Sign California Claim Safe

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[Music] hi everyone this is a from ESM today I'm going to be discussing governor newsome's executive order from May 6 related to covin 19 today's discussion will be workers comp oriented I'm going to be discussing how this executive order changes things what types of kovat 19 claims are going to be compensable or considered covered under workers comp who is covered what an employer's responsibilities are what should an employer do to manage these types of claims and how will this affect workers comp premiums moving forward it's a little bit of history on March 19th we all know that the initials of governor Newsome's executive order was for shelter in place the May 6 order creates a rebuttable presumption that Kovan 19 claims are compensable under workers comp I know that may be tricky for some of you that haven't heard of those types of terms before so I'll discuss those in further detail as well as what a presumptive case is it's really broadly applied so it applies to anyone any worker who is directed to work outside of their home not just essential workers so for example I'm working remotely right now and I'm one of the few that would be actually excluded I haven't been back to work since shelter-in-place in in person at the office if I were to be directed to go into the office next week for example and I tested positive for Cova 19 within 14 days of that afterward obviously that would be a presumptive case if it felt within this window orders in effect till July 5th so that's really important there's there's a shortened window for when this is in effect however there is some legislation coming down the pipeline that may make this more permanent what that looks like we're not sure yet there's some bills pending and I won't get in those too much yet we'll keep you updated with any developments on that front so with regard to Coba 19 the date of exposure must be between 319 and 75 in order to have this presumption one of two things has to happen you either have to have a positive test or a diagnosis of koban 19 now if you have a positive diagnosis you actually have to supplement that with a test but you have an additional 30 days to present that positive test or wait till the test results get back whatever the case may be and all that has to occur within 14 days of performing work at the place of employment again not if somebody's just strictly working from home without any co-workers so some of the elements of the executive order really some of these are unprecedented they've shortened the window for carriers to 30 days effective five six to investigate these types of claims that's opposed to the normal 90-day window that they give to insurance carriers in order to evaluate whether something is compensable or work-related another issue is going to be for temporary disability it's not automatic they're also waiving the waiting period some of you may know that the waiting period in California is three days so it takes three days before that temporary disability starts accumulating without getting into too many details about it that portion is going to be waived however all sick leave and benefits have to be used before temporary disability is due so this is where communication with the carrier will come into play making sure that you understand what types of sick leave we're talking about here it's not the normal sick leave that people accumulate do you just by generally working obviously that doesn't apply to normal or comp claims as well as these types of claims we're talking about the sick leave specifically targeted to Kovan 19 under the familiesfirst coronavirus response act PD also must be recertified every 15 days rather than the normal 45 days what that means is tip with a normal claim so to speak you'll see work status updates around every 45 days or so and usually the adjuster will reach out to you and see if you can accommodate those work restrictions Kovan 19 cases they need to recertify every 15 days and ostensibly that so that they're not taking protracted time off maybe they're asymptomatic and they're able to return a little bit quicker and also to make sure that they're getting the care that they need so what does rebuttable mean really I talked about how an employee establishes a presumptive case you know they fall within the window they have a positive test for example and it's within 14 days of them working there it's presumed work-related that burden then shifts over to the employer to show that it didn't actually occur at work which is of course a high bar it's like as I mentioned proving something like the flu didn't occur at work when you know you're around a lot of other co-workers and other people in the office habit there's obviously evidence that may prove otherwise or perhaps they tested positive previously there's a there's a variety of ways that that might play out but it's going to be obviously case-by-case so once the burden is shifted over to the employer they can rebut that with other evidence they can rebut that presumption that it actually occurred at work maybe their wife had it previously or their spouse and they had come into work subsequently and it was their first day back on the job who knows some things that you can control in this are going to be some of the responsibilities now with regard to reporting these types of claims it's really important to reach out to the carrier to see what their guidance is a lot of carriers are just having you report any types of Kovan 19:00 activity providing a DWC one I would be on the safe side and handing those types of claim forms out now there's no necessary heightened duty to hand these types of forms out per the order usually that standard is pretty high it's not just a sneaking suspicion it's something that they're affirmatively saying I have a work-related injury with these with a presumption it implies a different type of standard and this should get clarified if any of this becomes codified into law time will tell but I would be on the safe side because there's such a shortened no to investigate I would be giving all the information I have to the insurance carrier following your claims timely and having them adjust it and take a look at it with their lawyers and their adjusters that will be trained to look at these types of issues and compensability concerns and that really goes along with staying in touch with your claims examiner's making sure that they have accurate information making sure that there is no delay for benefits that they're getting everything that they need and also investigating those cases that may be questionable to you and highlighting those red flags that you can bring to their attention it's also important really communication is key in workers comp in general but you can imagine if you're an employee and you're diagnosed with Cova 19 you get a positive test back they may not be aware of what their you know rights are to file a claim or they may be concerned with their livelihood they may be concerned about their health they may be concerned about spreading it to co-workers or their family so really want to put yourself in their shoes and provide that support give them the information that they need allow them to file a claim if it's something that you know they're not at a remote employee and they put it potentially could have caught it at work so you can discuss all those options with them let them know that you're in contact with the carrier let them know about the the families first benefits those are things that you can control as an employer during this case it's also important to keep a separate volkova 19 claims that are submitted to the carrier the WCIRB proposed unanimously and approved unanimously in fact to exclude these types of claims from the ex mod X mod is kind of like your credit score for determining your workers comp premium it's still pending approval as of this recording from Commissioner Laura that vote should take place on July 1st but I'd be really surprised if it doesn't pass it's still going to be important either way to make sure you're keeping a log of all those types of claims going along with that you'll also want to keep just good records in general people that are working from home during this time obviously if they haven't worked within the last 14 days at a specific job site that they alleged to have gotten cove at 19 well that's going to be material information that you want to be able to provide to the insurance carrier so keeping track of who's working from home keeping track of that payroll will be really important WCR b also has a proposal that they approved in its pending approval from commissioner laura again for salary continuation to be excluded for work work comp premiums as well as changing the payroll class code for people that are just working from home so there's a bunch of different elements there you don't have to memorize you know all the different elements of even a compensable claim or a presumptive case really this is just to familiarize yourself with it once you have this kind of documentation you can hand it over to either your broker or the insurance carrier and have them walk you through it we're seeing a lot of reopening obviously as that occurs there's going to be a lot of different reopening requirements different stages I won't get into this too much because it could be a totally separate webinar but the resources are there governor Newsom has his reopening requirements for example performing a detailed risk assessment and implementing a site-specific protection program disinfecting protocols so for Liston Singh all of that is is changing day by day certain things are obviously going to be in there no matter what while we're working through the pandemic but make sure you're tracking those resources so that you're in compliance and you're up to date on all the reopening requirements as you're bringing employees back we obviously have been working on Cova 19 or compliance centers since day one so you know we've given webinars and we have training really everything that you need for reopening exposure control remote work employees returning them to work so you don't have to reinvent the wheel we have all the information and resources available for you just check it out at es I'm calm the link is right on the slide there I mentioned a few bills in the legislature I'm not going to go over these just because we're not sure which ones will actually become law there's there's actually as of the dis recording there's more than just the ones I'm showing here but their varying rebuttable presumptions for certain types of workers hospital employees really to make this type of thing permanent moving forward so that they're not just treated like another type of claim with that I will sign off as always feel free to reach out and utilize our resources if you have any questions thank you for your time [Music]