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What happens if your COVID-19 workers’ compensation claim is denied?

| Feb 12, 2021 | Firm News

We’ve talked a great deal in recent weeks about the circumstances facing workers infected with COVID-19. We’ve looked at some good news in the form of legislative and executive actions. This week we look at a possible concern.

Last week we noted that legislative efforts aim to encourage employer action by giving them an out. However, the existence of an out — the ability to challenge a COVID-19 diagnosis presumption — means that some employers will take this option. What happens to people then?

Denials and appeals

If an employer rebuts the status of a workers’ compensation claim, that will lead to a denial of benefits. In most cases, which would mean you and your attorney would need to follow California’s workers’ compensation appeals process. Meaning the process is far from over.

Workers’ compensation appeals are a common occurrence and by no means mean that you cannot receive compensation for an injury or illness. It might take some time, but your case will receive fair treatment from the workers’ compensation board. However, there is better news here:

The burden of proof is on your employer

To successfully rebut the presumption that you contracted COVID 19 at work, your employer will have to offer definitive proof. In this case, the power and presumption are firmly on the side of the employee.

We spoke a few weeks ago about the difficulty of proving that your job caused a “normal” condition. As difficult as proving that work-stress caused a heart condition, they would have to find a way to prove that work-conditions negated a coronavirus infection. That is to say: it’s not impossible, but it is a rather difficult proposition.

You have protections

In all, we’ve looked at many interesting facets and questions about coronavirus. Next week, we’ll pull it all together to talk about the state of California workers’ compensation and your place in it.