Important takeaways from recent studies: Long COVID, PPE use, construction struck-by injuries

Study: Long-COVID in Workers Compensation: A First Look – National Council on Compensation Insurance (NCCI)

Findings: Almost one-quarter of COVID claims in workers comp involve long COVID. Twenty percent of non-hospitalized and 47 percent of hospitalized COVID-19 work comp patients developed long COVID. About one-third of long COVID claims were in the 51-60 age group, and females were more likely to have long COVID, accounting for 79% of hospitalized claims and 61.8% of non-hospitalized claims. This is partially explained by the occupations that COVID-19 most impacted in Work Comp – healthcare workers and first responders dominate the top 10 long COVID class codes. The average temporary disability indemnity benefit duration for long COVID patients was about 160 days for hospitalized patients and 95 days for non-hospitalized patients and the duration of medical treatment was much longer. Hospitalized long COVID claims had the highest severity at just over $216k per claim, with about 80 percent of total claim costs going toward medical benefits, compared with nearly $40k, roughly split evenly between indemnity and medical for non-hospitalized long COVID claims. Only 29 percent of long COVID claims were closed within six months of the accident date. While the data indicates that long COVID is impacting workers comp, data was for claims with accident dates between March 2020 and June 2021 and “does not fully reflect the potentially longer-term impacts of long COVID.”

Takeaway: According to a recent article in the Boston Globe, “Long COVID costs at least $60 billion up to as much as $100 billion a year in just lost wages. The annual cost of medical care for these patients may be another $100 billion. And those numbers don’t factor in decreased productivity from people working with severe fatigue and brain fog, or family members of long COVID patients who must reduce their work hours to take on caretaker roles. Acute COVID is a pandemic; long COVID could be a mass disabling event.”

There is no standard definition of long COVID, but it describes the presence of various symptoms weeks or even months after the initial contraction of the virus. The symptoms can be continuous, changing, or on a relapsing basis and vary significantly by individual. Officially termed “post-acute sequelae of COVID-19 (PASC),” long COVID has had an ICD-10 diagnosis code since October 2021, however it still escapes identification on a systemic level. To be classified as Long COVID, there must be no alternate diagnosis to explain the symptoms.There are more than 150 medical codes associated with the diagnosis, which are grouped into eight symptom groups. The most common are pulmonary or cardiovascular, followed by neurological, systemic, endocrine, autoimmune, mood disorders, and sleep disorders. The illness remains perplexing and it’s unknown how long people with long COVID will remain ill. While pulmonary illness dominated the top ten for hospitalizations, symptoms reduced over time. However, over time there was an increase in symptoms associated with all other groups, such as neurological, mood, systemic, and sleep dysfunction.

Understandably, given these subjective conditions many employers were skeptical of long COVID, but increasingly understand it’s a real diagnosis that requires gradual rehabilitation and recovery. Many conditions associated with long COVID, such as malaise, fatigue, or the inability to concentrate, limit people’s ability to work. Educating supervisors about long COVID is key to identification and empathy.

Employee eligibility for workers’ compensation benefits follows the standard process and employees have a challenging burden of proof to show that their lingering symptoms are directly associated with their work-related COVID claims. While compensability is uncertain, employers should help workers understand the benefits available to them.

Long COVID is recognized as a potential disability under federal law and employers can use the process laid out in the ADA and engage in an interactive accommodation process, collaborating with employees on the nature, severity, duration, and resulting limitations of their extended COVID-related impairment. To retain valuable employees, employers may want to explore accommodations even when not required to do so. The Job Accommodation Network (JAN) provides suggestions to accommodate long-term limitations.

Another way to support employees with Long COVID is to refer them to available resources. Identifying Post-COVID Care Centers that have familiarity with the myriad of long-haul symptoms can help. Beyond physical recovery, some workers will also be faced with depression, anxiety, and post-traumatic disorder. If you have internal resources such as an Employee Assistance Program (EAP) or Employee Resource Group (ERG), remind employees that these options are available. If there is a surge in community cases, prioritizing prevention can help limit future cases of long COVID.

Study: Today’s Biggest PPE Challenges: Key Insights from Dedicated Safety Managers – J.J. Keller Center for Market Insight

Findings: Getting employees to wear PPE remains a struggle for over 90 percent of the employers surveyed. Underlying factors that contributed to PPE noncompliance were lack of adequate sizing, heat stress, and supply chain disruption. Over one-third of companies struggle to get PPE for female workers. The survey found that 50% of companies said their workers didn’t think the protective gear was necessary, another 50% said the gear “makes the job more difficult,” and 21% said workers forgo safety gear because they “didn’t know it was required.” (Total exceeds 100 because respondents could provide more than one answer.)

Takeaway: Take the time to drill down and understand why your employees are not using PPE. It may be as simple as a poor fit or there may be systemic issues in the organization that encourage employees to forgo its use. Recognize that comfort is a non-negotiable aspect, involve employees in the selection of the best PPE for the job, and perform fit tests. Lead by example, educate and train workers, hold employees accountable, and enforce compliance. Recognize the need for pre-positioning to ensure adequate inventory, multiple sourcing, and pre-qualifying alternative suppliers to mitigate supply chain issues.

Survey: Struck-by Hazards, Barriers, and Opportunities in the Construction Industry – The Center for Construction Research and Training (CPWR)

Findings: Nearly four out of five construction employers, supervisors, and workers say their organization needs training on identifying and preventing struck-by hazards as well as conducting job hazard analyses before work or new tasks begin. The results show that the leading causes of struck-by injuries are working around heavy equipment or vehicles (35.6%) and falling or flying objects from work performed at heights (29.8%). The employers identified three primary barriers to engaging in practices to prevent struck-by injuries: lack of understanding or information to address hazards (26.9%), scheduling pressure (25.5%), and lack of training in hazard identification and prevention (23.1%).

Takeaway: “Developing a training program for those involved in the planning process, which covers struck-by hazard identification, how to conduct job hazard analyses, and best practices for prevention, would address the biggest barriers and support more effective planning and decision-making,” CPWR says. It also suggests employers should explore giving employees stop-work authority to help enforce safe practices.