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CORONAVIRUS (COVID-19)

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California makes it easier to receive workers’ comp for coronavirus claims

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CORONAVIRUS (COVID-19) AND WORK – HOW WILL WORKERS’ COMPENSATION HANDLE?

CORONAVIRUS (COVID-19) AND WORKERS’ COMPENSATION INSURANCE

Over the past 40 years, Larson, Larson & Dauer (Previously Timothy A. Larson, ALC), has had significant success and notoriety, in representing those hard-working employees, who are repeatedly exposed to toxins and other carcinogens, at their place of employment.  This will soon include those employees that suffered injuries from coronavirus (COVID-19).  For the benefits offered by workers’ compensation insurance, please click here.

Workers' compensation is a very limited system only intended to provide benefits to those employees injured during the course and scope of their employment. Please understand that workers’ compensation is only one of many types of insurance that you might have.  However, this type of insurance is provided by your employer for physical and/or psychological injuries that you sustain from work.  In California, workers' compensation is generally speaking a no-fault system. This means that an injured employee is eligible for workers' compensation even if the employer is not negligent.

Due to the coronavirus (COVID-19) issue being new to the workers’ compensation system, we can only predict how the courts will handle these types of insurance claims.  As time goes on, new laws and cases will provide additional guidance.  This includes the likelihood that the courts will create presumed workers’ compensation injuries.

 

DOES YOUR WORK ENVIRONMENT SUBJECT YOU TO AN INCREASED RISK OF GETTING CORONAVIRUS (COVID-19)?

The California workers’ compensation system should be available for those of you, who are in a work environment, that subjects you to an increased risk to get coronavirus (COVID-19), compared to that of the general public.  Meaning, you get the virus because of that increased exposure at work.  Some of these jobs might include, but are not limited to: medical staff and doctors: peace officers: firefighters: grocery store workers: delivery drivers; bank tellers: state and government workers; gas station attendants;  and many others.  If you feel that you are at an increased risk at work, you likely have a workers’ compensation claim.

Also, for some of you, workers’ compensation might be the only benefit available if your employer does not have good health and/or short term disability coverage for you. Workers’ compensation can assist in getting your medical visits and treatment paid now and for additional treatment in the future.  Importantly, workers’ compensation can assist with paid time off of work (temporary total disability) in connection with coronavirus (COVID-19) and get you money for permanent physical and/or psychological residual injuries.  See questions and answers for all the benefits offered by workers’ compensation insurance.  (provide link)

Due to the coronavirus (COVID-19) issue being new to the workers’ compensation system, we can only predict how the courts will handle these types of insurance claims.  As time goes on, new laws and cases will provide additional guidance.  This includes the likelihood that the courts will create presumed workers’ compensation injuries.

Just as all of you continue to work hard for us during these difficult times, we are hopeful that we will be able to do the same for you.  See some below guidance on workers’ compensation and coronavirus (COVID-19)

 

ESSENTIAL JOBS FOR CARE OF CORONAVIRUS (COVID-19) PATIENTS, SUCH AS HEALTH CARE WORKERS

If your job is essential for the care and treatment of coronavirus (COVID-19) patients, then your employment is putting you in a position of greater risk to get coronavirus (COVID-19) compared to the general public.  Therefore, the courts would likely find an employee's exposure to the coronavirus (COVID-19) to be eligible for workers’ compensation benefits.

This means that doctors, nurses, or other health care workers, who are required to treat patients with the coronavirus, could file their own workers' compensation claim if they get the virus.

Even if you feel that you have viable workers’ compensation claim, we would recommend that you continue treating and caring for the coronavirus (COVID-19)  patients, until this pandemic slows down and then you explore the possibility of filing a workers’ compensation claim.

 

ESSENTIAL JOBS THAT REQUIRE YOU TO WORK IN CLOSE PROXIMITY TO PEOPLE WITH CORONAVIRUS (COVID-19) – PEACE OFFICERS, FIRE FIGHTERS ETC. AND LABOR CODE §3212

If your job is essential for the public, such as peace officers and firefighters, you are required to protect the public and interact and engage in your usual job duties.  This means that, as a part of your job, you are subject to an increased risk to get coronavirus (COVID-19), compared to that of the general public.

As stated above, new laws and cases will provide additional guidance in the near future.  However, it would be proper to assume that just as Labor Code §3212 provides presumed work-related injuries for some occupations, such as peace officers and firefighters, the courts will provide an additional presumption for coronavirus (COVID-19).  A presumption means that if you perform a specific job duty and you get coronavirus (COVID-19), you are entitled to workers’ compensation benefits.

The current presumptions for some occupations, such as peace officers and firefighters are the following (not exhaustive):

  1. Cancer
  2. Heart Trouble
  3. Hepatitis (all types)
  4. Hernia
  5. Meningitis
  6. Pneumonia
  7. Tuberculosis (not officially, but most likely caused by duty)
  8. HIV(AIDS)

Please note that heart trouble and pneumonia are commonly associated Coronavirus (COVID-19) and so it is likely that even if the presumption was not created for coronavirus (COVID-19) specifically, you would have the presumption that these health ailments (heart trouble and pneumonia – lung issues), would be caused by work.

