California comp bill would ‘set an unsupported precedent,’ analysis says

A bill that would give a rebuttable presumption of compensability to a wide range of hospital worker injury and illness claims for those providing direct patient care would “set an unsupported precedent by extending presumptions into the private sector,” according to an analysis published Tuesday by the California Workers’ Compensation Institute.

S.B. 632 also would require hospitals “to accept injuries that would normally be denied after investigation and expend significant costs” says the analysis, which also predicts more litigation.

The bill, pending in the California State Assembly, would create workers compensation presumptions for some hospital worker claims including musculoskeletal injuries, COVID-19 from SARS-CoV-2 and its variants, respiratory diseases (including asthma), cancer and post-traumatic stress disorder.

Presumptions generally are only for public sector employees, such as first responders, but recent trends have been leaning toward expansions. For example, in 2024 Washington enacted a presumption for nurses claiming to suffer from PTSD.

Using accident-year claims data from its Industry Research Information System database, CWCI’s analysis found that 55.7% of all hospital worker claims from accident years 2019 to 2024 would be presumptive injuries under the proposed change.

Of the hospital worker claims that would be accepted by presumption, the most common were for musculoskeletal injuries, accounting for 32.1% during the six-year study period. COVID-19 would have accounted for 21.7% and respiratory diseases 1.3%. Other injury categories that would be covered by the proposed presumptions together represented less than 1% of the hospital worker claims.

CWCI also found that claim denial rates for injuries and illnesses that would be covered by S.B. 632 are similar for hospital workers and the general workforce: For hospital workers the denial rate was 15.0% and for the general workforce it was 15.7%. CWCI found that hospitals already accept liability for such injuries at a slightly higher rate than employers do in the general workforce, “so evidence supporting the need for the proposed presumptions is lacking.”