Key Messages: Presumptions Will Harm Patients and Hospitals

Workers’ Compensation Presumptions Jeopardize Access to Health Care

Hospitals are committed to protecting and supporting injured or ill employees.

  • Hospitals value their employees and prioritize their well-being. Without them, hospitals could not fulfill their mission of care.
  • Hospitals comply with strict Cal/OSHA standards to reduce hazards in the workplace, including those for infectious diseases, musculoskeletal injuries, cancers, PTSD, and respiratory illnesses.
  • Despite best efforts, work-related injuries do occur. When that happens, hospitals accept the overwhelming majority of workers’ compensation claims, with a comprehensive and effective appealprocess in place for any denials.

A workers’ compensation presumption would jeopardize access to care.  

  • At a time when hospitals are laser-focused on caring for patients and communities as well as making health care more affordable, efforts to create presumptive eligibility would have the exact opposite effect.
  • Statewide, the cost of this proposal is estimated at between $1.5 billion and $2.5 billion annually. A presumption in workers’ compensation can result in hundreds of thousands of dollars for a single case,with zero evidence the injury occurred at work.
  • Increases in workers’ compensation costs will impair hospitals’ ability to ensure access to high-quality care, especially considering that more than half of California hospitals lose money every day to care for patients.

A workers’ compensation presumption for hospital employees would force the acceptance of claims
without any evidence that an injury occurred on the job.

  • Workers’ compensation eligibility presumptions would include a multitude of conditions — any infectious disease, musculoskeletal injury, cancer, PTSD, and respiratory illnesses such as asthma.
  • There is no reasonable rationale supporting the proposed presumptions. In fact, using the pandemic as an example, California’s hospitals saw a significantly lower rate of occupationally contracted COVID-19 claims compared to other sectors.
  • The current process works well for health care employees. According to the California Workers’ Compensation Institute, health care employers have one of the lowest denial rates of any sector, including public safety. In 2022-23, employers approved about 90% of all claims.