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Digital EditionNY Court Rules COVID-19 Workers’ Comp Claims Don’t Require Pinpointing Specific Exposure Event
A COVID-19 infection can be considered a compensable “accidental injury” without the claimant having to pinpoint a specific exposure event, according to a recent decision by the New York Court of Appeals with significant implications for workers’ compensation insurers.
The ruling in Matter of Aungst vs. Family Dollar upholds the New York State Workers’ Compensation Board’s “prevalence” framework, which assesses whether an employee’s work environment created an extraordinarily high risk of contracting a communicable disease. This Nov. 24 decision by New York’s highest court provides clarity on the evidentiary standard for such claims, particularly those arising from the COVID-19 pandemic.
The case originated in April 2020, when Frank Aungst, a manager at a high-volume Family Dollar store, contracted COVID-19 and subsequently suffered a stroke one week later. He filed a workers’ compensation claim, asserting that both the infection and the stroke were a direct result of his work environment.
During the early, uncertain months of the pandemic, Aungst worked over 50 hours per week in a public-facing role with what he described as almost constant customer contact. The store had not yet implemented protective measures like masks or sneeze guards. The Workers’ Compensation Board ultimately found that Aungst had sustained a work-related accidental injury, leading to a consequential stroke.
The employer, Family Dollar, appealed the decision, arguing that the claim did not meet the legal standard for an “accidental injury.” Their central argument was that historical case law required a claimant to identify a specific, singular event or moment of exposure that caused the illness. They contended that without being able to name the specific customer or interaction that led to the infection, Aungst’s claim was based on speculation.
The employer challenged the Board’s “prevalence” framework, which allows a claim based on evidence of a significantly elevated risk of exposure in the workplace, as an improper lowering of the claimant’s burden of proof.
The New York Court of Appeals rejected the employer’s arguments, holding that the Board’s framework is consistent with modern legal precedent.
The court explained that the standard for an “accidental injury” has evolved beyond requiring a single, identifiable event. Instead, the determination should be made from the “common-sense viewpoint of the average [person].” The court found that the “prevalence” framework—which considers factors like the nature of work activities, the level of public contact, and the spread of the virus in the community—was a rational method for establishing a causal link between employment and illness.
Substantial evidence supported the finding that Aungst’s high-risk work environment, contrasted with his minimal personal contacts, made it plausible that he contracted the virus at his job.
Ultimately, the Court of Appeals affirmed the lower court’s decision, ruling that both Aungst’s COVID-19 infection and his resulting stroke were compensable under the Workers’ Compensation Law.
View the full decision here. &
