COVID-19 claims are covered under California Workers’ Compensation

Governor Newsome’s May 6, 2020 Executive Order creates a rebuttable presumption that COVID-19 claims are compensable.

What should an employer do?

  • Keep accurate records of all periods of employment for each employee, including when they were at the workplace and when they worked from home or did not work. Track payroll separately at each place of work.

    • WHY? The WCIRB has proposed the following; awaiting approval by Insurance Commissioner Lara.

      • Payroll for salary continuation with no work will be excluded from W.C. premiums

      • Payroll for employees working from home will be calculated at the lower Clerical class code (8810) for W.C. premiums

  • Keep a separate log of all COVID-19 claims that are submitted to your carrier.

    • WHY?  The WCIRB has proposed that all COVID-19 claims be excluded from the X-Mod; awaiting approval by Insurance Commissioner Lara.

  • Stay in touch with your carrier’s claims handlers

    • WHY? To ensure that they receive accurate information in order to make prompt decisions about compensability

  • Stay in touch with any employee who files a COVID-19 claim

    • Why? To ensure that they are receive prompt carrier responses, appropriate treatment and to discuss options for returning to work.

Here are the Basics of the Executive Order…. Still being interpreted, some contradictions, more to come…

Applies to any worker who must go to his or her place of employment (not just to essential employees)

Date of exposure must be between 3/19/2020 - 7/5/2020

  1. Must test positive or

  2. Medical diagnosis of COVID-19 within 14 days of performing work at the place of employment. (not if working at home)

2 paths for claims

  1. COVID-19. No presumption. (falls outside the select criteria for presumption)

  2. COVID-19. Rebuttable presumption (this means that the burden of proof shifts from the employee to the employer)

Carrier’s only have 30 days, instead of the normal 90 days, to investigate and decide if a COVID-19 claim is compensable. (AOE/COE)

All sick leave and benefits must be used before Temporary Disability is due.

For more information, please contact us at info@esminsite.com

Abe Jabhan, JDclaims management, covid, california, workers' compensation, governor, WCIRBComment