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FAQs

TDIC continues to receive inquiries from TDIC policyholders on how to assess and manage the risk of potential exposure.

Workers' Compensation

An employee tested positive with COVID-19 and is unsure if they contracted it at work or elsewhere. Do I need to file a claim?

A: Yes. In California, Gov. Newsom signed an Executive Order (N-62-20) on May 6, 2020, stating that an employee who tests positive for COVID-19 from March 19, 2020, to July 5, 2020, can file a workers’ compensation claim, and it may be accepted if all of the following exist:

Any COVID-19-related illness of an employee shall be presumed to arise out of and in the course of the employment for purposes of awarding workers’ compensation benefits if all of the following requirements are satisfied:  

a) The employee tested positive for or was diagnosed with COVID-19 within 14 days after a day that the employee performed labor or services at the employee’s place of employment at the employer’s direction. 
b) The day of supposed exposure to COVID-19 was on or after March 19, 2020. 
c) The employee’s place of employment was not the employee’s home or residence. 
d) A diagnosis of COVID-19 can only be provided by a physician who holds a physician or surgeon license issued by the California Medical Board; a diagnosis must be confirmed by a test within 30 days of the date of the diagnosis. 

The Executive Order created a rebuttable presumption, meaning, if it was discovered through a claims investigation that the employee was exposed to COVID-19 outside of work, the claim would be denied. 

If your employee worked for you from March 19, 2020, through July 5, 2020, and tested positive for COVID, call your workers’ compensation carrier to determine if a claim needs to be opened. 

If your employee contracted COVID after July 5, 2020, and they believe they got it at work, contact your workers’ compensation carrier to determine if a workers’ compensation claim should be filed. 

 

Because my employee tested positive for COVID-19, do I need to close my practice?

A: It may not be necessary to close your practice after learning that an employee has COVID-19 or a patient has symptoms or tests positive for COVID-19 within two days of being seen in the practice. As long as you and your employees have avoided “close contact” by wearing PPE correctly, practicing social distancing during break and meal periods and are sanitizing your office, operatories and common areas regularly, there is low risk of COVID-19 transmission to you and your employees.  

For more information on determining your office’s exposure risk level, CDA Practice Support has created a flowchart to assist you.  

Ultimately, what will determine if your office remains open is whether the dental practice can continue to operate safely without the employees who are sent home.  

 

I have several employees showing COVID-19 symptoms. Do I need to file a workers’ compensation claim?

There is no reason for them to file a claim unless they receive a positive COVID-19 test and believe they contracted it at work. Until a positive test result is received, there is no claim for them to file. The Center for Disease Control and Prevention (CDC) recommends visiting both state and local health departments for guidance on when to get tested and where to get tested for COVID-19. 

If your employee gets tested and the result is positive, talk to your employee to determine if they want to file a workers’ compensation claim. 

If your employee tests positive for COVID-19, the CDC has provided guidance as to when your employee can return to work. Refer to CDA’s flowchart for more information. 

 

One of my employees got COVID-19 outside of work and now the rest of my employees are worried about coming into work. Should I send them home, and do I need to open a workers’ compensation claim for them?

If your employees have been consistently wearing PPE while in the practice, practicing infection prevention procedures and are showing no symptoms related to COVID-19, they can continue to work, and should actively self-monitor for 14 days. If at any time they begin to feel sick, it is recommended that they stay home and consult with their medical provider or get tested. If the result comes back positive, call your workers’ compensation carrier for next steps. If the result is negative, your employee can return to work. 

If your employees still refuse to come into work and want to self-quarantine for 14 days, call TDIC’s Risk Management Advice Line at 800.733.0633 for guidance on employer best practices. 

 

I have employees who tested positive for COVID-19 and they are off work for the next 14 days. Workers’ compensation claims have been filed for them. How will they get paid?

If the workers’ compensation claim was filed when Gov. Newsom’s Executive Order was in effect from March 19 through July 5, the eligible employee must first be paid according to the Families First Coronavirus Response Act (FFCRA). The employee may be eligible to receive up to 80 hours of paid sick leave (prorated for part-time employees on average hours worked). 

If the workers’ compensation claim is filed after July 5, until the workers’ compensation claim is accepted, the employee may be paid according to the FFCRA by using accrued paid time off or by filing a short-term disability insurance claim. 

If the workers’ compensation claim is accepted, the employee would be eligible to receive temporary disability benefits after fulfilling a three-day waiting period. 

 

My employees have to wear PPE on a continual basis since reopening, and some of my employees have expressed that wearing PPE for long periods of time is making them uncomfortable. Do I need to file a workers’ compensation claim for them?

Since returning to practice, employees are required to wear PPE throughout most of their shifts. If any of your employees begin complaining of pain, strain or discomfort due to wearing PPE, it is best to discuss this with your employees to ensure the schedule is allowing for, and they are taking, their mandatory meal and rest breaks.  

You may also determine alternatives for them, such as allowing them to take short breaks in between seeing patients or even working with them to determine if there is alternative PPE that may work for them.  

