Who pays when a graduate student gets hurt?

On Nov. 2, 2018, chemistry PhD student Shiva Dastjerdi was working in her Boston University research lab synthesizing candidates for cancer drugs. She was walking across the lab carrying a small vial containing trifluoroacetic acid when her foot slipped on a wet spot on the floor.

Dastjerdi was wearing gloves, goggles, and a lab coat, as her work required. But her lab coat, like many, didn’t button all the way to her neck, and Dastjerdi was wearing a V-neck shirt. As she caught her balance, a few milliliters of the acidic solution splashed out of the uncapped vial and onto her upper chest.

Not wanting to take off her shirt to use the lab’s safety shower, which had and still has no curtain, Dastjerdi ran across the hall to the bathroom. There, she poured water over her chest for several minutes. When she emerged, a lab mate and her adviser, chemistry professor Aaron Beeler, helped her report the incident to campus emergency services and BU’s Environmental Health and Safety office and Research Occupational Health Program, following university protocol.

The burn felt like hot water seeping deep into her skin, Dastjerdi says.

She remembers the next few hours as frustrating: The ambulance crew didn’t seem to know how to treat her injury. The emergency room staff initially thought her accident involved a few liters of hydrofluoric acid. After she sat for several hours in an exam room using a wet paper towel to soothe the burn, doctors sent her home with instructions to wash the area with soap and water, saying there wasn’t much else they could do.

But that frustration was minor compared with what happened over the next several months, as Dastjerdi landed in the maddeningly complex world of US workers’ compensation laws and how they do—or do not—cover medical expenses for graduate students injured while working in a research lab. Dastjerdi dealt with collection notices for overdue hospital bills and confusing and contradictory information from BU officials. Eventually she hired a lawyer who convinced the university to pay some of her medical expenses.

Dastjerdi is far from the only US graduate student or postdoctoral researcher to be injured while at work. She is also not the only one to have been surprised that collecting a paycheck does not safeguard against personally paying medical bills for work injuries. Nor is BU the only institution with unclear policies—a C&EN review found that other schools’ stances seem similarly vague, and a federal fight continues over whether graduate students are considered employees for certain purposes. It’s yet another vulnerability for graduate students in a system in which they have the least money and power.

Grand bargain

To understand how a graduate student ends up fighting her own university over medical bills, start at the turn of the 20th century. At that time there was little chance US workers injured on the job could get any help from their employers to pay medical bills or cover lost income. The legal deck was stacked against workers, letting business owners use the thinnest justifications to duck any financial or legal responsibility for accidents.

In the late 1800s and early 1900s, US states began to pass laws to protect workers, following European examples. These new laws were seen as a grand bargain between employers and employees, says Michael C. Duff, a workers’ compensation law expert at the University of Wyoming College of Law. In exchange for a guaranteed payment if they were injured on the job, workers gave up their right to sue employers over the accidents. For business owners, Duff says, that agreement meant paying a few claims while avoiding “the one big lawsuit that really blows the doors off.”

Workers who make successful claims may be eligible for different kinds of payments. One is reimbursement for medical expenses, which Dastjerdi was expecting. Because her injuries didn’t keep her from coming back to work, she wouldn’t have been eligible for lost-wage payments—usually two-thirds of an employee’s pay, though that varies between states—or an award to compensate for being permanently unable to work.

Today, each state has its own definition of who qualifies for workers’ compensation. In general, the decision comes down to questions like, Did the workers bid for the job? Did they bring their own tools? Can the company fire them at will? says William L. Smith II, a workers’ compensation lawyer in South Carolina. As Dastjerdi discovered, just getting a paycheck isn’t enough.

Those standards might be changing. A 2019 California law mandates that employers consider workers to be employees unless the workers fit certain criteria. Other states are considering similar laws. It’s unclear how such laws might affect graduate students.

Whether a worker in the US is an employee is “one of the most contested areas of labor employment law right now,” Duff says. And the situation for students who may also be employees is even more complex. That’s reflected in ongoing fights over the unionization of graduate students. In separate cases over the past 2 decades, the US National Labor Relations Board has gone back and forth on whether graduate students can unionize, and in 2019 it proposed a rule clarifying that student workers are not employees. The board is expected to make a final decision this fall.

Making the situation more confusing is that students—or any workers—may find that they are considered employees for some purposes, such as federal tax law, but not for others. Dastjerdi, for example, got weekly paychecks, and BU filed with the US Internal Revenue Service the annual W-2 tax form reporting wages paid to her and the taxes withheld from them.

Looking for clarity, Dastjerdi contacted Massachusetts’s Department of Industrial Accidents (DIA), which regulates the state’s workers’ compensation system. She says the agency told her anyone who gets an annual W-2 should be considered an employee. It recommended she submit a workers’ compensation claim. She gave the claim form to her lawyer, although she says she isn’t sure if he ever submitted it. Neither the DIA nor her lawyer answered C&EN’s questions.

