Workers compensation claims involving long COVID may rise this year, though cost projections are hard to come by, experts say.

In January, the Workers Compensation Research Institute reported that comp claims with long COVID had higher-than-average medical payments and indemnity payments and longer durations of temporary disability than regular COVID-19 claims.

“In particular, we found a nearly 10-fold difference in the average medical payment per claim,” WCRI researcher Bogdan Savych wrote in the report, which analyzed infections between March 2 and Sept. 30, 2020.

The National Council on Compensation Insurance reported in October 2022 that post-infection health issues appeared in 24% of all COVID-19 comp claims between March 2020 and June 2021, and that the average temporary disability indemnity benefit duration for long COVID patients was just over four months for hospitalized patients and around 95 days for non-hospitalized patients.

Yet putting a dollar figure on the cost of long COVID comp claims for employers and insurers is difficult because there is no universal definition of long COVID, according to Nedzad Arnautovic, associate actuary at NCCI.

Mr. Arnautovic said there’s a “reasonable expectation” that long COVID claims will continue in 2023. “Of course, this is highly subject to virus variants, long-term effectiveness of vaccines, and population rate of re-vaccination,” he said.

“From the WC insurer perspective, I am not sure there is much difference in whether a claim is regular or long COVID,” Mr. Arnautovic said. “As long as the claim is compensable, they will continue to provide medical/indemnity benefits regardless of how it is classified.”

Employers, however, may be more concerned about how COVID-19 claims are classified, since long COVID could result in decreased productivity, revenue loss and costs for substituting workers, Mr. Arnautovic said.

Mr. Savych wrote in an email that factors that could affect long COVID claims in 2023 include new virus variants, vaccination impact and the “responsiveness of state and federal policies.”

Joe Paduda, principal with Plainfield, New Hampshire-based Health Strategies Associates, said the nuances of long COVID makes it a challenge for an industry seeking information on costs.

“Complicating this is the wide range of potential signs, symptoms and effects of COVID, many of which might be caused or exacerbated by patients’ other health factors, medical history, lifestyle, genetic profile and/or pre-existing conditions,” Mr. Paduda said.

He said long COVID claims will likely increase this year, “particularly in states with broad or ill-defined definitions of and/or presumptions relative to COVID.”

Mr. Paduda said payers are concerned about the potential for additional costs for long-term claims, “however, there’s far too much catastrophizing based on far too little actual data or research.”

“Reality is we don’t know much about COVID’s long-term impact, how it can vary by person, the effect of comorbidities and past medical history, and treatment options,” he said.

Delainne Bond, CEO of Kissimmee, Florida-based COVID Care Group LLC, said there is “broadly a lack of awareness of how long COVID is affecting claims,” and that her concern is that “long COVID is affecting our workforce whether or not there’s a claim associated with it.”

“What I’m seeing now is so tragic,” Ms. Bond said. “These people with long COVID are not able to maintain their jobs” and the issue is creating a “ripple effect on the employment sector.”

This article was first published in Business Insurance.

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