Rousmaniere: COVID Workers' Comp and Me

I am glad how the workers’ compensation industry has tackled the issue of COVID. I have a few observations here, based in part on a sample with one: my own COVID experience and my work.

I contracted COVID in mid-January, had two short hospital stays, and two months later I am largely house-bound with supplemental oxygen. I qualify as a long hauler.  My symptoms post-discharge are primarily fatigue, with several manifestations of brain fogs. CT scans reveal zero lung scarring. As an injured worker and long hauler, what is my experience?

My workday.  Having formally resigned my obligations as journalist and consultant in workers’ comp, my work involves essay writing, zoom calls, walking the dog, and driving the grandkid to school.

Medical care. post discharge, western medicine has little to offer. MDs are largely out of the picture. A physical therapist, home visit, is essential. Exercise regimes offered to me otherwise have been either useless or iatrogenic.

Because of my experience with case managers in WC (a feature almost entirely unknown outside WC), I found a case manager through the firm of Conduent; the case manager has also been essential, to provide an integrated view of nutrition, supplements, and most important, the management of expectations.  My MD has been basically of no use except to approve my requests and deliver bad advice.

I expect the medical spend on long haulers will be relatively low, as established medicine has little to offer, until new drugs come in if at all. What I think is important to track is case management expenses, and home onsite or zoom-based PT as well. Watch out for medical food scams but consider paying for supplements I take five).

When and how will I RTW? My work is basically office work, chauffeuring and canine management. Here the uncertainties of recovery, relapse and infection (by others, and to others), loom large.

I cannot emphasize enough the lack of credible duration for disability data for COVID long haulers. All of your members are using something like ODG for duration guidelines.  “When do you think you can return to work?” Is a somewhat pointless question for a long hauler unless you do regular functional assessments.

The uncertainties about cognitive (thinking, decision making) and physical exertion are large.  In both domains week to week changes are both unpredictable and are often large.

In my case, cognitive power recovery has been on an upward slope for the past 40 out of 60 days. I failed the three-word memory test on my 20th day post first symptoms. Now I can read heavy non-fiction. But the course of recovery is uncertain. I have broken down “brain fog” into five categories, one of which is the rather important one of not retaining instructions given to me (my daughter gets in one many encounters). 

There needs to be a more fine-grained assessment tool to measure recovery of cognitive capacity. How my brain fog (partly) diminished is a mystery. Time? Some light exercise? My acupuncture?

Regarding physical impairment, there remains great confusion about the roles of COVID- driven impairment on the one hand and de-conditioning.  Is the distinction irrelevant? My physical recovery has involved three significant relapses and, most recently, an unexpected and significant improvement. There needs to be repeated assessment of physical capacity.

I leave with a broader observation about workers’ comp and covid, involving risk of infection (giving and getting) and re-infection. An under-appreciated role of workers’ comp is to make it safe for people to decide to work, whether that means mining or work in the accounting department. The early wave of presumption legislation was an attempt to make people feel safe to work. I am living and working alone. Were I working with others, I expect would be extremely cautious about RTW, as well as my co-workers.

By Peter Rousmaniere

Peter Rousmaniere is a former columnist for Workerscompensation.com. He can be reached at pfr@rousmaniere.com

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