SB 1159 provides a presumptive injury for employees who test positive for COVID-19 as a result of an industrial exposure providing they meet all of the presumption qualifiers outlined within the applicable section of the bill.  

Pursuant to the PRISM Memorandum of Coverage (MOC), coverage would apply for employees who test positive for COVID-19 and meet all of the presumption qualifiers outlined within Sections 2, 3 or 4 of the bill.

Any benefits provided for workers’ compensation claims filed that do not meet the criterion outlined within SB 1159 would not be covered under the Memorandum of Coverage (MOC). Examples of these may include, but are not limited to, the following:

  • Employees who test negative for COVID-19
  • Employees who were not tested for COVID-19
  • Employees who test positive for COVID-19 due to a known non-industrial exposure (eg vacation, cruise, family member) and the claim is determined to be non-industrial
  • Employees who test positive for COVID-19 but do not meet the criterion for the presumption qualifier pursuant to Sections 2, 3 and 4
  • Benefits including medical treatment, testing related costs, Temporary Disability, LC 4850 or Education Code, Permanent Disability, Death benefits, cost containment or legal expenses provided during a self-isolation or quarantine period in which the employee’s injury did not meet the threshold for compensability

In the event a member elects to provide coverage beyond the benefits allowed within the WC Act or exceeding the provisions outlined within the MOC, the member bears full responsibility for those associated claims costs and such costs/claims will not be covered under the Primary Workers’ Compensation and/or Excess Workers’ Compensation programs.