California SB 1159 Overview

The California Legislature recently passed new COVID-19 legislation and implemented SB 1159. This new bill impacts all California employers.  SB 1159 creates a rebuttable presumption that COVID-19 arose out of and in the course of employment for certain workers, depending on the date of injury. There are several changes that should be noted if you employ anyone in California.

At Diversified, we are trying to keep the community and our clients aware of any changes and news that occurs because of COVID-19. You can find all of the information in our Coronavirus Resource Center.

Important California COVID-19 Legislation Changes to Note

• If an employee worked outside their own residence and was diagnosed with COVID-19 between March 19, 2020, and July 5, 2020, it will be presumed that COVID-19 arose out of and in the course of employment.
• From July 6, 2020, until January 1, 2023, certain workers will be entitled to an ongoing presumption that COVID-19 arose out of and in the course of employment. The ongoing presumption applies to firefighters, peace officers, rescue service workers, registered nurses, emergency medical technicians, paramedics, employees who provide direct patient care at a health facility or home health agency, and employees who provide in-home support services. An employee of a healthcare facility who does not provide direct patient care is also entitled to the presumption unless you can show the employee did not have contact with a health facility patient who tested positive for COVID-19 within the last 14 days.
• From July 6, 2020, until January 1, 2023, all other employees who test positive for COVID-19 during a period of an “outbreak” at their specific place of employment other than their home or residence will also be entitled to a presumption that COVID-19 arose out of and in the course of employment. If you have five to 100 employees at a specific place of employment, an outbreak occurs when four employees test positive for COVID-19 within 14 calendar days. If you have more than 100 employees at a specific place of employment, an outbreak occurs when 4% of your employees test positive for COVID-19 within 14 calendar days. SB 1159 requires employers to keep track of each specific worksite where an employee works on a daily basis.
• You may dispute the presumption that COVID-19 arose out of and in the course of employment with other evidence, including evidence that an employee contracted COVID-19 outside of work or that you had measures in place to reduce the potential transmission of COVID-19. It is important that you assist your claims administrator in quickly gathering evidence. If the claims administrator fails to deny a claim within 45 days, the claim will be presumed compensable.

Available Benefits for Employees

In the new California COVID-19 legislation, an employee who contracts COVID-19 in the course and scope of employment is entitled to hospital treatment, surgical treatment, medical treatment, indemnity benefits, and death benefits. However, if you offer sick leave benefits specifically in response to COVID-19, those benefits must be exhausted by the employee before temporary disability benefits will be paid.

Employee Duties to Qualify

Also mentioned in the California COVID-19 legislation is to qualify for a workers’ compensation presumption, an employee must show that they tested positive for COVID-19 within 14 days after performing labor or services on your behalf. Beginning July 6, 2020, the employee must test positive using a PCR (polymerase chain reaction) test or other test approved for use or emergency use by the United States Food and Drug Administration (U.S. FDA) to detect the presence of viral RNA. Employees can no longer rely on serological testing, which is also known as antibody testing.

To receive indemnity benefits, an employee must also be certified by a physician for temporary disability within 15 days after the initial diagnosis and every 15 days thereafter.

Employer Duties

SB 1159 requires employers who have five or more employees to report employee positive tests for COVID-19 that occur after July 5, 2020 to the employer’s workers’ compensation claims administrator regardless of whether the employer or employee believes the employee contracted COVID-19 at work or not.

If an employee tests positive

As mentioned in the new California COVID-19 legislation, if you learn that an employee has tested positive for COVID-19, you must report the following information in writing to your workers’ compensation claims administrator within three business days:

1. An employee has tested positive (you should not report the employee’s identifying information unless the employee asserts the infection is work-related).
2. The date the employee tested positive.
3. The specific addresses where the employee worked during the 14 days prior to testing positive for COVID-19.
4. The highest number of employees who reported to the same place of employment during the 45 days prior to the injured employee testing positive for COVID-19.

Help to navigate new legislation

One of our key workers’ compensation carriers, WCF Insurance, has prepared the following instructions to help you navigate the new CA legislation: HERE

Please contact your representative at Diversified Insurance Group for further assistance.