FAQs for Massages During the Covid-19 Pandemic

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04/01/2020

Updated 08/11/2020

Can I work? Should I work?
Given current conditions, several factors must be taken into account as you consider your practice. First, check your state and county regulations, as restrictions are being updated often. We also encourage you to read our Back-to-Practice statement for a full review of considerations. 

Is my liability insurance valid during this time?
Yes, your liability insurance is valid, as long as you are in compliance with your state and local regulations. Check here for state updates. 

Does the insurance policy included with ABMP membership cover COVID-19 transmission? What about other liability insurance policies?
The insurance policy included with ABMP membership contains an exclusion:
“39. Transmission or Fear of Disease. Any claim arising from or related to the transmission of Acquired Immunodeficiency Syndrome or Human Immunodeficiency Virus, or exposure to another having same, or to substances or materials contaminated with same, or fear of contracting Acquired Immunodeficiency Syndrome or Human Immunodeficiency Virus or any other disease or illness; or any sexually transmitted disease; or any form of communicable disease.”

We are aware of recent messaging regarding the coverage of claims and COVID-19 transmission in massage therapy. In the spirit of full transparency, there are no black-and-white answers to these questions. Based on a review conducted by insurance industry experts, especially focusing on “sickness,” “disease,” and “microbial transmission,” there is no liability insurance policy in the massage profession that can unconditionally claim coverage of infectious disease transmission. Language stating "there is no direct exclusion" is not the same as an affirmation of coverage. We suggest being wary of any such assurances and asking for precise language that you would be covered, instead of relying on language that a specific exclusion does not exist.

To help bridge the gap and reduce risk, ABMP created an informed client consent form, Health Information: COVID-19 Addendum. While not a guarantee, such a waiver could provide legal protection. As is the case with any legal agreement, policy, or form, it would be subject to review and dependent on the level of enforcement provided in each state.

In addition, to help keep you and your clients safe, we’ve produced a thorough Back-to-Practice Guide to inform your return to work. 

Is my job as a massage therapist considered “essential”?
ABMP does not determine whether massage is essential or nonessential; that is a decision made by local and federal authorities. Check here for state updates. 

Are virtual sessions included in my liability insurance policy?
Your liability insurance policy is valid with virtual sessions under the following circumstances:

  • The client must be located in the same state that the practitioner is legally allowed to practice in;
  • For new clients, the practitioner must do a full intake form;
  • The practitioner must be able to see the client as they are virtually working with her/him;
  • The sessions are live and not prerecorded;
  • Policy language applies (exclusions, etc.). The practitioner must be within scope of practice.

The above constitutes expanded emergency coverage, and is conditional based on the unique COVID-19 pandemic circumstances, during which practitioners can’t perform hands-on work. Please check back for updates on virtual coverage, as the situation evolves.

Are virtual product recommendations included in my liability insurance policy?
Recommending retail sales products during a virtual consultation session is acceptable as long as the practitioner has met the virtual consultation session circumstances above. Practitioners are not to sell “Professional-Use Only” products to clients.

Does my policy cover me for being out of work (business interruption)?
Your liability insurance policy does not cover business interruption. The “Loss of Earnings” clause in the policy specifically pertains to a member being reimbursed if they are required to take time away from their practice because of a lawsuit against them that is covered under the policy.

Can I apply for unemployment benefits or financial help?
Yes, we believe the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) issued March 27, 2020, allows massage therapists to file for unemployment benefits. Under the CARES Act, unemployment insurance benefits will temporarily be available to “an eligible self-employed individual” . . . “an individual who regularly carries on any trade or business.” It appears that this expanded eligibility applies to individuals who work “part-time,” a government definition that would cover a large proportion of massage therapists, estheticians, hair stylists, and nail professionals. You have to take the initiative to apply for unemployment insurance. 

Learn about unemployment benefits in your states. Many members are sharing their individual application experiences and information on Facebook at www.facebook.com/abmppage.

