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Coronavirus (COVID-19): Frequently Asked Questions

January 13, 2021 • Missouri Employers Mutual

Updated: Jan. 26, 2021

To provide our policyholders and agent partners with the most current information, we’ll update this post as new details emerge.

For more, visit Missouri Employers Mutual’s COVID-19 Resource Center for Employers.

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The Centers for Disease Control and Prevention are monitoring national and international data on the severity of the coronavirus (COVID-19). We encourage all policyholders to practice workplace safety hygiene best practices. Visit cdc.gov for the latest news, and read the below information that addresses possible exposure to your employees in the workplace.

We’re here to support you during this uncertain time. Policyholders should contact their agents or our Customer Care team with any questions or concerns.

FAQs for Policyholders

How will MEM handle COVID-19-related claims?

Each case is unique, and it is difficult to comment on an unknown event. Our team of claims experts will evaluate each claim on a case-by-case basis.

Are COVID-19 claims compensable?

It can be, if there is substantial and competent evidence that the employee contracted the disease due to occupational exposure. We will complete a thorough investigation into how the individual was exposed and any eventual diagnosis.

If an employer is offering the COVID-19 vaccination to all of its employees and employee suffers an adverse reaction to the vaccine, is this a compensable work-related injury?

Yes, but only if there exists objective testing that pinpoints a physical diagnosis that explains the symptoms and a connection between that diagnosis and the vaccine.

If the employee suffers a compensable injury due to a reaction to the COVID-19 vaccine, is this a compensable work-related accident?

Probably so. Our Missouri Supreme Court has indicated that when the inoculation (vaccine) is occasioned by the particular conditions of employment, or where the employer requires the inoculation (vaccine), or where there is a combination of strong urging by the employer and mutual benefit, then an injury resulting from inoculation (vaccine) arises out of and in the course of employment. Where the employer encouraged, advised and instructed its employee to take the vaccine and the purpose was to prevent Employee from getting COVID-19 and losing time from work, the employee’s injury arises out of employment because the conditions of employment created the need for the vaccine and the injury arises in the course of employment because it occurred within the period of employment at a place where she was directed to be and while she was engaged in doing something (receiving the vaccine) incidental to her employment, that is taking steps for the mutual benefit of herself and her employer to prevent absences from work because of COVID-19. An injury suffered by an employee while performing an act for the mutual benefit of the employer and the employee is usually compensable.

If an employer is offering the vaccine but it is not mandatory and an employee receives the vaccine voluntarily, is a reaction to the vaccine compensable?

Probably so. Injuries from a vaccine may be compensable even when receipt of the vaccine offered by the employer is voluntary, especially where there exists a greater likelihood of contracting infection at work than other public or private areas and the conditions of employment created the need for a vaccine; however, this will be fact and case specific and may not be compensable in certain situations. The level of encouragement and benefit to the employer beyond simply having healthy employees will be relevant in the determination.

If an employee is offered the vaccine by employer and refuses to receive it, then later contracts COVID-19 at work, is the safety penalty of 25-50% invoked for failure to get the vaccine?

Probably not. In order for there to be a safety violation under §287.120, there must be:

  • a reasonable rule adopted for the safety of employees,
  • the employee must have actual knowledge of the rule, and
  • the employer must have made a reasonable effort to cause his or her employees to obey or follow the rule.

Just recommending or encouraging someone take the vaccine probably does not qualify as a rule, and by allowing some to opt out, there is no reasonable effort to enforce or cause employees to obey or follow the “rule.”

The safety statute, §287.120,  “provides an indirect incentive for employers to promulgate, train employees on, and enforce safety rules designed to prevent workplace injuries. Courts have generally looked at an employer’s efforts to train and monitor employee compliance with safety rules when examining whether an employer has taken reasonable efforts to cause compliance. Specific factors that have been reviewed include: (1) distribution of written safety materials; (2) scheduling and presentation of regular training seminars educating employees concerning the rules; (3) warning employees that disciplinary action will be taken if employees fail to follow necessary guidelines; (4) completion by employees of a written test to confirm understanding of the rules; and (5) whether known violations of the safety rules have previously gone unpunished.” Where the employer has no plans to discipline or punish employees for not following the rule, no reasonable effort to enforce the rule can be found; however, if the rule is mandatory and these measures have been taken, then a safety violation may potentially be taken as long as there is also is evidence that the contraction of COVID-19 was from work and that it was caused by failure of the employee to take the vaccine (follow the rule).

