CA Boosts Worker’s Comp, Insurance Benefits for COVID-19 Diagnosis

A notice out of California Insurance Commissioner Ricardo Lara’s office seeks to remind insurance companies that all workers exposed to COVID-19 while working on the frontline are eligible for worker’s compensation benefits, regardless of immigration status.

This comes following California Governor Gavin Newsom’s March 12 executive order announcing that any worker exposed to the novel strain of the coronavirus on the job is eligible for worker’s compensation benefits from their insurer.

“This unprecedented pandemic has sparked questions and concerns among essential workers in the immigrant community who are showing up for work every day, bringing us vital goods and services,” Lara said in a statement. “Hard-working Californians who are exposed to COVID-19 are entitled to workers’ compensation benefits if they fall ill, regardless of their immigration status.”

To be clear, this notice does not change California insurance policy. It is regular practice for payers, agents, and employers in the state to offer worker’s compensation benefits to all workers regardless of immigration status. Lara instituted this policy in 2015 when he was a member of the California State Senate.

Undocumented immigrants are eligible for worker’s compensation by way of the Uninsured Employers Benefits Trust Fund or the Subsequent Injury Fund.

This latest notice serves as a reminder of that policy.

Additionally, worker’s compensation is separate from health insurance. Health insurance is an employee benefit, while worker’s compensation refers to the responsibility an employer has to a worker should that worker become ill or injured on the job.

However, with the spread of coronavirus, social distancing, and work at an essential business so closely linked at this time, this move for worker’s compensation has ramifications for a worker’s perceived financial security during this crisis.

“Workers’ compensation injuries caused by COVID-19 that arise out of and occur in the course of employment are compensable to the same extent as any other compensable injury or disease,” the notice states. “This Notice is a reminder that such claims may not be denied on the basis of the injured worker’s immigration status.”

This comes at an integral time for healthcare, as individuals nationwide grapple with the risks of contracting coronavirus and the potentially astronomical medical bills that could come with it. A March assessment from the Kaiser Family Foundation tracked the out-of-pocket costs from coronavirus at just over $13,000 for a mild case, or a little more than $9,000 for individuals with no complications or comorbidities.

But for individuals with more severe forms of COVID-19, costs could reach up to $20,000.

Assuring all workers that they may be eligible for worker’s compensation is important as they stare down those potentially high costs should they come down with the virus on the job. And with undocumented workers in California likely to be employed by an essential business, either in an agriculture job or otherwise, this is especially pressing.

"During this pandemic, essential workers face great risk to their health every time they clock in," said California Labor Federation Executive Secretary-Treasurer Art Pulaski. "If they are injured or get sick at work, they should know they can rely on workers’ compensation to provide the health care and benefits they need, regardless of immigration status. We commend Commissioner Lara for standing up for the workers who are among the most vulnerable in this time of crisis."

To their credit, healthcare payers are recognizing the serious financial pressure the risk of coronavirus diagnosis is placing on beneficiaries. In response to the astronomical cost estimates, healthcare payers across the country have been working to promote patient access to care and address cost as a care access barrier.

The good news is many public and commercial payers have made moves to ameliorate some of these costs. Major payers like Aetna, Cigna, and Humana have gotten rid of cost-sharing measures or out-of-pocket costs for coronavirus treatment.

This latest statement out of California’s Insurance Commission takes efforts a step further from traditional healthcare coverage. Ensuring employers and insurers understand workers’ rights to worker’s compensation benefits will be essential as some workers continue to go into essential businesses.