WELLSBURG – A day after a petition was filed to force the state insurance commissioner to open a workers’ compensation claim for a Weirton firefighter who contracted COVID-19 on the job, Encova Insurance says it will cover the claim.
“Upon review of the facts and circumstances of Lieutenant Ritchie’s claim, we have deemed his claim to be covered and will pay appropriate benefits,” Encova Assistant Vice President Casei Phillips told The West Virginia Record in a January 29 email. “Encova is proud to support all first responders, like Lieutenant Ritchie. We appreciate the selfless work of firefighters in our communities.”
Caleb Ritchie, the son of Brian Ritchie, filed the petition January 28 in Brooke Circuit Court through guardian Sierra Dunlevy against West Virginia State Insurance Commissioner James Dodrill. The petition seeks an Order to Show Cause as to why a Writ of Mandamus requiring Dodrill, through Encova, to perform his duty should not issue.
Toriseva
Caleb Ritchie is Brian’s 17-year-old son. Dunlevy is Brian’s longtime girlfriend. She applied to become Caleb’s guardian a month ago when Brian became incapacitated. Brian is a widower.
Brian Ritchie, a lieutenant with the Weirton Fire Department, has been a firefighter for 13 years, according to attorney Teresa Toriseva. He currently on a ventilator after having contracted COVID-19 on the job.
“Lieutenant Ritchie’s family and Toriseva Law are relieved and grateful that this matter has been quickly resolved,” Toriseva told The Record. “Please continue to pray for Lt. Brian Ritchie.”
The petition sought to have the court “to force the West Virginia Workers’ Compensation through Encova to open a claim, investigate that claim and make a written determination deciding whether Lt. Ritchie is covered or not. This complaint is a method to have Lt. Ritchie’s claim heard in court as the refusal by Encova leaves him with no other method to have his claim evaluated.”
Toriseva said the workers’ compensation claim for Ritchie was refiled January 29. The original claim was filed by the city.
“We alleged in our complaint, after the City of Weirton did its part by reporting the workplace illness to Encova , formerly Brickstreet, has refused to perform their statutory duty to open a claim and investigate the facts surrounding the illness,” Toriseva told The Record. “Despite there being no question that Brian got COVID at work, Encova is refusing to even acknowledge Brian’s claim, even though we can prove he got sick at work.”
“Encova, through its Large Loss Adjuster, has indicated Encova will not open an investigation to determine compensability because COVID-19 can be contracted in the community, not necessarily at work,” the petition states. “How can it be that firefighters are anything BUT covered by workers’ comp when they work in close quarters with each other for 24 hours at a time. and they call on and give direct emergency care to patients who are COVID-19 positive?”
According to the petition, Brian Ritchie began experiencing symptoms of COVID-19 on December 17. Three days later, he took a COVID-19 test. A day later, he learned he was positive for the Coronavirus.
“The City of Weirton has known of the COVID-19 symptoms and diagnosis since the onset of Brian’s symptoms,” the petition states. ‘In fact, all members of Brian’s fire fighter shift (B-shift) tested positive for COVID-19 at the same time. …
“All members of the shift of fire fighters Brian normally relieves tested positive for COVID-19 at the same time. The City of Weirton complied with the law and did its part by properly notifying Encova of the compensable workplace injury.”
But, Heather Copely, a Large Loss Adjuster at Encova, told Weirton employee Pamela Wright that a claim would not be opened or investigated because Encova considered COVID -19 a “community spread” illness.
“In direct contrast to its own insurance bulletin, the Insurance Commissioner or its private insurance carrier, Encova, has intentionally failed to investigate Brian’s claim because Brian’s medical care as a result of contracting COVID-19 on the job is exorbitantly expensive,” the petition states. “Encova does not want to pay compensable benefits to Brian or his family.”
According to a West Virginia Insurance Bulletin, the pandemic “has raised unique concerns and questions regarding the filing and compensability of workers’ compensation claims.”
“Insurers and self-insured employers will investigate workers’ compensation claims for COVID-19 to determine whether the injury occurred in the course of and resulting from the employee’s covered employment, which would necessarily include a determination of the cause and place of the injury,” the bulletin states.
The petition says Ritchie meets the legal requirements to have his workers’ comp claim opened, investigated and decided in writing.
“There is no other remedy for Brian to have his workplace injury or occupational disease investigated and decided,” the petition states.
The petitioners were represented by Toriseva and Joshua D. Miller of Toriseva Law in Wheeling. The case has been assigned to Circuit Judge David J. Sims.
Brooke Circuit Court case number 21-C-7