I have more questions. Can I contact you?
Yes, please! We’re here for you, and our member service team is available Monday-Friday, 7:30 a.m.–5:00 p.m. MT. Call us at 800-458-2267 or email expectmore@abmp.com.

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Comments

Toi B. replied on

When things start to open back up, what should I do to my business to protect my self and clients? I know washing hands, sanatizing face cradle and surfaces but is there anything new I need to implement that I’m not thinking about? So when things do slowly open up I can protect everyone. Thanks

Sandy W. replied on

I have worked this long (21 years)  in massage therapy because I accept the challenge of helping people and I am happy I chose this profession. However I am approaching 73 years of age and I have to say I am apprehensive. I am in excellent health and am one of the top  four in my spa who  have done the most massages in a given year. I am thinking it only takes one unknowingly-Covid-positive client to be my demise.. seriously perplexed as to the odds here!

Karen C. replied on

We have good reason to be concerned because we are indeed working in a high risk environment. We are dedicated professionals who also have bills to pay and maybe a little afraid to speak up to the powers that be, which is understandable.  I am looking at the social distancing rule as a guide. If I have to practice 6 Ft of social distancing and and wear a mask to buy groceries, then what would make it ok to work in a small room, sharing air space, from an arms distance away, making direct contact, continuously  for 50 minutes or more ?  Any other protocol, is senseless until social distancing is no longer in place. Don't allow yourself to be pressured by anyone. This is your life, your family's life and your clients as well.  If you are over 60 beware, you are at higher risk.   I have written to the NJ Board, my Governor and the Health Dept.

Im including a link of an open letter to LMTs and their employers, written in great detail, by a seasoned LMT with degrees in science and research.

I encourage you all to read it and pass it on to your colleagues.

https://www.tracywalton.com/an-open-letter-about-re-opening-to-massage-therapy-employers/

Hope this is helpful.

Diane M. replied on

In MN we are still in a stay at home order (extended to 5/17).  I work for a chiropractor, who re-opened the office last month because it was deemed exempt from order. They would like me to return to work.  MN Chiro Association states of clarification of massage in chiropractic clinics exempt if it is medical massage. So, would going back to work at chiropractor impact my liability coverage? 

Erik B. replied on

I have the same question. I'm feeling a little pressured by my clinic owner to return for massage since it technically falls under medical at the chiro clinic, but our county in OR is not yet in phase (also, I feel it is currently unsafe to return). I'm afraid my unemployment benefits will be jeopardized if I refuse to return before our county even enters phase 1 as well as questioning whether my liability insurance would even be active?

Nancy M. replied on

Will my liability insurance protect me in the event that someone contracts Covid-19 through me or my office despite my best sanitation practices?

Nancy

Judith B. replied on

How do you handle a client who just doesn't want to wear a mask? I will be opening soon and have sent out an email letting clients know about the changes and I have two that really don't want to wear a mask but still want to be seen.

Linda M. replied on

I have the same question Judith. In my group practice, we have told them they have to wear a mask at this time. It's not ideal, but it's what the State of Maine has mandated. I'm curious to hear how others have handled this issue. 

Rebecca S. replied on

I was wondering what you suggest we do if a client calls us to inform us that they have been exposed to COVID-19 and they have been recently in the office. 

I'm not talking about a client that thinks they have been exposed due to coming into the office. But rather, a client that has been in contact with someone with COVID-19 outside of the office but has come in recently for a massage. Therefore, possibly exposing me. 

Is it my duty to then close my office for 14 days to self-quarantine? There are so many gray areas here. 

Brandon Twyford replied on

Hi Rebecca,

    There are several things to consider as you assess your risk:

    1. Were you both wearing face masks during the duration of the appointment?

    2. Has the client been tested?

    3. Has the client developed any symptoms? (if yes, we would definitely recommend a 14-day quarantine)

    4. Do you know the degree of the exposure this client had to the COVID-positive patient? (a spouse, a random contact, etc)

 

    Certainly, if you are able to receive a COVID-19 test, that would be the best course of action. But, depending on your state and local municipality's response, you may not have access to testing if you are showing no signs of illness. However, we would encourage you to reach out to your primary care provider to discuss the situation and see if they can offer guidance and/or a referral for a COVID test.

