Work-Related COVID-19 as a Compensable Occupational Disease Under W. Va. Code §23-4-1(f)

Introduction

In Brittany Foster v. PrimeCare Medical of West Virginia, Inc., 247 W. Va. 590, 885 S.E.2d 171 (2025), the Supreme Court of Appeals of West Virginia addressed whether a health-care worker’s contraction of COVID-19 qualifies as a compensable “ordinary disease of life” under W. Va. Code §23-4-1(f) despite general public exposure to the virus. The Court clarified the standard for proving compensability: statistical risk evidence is relevant but not dispositive, and a claimant may prevail by a preponderance of the evidence—medical records, expert testimony, and known workplace exposures—demonstrating that COVID-19 was contracted in the course of employment.

Summary of the Judgment

Chief Justice Wooton, writing for the majority, reversed the Intermediate Court of Appeals’ reliance on a single statistical study that found no increased infection risk for health-care personnel. The Supreme Court held that:

Under W. Va. Code §23-4-1(f), a disease “to which the general public is exposed” may be compensable if the claimant demonstrates by a preponderance of the evidence that the disease “was incurred in the course of and resulting from the employment.”
Statistical studies comparing workplace and community risk are relevant but not dispositive of causation.
A claimant need only show, through all the evidence taken together—medical testimony, records, known exposures—that it is more likely than not the infection originated at work.
The Board of Review’s detailed findings that Ms. Foster’s COVID-19 and subsequent complications arose from her exposure in a correctional facility were upheld; the court remanded with directions to reinstate the Board’s award of benefits.

Analysis

Precedents Cited

Duff v. Kanawha Cnty. Comm’n, 250 W. Va. 510, 905 S.E.2d 528 (2024) (Syl. Pt. 3) – Standard of review for Board of Review decisions: questions of law de novo; factual findings respected unless clearly wrong.
Powell v. State Workmen’s Comp. Comm’r, 166 W. Va. 327, 273 S.E.2d 832 (1980) (Syl. Pt. 5) – A prima facie case of occupational disease arises when a claimant shows exposure to a hazard and suffers the disease connected to it.
Smith v. State Workmen’s Comp. Comm’r, 159 W. Va. 108, 219 S.E.2d 361 (1975) – Co-ordinate reading of statutory provisions to effectuate legislative intent.
Vanderpool v. Hunt, 241 W. Va. 254, 823 S.E.2d 526 (2019) (Syl. Pt. 7) – Statutes on the same subject must be read together.

Legal Reasoning

The Court first rejected the ICA’s risk-centric approach under W. Va. Code §23-4-1(f)(4). That provision requires inquiry into whether the disease “does not come from a hazard to which workmen would have been equally exposed outside of the employment.” The ICA had treated a single metropolitan study (“Risk Factors Study”) as dispositive proof that health-care workers faced no greater workplace risk and thus Ms. Foster could not satisfy factor 4 as a matter of law. The Supreme Court held:

The statutory test under §23-4-1(f) is holistic: causation depends on “all the circumstances,” including medical testimony, records, and known exposures.
Statistical studies are “relevant, but not dispositive.” They may inform factor 4, but they cannot override a claimant’s direct evidence that the disease was contracted at work.
A claimant proves causation by a preponderance of the evidence—no heightened burden requiring proof of an objectively greater occupational risk in every case.
The Board of Review, on remand, properly weighed the Risk Factors Study’s limitations (early‐pandemic data, urban zip‐code focus, evolving peer review) against Dr. Guberman’s medical certainty that Ms. Foster’s exposure to COVID-positive inmates and staff caused her infection.

Finally, the Court harmonized §23-4-1(f)(4) with W. Va. Code §55-19-6 (2021), which expressly contemplates compensable COVID-19 claims, presuming the Legislature intended to allow such claims notwithstanding general public exposure.

Impact

This decision has immediate and far-reaching implications for workers’ compensation law:

It confirms that COVID-19 may be compensable even when community transmission is widespread.
It reaffirms the preponderance standard in occupational disease claims—statistical risk evidence supplements but does not replace claimant-specific proof.
It provides a clear roadmap for adjudicating COVID-19 claims: evaluate all evidence (medical, epidemiological, testimonial) rather than relying on generalized studies alone.
Board of Review opinions must specifically analyze each factor of §23-4-1(f) and articulate findings in light of both claimant and employer evidence.

Complex Concepts Simplified

“Ordinary disease of life to which the general public is exposed” – Any illness (e.g., flu, colds, COVID-19) that anyone can catch, at work or outside.
“Preponderance of the evidence” – More likely than not (greater than 50% chance) that the claimant’s illness was caused by workplace exposure.
Six-factor test (W. Va. Code §23-4-1(f)) – A checklist for compensation:
1. Direct causal connection between work and disease.
2. Disease follows naturally from work exposure.
3. Disease proximately traced to employment.
4. Not a hazard equally faced outside work.
5. Incidental to the character of the business.
6. Originates in a workplace risk.

Conclusion

The Supreme Court of Appeals of West Virginia has resolved a pivotal question left open by the pandemic: COVID-19, though ubiquitous, can be an occupational disease if a worker shows by a preponderance of the evidence that the infection arose from workplace exposure. Statistical risk studies play a role but do not dictate the outcome. Employers and claimants alike must present and challenge direct, case-specific evidence—medical records, expert testimony, and documented exposures—while adjudicators must apply the full six-factor statutory framework. This ruling underscores a balanced approach: neither blanket exclusion of COVID-19 claims nor uncritical acceptance based on profession or general risk, but a fact-driven inquiry into causation in each individual case.