CALIFORNIA GOV. Gavin Newsom has issued an executive order requiring that workers who either test positive for COVID-19 or are diagnosed by a physician as having coronavirus are eligible for workers’ compensation benefits.
The order means that it will automatically be presumed that the employee contracted the virus on the job if they test positive or receive a diagnosis within 14 days of their last shift.
Additionally, the employee must have been working at a worksite and not from home to qualify, and the diagnosis must be confirmed by testing within 30 days of the original diagnosis.
The order covers any worker that reports to a worksite, including “essential workers,” which include those in health care, emergency services, trucking, construction, food, warehousing, delivery, and more.
Workers’ comp benefits include partial wage replacement for any missed time from work, as well as covering all related medical costs and death benefits for their family should the unthinkable happen.
If the employer believes an employee didn’t contract the virus at work, they will have the burden of proving the individual contracted the virus elsewhere, which would be a difficult endeavor.
The rule is temporary and will cover cases dating back to March 19. It will sunset on July 6 (60 days after the announcement was made on May 6).
No adverse X-Mod effects
While the order will make it easier for essential workers to file workers’ comp claims, employers do not have to worry about the effects on their workers’ compensation claims experience.
That’s because the Workers’ Compensation Insurance Rating Bureau has proposed its own rules that would exempt any COVID-19 claims from an employer’s claims history, so that it would not affect their experience modifier (X-Mod).
That means if an employer has any workers who file COVID-19 claims, their premiums would not rise due to those claims.
The proposal will be reviewed by the Department of Insurancein May and it’s likely, according to industry observers, that it will be approved. It too will sunset 30 days after shelter-at-home orders are lifted.
The Rating Bureau estimates that the cost of COVID-19 workers’ compensation claims in California could range from $2.2 billion to $33.6 billion annually.
A mid-range estimate of $11.2 billion would equate to more than 60% of all California workers’ comp annual claims before the pandemic.
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