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Posted on: Aug 17, 2020

State lawmakers are considering three separate bills, all of which will be heard in their respective Appropriations Committees in the next two weeks, that would establish various levels of workers’ compensation presumptions for essential workers who contract COVID-19 on the job. Here are some key facts they should consider when casting their votes.

Workers’ compensation claims are down overall in 2020. According to recent data from the California Workers’ Compensation Institute (CWCI), claims are down 29 percent for the first six months of 2020 compared to the first six months of 2019. Reported claims as of June 30 totaled 241,969 compared to 339,796 reported in the first half of 2019.

Overall claims have not increased due to COVID-19. The CWCI data shows 14,487 COVID-19 claims had been filed as of July 6, which were included in the overall count above and account for only 6 percent of claims reported this year.

The denial rate for COVID-19 claims is over three times as high as the denial rate for non-COVID-19 claims. Per the CWCI, the denial rate for COVID-19 claims for the first half of the year was 25 percent compared to 8 percent for claims not involving COVID-19.

Lastly, as we reported two weeks ago, payers don’t anticipate COVID-19 costs to be a problem. Health Strategy Associates, a national health industry consulting firm led by Principal Joseph Paduda, conducted a recent survey, which concluded:

  • When it comes to COVID-19 claims, the report found that they are typically inexpensive.
  • One survey respondent estimated that 96 percent of claims cost less than $3,500.
  • Another respondent reported that 3.8 percent of COVID-19 claims accounted for the vast majority of coronavirus-related costs.

One more key fact to consider: currently, there is no COVID-19 presumption in place for essential workers. Governor Newsom’s rebuttable presumption expired July 5, placing the burden of proof on employees who continue to put their lives on the line during this pandemic.

The state legislature should remember these facts and take appropriate action to enact a presumption that protects as many essential workers as possible.