Duff says the standards for workers’ compensation eligibility can be confusing for employers too. “I don’t think they’re pretending not to understand,” he says. Dastjerdi’s lawyer set legal proceedings in motion to take her case to the ultimate arbiter, a state court, but BU agreed to pay some of her bills before a judge heard the case.

Scarred, with $5,100 in bills

As an ambulance carried Dastjerdi to the emergency room, her adviser, Beeler, was Googling acid burns and follow-up treatments. He called a local burn center, at Massachusetts General Hospital, and texted its advice to Dastjerdi while she was still in the ER: that she should schedule an appointment with a Mass General specialist who could evaluate the burn and any scarring.

Dastjerdi did, and the specialist suggested half a dozen laser treatments. Dastjerdi says her burn scars started out painful and itchy every day. A few laser treatments helped, but the scars are still sometimes itchy, red, and dry. She also saw a dermatologist at Boston University’s medical school who she says advised her to try letting the scars heal on their own.

Billing records supplied by Dastjerdi show that her ambulance ride and ER visit cost just over $3,000, with Dastjerdi responsible for about $350 of that. She gave those bills and subsequent ones related to her scar treatments—amounting to about $4,700 out of pocket—to the BU Chemistry Department’s director of operations, Paul Ferrari. In an email obtained by C&EN, Ferrari wrote that he would “take care of this,” referring to the bills. Ferrari declined C&EN’s request for an interview.

What happened next is not completely clear. Dastjerdi says that after several laser treatments, she started getting notices from Mass General about unpaid bills. Emails obtained by C&EN show that she sent a second bill collection notice to Ferrari on April 19, 2019, more than 5 months after her accident. Ferrari emailed James Donohue, BU’s director of Risk Management, the office responsible for workers’ compensation and other insurance, asking how to answer Dastjerdi’s questions about whether she qualified for workers’ compensation.

Donohue’s reply to Ferrari on April 24 is curt: “Respond to what, her eligibility for Work. Comp? If so, there is nothing to respond to as this is dictated by MA state statute.” He continued: “I don’t know of any institution that has a policy to pay out of pocket costs for health insurance for student injuries.”

As a private school, BU is not subject to the Massachusetts Public Records Law, so C&EN could not verify the emails independently. C&EN gave copies of them to BU, which did not dispute their authenticity.

Also in April, Dastjerdi talked by phone with Karen Goyette, a university health insurance manager. Dastjerdi recalls that Goyette seemed surprised to hear that graduate students were not considered employees. Dastjerdi had received a letter from her insurance company, Aetna, and the Rawlings Group, which Aetna contracts to help it collect medical debts, asking for more information about her unpaid bills. She says Goyette told her to tell the companies her accident was work related.

Meanwhile, in the BU emails, Ferrari told Donohue and a human resources official, Kimberly Lyons, that an HR administrator said that office would handle Dastjerdi’s claims. Lyons replied on May 9 that HR wouldn’t handle the claims, because they were “a claim for a graduate student, not a student employee.” Ferrari communicated that information to Dastjerdi in October 2019.

BU declined C&EN’s requests for interviews with Donohue, Lyons, and Goyette. In response to emailed questions, Colin D. Riley, BU’s executive director of media relations, writes to C&EN that “chemistry graduate students are not eligible for workers’ compensation in their role as students.”

Even though all BU PhD students receive a stipend from the university, not all of them are employees, Riley says. Riley does note that some graduate students working as research assistants may be eligible for workers’ compensation, adding that a workers’ compensation administrator makes a decision about a graduate student’s eligibility case by case.

That fits with what legal experts told C&EN: graduate students’ eligibility could depend on a host of factors, including but not limited to the source of their funding and whether they were working as teaching assistants or research assistants when they were injured.

Donohue, in an email to Ferrari, and Riley, in an email to C&EN, point to state law in explaining BU’s determination of eligibility. It isn’t clear what statutes they are referring to. Massachusetts state law defines an employee entitled to workers’ compensation as “every person in the service of another under any contract of hire, express or implied, oral or written.” The law doesn’t specifically address graduate students.

Employee ambiguity

In interviews with officials at universities across the US, C&EN did not find a school with a clear-cut policy that would cover graduate students’ medical bills if they were injured in a lab. What those conversations did reveal—when university personnel were willing to talk—was a complex, irregular landscape. It is easy to imagine graduate students at other schools having just as much trouble deciphering workers’ compensation rules as Dastjerdi did at BU.

Of 16 universities C&EN contacted, officials at only 8 responded to requests for interviews about graduate students and workers’ compensation policies. Only one of the people C&EN was able to interview worked directly on workers’ compensation.

