COVID-19 Diagnosis Presumed Contracted at Work
Overview As California prepares to phase in the gradual reopening of the state, Governor Gavin Newsom signed an executive order that protects workers who contract COVID-19. Specifically, employees who are required to work outside of their homes during the stay at home order and who contract COVID-19 are presumed to have contracted the illness at work and thus are presumed eligible to receive workers’ compensation benefits. Governor Newsom said: “We are removing a burden for workers on the front lines, who risk their own health and safety to deliver critical services to our fellow Californians . . . Workers’ compensation is a critical piece to reopening the state and it will help workers get the care they need to get healthy, and in turn, protect public health.” The Details If an employee contracts COVID-19, it will be presumed to arise out of and in the course of employment for purposes of awarding workers’ compensation benefits if all of the following requirements are satisfied: 1. The employee tested positive for or was diagnosed with COVID-19 within 14 days after a day that the employee performed labor or services at the employee’s place of employment and at the employer’s direction, 2. The day of work was on or after March 19, 2020, 3. The place of employment was not the employee’s home or residence, and 4. The diagnosis was made by a physician who holds a physician and surgeon license issued by the California Medical Board and that diagnosis is confirmed by further testing within 30 days of the date of the diagnosis. Presumptive Benefits This presumption removes the burden of proof from the employee relative to a workers’ compensation claim. The presumption is disputable by the employer and may be controverted by other evidence; however, unless expressly refuted, workers’ compensation benefits are payable to the employee. If the claim is not refuted within 30 days after filing, benefits are presumed payable (unless evidence is discovered only subsequent to the 30-day period). While no examples are provided for what controvertible evidence might consist of, one might surmise something like a family member having already contracted COVID-19. All Carriers Impacted The order applies to all workers’ compensation insurance carriers writing policies that provide coverage in California, self-insured employers, and any other employer carrying its own risk. Nothing in the order limits the ability of insurance carriers to adjust the costs of their policies.
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