Employers in California, like others across the country, are dealing with a new health risk in their workplace: COVID-19. This has impacted everything about the way America does business, and how health care teams and medical practices interact with each other and with patients.
Not surprisingly, workers compensation schemes are also adjusting to the pandemic, with new rules in place surrounding claims and notification in California.
So, what happens when a team member tests positive for COVID-19 in California? Here’s what health care practices need to know about workers’ compensation.
Eligibility for Workers’ Compensation Due to COVID-19 Illness or Injury
As of September 17, 2020, there is a rebuttable presumption in California that illness or death from COVID-19 is work-related for two specific groups of workers:
- First responders and health care workers; and
- Employees who test positive for COVID-19 during an outbreak at their place of employment.
The legislation defines an “outbreak” as positive tests of 4 percent of employees if the organization has more than 100 employees, and 4 individuals if the employer has fewer than 100 employees. The positive tests must occur within a single 14-day period.
The burden is on the employer to show the COVID-19 illness or injury did not happen at work, if they so choose to rebut the presumption.
If an employee does not fall into one of these two categories, they are still eligible to apply for workers’ compensation. However, the burden is on the employee to show the COVID-19 illness or injury is work-related.
Once the claim is approved and the workers’ compensation scheme kicks in, the employee becomes eligible for benefits as a result of the COVID-19 illness or injury. Those benefits may include:
- Full hospital benefits
- Surgical benefits
- Medical treatment
- Disability indemnity
- Death benefits
This rebuttable presumption is currently on the books until January 1, 2023. Therefore this law will remain in place for some time, unless there are legislative changes.
Notification Requirements When Employees Test Positive for COVID-19
For all categories of workers, employers must report a positive COVID-19 test to their workers’ compensation claims administrator. They must report certain information three days from the time they know, or should know, that an employee has tested positive for COVID-19.
Here is the required information:
- The fact of the positive test.
- The date of the positive test, which is deemed to be the date the specimen was collected from the employee.
- The address of the employee’s place of employment in the 14 days prior to the positive test. (All addresses where the employee worked must be reported.)
- The highest number of employees who came to work at the employee’s place of work in the 45 days prior to the employee’s last day of work at the location.
By law, this information must be transmitted in writing, specifically by email or fax. A phone call will therefore not suffice.
Importantly, the employer’s report to the claims administrator must not identify the employee who tested positive. To make sure this is accomplished, you must remove any personally identifiable information from submitted documents. The exceptions to this rule are when the employee has filed a workers’ compensation claim or says the COVID-19 positive test is work-related.
Failing to Report COVID-19 Positive Tests in California
There are penalties for failing to report COVID-19 positive tests. California employers may receive a civil fine of up to $10,000 for either not reporting, or intentionally reporting information that is false or misleading.
Although the law gives employers three days to report a positive test at their workplace, it is therefore a good idea to gather the necessary information and get in touch with the workers’ compensation claims administrator as soon as possible.
HR for Health Helps Employers Stay on Top of Workers’ Compensation Claims
Health care teams know how to prioritize safety. Day after day, they work to protect patients and co-workers from a variety of risks. Health care employers deserve support from a partner like HR for Health. This solution increases administrative efficiency for team member records, including illness, absenteeism, and workers’ compensation. By partnering with HR for Health, you’ll also gain access to superior HR support and information, including how to navigate COVID-19 case reporting in your practice.
Want to learn more? Contact HR for Health today to learn more.
Did you know that we at HR for Health monitor all the specific laws and regulations that affect your practice? If you have questions about compliance issues, please reach out to us. Schedule a call, call (877) 779-4747, or email [email protected] now to learn more.
HR for Health is one of the nation’s leading Human Resources Management Systems (HRMS) used by small to mid-sized practices.
Quick note: This is not to be taken as legal or HR advice. Since employment laws change over time and can vary by location and industry, consult a lawyer or HR expert for specific guidance. Learn about HR for Health’s HR services
