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California senate bill modifies COVID-19 claim reporting requirements

On September 17, 2020, Governor Gavin Newsom signed Senate Bill (SB) 1159 into law. This law:

  • Creates new data reporting requirements for California employers reporting claims
  • Extends the presumption of compensability for COVID-19 exposures in certain circumstances

A key component of SB1159 is the employer’s responsibility for reporting and tracking all positive COVID-19 tests involving employees. Employers are required to report all positive tests to their claims administrator within three business days of being informed of the test results. Failure to report accurate data within this time frame may result in fines up to $10,000.

What information do employers need to report?

Employers are required to provide their claims administrator with current and retroactive data via email or fax.

We’ve established an email address and fax number specifically for reporting positive test results:

New case data

Employers need to provide basic tracking data for both alleged work-related and nonwork-related cases:

  • Work-related: Along with providing information on the positive COVID-19 test, submit a workers’ compensation claim through normal claim reporting methods.
  • Non-work-related cases: Don’t file a workers’ compensation claim. There’s no fee for reporting non-work-related cases.

Employers must submit the following information for tracking purposes:

  • Confirmation that an employee has tested positive for COVID-19
  • The date the employee had the COVID-19-positive specimen collected for testing
  • The address(es) of each location the employee worked during the 14 days preceding the positive test
  • The highest number of employees who reported to work at each location during the 45-day period preceding the last day the employee who tested positive worked at the same location

Download worksheet

*If you're unable to open Excel files, download a PDF of the reporting worksheet.

Employers shouldn’t provide the employee’s name or any other personally identifiable information unless the employee asserts that the COVID-19 exposure is work-related or files a claim form. If the employee asserts the exposure is work-related, the employer should provide their name and file a workers’ compensation claim.

Retroactive case data

Employers are also required to report data on any positive COVID-19 test results for July 6, 2020, through September 17, 2020. They’ll need to provide the following data to their claims administrator via fax or email by October 28, 2020:

  • Confirmation that an employee tested positive for COVID-19
  • The date the employee had the COVID-19-positive specimen collected for testing
  • The address(es) of each location the employee worked during the 14 days preceding the positive test
  • The highest number of employees who reported to work at each location on any workday between July 6, 2020, and September 17, 2020

Download worksheet

*If you're unable to open Excel files, download a PDF of the reporting worksheet.

Work-related exposures

The employer should file a workers’ compensation claim when:

  • They receive a claim form alleging a COVID-19 exposure
  • An employee tests positive and alleges the exposure occurred at work

As part of our workers’ compensation claim management program, we’ll investigate all previously reported work-related and non-work-related cases. This includes investigating each address associated with the claim to determine if an outbreak has occurred. An outbreak is defined as a scenario in which a location exceeds the following thresholds within a 28-day window surrounding the date of loss on the claim (14 days preceding the date of loss, and 14 days following the date of loss):

  • Locations with fewer than 100 employees: Four positive tests
  • Locations with more than 100 employees: Four percent of the location population

If an outbreak occurs, the presumption rule will apply to the claim. The claim adjuster will keep the employer informed as they investigate each claim.

Together, we can help slow the spread of COVID-19. Accurate and timely reporting of all positive COVID-19 tests at your locations provides the crucial information we need for proper claims management—and it helps you comply with SB1159.

If you have questions, please contact your Sentry representative.

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