Make sure that your employees are staying safe during their breaks by allowing them to break in a sanitary location that permits them to practice social distancing. 

If your employee continues to have issues with wearing PPE or if you need additional information on employer best practices, call the Risk Management Advice Line at 800.733.0633.  

Lastly, inform your employees of their right to file a workers’ compensation claim and provide them with a workers’ compensation DWC 1 claim form should they decide to seek treatment. 

 

We received word from a patient that they tested positive for COVID-19. At the time of their visit, they were asymptomatic; however, they believe they might have gotten COVID-19 prior to their dental visit. I am planning on closing my practice for 14 days and want all of my employees to get tested prior to reopening. Do I need to open a workers’ compensation claim for all of my employees?

First, it may not be necessary to close your practice. As long as you and your employees wore PPE correctly and appropriately and avoided “close contact” with individuals, you are at low risk of contracting COVID-19. However, if you desire to get COVID-19 tests completed for you and your staff and want to close your facility, you only need to stay closed until your test results come back. During the time of the employer-directed closure, employees may be offered the ability to use unused paid sick leave, vacation or PTO. If ordered by a federal, state or local agency or a health care provider to quarantine, employees may be eligible for emergency paid sick leave wages paid under the FFCRA. 

CDA’s flowchart can help guide you and your employees on when to stay home due to COVID-19 exposure in the workplace. 

Lastly, a workers’ compensation claim should not be filed until a positive test result comes back. Mere exposure in the workplace does not warrant a claim until an employee has a positive test result. 

 

For additional information

Dentists should consult industry guidance from the county where their office operates. Each county has different requirements for business as to phases of reopening, safety practices and protocols and mandatory employer postings and written notices.  

Should you have any additional questions related to COVID-19 and best employment practices, please contact our Risk Management Advice Line at 800.733.0633. 

 
Clinical FAQs
Infection Control Informed Consent Patient Screening Practice Interruptions Telehealth

Can I wash or reuse face masks?

Single-use masks, or disposable masks, should not be washed for the purpose of reusing with patients. The CDC provides guidance on extended use and reuse of N95 respirators. OSHA provides guidance on decontamination of respirators.

 

What do I do if I run out of face masks, gloves, or other PPE?

The FDA has stated that it is continuing to monitor the domestic and global supply chain for potential disruptions or shortages and will “use all available tools to react swiftly and mitigate the impact to U.S. patients and healthcare professionals.” In the meantime, the agency encourages healthcare facilities to report any supply disruptions to deviceshortages@fda.hhs.gov.

If you do not have adequate supplies to meet regulations, you should reschedule patient appointments when required PPE is replenished for your office.

 

What steps do we take when the patient presents for treatment?

When the patient presents:

  • Provide a face mask if the patient is not wearing one.
  • Take a temperature reading to verify the absence of a fever (any temperature above 100.4°F).
  • Reconfirm the screening questions by observation and verbally with the patient. We recommend using a screening form like CDA’s patient screening form, which is regularly updated with the most recent CDC symptoms.
  • Complete necessary documentation and discussion, such as health history and treatment informed consent form. Have the patient sign a statement agreeing to notify the dental practice if within two weeks of treatment they test positive for COVID-19.
  • A dental practice has a legal and ethical obligation to inform patients if a staff member they have been in contact with has tested positive for COVID-19.
 

What policies and practices should my office follow to minimize the chance of exposure?

Interim CDC guidance for businesses and employers recommends that:

  • Employers place posters that encourage coughing and sneezing etiquette and proper hand hygiene at the entrance to their workplace and in other areas where the posters are likely to be seen.
  • Clean and disinfect public areas frequently, including door handles, chairs and bathrooms.
  • Employees who report symptoms of acute respiratory illness should stay home and not return to work until they are free of symptoms for at least 24 hours without the use of fever-relieving or symptom-altering medications.
  • If an employee appears to be sick upon arrival to work, they should be separated from other employees and sent home immediately.
  • Employees cover a cough or sneeze with a tissue and disinfect frequently touched objects and surfaces using an appropriate disinfectant product.
  • Employees wash hands often with soap and water for at least 20 seconds. If soap and water are not readily available, an alcohol-based hand sanitizer with at least 60% alcohol can be used.
 

What personal protective equipment (PPE) should we wear? Do we have to have an N95 mask?

