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Langham: COVID September

By David Langham

Wednesday, September 16, 2020 | 192 | 0 | min read

It is hard to believe that it has been a month, but the Division of Workers' Compensation released its September COVID-19 report on Monday, covering the data available through Aug. 31.

Judge David Langham

Judge David Langham

As noted in past posts, the division seems to lead the pack in terms of keeping information flowing. I have previously posted regarding the developing data on such claims in COVID Florida Filing Update AugustFlorida COVID Claims June 2020 and COVID-19 in Florida Claims. The latest report includes information on COVID and other factors that are impacting insurance premiums as well.

As of Aug. 31, the division has information on 17,653 COVID-related workers' compensation indemnity claims. Any medical-only claims are not included in the figures. Those might be significant in terms of volume (many claims potentially for testing, perhaps) but are less likely to be significant in terms of costs expended.

The 17,653 are divided into open (6,933) and closed (10,720). A total of $22.5 million has been paid on these claims (in indemnity and medical benefits), which is 6.8% of the Florida overall claims cost.

The report likewise divides the 17,653 COVID-19 claims into the categories of compensable (9,893, 56%), full denied (7,728, 44%), and partially denied (32). The preponderance of payments ($22,186,002, 98%) is attributable to the compensable category, as would be expected. That payments are attributed to the other categories may reflect payments made in error or payments made during investigation of compensability. 

Beginning with COVID Florida Filing Update August, the division provided information regarding the severity of claims in terms of financial cost. That information is also presented in the September report. September demonstrates now two claims in the "over $500,000" category, with a total paid on two claims of $1.47 million.

Two important points: (1) the potential exists for very severe claims from the SARS/CoV-2 infection that causes COVID-19, and (2) thankfully, the most severe cases are not frequent.

Note that the preponderance (96%) of claims are in the range from $0 to $4,999 and that the average is about $718.54 ($12,203,641, 16,984). This expense average may be of interest in studying the probable severity of such claims overall (see Regressive Impact).

The claims of a much more serious nature ($100,000 or over) account for less than one-tenth of 1% of the volume, but 16% of the total expenditures ($3,651,784, $22,527,620). This illustrates that as the volume of medical care necessary increases, the financial significance of such claims can become notable. 

If all of the compensable claims cost is divided it is an average (mean) of about $2,243 ($22,186,002, 9,893) per compensable claim. That is significantly less than the average (mean) cost of all compensable indemnity claims $5,816 (331,385,115, 56,977).

As noted regarding the prior reports, the preponderance of the volume (55%) and dollar expenditures (67%) are in the Miami, Ft. Lauderdale, "not indicated" and West Palm Beach areas. However, the data suggests that some significant claims have occurred in Leon County, as monetary expenditures there are over $1.2 million, though only 142 total claims.

While multiple counties (Taylor, Dixie, Bradford, Franklin, Hendry and Lafayette) reflect payments under $2,000 total, only Hendry County reports $0 in benefits paid. 

The report notes that three counties similarly accounted for the largest volumes of COVID-19 positive tests in Florida: Miami/Dade (159,059, 25%), Ft. Lauderdale/Broward (72,245, 11%) and West Palm Beach/Palm Beach (43,387, 7%). Those three account for 43% of the Florida Diagnoses overall, but 55% of the COVID-19 claims and 67% of the claim expenditures. 

The distribution of indemnity claims has been illustrated in each of the four reports thus far. There have been fluctuations noted in the data, likely due to increasing volumes of information and clarification. But, notably, the predominant portion attributable to health care workers at the end of May (57%) has diminished, though the volume of claims for such workers has continued to increase.

The volume in protective services has been more marked in the months since June, leading to a reasonably similar portion for these two occupational groups (29%, 34%) in the September report.

The volume in the service industry reported through May accounted for less than 4% overall at that time. By the end of June, that segment had increased to approximately 23%. However, the volume continues to rise, and at the end of August, the service industry was 27%.

Three segments — health care, protective services and the service industry — by the end of August still account for 90% of COVID-19 claims. However, the share among these three is becoming increasingly consistent. 

Notably, the September report memorializes that there have been 24 COVID-19 compensable death claims to date. This represents a very small portion of the compensable claims overall. This rate is below the overall mortality rate for COVID-19 in the U.S., as reported by Johns Hopkins.

Still, it is troubling to see this volume of deaths reported. Overall, and despite significant safety focus and progress, on-the-job death continues to occur in significant numbers, according to the National Safety Council

The data supports that, overall, women (9,553, 54%) are more likely than men (7,918, 45%) to report a work-related COVID-19 diagnosis. 

Overall, the September report is another solid effort to illustrate and describe the ongoing impact of COVID-19 and SARS/CoV-2 on the Florida workforce and workers' compensation system. It is worthy of review and attention to any who study this system or are responsible for claims decisions within it. 

David Langham is deputy chief judge of the Florida Office of Judges of Compensation Claims. This column is reprinted, with his permission, from his Florida Workers' Comp Adjudication blog.

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