DWC: COVID Claims Drove 24% Jump in Frequency

Tuesday, August 30, 2022 | 0

The Texas Division of Workers’ Compensation reported that claim frequency is up 24% during the 28 months of the pandemic compared to the two-plus years immediately before it began.

“The increase in COVID-19 occupational disease claims reported during the pandemic has temporarily interrupted a 20-year trend in Texas of fewer workers’ compensation claims reported each year,” the division said in a study released Monday.

Carriers reported that more 90,306 claims for COVID-19 were filed between March 2020 and Aug. 7, including 459 fatalities. Just over half of the claims (51%) and the fatalities (55) involved first responders and correctional officers.

About 68% of claims involved workers who tested positive for or were diagnosed with COVID-19.

The division said carriers accepted about 59% of claims with a positive test or diagnosis and denied 39% of the cases with positive tests. Despite the more than 22,000 denials of claims with positive tests or diagnoses, only 207 disputes were filed with the DWC.

Overall during the pandemic, 65% of COVID-19 claims filed had indemnity-only payments associated with them, according to the report.

Of the 35% of claims with medical and indemnity benefits, 89% of the hospital/facility payments were made for inpatient services, followed by outpatient services (8%) and other (3%).

Between 23% and 24% of workers with accepted COVID-19 workers' compensation claims who received medical or hospital/facility services received the services beyond one month post-injury, the division reported.

Only a small percentage (8%-9%) of claims received these services for more than six months post-injury, according to the report.

Business Insurance, a sister publication of WorkCompCentral, contributed to this report.