Presumption for COVID-19
California Senate Bill 1159 changes the WC law so COVID-19 is presumed to be a work-related illness under certain circumstances.
Extension to Jan. 1, 2023
The bill codifies and expands an existing presumption until January 1st, 2023.
Employers with five or more employees will have 30 business days from 9/17/20 to submit retroactive WC reporting regarding any employees who have tested positive dating back to 7/6/20. Ongoing reporting requirements also apply.
Leave Use Requirement
The new law requires employees toexhaust any COVID-19-related paid leave before receiving WC benefits.
Senate Bill 1159 was passed by the CA Legislature on 8/31/2020 and signed into law by Governor Newsom 9/17/20. The law formalizes COVID-19 illnesses that would qualify under the Governor’s 5/06/20 Executive Order. It also creates two new presumptions dating back to 7/6/20 and remains in effect until 1/1/23. Two of the five sections of the bill directly affect CA employers:
First, section 3 (creating Labor Code 3212.87) of the bill applies to firefighters, peace officers, or certain health care professionals working at a health facility. This section creates a disputable presumption of workplace compensability for workers infected with COVID-19. The workers must have a positive PCR test within 14 days of working at the place of employment on or after 7/6/20. Note, the definition of healthcare professional is defined as a worker who has direct patient care responsibilities or who is a custodian in contact with COVID-19 patients. Much like the executive order, investigation and any challenges of compensability must be done within 30 days of an employer’s date of knowledge.
Second, section 4 of the bill is for every other business in CA with 5 or more employees:
Presumption arises only if there is a defined “outbreak” which is then broken down further by number of employees. The employee must have a positive PCR test within 14 days of working.
• Under 100 employees-4 or more employees who test positive at a specific
place of employment
• Over 100 employees-4% of the highest number of employees who report to
the same specific place of employment within 14 days of the positive test
• If the employer is ordered to close by a local or state health department or
OSHA due to a risk of infection from COVID-19
The claims administrator must determine compensability within 45 days from the Employee’s filing of the claim form.
It is up to the claims administrator to determine if there is an outbreak. Employers are required per the law to report “when the employer knows or reasonably should know that an employee has tested positive for COVID-19 they employer shall report the claim within 3 business days to the insurance carrier.” The law states employers must retroactively report back any positive test results that may have existed so the claims administrators can determine if there is an outbreak. If an employer fails to report or submits false information, they can be fined up to the amount of $10,000 per incident by the Labor Commissioner. Positive COVID-19 cases between 7/06/20 and the implementation of this law must be reported to the claims administrator within 30 days of the law’s enactment.
Items for employers to consider:
• Report to the claims administrator if you have employees testing positive
for COVID-19 immediately (if an employee was terminated and tests
positive within 14 days of working/termination, the claim must be
• The date of injury is the last day worked prior to the positive COVID-19 test
per section 2 of the bill
• MPN is enforceable for medical treatment and temporary disability
• Provide the claims administrator with all relevant information (i.e. Did the
employee state this was not work related and a family member had been
diagnosed in the household?)
• Review your COVID-19 safety program to ensure OSHA compliance (see
OSHA 7/16/2020 directive and AB 685) and claims reporting procedures
• Have your employees sign an acknowledgement form documenting they
know the requirements