Treatment of COVID-19 as Work Accident

On April 6, 2020, the Office of the General Occupational Risk Insurance of the Ecuadorian Institute of Social Security (IESS), issued the Guide for the Medical and Technical Qualification of Work Accidents by COVID-19, which establishes the following:

In which cases is COVID-19 considered a Work Accident?

  • COVID-19 will be considered a Work Accident for employees of private corporations or public institutions that carry out activities related to health, and for employees of economic activities that due to the emergency situation in the country, the control authorities have ordered them to continue with their activities1.

  • It is a fundamental requirement for a case of COVID-19 to be considered a work accident, the verification of the cause-effect relationship between the reported case and the work this person has been executing.

COVID-19 Qualification Process as a Work Accident

  • Once the case of COVID-19 has been determined, it is necessary to schedule an appointment with an occupational physician from the General Occupational Risk Insurance, which can be made virtually.

  • Before the appointment, the occupational doctor will request the documentation that must be sent to the institutional email of each doctor. This information consists on:

    1. Confirmed exam of COVID-19 from the Ministry of Public Health and / or from laboratories authorized by the competent entity.
    2. Medical certificate or medical history in case of being treated in public or private hospitals.
    3. Extended report of the company or institution showing the affiliate’s functions and hours and the certainty that the employee was exposed to confirmed cases of COVID-19 as part of their work.

  • In case that the affiliate or the employer does not submit this documentation, the occupational doctor will grant a term of 7 days for it’s submission. If the employer fails to comply, the Provincial Office or the Coordination of Occupational Risks must present evidence that the documents were requested from the employer twice, with a term of 3 days for each request, which will be used as evidence in favor of the employee.

  • All documentation must be requested and received through the institutional email.

  • Once the work accident is qualified, the occupational doctor must register the medical certificates to proceed with the payment of the corresponding financial benefit. In the event that it is evident that the qualified case produces a sequel with incapacity for work, the file must be sent to the technical area for the corresponding investigation.

Consequences of the Qualification of the Case of COVID-19 as a Work Accident

  • The employer is responsible for work risks and, as a consequence, if an employee suffers personal injury, he must compensate him in case the Ecuadorian Social Security Institute does not grant such benefit.

  • To establish the compensation, the law differences the following consequences of the work accident:

    1. Death.
    2. Permanent and absolute incapacity for all work.
    3. Permanent decrease in work capacity.
    4. Temporary disability.

  • In any case of accident, the employer shall be obliged to provide, without the right to reimbursement, medical or surgical and pharmaceutical assistance to the employee who is the victim of the accident until, -according to the medical opinion-, he is able to return to work or is declared to be in any of the cases of permanent disability and no longer require medical assistance.

  • In the event of the employee’s death, the deceased’s beneficiaries must be compensated2.

  • If the accident causes absolute and permanent incapacity for all work, the compensation will consist in a salary of 4 years, or an annuity equivalent to 66% of the last monthly remuneration received by the victim.

  • If the accident causes permanent decrease in the capacity for work, the employer will be obliged to compensate the victim in accordance with the proportion established in the value reduction table for work capacity.

  • The compensation for temporary disability will be 75% of the salary that the employee had at the time of the accident and will not exceed a period of one year.

  • The General Occupational Risk Insurance of the IESS covers the benefits and compensation resulting from work accidents.

  • In the event that the employer has not affiliated the employee to IESS or if the employer has not complied with the payment of contributions on time, then said employer is liable.

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1 According to art. 11 of the General Occupational Risk Insurance Regulations, Work Accident is any unexpected and sudden event that occurs due to cause, consequence or on the occasion of work, originated by work activity related to the job, causing injury to the member bodily or functional disturbance, disability, or immediate or subsequent death.
2 If it occurs within 180 days after the accident, the compensation is equal to a salary of 4 years. If it occurs after 180 days, the compensation is two thirds of the amount indicated above.

Disclaimer: This document is informative and does not, and is not intended to, constitute legal advice.