Workers’ Compensation Benefits for Long COVID
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Workers’ Compensation Benefits for Long COVID

Occupational Exposure

New Jersey Workers' Compensation Benefits for Long COVID: A Comprehensive 2025 Update

Understanding Your Rights Under New Jersey's Enhanced Protections for Essential Workers

Last Updated: September 2025

Executive Summary

New Jersey Senate Bill 2380 created a rebuttable presumption of workers' compensation for essential workers who contract COVID-19, providing significant legal advantages for workplace exposure claims. Recent studies show that Long COVID claims account for nearly 74% of COVID-related workers' compensation payments, with substantially higher costs and longer treatment periods than acute COVID cases.

I. New Jersey's Presumption Law: A Critical Legal Advantage

The Legal Framework

Under New Jersey Senate Bill 2380, enacted September 14, 2020, when workers deemed "essential" contract COVID-19, they are entitled to the presumption that the disease is "work-related and fully compensable." This creates a rebuttable presumption, meaning the burden shifts to employers to prove the infection did not occur at work.

The burden of proof establishing the causal relationship between occupational exposure and the infectious medical condition has been statutorily relaxed for essential workers and other classes of workers, allowing them to invoke a rebuttable presumption of causal relation that shifts the burden to employers to prove the lack of causal relationship.

Essential Worker Definition - Expanded and Clarified

The law provides a comprehensive definition of "essential employee" as an employee in the public health or private sector who, during a state of emergency, performs functions involving physical proximity to members of the public and are essential to public health, safety, and welfare. This includes:

Core Essential Workers:

  • Public safety workers and first responders (fire, police, emergency responders)

  • Healthcare workers and support staff

  • Transportation service workers

  • Hotel and residential service workers

  • Financial service workers

  • Workers in production, preparation, storage, sale, and distribution of essential goods (food, beverages, medicine, fuel)

Expanded Categories:

  • Educational staff (confirmed by recent case law)

  • Workers conducting essential business and work-at-home support

  • Any other employee deemed essential by a public authority declaring a state of emergency

Important Exclusion: Employees of the State of New Jersey who were offered the option to work from home but refused are not considered essential employees.

Recent Case Law Development

In Amato v Township of Ocean School District, 480 N.J.Super. 239, 327 A.3d 1212 (App. Div. 2024), the court confirmed that teachers are considered essential employees during the pandemic. The court reasoned that broad statutory language allows authorities to designate essential employees, relying on CISA (Cybersecurity and Infrastructure Security Agency) guidance, the New Jersey Office of Emergency Management's adoption of CISA guidelines, the Department of Health's vaccination plans, and Executive Order 175, which highlights the critical nature of in-person instruction.

II. Long COVID: Medical Recognition and Enhanced Understanding

Current Medical Classification

The 2025 edition of ICD-10-CM U09.9 "Post COVID-19 condition, unspecified" became effective on October 1, 2024, providing formal medical recognition for Long COVID conditions. This single code may prove insufficient given the phenotypic and severity variation seen in Long COVID patients, suggesting that subtypes of Long COVID exist.

Symptom Clusters and Clinical Presentation

Recent medical research has identified distinct clusters of Long COVID symptoms:

Respiratory Cluster (17.8% of cases):

  • Persistent cough and shortness of breath

  • Lung diffusion impairment

  • Radiographic abnormalities

Neurological Cluster (8.7% of cases):

  • Cognitive deficits ("brain fog")

  • Memory and concentration difficulties

  • Difficulty focusing and mental fatigue

Circulatory Cluster (9.0% of cases):

  • Tachycardia syndrome

  • Blood clots

  • Chest pain

Autonomic Dysfunction:

  • Temperature regulation problems

  • Sleep disorders and insomnia

  • Gastrointestinal issues

Mental Health Impacts (4.4% of cases):

  • Anxiety and depression

  • Post-traumatic stress related to illness

Duration and Disability Impact

A New York State study analyzing over 3,000 COVID-19 workers' compensation claims found that almost one-third of all workers infected with COVID-19 suffered or are suffering from Long COVID, with approximately 18 percent unable to return to work for more than one year.

California research shows that average medical payments were 105 times higher on Long COVID cases than on shorter-duration COVID claims, and average indemnity payments were 37 times higher.

III. Workers' Compensation Benefits Available in New Jersey

2025 Benefit Rates

Effective January 1, 2025, New Jersey workers' compensation rates increased to a maximum of $1,159.00 per week for temporary and permanent disability and a minimum of $309.00.

