Castillo: Key Facts to Consider

Tuesday, August 18, 2020 | 0

State lawmakers are considering three separate bills, all of which will be heard in their respective Appropriations Committees in the next two weeks, that would establish various levels of workers’ compensation presumptions for essential workers who contract COVID-19 on the job.

Michael Castillo

There are some key facts they should consider when casting their votes.

Workers’ compensation claims are down overall in 2020. According to recent data from the California Workers’ Compensation Institute, claims are down 29% for the first six months of 2020 compared to the first six months of 2019. Reported claims as of June 30 totaled 241,969, compared to 339,796 reported in the first half of 2019.

Overall claims have not increased due to COVID-19. The CWCI data shows 14,487 COVID-19 claims had been filed as of July 6, which were included in the overall total and account for only 6% of claims reported this year.

The denial rate for COVID-19 claims is more than three times as high as the denial rate for non-COVID-19 claims. Per the CWCI, the denial rate for COVID-19 claims for the first half of the year was 25%, compared to 8% for claims not involving COVID-19.

As we reported two weeks ago, payers don’t anticipate COVID-19 costs to be a problem. Health Strategy Associates, a national health industry consulting firm led by Joseph Paduda, conducted a recent survey that concluded:

• When it comes to COVID-19 claims, the survey found that they are typically inexpensive.
• One survey respondent estimated that 96% of claims cost less than $3,500.
• Another respondent reported that 3.8% of COVID-19 claims accounted for the vast majority of coronavirus-related costs.

One more key fact to consider: Currently, there is no COVID-19 presumption in place for essential workers. Gov. Newsom’s rebuttable presumption expired July 5, placing the burden of proof on employees who continue to put their lives on the line during the pandemic.

The state Legislature should remember these facts and take appropriate action to enact a presumption that protects as many essential workers as possible.

Michael Castillo is communications director for the California Applicants' Attorneys Association. This opinion is republished, with permission, from the CAAA website.