California SB-1159 – New Mandatory Reporting Guidelines for COVID-19 Claims

On September 17, 2020, California enacted SB-1159 which imposes certain reporting requirements on employers. Effective immediately, employers are required to report positive COVID-19 tests to their workers’ compensation claim administrator, regardless of whether there is an allegation the COVID-19 exposure is related to work or not. SB-1159 defines two separate periods of requirements for claims involving employees with COVID-19. The first period of March 19 through July 5 applies to claims that fall within the Governor’s original Executive Order. The second period applies reporting of employees who test positive with COVID-19 from July 6, 2020 through December 31, 2022. The new reporting requirements will be used to identify and establish claims that have been reported under an ‘outbreak’ presumption. An ‘outbreak’ exists when employees test positive for COVID-19 at a specific place of employment within 14 calendar days under the below circumstances:

• Date of injury is on or after July 6, 2020
• Employer has minimum of 5 employees
• Employer has 100 or less employees: 4 employees test positive
• Employer has 100 or more employees: 4 percent of the employees who report to a specific place of employment test positive
• A specific place of employment is ordered to close by a local public health department, the State Department of Public Health, OSHA, or a school superintendent due to a risk of infection with COVID-19

COMPENSABILITY AND PRESUMPTION APPLICATION

For claims involving health care workers, peace officers, firefighters and other frontline workers, the presumption of compensability applies in most cases with a positive COVID-19 test with a 30 day investigation period. For all other employers with 5 or more employees, the ‘outbreak’ presumption applies only when an employee tests positive during an outbreak. There is no presumption when there are less than 5 employees. SB-1159 allows for a 45-day investigation period for “all other employees” and provides for specific claim handling guidelines and transfer of information from the employer to the claims administrator.  

REPORTING REQUIREMENTS: POSITIVE TESTS JULY 6 FORWARD

SB-1159 provides that once an employer knows, or should have reasonably known, that an employee has tested positive for COVID-19, the employer must report a claim to their claim administrator within 3 business days, except as outlined below. This requirement pertains to both work and non-work related COVID-19 diagnoses.

• Positive test occurred July 6 through September 16
  • Any employer who is aware of an employee testing positive shall report to their claims administrator, within 30 business days of the effective date of this section

No Personal Identifying Information will be provided unless the employee:

• Asserts the virus is work-related
• Has filed a claim form pursuant to Labor Code Section 5401

An Employer Reporting Form for Outbreak Determination should be used for reporting all COVID-19 related claims. When an employee has tested positive for COVID-19, the following information is required when reporting to the claims administrator.

• Date the employee tests positive and date the specimen was collected for testing
• Address(es) of the employee’s specific place(s) of employment during the 14-day period preceding the date of the employee’s positive test
• Highest number of employees who reported to work at the employee’s specific place of employment in the 45-day period preceding the last day the employee worked at each specific place of employment

For positive test dates July 6 to September 16: The employer is to report the highest number of employees who reported to work at each of the employee’s specific places of employment on any given workday July 6 through September 16

The legislation also provides that an employer who intentionally submits false or misleading information or fails to submit information when reporting could be subject to a civil penalty in the amount of up to $10,000 to be assessed by the Labor Commissioner.