Exposure to Ebola and Workers’ Compensation Claims

With the multitude of press and social media posts about the two nurses from Texas who contracted the Ebola virus disease after providing care to Thomas Duncan, who traveled from Liberia after being exposed to the Ebola virus, we considered how workers’ compensation coverage may respond.

According to the Center for Disease Control and Prevention (CDC), the 2014 outbreak of the Ebola virus is occurring in West African countries and is spread through:

  1. Direct contact with bodily fluids from a person who is sick or has died from the Ebola virus;
  2. Direct contact with objects contaminated with Ebola; or
  3. Direct contact with animals infected with Ebola.

Ebola is spread by infected individuals, who are experiencing symptoms.  After 21 days, which is the incubation period for the Ebola virus, if an exposed person has not displayed symptoms of the virus, they will not become sick with Ebola. 

It is our understanding that members of staff who provided care to Mr. Duncan were advised to monitor their temperature twice daily through the 21-day incubation period.  Nurse Nina Pham reported an elevated temperature 2 days after Mr. Duncan died and subsequently, she tested positive for the Ebola virus.  She was admitted to the hospital and began treatment, and was then transferred to the National Institutes of Health in Maryland. Amber Vinson, the second nurse who has tested positive for Ebola, had been in communication with the Centers for Disease Control (CDC) and was admitted for treatment. She is currently undergoing treatment in Atlanta. In both situations, lost wages and medical expenses should be covered by the healthcare organization’s workers’ compensation insurance program, as it appears their exposure occurred in the course of their employment.

We expect the workers’ compensation claim costs for these two nurses to be very high, as they also included private transportation to other hospitals, and care outside of the state, which may or may not have fee structures in place.

Staff that may have been exposed in the course of employment may also be ordered to stay home and not work for the 21-day incubation period.  If the exposure occurred in the course of their employment, and they test positive, their wages (after the organization’s policy regarding use of personal time off) and associated medical expenses should be covered under their workers' compensation program. We suggest this issue be discussed proactively between the healthcare organization, the Third Party Administrator (TPA) and/or the workers’ compensation insurer. 

For staff that are ordered to remain home for the 21 days and test negative, we suggest the human resources department, risk management, the TPA, and the insurance broker discuss how you may cover this expense, as it may not meet the definition of a compensable workers’ compensation claim.

The definition of “compensability” varies between state workers’ compensation laws, and should be reviewed.  Depending on the jurisdiction, they may also make a claim for mental anguish or file stress claims for the period of time that they test negative, or the incubation period expires. The TPA or commercial insurer for these two nurses will also need to consider possible fee schedule reductions for medical care provided outside of their state. 

The CDC is preparing to issue revised healthcare worker protocol, which all healthcare organization will need to review. We will continue to monitor this outbreak and the evolving standard of care for treatment and quarantine periods for staff that may be exposed.