COVID-19 Presumed Work-Associated Beneath California Employees’ Compensation Guidelines

Omar Ochoa, Riverside Workers Compensation Attorney

First responders, healthcare workers, and certain other employees who contract COVID-19 are believed to be subject to new California law. By Catherine Kimble

I am confident that most COVID-19 cases are viable if the person believes the infection occurred in the workplace. “

– Omar Ochoa, California labor compensation attorney

RIVERSIDE, CALIFORNIA, UNITED STATES, Aug. 19, 2021 /EINPresswire.com/ – To date, California has seen 3.72 million COVID-19 infections resulting in 61,083 deaths. Only a fraction of the sick – around 90,000 in 2020 – applied for workers’ compensation insurance because they were unable to work. However, more than a quarter of these requests were denied, prompting a response from lawmakers. SB 1159, signed by Governor Newsom in September 2020, makes a presumption in California law that certain employees who contract COVID-19 are likely to have the disease at work and are therefore eligible for employee compensation benefits.

Executive Order N-62-20 creates a presumption

In May 2020, Governor Newsom signed an executive order stating that “any COVID-19-related illness of an employee for the purpose of providing employee compensation is likely to occur out of and during the employment relationship.” Under the current California employee compensation system, you must demonstrate that that your injury or illness is work-related in order to receive the benefits. In the case of COVID-19, however, the PO assumed that the infection was work-related as long as “the employee tested or diagnosed positive for COVID19 within 14 days of a day on which the employee performed work or services for the employee “Place of work on the instructions of the employer.” Any employee who tested positive for COVID-19 within 14 days of working on a construction site outside of the house was presumably ill at work for the purpose of employee compensation.

SB 1159 codifies the expired EO

California lawmakers met in Sacramento this summer trying to enforce a permanent COVID-19 presumption. The Legislature tabled several bills on this, but SB 1159 was the only one to put it before the governor, who signed it on September 17th when it went into effect immediately. This bill codified in California’s workers’ compensation laws the presumption that the coronavirus was infected at work and therefore can be compensated through worker compensation.

SB 1159 picks up where the PO left off and covers employees from 6 July 2020. However, as of July 6, the presumption will be limited to first responders and health care workers or employees who tested positive for COVID-19 during an “outbreak”. at their specific workplace. An outbreak means that four employees at workplaces with up to 100 employees have tested positive for COVID-19 or four percent of employees have tested positive at a larger construction site.

It is important for all California employees to understand that even if their occupation does not qualify them for the rebuttable presumption, they can claim COVID-19 sickness compensation if they believe the infection is in the workplace was acquired. Omar Ochoa, Riverside’s industrial injury insurance attorney at the Southern California law firm Ochoa & Calderón, explains the process as follows: [the California Workers’ Compensation Appeals Board], then either a treating doctor and / or a qualified medical assessor (QME), who would then determine whether it is medically probable that the COVID-19 transmission took place in the workplace. ”

If the doctor comes to the conclusion that this is likely, the employer / insurance company must decide whether to accept the claim or reject it. Ochoa comments that since the employer is unlikely to accept the claim that the employee’s next step would be to file a readiness to proceed with the WCAB so a judge can determine if the COVID-19 infection was work-related. “Usually at this point the case is either brought to court or the parties opt for a lump sum known as a compromise and release to avoid the risk of further litigation,” says Ochoa.

Shortened deadline for contesting claims

In California, an employer typically has 90 days to decide whether to accept or decline an application. However, for COVID-19 claims, the rules have now been changed to 30 days for first responders and certain frontline health workers and 45 days for employees who contracted COVID-19 during an outbreak in their workplace. Employees may be asked to complete any paid sickness or employment benefits, including benefits under the Familys First Coronavirus Response Act (FFCRA), prior to receiving temporary disability benefits.

All the employer needs to show to benefit from the presumption is that the worker has tested positive or been diagnosed with COVID-19 within 14 days of working on an off-site construction site. Employers wishing to contest (rebut) the presumption would likely need to conduct contract follow-up to prove that the employee was not exposed to COVID-19 at work and that the employee became infected with COVID-19 in their personal life. If the employer cannot prove this, the employer must be responsible for paying the claim.

Refuting this presumption is no walk in the park for employers. In one case, a person hospitalized for COVID-19 filed an application for compensation for workers. The plaintiff said he hugged a colleague in the parking lot at work and was spending time with that colleague. Outside of work, the plaintiff went to church and a political rally where no one was wearing a mask and everyone was in close contact with one another. There was no evidence that anyone had contracted COVID-19 at this service or political rally, but it was found that the applicant was at work within 14 days of contracting COVID-19. Therefore, this was classified as an occupational accident.

Separately, Attorney Ochoa notes that based on his experience, employers will almost always try to rebut the presumption through the investigative process by examining the employee’s daily activities outside of work to see if any of those activities could have caused the infection. “In an actual COVID case that our law firm is currently processing,” says Ochoa, “the defendants attempted to rebut the presumption in the upcoming trial by presenting relevant sections of the personnel files of the employees that point to the absence of COVID- 19 could indicate diagnoses. “

“Ultimately,” says Ochoa, “I think it’s a very high bar that defendants have to meet to disprove the presumption, and I’m confident that most COVID-19 cases that the person believes will be the infection took place in the workplace are sustainable. ”

These legislative changes apply to cases from July 6, 2020, but will expire on January 1, 2023.

Omar Ochoa
Ochoa & Calderón
+1 951-901-4444
email us here
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August 20, 2021, 6:12 am GMT

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