June 2020: Workers’ Compensation Coverage for COVID-19 Infections

June 4, 2020 8:54 pm

On May 6, 2020, Governor Newsom issued an Executive Order establishing a presumed eligibility for workers’ compensation benefits for employees who contract COVID-19 at work. Prior to this pandemic, having an infectious illness such as the flu would not entitle employees to workers’ comp. coverage because it is nearly impossible to confirm where a person contracted the illness.

Based on the governor’s order, an employee would receive workers’ comp. benefits for medical treatment if:

  • The employee worked outside of their home at the direction of the employer between March 19, 2020 and July 5, 2020, and
  • He/she is diagnosed with COVID-19 within 14 days of working at the employer’s place of business.

Reporting a COVID-19 Claim

If an employee informs you of a COVID-19 positive test or diagnosis by a qualified physician, you should respond in the same manner as with a workplace injury.
Provide the employee with a DWC-1 form within one working day of being informed of the illness.
Report the claim to your workers’ compensation carrier right away.
You do not need to make a report of possible exposure or suspected infection. The above steps are necessary only if the employee is confirmed to have COVID-19.

If you have employees who tested positive for COVID-19 between March 19 and May 6 (when the Executive Order was signed), contact your workers’ compensation carrier for guidance on how to proceed with these claims.

Claim Investigation

According to the Executive Order, employers have the ability to dispute COVID-19 claims. Your workers’ compensation carrier will investigate the circumstances involved. This could include evidence of your company’s safety policies such as required social distancing, facial coverings, and hygiene practices for all staff. Based on available facts, the claim may be accepted or denied.

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