How is COVID Impacting workers compensation claims in CA?
Workers’ compensation benefits in California have long provided needed medical care, free of charge, to injured California workers. Additionally, it can provide lost wages, depending on the extent of injury and how long you are expected to be out of work.
Who Gets Workers’ Compensation?
The great thing about workers compensation is that it does not matter who caused the accident or your injury or who is at fault. As long as you were injured while doing your job, a Modesto accident attorney can help you get workers’ compensation benefits for your injuries.
Sometimes it’s easy to show that you were injured at work. For example, if you are a driver and you get into a car accident, or if you are a construction worker and you are injured during an accident on the job site, it is clear that you were injured while at work.
Other times, it may not be so easy to show an injury is job-related, such as when someone contracts a disease or illness while at work. Because we can’t see germs in the air, there is often no way to tell exactly when or where we got a cold, the flu, COVID-19, or any other disease. The employer and insurance company will often say that you contracted your illness at home or while out in public.
To show that you became infected while at work, California law requires you to show that something about your job carries more risk or more exposure to disease than other jobs do. You also have to show exactly how you got the disease or how you were exposed to it while at work.
How Common Are COVID-19 Workers’ Compensation Claims in California?
COVID-19-related workers’ compensation claims were common nationally and in California in 2020. The California Workers’ Compensation Institute (CWCI) reported that 103,712 COVID-related workers’ compensation claims were made in 2020. That’s one of every six workers’ compensation claims that year.
Most COVID-19 claims were filed in the healthcare, government, and retail industries.
The state projects that as many as 4,000 COVID-related workers’ compensation claims could be filed for September 2021, and between 7,000 and 9,000 for August 2021.
This is likely due to the Delta variant of COVID-19, which caused cases to spike, especially in the more urban California areas like Los Angeles County. There, COVID-related workers’ compensation claims soared to five times their normal amount from June to July 2021. The county went from just under 19% of the total statewide reported COVID-19-related workers’ comp claims in June to 24% in July.
Getting Workers Compensation for Contracting COVID at Work
California recently made these rules a little easier for employees who get COVID-19 while at work.
The new California law makes it much easier for you to show that you got COVID from your workplace, which is required for you to get benefits.
COVID-19 Benefits for All Employees
The law says that as long as you are working at your job and not from home if there is an outbreak of COVID at work, the law will assume you contracted it from your workplace. This assumption applies to any workplace of more than five employees.
The law defines what an outbreak is to get the benefit of the presumption. If your employer has less than 100 employees, and at least four employees test positive for COVID-19 within 14 days, the event is considered an outbreak. For employers with more than 100 employees, an outbreak is when 4% of the total number of employees test positive within 14 days.
You must use any sick leave provided by your employer before you can get disability benefits from workers’ compensation. If your employer tries to deny your benefits, it must show that you contracted COVID from a source other than work. For example, your employer may try to show that one of your family members was sick or that you visited a public place that carried a high risk of COVID transmission.
The insurance company has only 45 days to deny your benefits. Otherwise, you will be considered approved. A Modesto accident attorney can help you fight any denial. However, while you are waiting for the insurance company to make its decision, you can still get up to $10,000 in medical benefits.
COVID-19 Benefits for Healthcare and Emergency Providers
Emergency responders, healthcare workers, and all others who work in a direct patient care setting also get the benefit of legal presumption.
Employees do not have to be doctors or nurses. Any job that deals with patients in a medical setting may qualify for the presumption, such as custodial staff, case or social workers, and in-home care providers. Unlike other workers, those in health care or emergency services do not need to show that there has been an outbreak to get workers’ compensation benefits after getting COVID-19.
Your employer can try to deny you benefits if it can show that you were never in contact with any person who had COVID. Once you make a claim, the workers’ compensation insurer has only 30 days to deny you. This is much less than the normal 90-day limit that insurers would have. You can get up to $10,000 in medical benefits while you are waiting for your insurance company to make a decision.
Just like employees who aren’t in these areas, health care or emergency responder employees must use work-provided sick leave before collecting workers’ compensation benefits for temporary disability.
New Legal Presumptions Are a Big Help to Sick Workers
The new law provides a huge benefit for sick California workers. The assumption means that if you and your employer meet the requirements in the executive order, you or your Modesto accident attorney don’t have to prove anything else. The law automatically assumes you contracted COVID at work, and thus that you should get workers’ compensation benefits.
This shifts the difficult part of a workers’ compensation case from you to your employer. Rather than you having to prove you got COVID-19 at work, your employer must disprove it.
What If You Don’t Meet the Requirements?
Remember that even if you don’t meet the requirements of the new law, you can still get workers’ compensation after getting COVID at work. The automatic assumption that you were infected while doing your job won’t apply to you, and you will have to prove that is what happened.
There are very strict time limits to report any workers’ compensation claims, COVID-related or not. If you don’t report a claim on time, you could lose your right to workers’ compensation benefits.
If you feel like you have symptoms of COVID-19, you should speak to a qualified Modesto accident attorney as soon as possible. Your attorney will help you analyze your case, make your claim, and start getting the benefits you need as quickly as possible.