Brian Clymer, Attorney at Law

Industrial Commission: Carriers must investigate COVID-19 claims before denying

In our April 15th blog posting we urged Arizona to adopt a workers' compensation rebuttable presumption that first responders, healthcare workers, and essential "front-line" workers who contract COVID-19 have their workers' compensation claims accepted, unless the employers and their insurance carrier could show that the employment was not the direct cause of the disease. We said this because we heard that at least one major workers' compensation insurance carrier was going to automatically deny these COVID-19 claims. We argued that doing so would constitute "bad faith".

While Arizona has not yet created such a rebuttable presumption, we are delighted to see the Industrial Commission of Arizona's new Substantive Policy Statement effective May 15th on COVID-19 cases. It agrees with us that automatically denying COVID-19 claims does indeed constitute "bad faith" and reminds the workers' compensation carriers' of their duty to review and investigate all claims in good faith. Any claim denials, the Industrial Commission warned, must be "well-grounded in fact" and "warranted by existing law". Brian Clymer says this Industrial Commission policy statement is unusual because he does not recall such statements being issued in the past, and it is extremely significant because it suggests the Industrial Commission will carefully scrutinize any denied claims.

If you have COVID-19 and have had your workers' compensation claim denied, please contact us. We are prepared to review your case and the basis for the denial to see if the denial was correct and issued in good faith. We have experience in handling workers' compensation cases involving bad faith because Laura Clymer was the attorney on the winning side of Tapia v. Industrial Commission of Arizona (Ariz. Ct of Appeals 2018), which set out the principle that workers' compensation carriers must make a good faith investigation before denying a claim.

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