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COVID-19: Worker’s Compensation Claim or Not?


The ever-changing COVID-19 protocols can be very confusing, especially in regards to workers’ compensation benefits. As an employer, it is imperative to understand the laws in place in order to properly navigate employee’s rights.

Under normal circumstances, it is very difficult for an employee to file a workers’ compensation claim and receive benefits for an infectious disease, especially one that is widespread in the community. But state laws passed in response to the pandemic have made it easier to qualify.

Senate Bill 1159

On September 20, 2020, California Gov. Gavin Newsom signed Senate Bill 1159 into law. Under this legislation, COVID-19 infection is designated a workplace injury, and if an employee contracts COVID-19 at work, the company is required by law to cover the costs of medical care, lost income, and even transportation expenses. Further, if an employee dies from a work-related COVID-19 infection, SB 1159 ensures that dependents are eligible to collect workers’ compensation benefits, including medical coverage, death benefits, and burial expenses. The new law is set to remain in effect until January 1, 2023.

Outbreak Presumption

Senate Bill 1159 has made it much more likely that worker infections will be covered under workers’ compensation coverage and has shifted the burden of proof to presume that covered workers who contracted COVID-19 did so at work, unless the employer can prove otherwise.

Specifically, this presumption covers custodians, EMTs, firefighters, healthcare workers, nurses, and peace officers who provide direct patient care. However, the presumption does not apply if the employer can prove that the employee did not have contact with a patient who tested positive for COIVD-19.

If you have employees that fall under the aforementioned occupations, it is important to note that they are required to use any available COVID-related sick leave benefits prior to collecting any temporary disability benefits and the insurance company has only 30 days to deny your COVID-19 claim, rather than the usual 90-day time limit.

Employees Non-Eligible for COVID-19 Presumptions

Even if your business does not fall under the aforementioned presumption qualifiers, your employees may still qualify for COVID-related workers’ compensation benefits. But it will be very difficult. Under a longstanding California rule, workers’ compensation won’t cover an infectious illness unless the employee can prove that both their job directly involves an exposure hazard greater than the risk of the general public and that the disease was contracted due to a specific, identifiable exposure at work. To meet that important threshold, an employee needs to establish a reasonable, factual basis for asserting that the workplace did indeed cause their illness.

Navigating the complicated world of COVID-19 contraction and exposure in relation to workers’ compensation claims has become a burden for many companies and employers as their employees are more likely to qualify for such benefits. Understanding the laws that surround the legislation is imperative to continued daily operations, maintaining your bottom line, and retaining healthy employee relationships. If you would like more information regarding SB 1159 or COVID-19 workers’ compensation claims, Trinity Occupational Health is here to help. Please contact us with any questions or concerns you may have.

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Monday, 24 June 2024

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