State of California Takes Expansive View of COVID-19-Related Claims for Workers’ Compensation

May 7, 2020California

California Governor Gavin Newsom issues Executive Order making COVID-19 illness presumptively work related.

The key takeaways from the order include:

  • Identification of four requirements to establish workers compensation benefits:
    1. The employee was diagnosed within 14 days of working at their “place of employment.”
    2. Employee received a COVID-19 diagnosis on or after March 19, 2020.
    3. Their place of employment is not their home.
    4. Diagnosis was done by a licensed California physician and confirmed by testing within 30 days.
  • Employers – or their insurance carrier – may dispute the claim within 30 days, instead of the usual 90 days permitted to dispute a claim.
  • Most importantly, the onus of providing evidence that infection arose from non-workplace exposure shifts to the employer, which may be difficult to establish.
  • This presumption applies to injuries which occur within the next 60 days, through July 5, 2020
  • There are altered rules for First Responders and for temporary disability benefit eligibility.
  • The Division of Workers’ Compensation is ordered to change any regulations “necessary to implement this order,” which could impact how claims are processed.
  • The presumption appears to apply to California workers regardless of the location of their employers.
  • Workers’ Compensation insurance carriers have the right to adjust costs as a result of this order.

Advice to Employers: 

  • There could be a great deal of uncertainty around how this order will be implemented in the coming days and weeks. Reach out to your MMA team with questions.
  • Workers’ compensation rates can be expected to rise due to increased claims.
  • On a positive note, this Order will likely greatly reduce litigation around employer liability.
  • The Order encourages working remote where possible and requires employers to consider whether to ask employees to return to the workplace, if they are able to work effectively remotely. Any employee who returns to their place of work in the next 60 days and is later diagnosed with COVID-19 within 14 days will be presumed to be a workplace injury.

     

The Governor’s order can be reviewed in its entirety at the link below:
https://www.gov.ca.gov/wp-content/uploads/2020/05/5.6.20-EO-N-62-20-text.pdf