the flu publicity and warnings earlier in the year were overstated because up until now, the manifestations of the flu have been very mild. According to WHO, there have been 429 fatalities out of 95,412 cases. Yet Lloyd’s points out that it has been having a devastating economic impact on some businesses and notes that, “Up to now flu cases have been relatively mild; however, Lloyd’s warned that “health officials worry that swine flu could mutate during the southern hemisphere winter and return in a more virulent form in the northern hemisphere this winter.” Keep up to date on any developments at Flu.gov.
Waste treatment fatalities – More on last week’s three fatalities at Regal Recycling: Old Story in Waste Removal: A Worker Collapses, Then Rescuers Do: “Dr. Hendrickson and two co-researchers found that in 42 incidences of workers’ dying of hydrogen sulfide toxicity between 1993 and 1997, more than one-fifth involved multiple deaths, including co-workers killed while trying to rescue a colleague. In all, 52 workers died over that period. The deaths have mounted despite strict standards governing work in confined spaces set by the federal Occupational Safety and Health Administration.”
And in another waste treatment plant, a worker recently died of burns suffered in an explosion that occurred while he was cleaning a tanker at CES Environmental Services in Houston. The death was the third at a regional CES operation since December, unleashing criticism from area residents, activists and city officials, who are looking to shut down the plant.
Useful Twitter feeds
@govsites – A searchable directory of any nation’s Government sites on Twitter
@NIOSH – The National Institute for Occupational Safety and Health
@usdol – Jobs, employment, workforce, safety, labor, government 2.0 issues & regulations news and information from the US Department of Labor
@Disabilitygov – Official U.S. Government Web site for People with Disabilities
@CCOHS – Canadian Centre for Occupational Health and Safety (CCOHS)
@FluGov – One-stop access to U.S. Government H1N1, avian and pandemic flu information
@VHAVeterans – Veterans Health Administration in the U.S. Dept. of Veterans Affairs
@usfire – Official Twitter account of the U.S. Fire Administration – Working for a Fire-Safe America
The Smallpox Conundrum
Friday, January 28th, 2005Remember smallpox? At the height of concerns about terrorism following 9/11, the federal government proposed that health care providers and first responders get vaccinated against the disease. The lack of response, as they say, was deafening. Recently there was a privately-funded simulation of a smallpox incident in the news. Headed up by former Secretary of State Madeline Albright, the exercise — dubbed “Atlantic Storm” — posed a scenario in which terrorists spread dried smallpox at an airport in Frankfurt, Germany and a number of other locations throughout Europe and the United States. The simulation revealed a number of serious weaknesses in our current planning. As the former Polish Prime Minister, Jerzy Buzek, put it: “Fortunately, we are not prime ministers anymore. Nobody is ready.”
Here are a few facts concerning the vaccination for smallpox (for detailed information, see the CDC’s website):
- For the most part, the vaccination is safe: the rate of adverse response to the vaccine is relatively small (1,000 serious reactions for every million vaccinated). However, given the scale of the anticipated inoculations that would be needed if all health care providers needed protection, there is cause for concern. Under rare circumstances the vaccine can lead to death.
- After vaccination, the individual is potentially contagious, for up to three weeks (as long as the vaccination site remains open). This means that health care workers — primary targets for vaccination — might not be able to work for a significant period of time.
- There is a portion of the general population that is at higher risk for adverse reaction to the vaccine (e.g., people with a history of eczema or acne, HIV positive individuals, burn victims, cancer patients, pregnant women). There are guidelines for screening these individuals out of a vaccination program.
The Public Policy conundrum
The smallpox vaccination program raises a number of issues involving workers compensation and other forms of insurance. In addition, there are some gray areas, where vaccinated workers and their families may face periods of disability that are not covered by insurance. Here is our take on just a few of these issues:
If employers require their employees to be vaccinated, any adverse responses would certainly be covered by workers comp, up to and including death. Even if the vaccination is “voluntary,” adverse reactions are still likely to be covered by workers comp. There is a potential “disproportionate impact” on insurers of health care facilities and ambulance services, whose workers are first in line for vaccination. This exposure is not currently contemplated in workers comp rates.
Regarding the significant portion of the general population that is at higher risk for adverse reaction to the vaccine (see above), many of these vulnerable individuals work in health care facilities, where their not being vaccinated might put them at higher risk for serious illness. If exposed to smallpox, they would be at very high risk when they are compelled to take the vaccine to stave off the illness.
As if the real risks were not enough, the considerable publicity about the dangers of the vaccine significantly increases the probability of “false positives” — people reporting what may be imaginary ailments. These “false positives” would immediately appear on the workers comp radar screen.
Here’s the crux of the problem for the health care industry: inoculated workers might not be allowed to come into contact with patients during their potentially contagious period (up to 21 days). This would apply especially to health care workers whose patients include the highly vulnerable groups mentioned above. This inability to work is not a period of “disability” but of quarantine. Workers comp would not apply. Who replaces the lost wages during this period? Is it fair to require workers to use their sick leave? What if they do not have any sick leave? Beyond that, if there is a mass inoculation of health care workers, how will hospitals staff their facilities during the quarantine period?
As if all the above weren’t enough to worry about, during the contagious period, a worker might infect family members. How would these exposures be covered?
This is not meant as a definitive summary of the smallpox policy issues. However, it is clear that any mass inoculation program will raise a number of concerns that need to be confronted head on, not as we are currently doing, with our heads buried in the sand.
