The outbreak of coronavirus is disrupting nearly every aspect of life in the US and throughout the globe. At West Coast Workers Comp Attorney (WCWCA) we know that the coronavirus pandemic has swept across the US and has resulted in tragedies in life and in economics for families.
Workers who have injuries during this time have more uncertainties about their situation than usual: Will I be laid off? How will I survive if my employer goes out of business? What are my rights?
Business Closed Because of COVID 19? You may still be Entitled to Temporary Disability Benefits
Due to the coronavirus, more employees are being asked to stay home, and many are working from home. However, keep in mind that unique challenges and situations are now arising especially in the worker’s comp arena concerning the injured workers’ eligibility to receive disability benefits. It is important to understand that in many cases, injured employees in California who were on modified work temporarily are entitled to temporary disability benefits (TTD) when said employer can no longer offer the modified work.
The more unique question that has arisen lately is whether the third party administrator or insurance carrier can deny your temporary disability benefits for the period the business is closed or shut down due to Shelter in Place or lockdown rules?
We know that the adverse impact of the coronavirus in California has led to layoffs because of the downturn in the economy. In most cases, TTD is payable to employees who are working light duty and then laid off from that light-duty position. Keep in mind that this is true even in cases where the layoff impacts the vast majority of the plant, and an injured worker is laid off based on seniority.
Case Law in California
It’s established law in California that when a worker is terminated from their employment for a good cause, then they’re not eligible to receive their temporary disability. So, what does constitute “good cause” for termination?
California courts have to dealt with similar situations in the past. Even when the employee was terminated for cause but cannot work due to his injuries courts have awarded temporary disability. In the past they have indicated that temporary total instead of partial benefits may also be owed through the application of the famous “odd lot” doctrine. Keep in mind that the doctrine is applicable where an employee who is only “partially disabled might receive temporary total disability benefits if his or her partial disability causes a total loss of wages. The doctrine was established in Pacific Employers Insurance. Co. vs. Industrial Acc. Com. (Stroer).
It is worth mentioning that in these cases, the burden of proof is often on the employer to establish that work within the skills and capability level of the partially disabled worker is available. If the employer fails to show that modified work is available to the employee, the employer can be liable for the payment of temporary disability benefits. Using precedents established in these cases where an employee’s termination or inability to resume work is not for cause, but because of other outside factors, such as COVID-19 closure, unrelated to the injury, the California WCAB will likely find that temporary disability benefit payments would be owed to affected employees.
However, each outcome is very fact specific as the rules are complex. Given the complexity of case law and frequent attempts to deny benefits, more than ever you need having West Coast Workers Comp Attorney or an experienced attorney by your side.
Presumption for Workers during COVID 19
California Gov. Gavin Newsom issued Executive Order N-62-20 on May 6, 2020. This order has significantly altered California’s workers’ comp coverage with regard to employees diagnosed with the coronavirus. The order creates a rebuttable presumption that a worker’s COVID-19 diagnosis arose out of the course of their employment (for the purpose of receiving workers’ comp benefits) if that employee was requested to work at the employer’s physical facility.
Thus, if your employer directs you to report to any workplace other than your home during shelter-in-place orders, your employer may have to pay workers’ compensation including temporary disability leave.
Get help from West Coast Worker’s Compensation Attorney
If you are an injured worker who has been laid off due to Shelter in Place or businesses shutting their doors or you have contracted the coronavirus while working, get an advocate on your side immediately. The rules are complex during this time and so are the uncertainties. Contact WCWCA today to fight for your rights and your life.