Is the Coronavirus Covered by Workers’ Compensation?

Yes, the coronavirus is covered by workers’ compensation in California. You can receive workers’ compensation benefits for coronavirus if you caught the illness at your workplace. The COVID-19 pandemic changed many things about the way people work. Many people were “essential workers” who needed to continue working despite the risk of contracting the virus. California wrote new laws to deal with workers’ compensation claims involving COVID-19 and to try to make workplaces safer both during and after the pandemic.

Two Presumptions About COVID-19 and Workers’ Compensation Claims

According to the Department of Industrial Relations (DIR), California’s Senate Bill 1159 created two rebuttable presumptions about workers’ compensation claims that involve coronavirus illness:

1. Workers’ compensation claims filed by first responders, healthcare workers, firefighters, and peace officers receive a rebuttable presumption that the COVID-19 illness is work-related and eligible for workers’ compensation benefits, including medical care.
2. When there is an outbreak at an employee’s specific workplace for an employer with five or more workers, there is a rebuttable presumption for an employee who tests positive for COVID-19 during the outbreak that the illness is work-related and eligible for workers’ compensation benefits, including medical treatment. The bill defines what is an outbreak for purposes of the presumption.

Senate Bill 1159 contains essential details that workers and employers should learn when filing or responding to a workers’ comp claim involving COVID-19.

New Laws in California in Response to COVID-19

The two rebuttable presumptions for these categories of workers who file workers’ compensation claims for work-related coronavirus were not the only legislation in our state that came out of a response to the COVID-19 pandemic. The DIR explains that employers had to increase the amount of supplemental paid sick leave related to COVID-19 up to 80 hours in the year 2022.

Whether the employee was sick with coronavirus, had been exposed to the virus, or was caring for a sick family member, the worker could receive more paid sick time. Also, workers could get paid sick leave when they were away from the job getting vaccinated or tested for the virus.

The justification for this new law was to create a safer and healthier workplace for everyone. Requiring people sick with the virus to come to work could spread the illness. There is, however, no definitive answer yet on whether workers’ compensation covers workers suffering from “long COVID.”

What to Do If You Think You Caught COVID-19 at Work

If you have a medical emergency, get medical attention immediately. As soon as possible, notify your boss of the illness and that you believe the illness is related to your job. You have only 30 days to provide notice to your employer. This time limit could get extended in some situations.

It is best to put the notice in writing and keep a signed, dated copy for your records. One common reason employers give for denying workers’ compensation claims is that the worker did not provide timely notice.

You also have to file a formal workers’ compensation claim. You will need to get the form from your boss, fill out your portion, and submit the form to your employer for them to complete. Again, you will want to keep a copy for your records. The claim must get filed within one year.

Workers’ Compensation Benefits for COVID-19 in California

As soon as the claims administrator decides that your COVID-19 illness was work-related and eligible for workers’ compensation benefits, you could receive all the categories of benefits as anyone else with a valid workers’ comp claim in our state.

The five types of workers’ compensation benefits in California are:

1. Medical care. Workers’ compensation insurance should cover the medical treatment for a qualifying case of COVID-19. You should tell all healthcare providers that you think you got exposed to the coronavirus at work. The provider should bill your employer’s insurer, not you. You should even have to pay a deductible or co-pays for your medical care for a work-related illness.
2. Temporary total disability. This benefit pays a portion of your lost wages when you cannot work because of the illness. Usually, the amount is two-thirds of the worker’s gross (pre-tax) wages. There are limitations to this benefit that could impact high-wage earners. If you do not have lost wages during recuperation, you can still get paid medical care.
3. Temporary partial disability. If you have work restrictions when you return to work and experience a decrease in your pay as a result, this benefit could replace some of those lost wages. The benefit can pay two-thirds of the difference in your gross pay.
4. Permanent disability. Sometimes, a worker does not recover 100 percent, even after completing their prescribed medical treatment. A worker who has residual impairments from COVID-19 can get a disability rating from a physician on a scale from zero to 100 percent. The claims administrator then calculates the amount of permanent disability benefit using several factors, including the disability rating and the employee’s previous income.
5. Retraining after job displacement. When a worker has a permanent disability and does not go back to work for the employer, they might be eligible to receive vouchers that can help to pay for education or job skills training. The purpose of the workers’ comp program is to help injured workers return to the job market, but sometimes, they need additional job skills training to do so.
6. Death benefits. When a worker dies from work-related coronavirus or its complications, their surviving dependents could receive death benefits, which can include burial costs.

You do not automatically receive all of these benefits. The facts of your situation will determine the benefits for which you qualify. For example, if you heal completely from your illness and have no long-term impairments that impact your ability to make a living, you will not receive permanent disability benefits.You can work with a workers’ compensation lawyer at the KJT Law Group when seeking benefits for the coronavirus/COVID-19. Please feel free to call us at (818) 507-8525.