Types of Benefits

1. Medical Benefits All reasonable and necessary medical treatment is covered, including:

  • Diagnostic testing and monitoring

  • Specialist consultations and evaluations

  • Prescription medications

  • Physical therapy and rehabilitation

  • Mental health services

  • Long-term care coordination

  • Telehealth and telemedicine services (expanded during pandemic)

2. Temporary Disability Benefits

  • Temporary total disability (TTD) benefits: up to 70% of average weekly wages

  • Subject to state maximums ($1,159 weekly maximum)

  • Available for up to 400 weeks or until maximum medical improvement

  • Benefits begin after seven days out of work (retroactive if disability continues)

3. Permanent Disability Benefits For Long COVID cases resulting in permanent functional limitations, workers may be entitled to benefits based on:

  • Demonstrable, objective medical evidence of disability

  • Restriction of bodily functions or organs

  • Appreciable impairment of ability to work

  • Substantial interference with other life aspects

Special COVID-19 Death Benefits

For essential employees who died from COVID-19 contracted in the course of employment after March 1, 2020, dependents are entitled to supplemental dependency benefits paid from the Second Injury Fund. Insurance carriers and self-insured employers must notify the Division of Workers' Compensation to initiate these supplemental benefits.

IV. Proving Occupational Exposure: Enhanced Framework

Medical Evidence Requirements

Successful Long COVID claims require comprehensive documentation:

1. COVID-19 Diagnosis Documentation

  • Positive PCR, antigen, or antibody test results

  • Medical records showing COVID-19 symptoms and treatment

  • Physician diagnosis with rationalized medical opinion if testing unavailable

  • Home tests are insufficient without professional confirmation

2. Long COVID Medical Evidence

  • ICD-10-CM code U09.9 diagnosis

  • Objective medical testing showing ongoing symptoms

  • Specialist evaluations documenting functional limitations

  • Medical opinions connecting Long COVID to initial workplace exposure

  • Documentation of symptoms persisting beyond the acute phase

3. Work Exposure Evidence

  • Description of job duties and work environment

  • Documentation of workplace COVID-19 outbreaks or exposures

  • Evidence of interaction with the public, patients, or co-workers within 21 days of diagnosis

  • Employer safety protocols and compliance records

Time Limitations - Relaxed Standard

New Jersey provides a relaxed time limitation for infectious disease claims. Claims must be filed within two years of when the worker knows of the disability and its employment relationship, providing additional protection for Long COVID sufferers whose symptoms may develop or worsen over time.

PPE Defense Limitations

Employers seeking to defend against COVID-19 claims based on PPE non-compliance must establish that the employee had willful self-exposure to a known hazard or willful failure to use PPE, with documented repeated warnings and clear employment requirements.

V. Legal Protections and Anti-Retaliation Measures

Comprehensive Discrimination Protection

New Jersey provides multiple layers of protection against employer retaliation:

Administrative Remedies:

  • Discrimination complaints with the Division of Workers' Compensation

  • Commissioner of Labor investigation and enforcement

  • Fines of $100-$1,000 and/or imprisonment up to 60 days

  • Restoration to employment and wage loss compensation

Civil Remedies:

  • Common law wrongful discharge actions

  • Two-year statute of limitations from the termination date

  • Compensatory and punitive damages are available

  • Coverage under the Conscientious Employee Protection Act

Employment Security: During public health emergencies, employers cannot terminate or penalize employees who request time off based on licensed medical provider recommendations.

VI. Public Employee Considerations

Pension Coordination

Public employees with Long COVID face complex coordination between workers' compensation and pension benefits:

Age and Service Benefits: Not subject to workers' compensation offset. 

Disability Benefits: Subject to dollar-for-dollar offset to prevent double recovery. 

Conversion Options: Employees can convert ordinary disability to service retirement for an optimal benefit combination.

Recent Regulatory Changes

The New Jersey Office of State Comptroller determined that medical monitoring settlements were inconsistent with law and public policy, leading to rescission of policies that encouraged stand-alone medical monitoring settlements. This ensures employers pay complete workers' compensation benefits rather than shifting costs to taxpayers.

VII. Special Considerations for Long COVID Claims

Vaccination Injury Coverage

Employees who suffer adverse consequences from employer-provided COVID-19 vaccinations may recover workers' compensation benefits under the Mutual Benefit Doctrine, similar to historical smallpox vaccination coverage.

Telehealth Treatment

The pandemic expanded telehealth and telemedicine authorization, allowing socially distanced medical treatment and evaluations. Fees must be reasonable and consistent with ordinary charges for services rendered.

Hiring Preference Requirements

Employers with 50 or more workers must give injured workers hiring preference if they reach maximum medical improvement but cannot return to their prior position. Professional athletes are exempt from this requirement.