  • Dental professionals should use the level of PPE appropriate to the disease transmission risk, with higher-level PPE reserved for procedures that may pose a higher risk.
  • Consider designating a “work-only” pair of shoes that you leave at the office.
  • A Level 3 mask and face shield are considered appropriate respiratory protection and should be worn by all treatment staff for non-aerosol-producing procedures, as these masks protect the nose and mouth from spatter, but not from inhalation of small potentially infectious aerosols.
  • Aerosol-producing procedures warrant additional focus on respiratory protection for all treatment staff. N95 filtering facepiece respirators or other types of N95 masks and face shields are recommended. Use a Level 3 surgical mask with a face shield only if an N95 mask is not available.
  • N95 masks are only effective if properly fitted. Dental professionals should follow all N95 use all requirements, including obtaining a medical clearance and initial fit test if an N95 mask is employed.
  • PPE functions as just one layer of disease transmission protection. The judicious use of intraoral engineering controls, such as rubber dams and high-speed suction, reduce aerosol spread beyond the immediate extraoral space to treatment staff and beyond. For aerosol-generating procedures, these additional procedural precautions should be considered during this interim time in the COVID-19 pandemic:
    • Consider a preoperative viricidal rinse or mouth swab (e.g., hydrogen peroxide or povidone-iodine).
    • Choose dental treatment options that minimize aerosols; use rubber dams or continuous suction dental isolation systems as much as possible.
    • Rinse the oral cavity slowly, avoiding unnecessary splatter.
    • Use chairside high-speed evacuation and/or other engineering or equipment controls for aerosol management.
    • Minimize intraoral X-rays for patients prone to coughing or gagging.
 

What do I do if I suspect exposure to COVID-19 in the practice? Do my staff and I need to self-quarantine?

That is a decision that can only be made at the time of the event and certain factors would have to be considered and assessed. For example, an employee or a patient whose partner has a co-worker exhibiting symptoms is a low-risk situation compared to a situation where an employee or patient has a partner who has symptoms consistent with COVID-19. Individuals who have reported possible exposures to their medical care providers should follow the provider’s instructions. Consult with your local public health department if exposure risk is high, for example, when a patient was seen in the office and then reports within a couple weeks that they have tested positive for COVID-19. CDC has FAQs on suspected or confirmed cases of COVID-19 in the workplace.

Be sure to keep up with news on the virus and on guidelines or orders from your local public health department.

 

Treating a patient who had COVID-19: How long should I wait?

  • Without testing, it is currently recommended that symptomatic individuals who had the disease may leave home isolation 10 days after symptoms first appeared and at least three days after recovery (including fever reduction without the use of fever-reducing medication).
  • An individual who tested positive for COVID-19 but was asymptomatic can be scheduled for an appointment at least seven days after the date of the positive test.
  • Until clearer evidence on infectivity timelines is determined, dentists and staff should take the additional respiratory protection precautions described above.
  • If testing is available, it is recommended that a person be considered recovered if fever is resolved without fever-reducing medication, respiratory symptoms have improved and at least two consecutive FDA emergency-use authorized COVID-19 molecular assay for detection of SARS-CoV-2 RNA tests, using respiratory specimens collected > 24 hours apart, produce negative results. This testing requirement will change over time as tests and test accuracy improves.
 

Practice Management FAQs
Coverage Economic Relief Employment

With many policies renewing on July 1, what opportunities are there for dentists to help manage their cash flow?

Eligible members can switch from an annual or semi-annual premium payment option to a monthly payment option to help with short term cash flow.

 

What if a patient claims to believe they acquired the coronavirus in my practice? Will TDIC defend me?

TDIC can’t make a blanket coverage determination, and a claim would have to be filed for TDIC to fully evaluate coverage for your particular case.

You should notify your professional liability carrier immediately to advise of a potential claim. Regardless of whether a patient can conclusively demonstrate that they acquired the virus from your practice, you should consult with your professional liability carrier to develop a plan to address the patient’s concerns. The plan’s approach may simply be to demonstrate the appropriate infection control procedures the office has taken and to have further discussion with the patient to determine when they first developed symptoms.

Whenever you are in doubt about how to handle a situation, TDIC’s Risk Management analysts can work with you to find a solution. To schedule a confidential consultation with an experienced risk management analyst, visit tdicinsurance.com/RMconsult or call 800.733.0633.

 

Contact TDIC

800.733.0633
riskmanagement@tdicins.com

For policyholders in Idaho, Oregon, Montana, Tennessee or Washington, call 800.452.0504.

TDIC Endorsed Brokers

TDIC Insurance Solutions
California, Arizona, Illinois, Minnesota and Nevada
Phone:800.733.0633
Email: insuranceinfo@tdicins.com

Montana, Oregon and Tennessee
Phone: 800.452.0504
Email: protected@tdicins.com

Conrad-Houston Insurance (Alaska)
Phone: 907.276.7667
www.chialaska.com

Idaho Dentist Insurance Agency (IDIA)
Phone: 208.371.3052
Email: mike@idahodia.com
www.theisda.org

Jerry Hay, Inc. (Hawaii)
Phone: 808.521.1841
www.jerryhay.com

Mid-Atlantic Insurance Resources (New Jersey)
Phone: 877.476.4588
Email: MAIR@pdais.com
www.midatlanticir.com

Pennsylvania Dental Association Insurance Services (PDAIS)
Phone: 717.234.6530
www.pdais.com

Washington State Dentists’ Insurance Agency (WDIA)
Phone: 800.282.9342
www.wdiains.com