Chemistry department chairs and environmental health and safety officials stressed to C&EN that their first priority is graduate students’ safety, not the details of their employment status or workers’ compensation eligibility. Several told C&EN they did not know their university’s policy or didn’t know enough to feel comfortable answering questions about it.

“We really tend not to think about insurance when a student gets in an accident,” says M. G. Finn, chair of the School of Chemistry and Biochemistry at the Georgia Institute of Technology.

The chair of the University of Florida’s Chemistry Department, Lisa McElwee-White, tells C&EN that graduate students there are covered by workers’ compensation if they get injured in a lab accident. A university handbook does not confirm that, but it directs graduate students to call the university’s Workers’ Compensation Office before seeking medical care, except in emergency situations. The university official in charge of risk management, who handles workers’ compensation, declined C&EN’s interview request.

The University of Southern California does not consider all graduate students eligible for workers’ compensation, according to Chemistry Department chair G. K. Surya Prakash. But Prakash says that in his experience, the school has found ways to cover students’ medical costs even when they were not eligible for workers’ compensation. He recalls in particular one situation in which the university’s provost contributed money to a student’s long-term medical care, but he didn’t provide additional details. No other USC officials agreed to C&EN’s requests for interviews.

Prakash notes that USC and other universities in California are especially sensitive to issues related to lab safety since the death of Sheharbano “Sheri” Sangji after a 2008 University of California, Los Angeles, chemistry lab fire. One outcome of that incident was the creation of the UC Center for Laboratory Safety in 2011. The center’s research project manager, Imke Schroeder, says chemistry graduate students at University of California campuses are not eligible for workers’ compensation. She says she has heard that the university system uses workers’ compensation funds to cover some graduate students’ injuries case by case, but she says she does not have access to data to confirm that. No other UC system officials agreed to C&EN’s requests for an interview.

Whether a university is public or private does not seem to affect students’ eligibility for workers’ compensation. Northwestern University is private, and its executive director of research safety, Michael Blayney, tells C&EN that graduate students are employees for the purposes of workers’ compensation, but he directs questions on the details of university policy to Reynold Andre, who was a workers’ compensation claims manager at the school until he retired in August.

In an interview before he retired, Andre told C&EN that whether graduate students are eligible for workers’ compensation depends on whether they are working for their advisers or on their dissertation projects, similar to BU’s policy. Andre said that the university evaluates each claim individually and that the school has paid workers’ compensation claims for graduate students. Asked about how Northwestern communicates these policies to graduate students, Andre directed C&EN to a university website listing the school’s workers’ compensation policies. C&EN could not find on the website a policy about who is and isn’t eligible for workers’ compensation.

Blayney also suggests that Northwestern does what it can to cover students’ medical bills, calling it “a matter of moral imperative” to help reduce the impact of medical costs.

In follow-up correspondence, Northwestern’s director of risk and insurance, Elizabeth Marshall Hammer, does not explicitly say whether graduate students are eligible for workers’ compensation. “Graduate students often receive financial support in the form of stipends to help offset expenses tied to their academic and research endeavors. However, stipends do not represent salaries,” she says via email. “Northwestern has and continues to look for ways to protect the interests of employees and students, including graduate students working in a lab setting.”

More than 220 km south of Northwestern and subject to the same state laws is the public University of Illinois at Urbana-Champaign. There, graduate students are entitled to workers’ compensation, says Martin Gruebele, head of the Chemistry Department until June 2020. At first glance, a university website appears to support that claim, listing graduate assistants among employees covered by the Illinois Workers’ Compensation Act. But reading further reveals that not all graduate students are graduate assistants. Only teaching assistants and research assistants are eligible for workers’ compensation; the site doesn’t clarify when a graduate student may or may not be a research assistant and therefore eligible. A university human resources official did not respond to C&EN’s request for an interview.

Unions might seem like one remedy for graduate students seeking workers’ compensation coverage or perhaps just better communication of school policies. But Marwan Shalaby, a chemical engineering PhD candidate at New York University and a representative for the school’s graduate student labor union, says its contract is not clear on workers’ compensation eligibility. Like BU and other schools, NYU considers teaching assistants but not graduate students doing research, like Dastjerdi, to be employees.

An experience similar to Dastjerdi’s is why University of California, Berkeley, neuroscience PhD student Holly Gildea got involved with graduate student union efforts there. She burned her thigh and hand with phenol as she was cleaning out a lab freezer. After emergency treatment, the student medical center sent her for follow-up care to the university’s Occupational Health office, which treats work-related injuries. But when her laboratory manager tried to file a workers’ compensation claim, they found out the university didn’t consider her an employee and was charging her for her care. Gildea says that her adviser, Andrew Dillin, asked the Howard Hughes Medical Institute, where he is an investigator, to cover her costs, and HHMI did.

