A long-term care worker’s family can receive workers’ compensation payments resulting from his 2020 death due to COVID-19, the Colorado Court of Appeals has ruled. 

The decision is the latest wrinkle in the complicated and often contradictory web of legal decisions about providers’ liability for COVID outbreaks during the peak of the pandemic. 

Three judges upheld an earlier ruling by a panel with the state’s Industrial Claim Appeals Office. It had been appealed by provider Life Care Centers of America and its insurer. The judges decided that COVID qualified as an “occupational disease” in the circumstances of this particular case.

In 2020, Vincent Gaines was a 20-year veteran floor technician and housekeeper at a Life Care nursing home in Colorado, according to court documents. He contracted COVID in late May during an outbreak at the facility. He was hospitalized on June 2 and died a month later.

Gaines’ spouse, Sheila Jackson, filed a workers’ compensation claim June 8, 2020. An administrative law judge ruled that it was likely Gaines’ exposure to COVID at work had caused his death and ordered one month of disability benefits and death benefits be paid to his spouse. 

In Colorado, death benefits cover two-thirds of the deceased’s salary. As Gaines’ spouse, Jackson would receive these payments for life, or until remarriage, which could amount to hundreds of thousands of dollars in the long run.

In their appeal, lawyers for the petitioners argued that there was no proof Gaines had contracted COVID at work. 

However, Gaines’ case was very likely caused by exposure at work, according to testimony by Marcus Oginsky, MD, a doctor of internal medicine. The doctor noted that community exposure rates were very low at that time and that Gaines had no known exposures to COVID from his household. 

COVID knots still tangled

The appellate court judges agreed with earlier decisions to award the workers’ compensation claim, writing that there was ample evidence of workplace exposure and no proof of exposure outside of work.

“Ultimately, we agree with Jackson that, because Gaines’s exposure to COVID-19 was shown to have arisen out of his employment based on substantial evidence presented to the ALJ and upheld by the panel, his award of benefits should not be reversed on appeal,” wrote Judge Ted Tow.

Tow — along with concurring judges Matthew Grove and Lino Lipinsky — upheld the original administrative law judge ruling on the workers’ compensation claim. 

Life Care did not respond to McKnight’s Long-Term Care News’ requests for comment Monday.

The provider had previously been vindicated in a landmark COVID-related wrongful death case against a Washington nursing home where one of the nation’s first outbreaks occurred. 

In the ongoing process of settling remaining COVID legal cases, however, not all providers have been so fortunate. Cases in Oregon, New York and New Jersey have resulted in expensive settlements and ongoing litigation — some of these despite immunity provisions put into place to protect nursing homes in many states across the country.