COVID-19 May Be Considered an Occupational Disease Under the Workers’ Compensation Act of Colorado
Ashley Graves, Associate
On May 2, 2024, the Colorado Court of Appeals (the “court”) issued its decision in Life Care Centers of America v. Industrial Claim Appeals Office,[1] holding that COVID-19--depending on the circumstances—can satisfy the statutory definition of an occupational disease under the Workers’ Compensation Act of Colorado (the “Act”). The petitioners’ argument that the General Assembly intended to limit the scope of occupational diseases to those resulting from working conditions that are “characteristic of the vocation” was unanimously rejected, and the court clarified that a claimant only needs to show that their employment exposed them “to the risk of contracting COVID-19 to a measurably greater degree and in a substantially different manner than persons in employment generally.”
Life Care Centers of America v. Industrial Claim Appeals Office - Background
Vincent Gaines (“Gaines”) worked for Life Care Centers of America (“Life Care”), a long-term nursing facility, as a floor technician and housekeeper where his duties primarily consisted of cleaning and maintaining the building. The first positive COVID-19 case at the facility was reported on May 24, 2020, and Gaines tested positive shortly thereafter with the facility then declaring a COVID-19 outbreak a few days later. By July 29, 2020, forty-eight residents and staff members contracted the virus and eight of those cases were fatal. Gaines was the third staff member to test positive for COVID-19, resulting in his hospitalization. His condition worsened and he passed away a month later. Gaines’ wife, Sheila Jackson (“Jackson”) filed a workers’ compensation claim based on his exposure to and contraction of COVID-19 at the facility.
The administrative law judge (“ALJ”) who initially heard the claim concluded that “it was more probable than not” that Gaines’ COVID-19 infection was related to his presence at Life Care, and found that his infection “followed as a natural incident of his work in the facility[,]” which ultimately led to his death. Life Care was therefore ordered to pay disability and death benefits. Life Care then appealed the ALJ’s decision to the Industrial Claim Appeals Office (the “Panel”), arguing that the order was not supported by substantial evidence and failed to resolve conflicting evidence in the record.
The Panel rejected Life Care’s arguments, finding that at the time Gaines was exposed to the virus, there was a high prevalence of residents who tested positive for COVID-19 in addition to residents who had unknowingly been exposed to the virus, but were asymptomatic. The Panel also noted that the virus “raise[d] a unique consideration under Colorado workers’ compensation law” because the very nature of the virus makes it near impossible to prove, beyond a reasonable doubt, precisely where or from whom an individual contracted the disease.
The Colorado Court of Appeals’ Holding
The court noted that the issue of whether COVID-19 may be an occupational disease under Colorado's Workers’ Compensation Act was a matter of first impression. The first question before the court was whether the ALJ’s and the Panel’s factual finding that Gaines was likely infected by COVID-19 while at work, as opposed to elsewhere, was supported by substantial evidence.[2] The court declined to disturb the ALJ’s and Panel’s fact findings, noting that Gaines may have moved infected patients, was responsible for cleaning resident rooms, and that he may have encountered infected staff members. While Life Care attempted to show that Gaines may have contracted the virus from one of his family members and that Gaines typically did not go into resident rooms or transport infected residents, the court ultimately agreed with the ALJ’s reasoning that there was no credible evidence of anyone within the home testing positive for COVID-19, and that—based on the virus’ relatively low prevalence in the city in early 2020—Gaines only had a 0.3% chance of contracting the virus from someone in the community. Moreover, the court also considered the expert’s finding that healthcare workers in particular are at a higher risk of contracting COVID-19.
Having found that the record evidence supported the finding that Gaines was likely infected with COVID-19 while at work, the court turned to the question of whether Gaines’ COVID-19 infection constituted an occupational disease for purposes of workers’ compensation. Given that diseases, unlike other physical injuries, are inherently difficult to trace, Jackson was required to demonstrate that Gaines’ employment exposed him to the risk of contracting COVID-19 to a measurably greater degree and in a substantially different manner than persons in employment, generally. The court found that the ALJ and Panel appropriately applied existing law and determined that Jackson had met this burden—particularly given Gaines’ employment in the healthcare field and the exceptionally high rate of infection among residents and staff (30%).
Employer Considerations
While the court’s decision affirms that COVID-19 may be a compensable occupational disease for workers’ compensation purposes, the court’s holding is narrow. The very nature of Gaines’ employment and the factual circumstances surrounding infections within the facility in contrast with the broader community heavily influenced the ALJ’s, the Panel’s, and the court’s determination. However, while the court emphasized the specific high-risk nature of the nursing home worker's employment in this case, the ruling highlights the potential for other workers in industries with significantly higher exposure risk to successfully claim workers' compensation benefits for COVID-19 infections.
[1]2024 COA 47, --- P.3d ---- (Colo. Ct. App. 2024).
[2]By law, the court’s review of the underlying fact findings was limited. The court was bound to the ALJ’s and Panel’s findings of fact which were supported by “substantial evidence,” and was required to defer to the ALJ’s and Panel’s credibility determinations and resolution of conflicts in the evidence.