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Tuesday, 13 October 2020 19:02

California COVID Presumption Law Creates New Data Tracking Burdens

Written by Jim Sams, Claims Journal

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A California law enacted last month that eases the path to workers’ compensation benefits for employees who contract COVID-19 will require an unprecedented level of documentation and communication between claims managers and employers.

“I have joked that this should be called a job-creation bill because of all the data tracking that is required,” said Brenna E. Hampton, managing partner in San Diego for the Hanna Brophy law firm, during a webinar on Oct. 7. “Not a lot of people have found that funny.”

 

Michelle Tucker, vice president of enterprise workers’ compensation operations for CorVel, said for the first time claims adjusters will have to keep track of all reports of COVID-19 infections, even those that don’t result in claims. Employers bear the burden of reporting infections without identifying employees by name, while also logging the total number of workers at each worksite and the total number of infections at each.

 

The new data-tracking requirements are tied to the unique presumption created by California lawmakers with passage of Senate Bill 1159, which Gov. Gavin Newsom signed into law Sept. 17. The bill took effect immediately. It replaces an executive order that Newsom issued in March and expired on July 6.

 

Tucker said the bill is easily the most complicated of any of the presumption laws, regulations and executive orders imposed by 19 states so far, showing once again that “in California, we like to go our own way.”

 

She said CorVel has created a portal and forms that employers can use to report data about COVID infections. Sedgwick, a national third-party administrator based in Memphis, TN, announced a similar “intake portal” for reporting COVID-19 positive test results.

 

The legislation limited the number of workers who will be granted a presumption that COVID-19 infections arose out of and in the course of employment. The presumption applies to all first responders and health care workers who have contact with COVID-19 patients. For that group, the employer or insurer must approve or deny the claim within 30 days, rather than the 90-day investigation period usually allowed by California law.

 

For other workers who have contact with the public, the presumption is applied only if there was an outbreak of the disease at the worker’s job site. For that group, employers must complete their investigation within 45 days. No presumption applies for employees who work from home.


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