 

HIGH RISK EMPLOYEES FROM UNDERLYING HEATLH ISSUES AND AGGRAVATIONS

Besides being 65 years and older, the CDC states that people of all ages, might be at higher risk for severe illness from coronavirus (COVID-19), if they suffer from the following underlying medical conditions:

  1. People with chronic lung disease or moderate to severe asthma
  2. People who have serious heart conditions
  3. People who are immunocompromised
  4. Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications
  5. People with severe obesity (body mass index [BMI] of 40 or higher)
  6. People with diabetes
  7. People with chronic kidney disease undergoing dialysis
  8. People with liver disease

In workers’ compensation, an injury does not have to be 100% caused by work to be compensable.  By compensable, that means that you can still get workers’ compensation benefits for an aggravation of your underlying, non-work-related injury.

For example, if you suffer from bronchitis, you get coronavirus (COVID-19), the virus will attack your lungs, clearly aggravating your underlying bronchitis and likely leading to pneumonia.  You would make a workers’ compensation claim stating the employer (your job duties) are responsible for aggravating your underlying health condition. This is because of the long-established rule that "an employer takes the employee as he finds him at the time of the employment.

 

EMOTIONAL DISORDERS, SUCH AS STRESS AND ANXIETY FROM WORK, IN CONNECTION WITH CORONAVIRUS (COVID-19)

The uncertainty and severity of coronavirus (COVID-19), makes many people scared.  This includes wondering when and if you will get it.  This sense of being scared is only heightened and aggravated, if you are forced to work in an environment that subjects you to an increased risk to get coronavirus (COVID-19), compared to that of the general public.

For example, if you are an administrative worker for an Oncology Medical Office.  You are obviously concerned that you could get coronavirus (COVID-19) from your work environment (hospital etc.) and/or your co-workers.  However, you are very concerned about the well being of your patients.  You know that if you get it, then you could pass it on to one of your severely immunocompromised patients, which would potentially cause them to die.  This is going to be very stressful and this stress and anxiety will likely last you months.

If you feel that you have an emotional disorder including stress, anxiety and/or depression stemming from your work environment, it is legally appropriate to file a workers’ compensation claim with your employer.  This would specifically include those employees that are repeatedly subjected to the psychological stressors associated with the uncertainty and severity of coronavirus (COVID-19).  However, even if you feel that you have viable workers’ compensation claim, we would recommend that you continue treating and caring for the coronavirus (COVID-19)  patients until this pandemic slows down and then you explore the possibility of filing a workers’ compensation claim.

 

HOW DO YOU FILE A WORKERS’ COMPENSATION CLAIM?

With regards to workers’ compensation claims stemming from coronavirus (COVID-19), it is highly encouraged for you to get an attorney.  This is because, even the most straight forward of insurance claims, are denied by the workers’ compensation insurance companies.  It is safe to assume, that no insurance company will be providing workers’ compensation benefits for claims made in connection to coronavirus (COVID-19).  This can change once you get an attorney and fight their denial.

If you want to try filing a workers’ compensation claim (claim for insurance benefits) on your own, the first step would be to obtain, complete and submit a Workers’ Compensation DWC-1 Claim Form (Link to https://www.dir.ca.gov/dwc/DWCForm1.pdf) to your employer.)

Please note that in most cases, even a validly filed workers’ compensation claim may take months or longer to determine eligibility for benefits.  Even after months, most claims are denied.

For learning about the benefits of workers’ compensation, please see workers’ compensation questions and answers (LINK TO Larson Dauer Questions and Answers- also has link at top of this page https://www.larsondauer.com/workers-compensation-q-a/).

When your claim is denied, delayed or they are giving you the runaround, it is imperative that those who are medically unable to work (physically or psychologically), should immediately apply for State Disability Insurance through the California Employment Development Department (link is https://edd.ca.gov/about_edd/coronavirus-2019.htm) if you paid into that system.  Alternatively, if you or your employer has paid into any short-term or long-term disability policy that may be applicable, you may want to look into that (LA County, LA City, LAUSD, State of California).

If you are thinking that you will be filing a workers’ compensation claim, with or without an attorney, please be sure to keep a paper trail of all your medical treatment, and keep your employer informed of your medical and work status.

 

APPLY FOR BENEFITS ON ALL YOUR INSURANCE POLICIES

Regardless of whether you have made a workers’ compensation claim, you can treat through your personal medical insurance for any and all health issues.  This is especially the case if you get coronavirus (COVID-19).

Even if you had an accepted (rare) workers’ compensation claim, the treatment is generally slow and/or denied anyways.  For that reason, you always should use your personal insurance.  Please note that this means you are using your personal insurance, not seeing your personal insurance doctors on the worker’s compensation claim.  You are seeing your personal doctor/s on your personal insurance.  If they ask if this is work related, always be truthful, but you can say you thought it was work related, but the treatment is being delayed, denied, refused, taking forever and/or you are not happy with the treatment you are receiving.

As stated before, you can always apply for ANY insurance policies that you may have.  This is when you have an opportunity to cash in on those insurance policies that you or your employer have been paying into for years.

 

KEEP YOURSELF APPRISED OF GOVERNMENT RELIEF

All of the coronavirus (COVID-19)  issues remain fluid and you need to keep yourself educated and informed.  The government is developing plans on a daily basis to try to preserve the economy.  This includes making unemployment benefits available to those unable to work due to the virus infection.  Again, if you are off of work, due to ANY health reason during this pandemic, apply for EDD State Disability.  This does not prevent you from later filing a workers’ compensation claim.

Please remember that your workers’ compensation claim would/will likely be denied anyways, so you would be applying for EDD State Disability regardless.

 

Here are some helpful links:

https://edd.ca.gov/about_edd/coronavirus-2019.htm

https://www.labor.ca.gov/coronavirus2019/#chart

 

Please do not hesitate to contact us with ANY questions.  We offer free phone consultations.

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