A WCNC Charlotte review of North Carolina and city of Charlotte pandemic workers' comp claims revealed most who apply for benefits are getting denied, including some front-line workers.
David Rogers, an insurance agent in the Charlotte area, said aside from some health care workers, police officers, EMS crews, firefighters and airline workers, most people are having trouble meeting the criteria for workers' comp.
"I've seen very little claims paid," Rogers said. "In my direct experience paid out, probably not even 5%. It's been that low."
The North Carolina Industrial Commission requires workers prove two things in order to collect benefits: Their job exposed them to a greater risk than the general public, and directly caused them to get COVID. Rogers said that's a heavy burden considering the virus is still new and often untraceable.
"It's very hard to say, did you not catch it at the grocery store or wherever you may be when you're not at work?" he said.
The decision to approve or deny is up to each employer. Those approved receive two-thirds of their pay over a period of time.
State records show North Carolina has only paid COVID workers' comp to seven out of the 35 employees whose claims went to its third-party administrator.
"Community spread was established early, making it difficult to definitively state where or how someone was exposed," Office of State Human Resources Communications Director Jill Warren Lucas told WCNC Charlotte. "Not all claimants were necessarily exposed to COVID; some were determined not to have been infected. State provides paid time off for eligible employees who are directed to quarantine or isolate. Many employees not experiencing severe illness have been able to telework."
Statewide, data through August 31, 2021, show 63% of workers (government and non-government) who filed pandemic-related claims in North Carolina were denied.
Public records show the city of Charlotte, meanwhile, has used federal COVID-19 money to compensate nearly 600 employees a combined $515,000. Water, fire and police employees had the highest total amount of claims paid and received 94% of all money paid out, according to WCNC Charlotte's analysis of the data. Records show more than 1,000 other employees, mostly police and fire, had not yet received workers comp payments as of early February.
Cheryl Andrews McDonald knows the pain of losing a loved one. Her husband, 49-year-old Sgt. Michael McDonald, died in October. His death certificate lists COVID-19 pneumonia as an underlying cause.
"I don't want his name to ever be forgotten," the widow said. "He was a good, honorable man who always showed up. Whenever he was called in, he was there. He didn't complain. He didn't question. He did what he needed to do because he was a part of a team in the police department."
McDonald said her husband's job cost him his life. She said the Winston-Salem Police Department veteran officer contracted COVID-19 while working the Carolina Classic fair.
"He was mandated to work all 10 days of the fair," she said. "When he was not at work, he was at home."
Already suffering unbearable loss, McDonald said the family now also feels abandoned. She applied for workers' comp, but the city recently denied her claim.
"It's about honor for him. This is not about a monetary sum," she said. "He's gone. His (12-year-old) son will never have a father again and money's not going to fix that, but showing him the honor that he deserves, that's the best that we can do."
WCNC Charlotte is always asking "where's the money?" If you need help, reach out to WCNC Charlotte by emailing email@example.com.
In a denial letter reviewed by WCNC Charlotte, the city concluded there's no medical evidence McDonald contracted COVID-19 at work, said its masking requirement resulted in reduced risk and pointed out the sergeant refused an available vaccine.
"He was waiting for the city to mandate it," his wife said of his vaccine decision. "So then if he got sick or felt unwell and needed to take time off work, he felt like the city would have to give him that time off work."
His wife and father said they were vaccinated and didn't get COVID at the same time.
"For them to turn their back on him now is very disgusting to me," Ronnie McDonald said. "I want them to honor him as he has honored the police department for 25 years."
McDonald family attorney Ben Winikoff said the approval and denial of workers' comp benefits remain inconsistent across the state. He cited the case of Montgomery County Sheriff's Office school resource officer Sypraseuth Phouangphrachan, who died during the first month of the pandemic. State records show the North Carolina Industrial Commission determined his employer should pay death benefits for 500 weeks.
"I feel Cheryl's frustration, not just with this case, but that we're seeing it inconsistently enforced across the departments," he said.
McDonald said the city's denial and overall response feel "like a slap in the face."
"Very cold, like he just never existed," she said. "Like all of the things that he did never happened. It's made us feel alone."
His father said the denial has only piled on the pain.
"I can't replace what I lost. He was my only child," he said. "I don't understand why they won't honor him. To me, it's not about the money. It's about the honor. I know he's watching me somewhere and I'll see him again, but until then I'll be in pure misery for the rest of my life."
McDonald's family intends to appeal the denial to the North Carolina Industrial Commission.
The city of Winston-Salem, meanwhile, declined comment, at the recommendation of legal counsel, citing "personnel privacy laws and other applicable laws."
"As such, the City must reserve all comments for the appropriate legal forum," Winston-Salem City Attorney Angela I. Carmon said.