James "Mike" Anderson was a hospital employee in suburban Philadelphia with a low-profile though critical job: changing air filters in COVID-19 patients' rooms.
By late March, new COVID-19 cases in Bucks County, Pennsylvania, had ramped up to as many as 90 per day. At the hospital, Anderson handled air filters and other surfaces that might have been contaminated with the deadly virus, also known to hang in the air.
In early April, Anderson, 51, came down with what he thought was a cold, according to his family's lawyer, David Stern. On April 13 Anderson was rushed to the hospital, where he died of acute respiratory distress syndrome from COVID-19, according to the county coroner. He left behind a wife and two children, ages 5 and 9.
Anderson was exposed to the virus at work, the lawyer contends, making his family eligible for workers' compensation death benefits paid by his employer's insurer.
"His family deserves to have that income replaced," Stern said. "Their husband and father certainly can't be."
But in a June 16 response to Stern's death benefits claim, St. Mary Medical Center denied all allegations.
As the COVID-19 toll climbs, sick workers and families of the dead face another daunting burden: fighting for benefits from workers' compensation systems that, in some states, are stacked against them.
In interviews with lawyers and families across the nation, KHN found that health care workers -- including nurses' aides, physician assistants and maintenance workers -- have faced denials or long-shot odds of getting benefits paid. In some cases, those benefits amount to an ambulance bill. In others, they would provide lifetime salary replacement for a spouse.
Legal experts say that in some states COVID-19 falls into a long-standing category of diseases like a cold or the flu -- conditions not covered by workers' compensation -- with no plans to change that. Other states force workers to prove they caught the virus at work, rather than from a family member or in the community.
"We are asking people to risk their lives every single day -- not just doctors, nurses and first responders, but also nurses' aides and grocery store clerks," said Laurie Pohutsky, a Democratic Michigan lawmaker who proposed a bill to help essential workers get coverage more easily. "These people are heroes, but we have to actually back those words up with actions."