VII. Strategic Legal Approaches for Successful Claims

Leveraging the Presumption

For essential workers:

  1. Document essential worker status using a comprehensive definition

  2. Establish a timeline of workplace exposure within a 21-day window

  3. Obtain robust medical documentation supporting a Long COVID diagnosis

  4. Challenge the employer's rebuttal attempts with evidence of workplace transmission

Building Medical Foundation

  1. Secure specialist evaluations from physicians experienced with Long COVID

  2. Document functional limitations through objective testing and evaluations

  3. Maintain detailed symptom diaries showing ongoing impairment patterns

  4. Obtain medical opinions linking Long COVID to workplace COVID-19 exposure

  5. Use ICD-10-CM U09.9 coding for formal medical recognition

Procedural Compliance

Filing Requirements:

  • Electronic filing mandatory for initial pleadings by licensed attorneys

  • Claim petitions must be filed within two years of knowledge of disability

  • Employers must notify the Division of Workers' Compensation of the need for dependency benefits

Evidence Preservation:

  • Maintain identical paper copies of electronic filings with verification

  • Document all workplace exposures and safety protocol compliance

  • Preserve medical records establishing continuous treatment

IX. Current Challenges and Opportunities

Evolving Medical Understanding

The clinical definition and understanding of Long COVID mechanisms continue evolving, with the ICD-10-CM code deployment occurring nearly two years after patients began describing their conditions. This evolving recognition strengthens the medical foundation for workers' compensation claims.

Cost and Duration Implications

Research demonstrates that while only 4.7% of COVID-19 claims result in Long COVID cases, these cases lead to dramatically higher costs due to long-term medical conditions that prevent a return to work. Average medical payments are 105 times higher and indemnity payments 37 times higher than short-duration COVID claims.

Gender and Age Considerations

Studies reveal significant disparities: 37% of female workers developed Long COVID compared to 26% of male workers. Adults over 60 often face particular difficulties returning to work, with these challenges intensifying with age.

X. Recommendations for Workers and Practitioners

Immediate Actions for Workers

If you believe you contracted COVID-19 at work and experience long-term symptoms:

  1. Seek immediate medical attention and document work-related exposure

  2. Notify the employer in writing of the workplace injury within the reporting requirements

  3. File workers' compensation claim promptly with the Division of Workers' Compensation

  4. Document all symptoms and limitations affecting work and daily activities

  5. Consult an experienced workers' compensation attorney familiar with Long COVID claims

Strategic Documentation

  • Request medical providers to note the work-related nature of the condition

  • Obtain copies of all medical records and diagnostic test results

  • Document functional limitations through specialist evaluations

  • Consider neuropsychological testing for cognitive symptoms

  • Maintain employment records showing essential worker status

XI. Conclusion and Future Outlook

New Jersey's comprehensive legal framework provides essential workers with significant advantages in pursuing Long COVID workers' compensation claims. The rebuttable presumption, expanded essential worker definition, enhanced anti-retaliation protections, and recent regulatory clarifications create a favorable environment for legitimate claims.

With nearly one-third of COVID-infected workers developing Long COVID and dramatically higher associated costs, these protections represent substantial financial security for affected workers. The key to success lies in understanding the full scope of available protections, obtaining comprehensive medical documentation, and working with experienced legal counsel who understands both the medical complexities of Long COVID and New Jersey's unique legal advantages.

The evolving medical understanding of Long COVID, combined with New Jersey's worker-protective legal framework, continues to strengthen the foundation for successful claims. As research advances and medical recognition expands, workers with Long COVID can expect continued support through the state's comprehensive workers' compensation system.

For immediate assistance with New Jersey Long COVID workers' compensation claims, consult with qualified legal counsel who understands the intersection of medical evidence, procedural requirements, and New Jersey's unique presumption protections.


This article is for informational purposes only and does not constitute legal advice. Workers' compensation law is complex and varies by individual circumstances. Always consult with a qualified attorney for advice specific to your situation. Laws and regulations may change after the publication date.

Recommended Citation: Jon L. Gelman,   Workers’ Compensation Benefits for Long COVID: A Comprehensive 2025 Update, gelmans.com (September 13, 2025), https://www.gelmans.com/ReadingRoom/TabId/65/ArtMID/1482/ArticleID/1087/Workers’-Compensation-Benefits-for-Long-COVID.aspx

Recognition of Post-Acute Sequelae of COVID

"The World Health Organization (WHO) created the ICD-10 code, U09.9, which is being proposed to be adopted into ICD-10-CM (the United States version of the classification system) without modification. WHO named it ‘Post COVID-19 condition, unspecified,’ and their instructional note says, “this optional code serves to allow the establishment of a link with COVID-19. This code is not to be used in cases that still present COVID-19.”

The ICD U09.0 was officially adopted on October 1, 2021, as the International Code of Diseases for insurance billing purposes.

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Jon L. Gelman of Wayne, NJ is the author of NJ Workers’ Compensation Law (Thomson-Reuters) and co-author of the national treatise Modern Workers’ Compensation Law (Thomson-Reuters). For over five decades, the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  have represented injured workers and their families who have suffered occupational accidents and illnesses.

Updated: September 14, 2025

© 2001-2025 Jon L Gelman. All rights reserved.

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We are dedicated to utilizing our knowledge and skills in conjunction with the most modern technology to provide the best possible legal representation. Our practice is built on a strong foundation of in-depth knowledge of the subject matter which is reflected in the 3-volume treatise entitled Workers' Compensation Law , (Thomson-West), that we authored, and in the 3-volume national treatise, Modern Compensation Law, (Thomson-West), that we co-authored.

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