Keenan Briefings

Briefings

COVID-19 Update: Further Changes to Workers’ Compensation Programs

April 08, 2020

Last week, the Department of Industrial Relations (DIR), Division of Workers’ Compensation (DWC) and the Workers’ Compensation Appeals Board (WCAB) announced another set of changes to the state’s workers’ compensation programs in response to the COVID-19 emergency and the stay at home order in place in California.

Updated Codes

The DWC announced that it has issued an order updating the workers’ compensation Pathology and Clinical Laboratory Fee Schedule to adopt two HCPCS codes related to COVID-19, effective for services on or after February 4, 2020:

  • U0001 - CDC 2019 Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel
  • U0002 - 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC

The order also sets maximum fees based upon 120% of the California Medicare fees set by the Medicare Administrative Contractor.

The order does not adopt the American Medical Association (AMA) CPT code 87635 into the fee schedule at this time, as there is no Medicare fee established for this code. The AMA added the Category I Pathology and Laboratory CPT code 87635 in reference to COVID-19 testing, effective March 13, 2020. The CPT code 87635 will however pass the WCIS validation edit, since it is a valid CPT code and may be in use by providers of the COVID-19 test.

The order also notes that the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) in collaboration with other agencies have created one new ICD-10-CM code: U07.1 - 2019-nCoV acute respiratory disease. For medical bill data reporting, the WCIS has included all of the above codes in its incoming data validation tables and will accept medical bills with these codes.

Signatures

Until otherwise notified, DWC will accept an electronic signature on any settlement documents, applications, pleadings, petitions or motions that are sent to the district offices or filed in EAMS. For all e-forms, the DWC directs that parties should utilize “S signature” as shown in the E-forms Filing Reference Guide and the JET File Business Rules.

Office Closures

The WCAB Commissioners’ office is closed to the public for in-person inquiries and requests until further notice.

Updated Hearing Procedures

Hearing procedures are changed as follows:

April 6 through April 10:

  • DWC will continue to hear expedited hearings for parties that appear at the district offices.
  • DWC will also hear status conferences, mandatory settlement conferences and priority conferences via CourtCall only. If all parties do not appear via CourtCall, the case will be continued and notice will be given.
  • All other hearings will be continued. No trials or lien conferences will be heard during this time.
  • Parties are required to adhere to social distancing guidelines when visiting DWC district offices.

Effective April 13:

  • DWC conferences including mandatory settlement conferences, priority conferences, status conferences and all expedited hearings will be heard telephonically.
  • All DWC judges in California will hear cases by an individually assigned conference line. These conference lines are available toll-free. A list of all conference line numbers will be posted on DWC’s website prior to the effective date.
  • Parties should call the conference line for the judge in front of whom the case is set, at the designated hearing time listed on the hearing notice. When prompted, parties should enter the access code assigned to that line. DWC staff will instruct participants as to the procedure to follow during the call.
  • All trials and lien conferences will be continued until further notice. District offices will hold no in-person hearings.

Updated Filing Procedures

Filing procedures are also changed as follows:

April 6 through April 10:

  • District offices will remain closed for filing purposes. Accordingly, all filing deadlines are extended to Monday, April 13.
  • DWC will not accept walk-through documents, walk-in filings, or in-person requests.
  • Parties may utilize the Electronic Adjudication Management System (EAMS) to file documents online. Parties may also mail settlement documents or petitions to the district office where the case is filed.
  • Refer to the district office page for e-mail and other contact information.
  • Additional information will be posted on the DWC website to assist parties with filing settlement documents in EAMS.

Effective April 13:

  • DWC will reopen for filing purposes, however it will only accept filing by e-filing via EAMS, JET file or by mail.
  • DWC will not accept walk-in filings, walk-through documents or in-person requests. Injured workers who are unable to file utilizing these options or need assistance may contact DWC’s call center at 909-383-4522.

The Keenan team is already working in compliance with all of the coding, filing and hearing changes described above.

For questions regarding the status of a specific workers’ compensation claim, the best course of action is to contact the appropriate claims examiner or claims supervisor. For general questions regarding the workers’ compensation system or the information in this Briefing, please contact your Workers’ Compensation Risk Management Analyst.


Keenan & Associates is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Clients are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the clients’ business activities.