Many legislative changes due to COVID-19 have occurred recently regarding Workers' Compensation coverage, claims, and claims handling. PRISM staff has complied this latest update of information on the changes.
Workers' Compensation Legislative Update
Senate Bill 1159 has been enrolled and is pending the Governor’s signature. More information with highlights of the bill can be found here.
Employer Reporting Obligations Legislative Update
There are two bills related to COVID-19 employer tracking and reporting requirements: Assembly Bill 685 and Senate Bill 1159 have been enrolled and are pending the Governor’s signature. More information with highlights of these bills can be found here.
Assembly Bill 1867 providing COVID-19 specific supplemental paid sick leave was signed by the Governor on September 9, 2020 and is now in effect. More information with highlights of this bill can be found here.
COVID-19: How SB 1159 Works With your PRISM Workers' Compensation Coverage
SB 1559 provides a presumptive injury for employees who test positive for COVID-19 as a result of an industrial exposure providing they meet all of the presumption qualifiers outlined within the applicable section of the bill. Pursuant to the PRISM Memorandum of Coverage (MOC), coverage would apply for employees who test positive for COVID-19 and meet all of the presumption qualifiers outlined within Sections 2, 3 or 4 of the bill. Read more here.
Future Reporting of COVID-19 Claims to PRISM
Thank you to all the members and claims administrators for reporting all claims, both positive and negative, while we waited for the legislature to determine what would be included within the final piece of legislation. Based on the provisions outlined within SB 1159, moving forward only positive COVID-19 claims need to be reported to PRISM. Please continue to send all First Reports to Excess and ongoing Excess Supplemental Reporting pursuant to the MOC and EWC Reporting and Reimbursement Procedures to our general WC inbox at wcclaims@csac-eia.org.
Workers’ Compensation Claims Administration Tips
While SB 1159 provides a rebuttable presumption for employees who test positive for COVID-19, the claims administrator still has a duty to complete the initial investigation portion of the claim. For more information, please continue reading here.
COVID-19 Workers’ Compensation Claims Coding
As a reminder, in April of this year, the Department of Industrial Relations adopted new codes specific to the COVID-19 pandemic in order for these claims to be easily identified. More information on what codes to use can be found here.
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