 

    The information on this topic remains inconsistent, but we were able to find this from the Wexner Medical Center at Ohio State University:

    "If you’ve been exposed to someone but aren’t sure they have a confirmed case…

    Self-monitor for symptoms for 14 days after exposure

    Call your primary care provider if you experience COVID-19 symptoms"

Kirstan B. replied on

I am currently in quarantine due to Covid 19 exposure. I work in a physical therapy/chiropractic clinic and my practice manager along with some clients have tested positive for Covid 19.
I made the choice to quarantine on my own, the owners of the business have not responded or given direction and the practice manager had to tell me themselves about their positive test.
It just makes me wonder how many times we are being exposed without knowing. Had the manger not told me, I would’ve continued working and potentially exposed more clients. My family has already been exposed and is awaiting testing.
I write this because I feel like people have not taken this infection seriously and continue to bury their heads in the sand.
It makes me frustrated and infuriated.
I work in Florida and our government is lax in putting more protections in place (I returned to work on May 11). There is no clear direction.
From the start of this pandemic, I feel like massage therapists have been ignored and left behind. I don’t know what my fate will be, will I get infected, will my family or clients by proxy? I feel stress everyday I go into work and now, after I survive this self imposed quarantine, I know it will be very hard for me to give the kind and quality of massage I would like to.
I hope this post helps someone out there. You aren’t alone. Although, I don’t have the answers, at least take comfort in knowing that we all likely have the same fears and sense of uncertainty.

Brandon Twyford replied on

Hi Kirstan,

Thank you for your thoughtful comment and sharing your experience. Would you please reach out to us at editor@abmp.com? We're interested in hearing more of your story.

Andrea L. replied on

I was just informed by a client of mine that I worked with on 8/6 that she started feeling ill on 8/8 and told me last night 8/11 that her COVID test came back positive. So now I have a known exposure to a positive case. I live and work in MN. Mandatory face mask policy in effect and I have implemented a strict cleaning policy, temp checks upon arrival to my office, COVID screening and liability form, handwashing.  I am doing everything I can to keep myself and clients safe while in my space (I work independently in my own office). I talked with the MN Dept of Health to ask them how to handle the situation and they told me I was not eligible to get tested since I do not have any symptoms. They just told me to monitor myself for two weeks and get tested IF I experience any symptoms.  They told me my test would not be covered since I don't meet the screening criteria. This just didn't seem responsible, so I called my insurance.  Turns out I AM COVERED to get testing done, and everyone should be, regardless if they have symptoms or not. So now I have informed all clients that I have seen since the client who tested positive and I have canceled all appointments until I get my test results back.  We have a duty to keep ourselves safe and maintain transparency with our clients about our exposure. I hope everyone is managing as best they can. Thank you AMBP for being a sounding board for all of us to navigate these crazy times!

Linda Nunn N. replied on

Most of my clients come from out of state and travel by plane . Is it ok to do massage or would it be unwise to do so during this pandemic ?

Beth U. replied on

Any thoughts on continuing outcall services with longtime clients who have their own equipment and supplies in their homes? Obviously with appropriate pre-session screening questions that would include others in the household as well as the client.

Courtney K. replied on

Hi!

So I have seen other companies making digital versions of the paper intake forms for the Covid-19 questionnaire that allows you to click buttons for "yes/no" and typed responses. I was wondering if ABMP was interested in doing something like this to make it easier for both the client and practitioner; it can be done remotely before the client arrives on location. Maybe it can be taken a step further and created to be a full "app" that the client can download that has all their information, soap notes, access to Body Sense Magazines whenever they want it, stretching resources, meditations, etc. Possibly a way for us to include pictures into their digital files to keep track of things like gate alignment or skin conditions, etc. This really could become something all-encompassing for client healthcare and for a more streamlined connection between us and our clients. I know your site and affiliate sites are great resources already but am curious to see how something like what I describe above could increase participation and accelerate client self-care. Would love to brainstorm with further development.

