Five years after the onset of the COVID-19 pandemic, workers compensation litigation over the virus continues to move through jurisdictions.
Courts are actively revisiting questions of causation, rebuttals of statutory presumptions — many of which have expired — long-COVID determinations, disability and the broader boundaries of occupational disease law.
Decisions issued in 2024 and 2025 continue to reshape the system, according to the National Council on Compensation Insurance, which began tracking coronavirus-related cases in 2020.
NCCI’s monitoring includes cases addressing compensability, exclusive-remedy defenses and evolving definitions of workplace exposure. It includes cases in Colorado, Kentucky, Nebraska and West Virginia that the rating agency deemed significant.
A review of recent rulings shows a doctrinal variety emerging across jurisdictions, some setting precedent for infectious diseases overall, not just for COVID, experts say.
One recent ruling, a Nov. 24 decision from the New York Court of Appeals, is of particular interest. In Matter of the Claim of Frank Aungst v. Family Dollar, the court clarified the state’s “prevalence” doctrine, holding that employees may establish “extraordinary” workplace exposure through frequent contact with the public or co-workers in an area where COVID-19 is prevalent. Thus the court upheld findings that a Family Dollar employee contracted COVID-19 at work in 2020 and later suffered a compensable stroke.
The employer argued that case law required more precise identification of the moment of exposure. The Court of Appeals rejected that position, pointing to later decisions that recognize compensability even when a claimant cannot pinpoint the time of exposure.
The Aungst ruling “is building this framework for all communicable diseases, not just COVID,” which could influence future cases involving influenza and other airborne illnesses, said Michele Hibbert, San Diego-based senior vice president of regulatory compliance and governmental affairs for Enlyte.
In another COVID case that made news, the Washington Supreme Court ruled Nov. 6 that the state’s “traveling employee” doctrine extends to occupational diseases, potentially broadening workers comp coverage for employees who become ill while traveling for work. As documented in Azorit-Wortham v. Department of Labor & Industries of Washington and Alaska Airlines, at issue is a flight attendant who alleged she contracted COVID-19 in March 2020 while working for the airline. The ruling sent the case back to the state Court of Appeals to determine whether sufficient evidence supports a jury’s finding that her infection “arose naturally and proximately” from her employment.
As the industry watches decisions, Ms. Hibbert said, the nuances among jurisdictions are adding to the complexity. “You have to operate with the characteristics of the different states and the different rulings; some states require a lot more information to get that presumption, whereas other states are more liberal,” she said.
Brian Allen, Salt Lake City-based vice president of government affairs for Enlyte, said he expects a surge in litigation in the coming years even though many COVID presumptions created by legislators in more than a dozen states have expired. “A lot of the presumptions weren’t super clear on what the standards were for claiming a presumption,” leaving it up to the courts, he said.
The fact that many were rebuttable, meaning if the employer could create an argument that the worker was infected elsewhere, created an avenue for litigation, he said. Most of the litigated claims seen in the courts throughout 2024 and 2025 involve death, hospitalizations, disability or long COVID symptoms and tend to be the expensive claims, he said.
That bucks the overall trend for most COVID claims during the pandemic. Data from several ratings agencies, insurers and states showed that most COVID claims were indemnity-only — with no medical component — and cost a few thousand dollars. For example, Florida, which regularly released data on COVID claims, showed fewer than 25 total claims in 2020 and 2021 that surpassed $500,000. A lion’s share — more than 50,000 — cost $4,999 or less. The next category range, $5,000 to $9,999, never surpassed 2,000 claims. Data across other states were similar.
Industry observers describe a landscape that remains active but increasingly among older claims.
“(T)he industry continues to efficiently handle COVID claims,” Christy Thiems, assistant vice president of workers compensation for the Washington D.C.-based American Property Casualty Insurance Association, said in an emailed statement. “We believe that most COVID claims have been resolved timely and appropriately without dispute. The number of COVID claims continues to decrease and has decreased significantly in recent years.”
Her assessment reflects insurer data showing that while litigation persists, the volume of new COVID filings has fallen sharply from early-pandemic peaks.
Jennifer Cogbill, Frisco, Texas-based senior vice president of GB Care with Gallagher Bassett Services, said that while “new COVID cases have flatlined,” half of 1% of older COVID claims remain in litigation. Long COVID and so-called take-home COVID, when a worker brings an infection home to relatives, are common areas of contention.
Overall, the industry is concerned with what infectious disease claims will look like in the future, according to experts.
Seven states introduced legislation in 2025 to create presumptions or clear hurdles for workers who say they contracted an infectious disease at work, Ms. Hibbert said. Two states enacted changes: Tennessee and Washington.
Changes to state laws coupled with precedents set by case law have the industry on edge about what the future holds for infectious diseases, Ms. Cogbill said.
Before COVID, the industry, for example, had rules in place for certain diseases, such as tuberculosis, she said. “There were very clear guidelines in terms of what would be work-related and how we would handle that, and now the landscape is evolving.”
“There could be another pandemic. There could be some other type of communicable disease that isn’t a pandemic, but certain jurisdictions may treat it as work-related, where in the past they may not,” Ms. Cogbill said. “We are being very mindful of that and working with our attorneys to pay close attention to any verdicts that may come in that will affect how we handle conflicts.”
This article was first published in Business Insurance
