How to File a Workers’ Comp Claim for Coronavirus (COVID-19)
As of the end of May, COVID-19, or Coronavirus, has infected nearly 90,000 people in the state of California. Many of these cases were likely contracted at work through exposure to an infected individual. As with any work exposure that results in injury, time off work, and medical treatment, a claim may be made for contracting COVID-19 at work. That being the case, a temporary new rule allows for you to file a Workers’ Comp claim with your employer.
How to Establish Coronavirus is Work Related
In order for a workers’ comp claim to be accepted, there must be evidence that the virus was contracted in the course of the claimant’s employment. When the disease is caused by an exposure to a virus such as Cocvid-19, which could have happened anywhere, this can be a particularly difficult burden to meet.
To address this problem in a way that recognizes the extra risks taken by those leaving home to work during the pandemic, Governor Newson has announced a temporary new rule: those working outside of their homes on or after the March 19th stay-at-home order and who later develop COVID-19 will be favored by a “presumption” that the disease was caused by work.
Steps for Filing for Workers’ Comp for Coronavirus (COVID-19)
As with any workers’ comp claim, the claimant needs to complete and submit a Workers’ Compensation Claim Form (Form DWC-1) to the employer. The claim must be made in writing; a verbal report alone is not enough to open a claim.
When the employer receives the DWC-1 Form, it must submit the form to its insurance company within 24 hours. The employer must also refer you to a medical provider. The law gives the insurance company 14 days to decide whether it will accept, reject or delay the claim.
What to Do if the Workers’ Comp Claim for Coronavirus (COVID-19) is Delayed
Because filing COVID-19 claims in the Workers’ Comp system borders on uncharted territory, insurers may initially deny the claim, based on a lack of medical evidence linking the exposure to the workplace. Governor Newsom’s directive contradicts this approach. Even so, the insurance company may delay decision, giving it an additional 90 days from receipt of the claim form to make a determination as to acceptance or rejection of the claim.
Time, however, is of the essence in terms of getting treatment for COVID-19. It is important to understand that even if the insurance company delays a decision, during that delay period, the insurance company must cover medical costs up to $10,000 incurred up to the date the claim is denied. Unfortunately, no money is paid for temporary disability or time off work during the delay period.
Temporary Disability for COVID-19 under Workers’ Comp
California Workers’ Comp law provides temporary disability for employees who are off work due to injuries or illnesses sustained while on the job. Calculating when the benefits actually begin is a bit complicated. The law states that the first three days of temporary disability are not paid until the employee has been off work for 14 days. After that, payments begin, and continue every two weeks until the physician determines the employee is ready to return to work.
There may be some relief available to you outside of the Workers’ Comp system. If you are off work for an extended period of time, you may also apply for State Disability Insurance through the California Employment Development Department, assuming you have paid into that system. Or, some employers provide short-term or long-term disability policies that may apply. Your employer can provide information if such a policy is in effect.
Workers’ Comp Attorneys Can Help with COVID-19 Claim Delays
The Workers’ Comp system is slow even in the best of circumstances. With the influx of thousands of COVID-19 claims coupled with new regulations and frequent policy changes, insurance companies are overwhelmed. Even a validly filed Workers’ Comp claim could take several months before eligibility for medical treatment and temporary disability are determined. This is where the experienced Workers’ Comp attorneys at Cantrell Green can step in to assist you to speed up the process.
Keeping a thorough and accurate paper trail of any medical treatment you receive (including mileage records) will provide your attorney with the documentation necessary to pursue your claim. And, of course, you will need to keep your employer informed of your medical and work status.
Workers Comp Attorneys for Coronavirus (COVID-19)
As these issues remain fluid, our Workers Comp attorneys at Cantrell Green will continue to provide information to our clients to ensure that they are educated and informed.
COVID-19 has given rise to new ways of thinking, new ways of doing life, and new laws and regulations to protect employees. We are here to help you navigate these uncharted waters. If you have any questions or believe you may have contracted COVID-19, of course, first seek the medical attention you need. Then, call our attorneys in our Long Beach office, and let us help you find the best way to proceed with your workers’ comp claim.