Thank you for your time and consideration.

Karen B. replied on

I am so grateful to be a member of ABMP. I have used the COVID health form, the signs, the face hammock concept and keep abreast of the pathology with Ruth Werner. I realize we are in uncertain times but I can state full heartedly that you have made the transition back to massage less scary in this ever changing envirnoment. Thank you for all your efforts!

Darren T. replied on

Is there any contraindications that anyone is aware of for massaging a client who has just been given the vaccine or is it best ti treat it like a flu shot?

Gretchen W. replied on

Thank you for all your guidance during this pandemic. I am currently not providing massage. I returned to work, following all the guidelines, at the end of the summer, but I began to feel unsafe again in the fall as the numbers rose here in Massachusetts. As vaccines begin to be available, I am wondering about seeing clients for their vaccination status. I will be among the last demographic to have access to the vaccine, but many of my clients will have it before me. What guidance do you have about offering massage to clients who have been vaccinated? Is it legal and ethical to ask and are there any pitfalls to avoid? Thanks

Shellee A. replied on

I have a client who has tested positive for Covid about a mont after I last saw her. Her case has been mild, but how long should I have her wait before allowing her to come in for a massage? I've read that some people will continue to test positive for quite sometime even if they have no symptoms. I know she's going to ask to schedule an appointment and am not sure how to handle the situation

Debra B. replied on

I know there are concerns for circulatory system issues with those who have recovered from covid. What is the time after recovery recommendation for massaging them? According to the CDC they are safe to be around others 10-20 days depending on there immune status. 

Thank You

Cindy M. replied on

Hi there, 

I've been in practice for 25 yrs and am finally getting busier after a long period of slow weeks after our mandatory shut down here in CO. I was able to get vaccinated early, so grateful!

Most of my clients coming in now are vaccinated (yay!) and someone asked if we are both vaccinated, could I work on her face and jaw. I left my mask on and we didn't talk while I was working there. Is this acceptable? What do you think is the risk level?

Thank you, 

cindy mayhew

Cindi Z. replied on

I was looking forward getting my vaccination,  finally getting back to normal and returning to work.  I wanted to protect my clients and do my part to contain this virus.

I personally didn't feel comfortable getting the 2 dose, so I received the 1 and done (J&J).  I hadn't received any bodywork (except Chiropractic) since the pandemic began. I did need bodywork and I knew Myofascial Release would be awesome for some arm issues to be in peak form. 

I found a OT who specialized in it (25+ years) and accepted my insurance.  I contacted her, and she had some personal issues coming up, which meant I needed to start treatments immediately.  This was 6 days after my vaccination.

There is a reasons I am sharing this.

The first session was more on my arm . Then  as we progressed, she used  other techniques, such as deep work in my pec minor, cupping along on spine and cranial decompression. I started to have chills, major brain fog, memory issues and now balance issues.  I feel this work  near my lymph nodes effected me, also  affecting my cranial sacral fluid among other things. 

My body was trying to intergrade the vaccine and all this intensive work (6 days after I was vaccinated)  was making me feel like I was out of my body.  I am still not right.  Later I remembered my Lymph Drainage courses, and how intense working in these areas can be.

I am  sharing this because, a client (or new client) who was just vaccinated may need time to adjust and integrate before any deep work or maybe any body work at all.  Everybody's may have different experience, I just thought I'd share mine. 

 

Tracey E. replied on

There are some great questions posted here. I logged in so I could read the answers, and found there are very few answers. Is there someone with appropriated knowledge who could answer the questions posted? Thank you.

Steven T. replied on

Should we disclose if we have or have not had the vaccine?

It can be a hot topic where I work, I don't feel comfortable talking about if I have or have not received the vaccine.

Some people have strong opinions both ways. I was just wondering a safe way to approach this topic when a client asks if I have had it or not.

I do feel safe saying something like "they ask us not to talk about it" but still find this is not enough.