On Wednesday, California Governor Newsom issued an executive order in regards to workers and coronavirus. If a worker meets certain criteria, that worker will have a rebuttable presumption that they got covid-19 from work and will have a compensable work comp case.
If you get any of these calls, we would love to help these clients. We already have our first covid-19 case, and it’s been accepted by the carrier.
Here are the criteria:
1) All Employees are eligible.
It was initially rumored that only ‘essential workers’ would be eligible under the law. Some bills were presented which only covered a subset of ‘essential workers’; however, the executive order doesn’t discriminate. Any and all employees can be covered.
2) Must be diagnosed by or test positive for Covid-19 through a licensed physician
3) The diagnosis must happen within 14 days after the last date of work
If a worker stops working and waits more than 14 days before they get an official diagnosis, it may be harder to get them covered under this presumption. I think saavy insurance carriers will look closely at this one.
4) The worker must be performing work at a workplace location, NOT their residence.
Workers who work from home or who have been working from home for more than 14 days won’t fall under the presumption. They should be at a workplace location or job site.
5) The order applies for the dates of injury between March 19 – July 5
The Governor may extend this date dependent on the circumstances.
What happen if the employee meets these criteria?
1) Rebuttable presumption of workplace injury
The insurance can still rebut but it will be very hard, if not impossible, to do so. Also, they must accept or deny within 30 days, not the normal 90 days.
2) Medical Treatment and/or out of pocket expenses
The injured worker can get medical treatment. If they self procure treatment, arguably they can get reimbursed the medicals as out of pocket costs.
3) Temporary Disability Benefits
To get temporary disability benefits, they must first exhaust their benefits under the Federal Sick leave provision for covid-19 and they must be certified TD by a doctor.
4) Death Benefits
If a worker meets the above criteria, but passes away, they may be entitled to death benefits depending on the number and type of dependents they have.
Dustin Saiidi, “The New Workplace Coronavirus Presumption – California Executive Order,” Law at Your Side, Accessed May 7, 2020