These days, workers who refuse to get vaccinated against covid-19 may face financial repercussions, from higher health insurance premiums to loss of their jobs. Now, the financial fallout might follow workers beyond the grave. If they die of covid and weren't vaccinated, their families may not get death benefits they would otherwise have received.
New York's Metropolitan Transportation Authority no longer pays a $500,000 death benefit to the families of subway, bus and commuter rail workers who die of covid if the workers were unvaccinated at the time of death.
"It strikes me as needlessly cruel," said Mark DeBofsky, a lawyer at DeBofsky Sherman Casciari Reynolds in Chicago who represents workers in benefit disputes.
Other employers have similar concerns about providing death or other benefits to employees who refuse to be vaccinated.
In Massachusetts, the New Bedford City Council sought to extend accidental death benefits to city employees who died of covid, but the mayor didn't sign that legislation because, among other things, it didn't prohibit payment if the worker was unvaccinated.
President Joe Biden has leaned hard on businesses to make sure their workers are vaccinated. In September, the administration announced all employers with 100 or more workers would be required to either ensure they're vaccinated or test employees every week for covid.
Among employers, "there's a frustration level, particularly at this point when these vaccines are fully approved," said Carol Harnett, president of the Council for Disability Awareness, an industry group. "You're trying to protect yourselves and your employees, both from themselves and the general public."
The New York transportation authority is the highest-profile employer to take this action. Since the pandemic crisis began in 2020, 173 MTA workers have contracted covid and died. Five of those deaths occurred after June 1 of this year, when the policy changed, according to the MTA.
"We are not aware they have been vaccinated," an MTA spokesperson said of the five workers who died since the policy took effect.
The transit authority's policy was a shift from an earlier pact with workers. In April 2020, as covid ravaged New York, transit officials and the labor unions representing employees reached agreements that workers who died of covid would be eligible to receive a $500,000 lump-sum death benefit, just like payments to which families of MTA workers who have other job-related deaths are entitled. The program will continue through the end of this year.
But with covid vaccines now widely available and fully approved by the Food and Drug Administration, the MTA Board determined that, starting June 1, workers who died of covid had to have been vaccinated for their families to be eligible for the payment.
The change comes as the MTA has struggled to improve vaccination rates among its roughly 67,000 workers. More than 70% of transit employees are estimated to be vaccinated, according to MTA officials.
A spokesperson for the MTA stressed that the program remains in effect, and noted that it has been extended past its original one-year term. The only change is the vaccination requirement.
"The program is not being revoked," the MTA spokesperson said in an email. "In fact, the MTA has twice extended it."
Local 100 of the Transport Workers Union, which represents roughly 38,000 MTA workers, pushed hard to negotiate the benefit. "No other workforce in the city, probably the country, secured what TWU secured: a $500,000 payment from the employer to the families of workers who died after getting covid," said Pete Donohue, a union spokesperson. "We look at it that during a terrible time, we got [the benefit] for people."
It's not unusual for employers of workers in risky occupations — such as police, firefighters, utility company workers and transit workers, who could succumb to an industrial accident or get hit by a train on the tracks — to offer extra insurance coverage that pays if they die on the job. The coverage is often provided in addition to a regular life insurance policy.
These so-called line-of-duty or accidental death and dismemberment policies typically don't pay out if someone dies of a disease. How can it be proved that someone picked up a deadly infection at work rather than at the supermarket?
But with covid, some front-line workers have been considered eligible for accidental death benefits because they are presumed to have gotten sick on the job, DeBofsky said.
Workers may be denied death benefits, however, if they didn't follow established safety protocols, said John Ehrlich, the national lead consultant at Willis Towers Watson on group life insurance. Failing to wear a bulletproof vest, a helmet or other safety equipment, for example, might make their families ineligible for payment under a policy.
Now that vaccines are widely available, some employers have considered limiting other benefits paid to unvaccinated workers, including reducing short-term disability payments, said Rich Fuerstenberg, a senior partner at benefits consultant Mercer. But Fuerstenberg said he had not heard of other employers eliminating death benefits for unvaccinated workers.
In the New Bedford case, the City Council unanimously passed a petition in August stating the covid death of any city employee would be considered to have occurred in the line of duty, enabling family members to receive accidental death benefits.
Mayor Jon Mitchell, however, objected for several reasons — the question of vaccination among them.
"As I am certain the Council would agree, it would be inappropriate to extend accidental death benefits where the employee refused to take a vaccine that had been found to be nearly 100% effective," Mitchell said in a letter to the council. The proposal has been tabled for further negotiation, according to a spokesperson for the mayor.
For more than 17 years, Joseph Fletcher worked for the MTA in Brooklyn, doing body work and other maintenance on buses.
When he died of covid on April 11, 2020, at age 60, he left behind his wife, Veronica, a former high school teacher who was disabled after a car accident, and three children, now 9, 13 and 16.
Coping with his death was hard enough, but looking toward the future has been overwhelming, Veronica said.
"How am I going to keep afloat financially?" she worried. "Everything about this journey is terrifying."
The $500,000 death benefit helped cover the family's regular bills and pay the mortgage on their Brooklyn home. But she's aware it will go only so far, and her three children need to go to college.
If the MTA vaccination requirement had been in place when her husband died, it wouldn't have been a problem, Fletcher said.
"I wish that my husband were able to have been vaccinated," she said. "Knowing my late husband, he would have taken the opportunity to protect himself and his family."
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.