On May 6, 2020, Governor Gavin Newsom signed an Executive Order creating a temporary rebuttable presumption for COVID-19 cases. This Executive Order will be in effect for 60 days from May 6, 2020, but it also retroactively applies to all claims made after the March 19, 2020 shelter in place order.

The Executive Order indicates that “any COVID-19 related illness” is rebuttably presumed compensable if it meets the following requirements:

  1. The employee tested positive for or was diagnosed for COVID-19 within 14 days of working at their place of employment.
  2. The employee was working on or after March 19, 2020.
  3. The employee was not working from home during that time period.
  4. The diagnosis was made by a licensed California physician. The diagnosis is confirmed by testing  within 30 days of the date of the diagnosis.

The Order also addresses benefit eligibility, apportionment and most notably a shortening of the standard investigative period from 90 days to 30 days.

WHAT ATHENS IS DOING:

There is a significant amount of information on this topic emerging daily. Athens management and staff continue to track these developing changes and keep our clients informed with the latest information available on the impact of this Executive Order.

Athens recognizes this Executive Order might only be the initial legislation for virus-based exposures with various presumption-based bills being reviewed in the California Congress at this time. We continue to monitor these newly developing bills to maintain a pulse on potential changes and to determine how proposed legislation will impact our employers and their employees.

WHAT THIS MEANS TO YOU:

Athens is committed to assisting you and your employees during this challenging time. We have developed a COVID-19 Care Line (877.494.4300)to offer education and support from a licensed medical professional for injured workers who were exposed to COVID-19.

We are also working with our Medical Provider Networks to ensure they have expanded their networks to include additional pulmonologists and immunologists as well as telehealth options.

One of the most important things you can do for a COVID-19 claim is report it timely. This allows us to facilitate immediate treatment for the injured employee and enables your claims team to gather all necessary information during the shortened investigation window. When you are reporting a new claim, the following information would greatly assist with the initial claim processing:
  • Confirm if the employee was directed to work outside of the home or residence
  • Determine if the specific worksite has any other positive COVID-19 cases
  • Notify us if an employee was paid sick leave benefits specifically available in response to COVID-19
Athens is here to assist you with any questions or planning regarding this Executive Order or COVID-19 claims reporting. We will continue to monitor the developments in our industry related to COVID-19 as well as legislation on presumptions to ensure consistent claims handling and information sharing with our client partners.