May 26, 2022
The authors use a mixed-methods (including both qualitative and quantitative methods) approach to evaluate the overall effects of COVID-19 claims on the California workers' compensation system and on the payment of workers' compensation benefits. They also analyze the effects of the different presumptions for COVID-19 established by Senate Bill 1159 and describe patterns of COVID-19 claim filing and claim outcomes by industry and occupation.
With COVID-19 cases and deaths in California mounting in 2020, state policymakers enacted untested policies to cope with the most severe global pandemic in more than 100 years. One of those policies, Senate Bill 1159, facilitated access to workers' compensation (WC) benefits for select groups of workers. SB 1159 expanded access to WC benefits by establishing presumptions in the law that relieved certain workers — specifically frontline workers defined as health care and public safety employees, as well as workers whose job sites experienced a COVID-19 outbreak — of the burden of proving that the claimed injuries due to COVID-19 were related to work exposure. The authors use a mixed-methods (including both qualitative and quantitative methods) approach to evaluate the overall effects of COVID-19 claims on the California WC system and on the payment of WC benefits. They also analyze the effects of the different presumptions for COVID-19 established by SB 1159 and describe patterns of COVID-19 claim filing and claim outcomes by industry and occupation. The study found that COVID-19 claims accounted for 15 percent of all WC claims in the 18 months commencing at the beginning of 2020. COVID-19 claims were more likely to be initially denied than non–COVID-19 WC claims. The study also brought to light several challenges that the WC system experienced during the pandemic. For employers, these challenges primarily related to handling a large, fluctuating volume of claims within shortened time frames for claims investigations.
Background and Overview of Study
COVID-19 Claims Volumes, Denial Rates, and Benefit Receipt
Differences in COVID-19 Claim Outcomes Across Industries and Workers
COVID-19 Claims and Other COVID-19 Polices About Income Loss and Medical Care
Health and Safety Impacts of SB 1159
Administration of COVID-19 Claims
Costs of COVID-19 Claims
Conclusions, Policy Implications and Future Research Priorities
Summary of Literature Review Results
Additional Information and Supplementary Results on Quantitative Analyses