How does the Emergency Rule regarding presumptive coverage apply?

An April 2020 Emergency Rule issued by the Missouri Department of Labor and Industrial Relations created a new presumption of compensability for first responders that contract COVID-19.

The presumption applies to law enforcement officers, firefighters and emergency medical technicians as they are defined in Missouri statute (Section 287.243). Not all public safety occupations meet the definition of a first responder to get the benefit of the presumption; however, these claims may still be compensable if it is determined that work was the prevailing factor in contracting the virus.

The presumption order does not mean claims for first responders must be automatically accepted; we have a responsibility to the law and our mutual policyholders to investigate claim reports to confirm compensability.

How should I report a COVID-19-related claim?

Please report all claims suspected to be work related using our online claim reporting options.

Can I adjust my payroll based on staffing changes related to COVID-19?

Yes. Please contact your agent, who will work with MEM to make the adjustment.

What should I do if I have concerns about my bill or making a payment?

We are committed to supporting our policyholders during this time. Please contact your agent or our Customer Care team at 1.800.442.0593 about any payment concerns, including Auto EFT.

What steps should I take to best protect my employees?

The CDC recommends the following strategies for employers:

  • Actively encourage sick employees to stay home.
  • Separate sick employees.
  • Emphasize respiratory etiquette and hand hygiene.
  • Perform routine environmental cleaning.
  • Advise employees to check the CDC’s Traveler’s Health Notices before traveling.

How should I prepare my business for an outbreak in my area?

Your top priority is to keep your employees safe. Older adults and those with chronic medical conditions may be at higher risk for adverse health complications from COVID-19. Communicate your outbreak response plan with your employees. Identify possible work-related exposures and the steps you’ll take to minimize them. If your business has multiple locations, empower local managers with the authority to respond to developing outbreak situations in their geographic area. You can find more information on how to protect workers from potential exposures at osha.gov.

FAQs for Agents

How are Previsor and MEM responding to the pandemic situation?

We take workplace safety very seriously. The health and safety of our employees, our customers, and the surrounding community remain our highest priority. We are currently requesting all MEM employees to work from home until further notice. All business operations are continuing as usual, and our phone numbers and contact information remain the same.

Will I or my clients notice a disruption in service?

We are committed to providing you and your clients excellent service during this time of uncertainty. We have asked our employees to limit business travel and meetings until further notice. Face-to-face visits with agents, policyholders and injured workers are limited to only the most essential. However, critical business needs remain a priority and we will stay connected to you and our policyholders.

Can I adjust my clients’ payroll based on staffing changes related to COVID-19?

Yes. Please communicate with your underwriter about your clients’ payroll situations. We will work with you to ensure staffing changes, including policyholders who continue paying staff who have been sent home, are properly reflected in payroll documentation.

What should I do if a client has concerns about a bill or making a payment?

We are committed to supporting our policyholders during this time. Please contact our Customer Care team at 1.800.442.0593 with any payment concerns, including Auto EFT.

How will my clients complete audits if MEM employees are limiting travel?

Our premium consultants will continue conducting online and telephone audits as usual. We will work with policyholders who cannot produce audit records due to hardships caused by COVID-19.

I have an unlisted concern regarding COVID-19.

We are dealing with a unique situation that isn’t in any playbook, but we are here for you and your clients. Please reach out to your MEM underwriter and/or sales executive with any questions or concerns. Communication is crucial as we work together to ensure our policyholders and their employees are protected.

Not sure who to contact? Use our Agent Contact Form.

For more information

Protect your employees and your business by staying up to date on COVID-19 developments in the U.S. and sharing simple prevention measures with your employees.

We recommend getting the most current information from the below organizations:

Centers for Disease Control

Occupational Safety and Health Administration

National Safety Council

Date
January 13, 2021
Author
Missouri Employers Mutual
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