BU’s graduate students tried for several years to unionize. Those efforts ended when Dastjerdi was in her second year, after the university declined to recognize the union.

There are also examples when young academic researchers eligible for workers’ compensation may find the benefit unsatisfactory. In 2016, a gas cylinder explosion at the University of Hawaii at Manoa cost postdoctoral researcher Thea Ekins-Coward part of her arm. The school granted Ekins-Coward workers’ compensation payments. Nevertheless, she sued the university, claiming that the school’s negligence led to unsafe working conditions and seeking “reasonable expenses of injury, special and general damages, pre-judgment and post-judgment interest, costs, attorneys’ fees and such other relief as the Court deems just,” according to one of the complaints filed with the Hawaii Supreme Court. Workers’ compensation laws say that employees may not sue their employers, but Ekins-Coward’s attorneys argued that school officials told her when she started as a postdoc that she was not an employee. After the accident, the university’s lawyers argued that Ekins-Coward met the definition of an employee for workers’ compensation purposes, according to a court filing. The case has been stayed.

Treatment—and payment—incomplete

Clearly, even if prospective or current graduate students or postdocs think to ask about workers’ compensation, they’re unlikely to get a useful answer. Most schools will have workers’ compensation insurance to cover employee claims, attorney Smith says, but the devil is in the details of eligibility.

Wyoming’s Duff says he advises clients to file a workers’ compensation claim whether or not they think they are eligible. States have different processes for making claims, but doing so promptly gives people the best chance of getting a payment, he says.

Dastjerdi didn’t ask BU before the accident if she was eligible for workers’ compensation. She says that after her emergency visit, she assumed the school would cover her bills. When she talked to other graduate students, it also seemed obvious to them that the university would cover injuries that happened while she was at work, she says.

After Dastjerdi dropped off her medical bills with Ferrari, she spent months getting notices of unpaid bills. At that point she decided to hire a lawyer, Griffin Hanrahan of Keches Law Group, a personal injury firm in Boston. Dastjerdi says even Hanrahan wasn’t initially sure whether she qualified for workers’ compensation. Hanrahan did not respond to C&EN’s requests for an interview.

In January 2019, around the time Dastjerdi started talking to lawyers, Ferrari paid for her ambulance and emergency room bills using a Chemistry Department discretionary account.

It took another year and the threat of a lawsuit for BU to pay the bills for her scar treatments. Dastjerdi got only three of the recommended five to seven treatments; she stopped in August 2019 as her unpaid bills piled up, totaling $4,700 in out-of-pocket costs just for those laser appointments. In January 2020, Hanrahan had an out-of-court meeting with BU lawyers to try to resolve the issue, a preliminary step before a hearing in front of a judge.

Afterward, Hanrahan reported by email to Dastjerdi that BU believed that because she was working on her PhD research when the accident happened, her work didn’t further BU’s interests. For that reason, BU was sticking with its judgment that she was not eligible for workers’ compensation.

C&EN contacted several chemistry department chairs about the distinction various university administrators made between when graduate students are considered employees—when they are working for their advisers and furthering their advisers’ or the school’s interests—and not considered employees—for example, when they are working on their dissertations. The department chairs largely agreed that it is rare in chemistry departments to have students working on dissertation projects that aren’t also research for their advisers. They suggested some examples of such situations, like when students have their own fellowships or are working on projects outside the department and the chemistry advisers are pro forma. These situations don’t apply to Dastjerdi.

Despite BU’s decision that Dastjerdi was not eligible for workers’ compensation, the university agreed to pay her outstanding bills after meeting with her attorney. That sounds similar to stories from officials at other universities about finding ways to pay medical costs outside the workers’ compensation system. But Dastjerdi says BU made no promise to pay for any future treatments, and her health insurance account shows she still owes about $350. BU’s Riley says Dastjerdi’s experience has prompted the school “to look more carefully at student injuries” in similar circumstances “so we can be sure that students who are injured in the course of their employment receive the benefits of workers’ compensation.”

The scars still look and feel different from her own skin, Dastjerdi says, and they dry out in cold weather. But without a commitment from BU to pay, she doesn’t think she’ll get more treatments.

Dastjerdi also recognizes that she could have done things differently that day. She now clips her lab coat at the neck, although she sees other students wearing them open. And she knows that if she’d followed accident protocol, she would have used the lab’s safety shower rather than a sink in the bathroom.

Dastjerdi wants BU and other schools to fix or clarify their workers’ compensation policies. She thinks universities need to start treating graduate students with more respect, especially when they’re injured in lab accidents. She wants to make sure other students won’t have to go through what she did.

“It’s really unfair,” Dastjerdi says. “I don’t want it to keep happening.”