Is Lyme Disease Covered By Wisconsin Worker’s Compensation?
With deer tick populations on the rise in Wisconsin, the incidence of Lyme disease has sky rocketed. While Wisconsin physicians documented around 350 cases of Lyme in 1990, the WI Division of Public Health estimated around 4300 cases statewide in 2017. Wisconsin employees who contract Lyme disease while at work will be interested to learn state worker’s compensation law covers Lyme disease for workers who contract the disease in the workplace.
Specifically, Wisconsin worker’s compensation covers Lyme Disease if:
(1) the infected worker was in the “course and scope” of employment when they were infected, and
(2) their exposure to the disease “arose out of” their employment.
If a worker’s Lyme infection meets these two criteria, the worker’s compensation carrier should cover all treatment related to or necessary for Lyme disease treatment, and provide all other benefits dictated by Wisconsin worker’s compensation laws.
Determining “Course & Scope” in Wisconsin Workers Comp Law
The question of “course and scope” generally refers to the activities of the worker at the time of the “injury” – or infection, in the case of Lyme Disease. If the employee was performing work activities at the time they were exposed to the disease, they were clearly in the course and scope of employment.
For example, a DNR employee might be required to patrol a wooded area as part of their job. If they were bitten by a tick carrying Lyme Disease while patrolling a state park, he or she would have been in the course and scope of employment. Similarly, if a line worker was working on a power line and was bitten by a tick carrying Lyme Disease, he or she was in the course and scope of employment.
Lyme Disease Affects Both Outdoor and Indoor Workers
Lyme Disease doesn’t only endanger people who spend most days working outdoors. An office worker might decide to step outside during the day for a breath of fresh air. Under what courts have called the “personal comfort doctrine,” an employee is still considered to be in the course and scope of employment while attending to personal needs during the workday. Therefore, the office worker who is bitten by an infected tick while outside – and on the employer’s property – during the workday could still be considered to have been in the course and scope of their employment
Site of Disease Contraction is Critical to Worker’s Comp Coverage
The question of whether a worker’s Lyme Disease infection “arose out of” their employment refers to whether the infection was in some way a consequence of their employment. Wisconsin’s worker’s comp law recognizes an injury may arise out of an individual’s employment if the circumstances of their job place them in a particular time and place where they suffer harm from an outside source – like a tick. In the example of a DNR employee, the worker was bitten by a Lyme Disease-carrying tick at that time and place because their work took them there. In the example of the office worker, they were exposed to that disease-carrying tick because the tick happened to be on their employer’s premises.
Recommended Action for Workers Bitten by Ticks
If you find a tick on you, try to preserve the tick in the event you later develop symptoms. Seek treatment with your primary care doctor, including a blood test of Lyme disease, and bring the tick in for testing. If you have Lyme Disease, your doctor will likely refer you to a specialist for treatment, or provide you with antibiotics and other medication. Ask for a referral to an infectious disease specialist if your symptoms persist and you have not been offered a referral. Further, if you lose time from work due to Lyme Disease, ask for a referral to an occupational medicine doctor or a physical medicine & rehabilitation (PM&R) doctor. These physicians assist with your treatment, oversee your recovery, provide appropriate referrals and ensure appropriate treatment, and are knowledgeable in worker’s compensation issues.
Employees who Contract Lyme Disease at Work Receive Various Benefits
Lyme disease can cause significant, long-lasting or permanent problems, including damage to the central nervous system and autoimmune system. If you have temporary work restrictions and lose time from work during the initial treatment, you are entitled to temporary total disability (TTD) wage loss benefits, and your medical expenses should be covered by the worker’s compensation carrier. After you have reached end of healing – also known as a healing plateau – if you have permanent damage to your body, you will be given a permanent partial disability (PPD) rating, and also permanent restrictions if appropriate. The PPD rating translates to a dollar amount that the worker’s comp carrier will need to pay you monthly until it is paid out in full. PPD is not a settlement. Your employer will need to accommodate your permanent restrictions without much of a wage loss. If it does not, you may be entitled to further benefits, such as retraining (schooling) or loss of earning capacity.
Worker’s Compensation Attorneys Can Help Secure Benefits
The worker’s compensation carrier is supposed to pay your benefits without the need for a lawyer, as long as the medical documentation and other evidence indicates your Lyme Disease arose out of employment and you were in the course and scope of employment when you contracted the disease. However, you may need a lawyer if the carrier does not pay. For example, the worker’s compensation carrier may contest you contracted Lyme disease at work and refuse to pay benefits. In this case, you would need to provide evidence to sustain your claim.
Contact a worker’s compensation attorney right away if your benefits have been denied, if you have permanent restrictions from Lyme Disease, or if you lose your job due to Lyme Disease that you contracted at work.
Please check with the Wisconsin Department of Health Services for advice on preventing tick bites.