When Should a Claim Form Be Provided?

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WHEN SHOULD A CLAIM FORM BE PROVIDED?

Despite the high bar for when an employer "must" provide a claim form, different factors must be considered in deciding whether employers "should" provide a claim form. After all, the claim form and notice of potential eligibility for benefits are intended to advise employees of the various rights and benefits available for workers' compensation injuries.

Many essential employees are continuing to work while California remains on lockdown. Notably, doctors, nurses and other medical professionals who treat COVID-19 patients are exposed to the coronavirus. Police officers, paramedics, mass transit workers, grocery workers and other essential workers are far more likely to be exposed to the coronavirus than workers who are required to stay home.

Employers of essential employees might consider providing them with a claim form if they contract COVID-19 to recognize their continuing service to the community. When given the claim form, an employee can choose whether to file a claim. And if he or she does file the form, that doesn't require the employer to accept the claim. It simply triggers the 90-day period to investigate the claim, although the employer also would be required to pay as much as $10,000 in medical treatment until the claim is accepted or denied.

Beyond altruism, employers might want to protect themselves by providing claim forms to employees even if they aren't necessarily required. If an employer does not notify an employee of the right to medical care, the result could be the employee self-procuring medical care with doctors, a process over which the employer has no control. In some cases, an employee might forgo medical care entirely if he or she can't afford it, the worst-case result of which could be the employee's death. If the claim is filed later, the employer could be liable for consequences resulting from the failure to obtain treatment early.

So, in deciding whether to provide a claim form, employers must consider whether the long-term costs of failing to provide the form and treatment outweigh the immediate costs.