Northern California Engineering Contractors Association

Senate Bill 1159 – California Workers compensation laws related to COVID-19 claims

We have just learned that Senate Bill 1159 was signed into law by Governor
Gavin Newsom on 9-17-20.  We wanted to make you all aware of some of the key
points of this Bill because it take effect immediately.  Since we are not
attorneys and can not provide legal advice, you may want to contact your
Labor Counsel to clarify your obligations under this new bill.  We expect
that your Workers’ Compensation Carriers will be communicating with you
about this new law and their plans for implementation in the coming days and
weeks.

**Please pay particular attention to Section 4, as it requires immediate
action**

SB 1159 Information for Insureds

There are new changes to California Workers Compensation laws related to
COVID-19 claims.  These changes – SB 1159 – were passed by the California
Legislature on 8/31/2020 and signed into law by Governor Newsom on
9/17/2020.  SB 1159 is effective immediately and certain provisions apply
retroactively to July 6, 2020 and will remain effective until January 1,
2023.

Below are some bullet points on the new law, which is broken into five
sections.

Section 1: A COVID-19 task force is being formed to study the impact of
COVID on the work comp system.

Section 2: Mirrors the Executive Order regarding the presumption of
occupational causation for COVID-19 illness for dates of employment between
3/19/20 and 7/5/20, now part of LC Section 3212.86. The following criteria
must be met for the presumption to apply:
* Must be outside the home at direction/control of employer
* Must have positive test or diagnosis and confirming test within 30 days
* Positive test must be within 14 days from date last worked
* Insurance companies have 30 days to make a compensability decision
* SB 1159 does not change the Executive Order

Section 3: Specific to firefighters, peace officers and health care workers
who provide direct patient care or have contact with COVID
patients.  For the presumption to apply the following criteria must
apply:
* 30 days to make a compensability decision
* Must have positive PCR test
* Positive test must be within 14 days from date last worked

Section 4: Applies to all other CA businesses with 5 or more employees
* Applies Retroactively to 7/6/20 and is in effect until 1/1/23

*   All positive test results an employer is aware of from its employees,
whether or not there was occupational/industrial causation from 7-6-20 to
9-16-20, must be reported to your Workers’ Compensation carrier within 30
business days of 9-17-20.
*   Any new positive test results 9-17-20 or after must reported to your
insurance company within 3 business days.
*   Many carriers are setting specific protocols to facilitate these new
reporting obligations.    In the meantime, we are including a generic form
you can complete and provide to your carrier using the same email address
you would use to report a claim.  The information you need to report is
*   Date of the test (date specimen was collected
*   Specific place or places of employment during 14 day period
preceding the employee’s positive test
*   The highest number of employees who reported to the  positive
employee’s specific place of employment in the 45 day period preceding the
last day the positive employee worked at each specific place of employment
*   No personally identifiable information (unless the positive
employee is claiming occupational/industrial causation or filing a claim)
*   We have attached a list of many of the carriers we represent with
phone numbers and email addresses for reference.
*   Please keep in mind, if the employee is alleging that they contracted
it at work, you must also provide them with a DWC-1 and file it as claim.
Your insurance company is responsible for investigating and determining
compensability
*   Civil Penalties of up to $10,000 for failure to report.
* Compensability has to be determined within 45 days instead of the typical
90 days allowed for other claims, so time is of the essence in filing claims
if applicable
* Must have a positive Covid test, (PCR or other FDA approved viral culture
test)
* Defines “outbreak” – “outbreak” will determine if the rebuttable
presumption applies.

*   An Outbreak is:

*   4 or more employees with positive tests within 14 days of each other
(5-100 employees at same “specific place of employment”)
*   4% or more with positive tests within 14 days of each other (over 100
employees at same “specific place of employment”)
– Calculation of 4% is based on the highest number of employees at that
specific location in the last 45 days

*   Outbreak = Rebuttable Presumption of Compensability
* The Presumption can be rebutted if proven that the employer had measures
in place to reduce transmission or can prove employee had nonoccupational
exposure
* COVID related sick leave must be exhausted prior to temporary disability
being initiated with no waiting period

Section 5: This is an “urgency” measure so as soon as Governor Newsom signs
the bill, which he did on 9-17-20, it’s effective immediately and
retroactively from 7/6/20 – 1/1/23.

Please look for communication from your Workers’ Compensation carriers or
use the phone numbers listed on the attachment if you have specific
questions about how this will be implemented.  You can also contact us if
you have questions.

Daniel Powers, CAWC
Account Executive
Don Ramatici Insurance, Inc.
Petaluma Sunrise Rotary Past President
P: 707-782-9200 ext. 106
License #0449871
E: daniel@ramaticiins.com<mailto:daniel@ramaticiins.com