This Bill Could Transform Workers' Comp for California Nurses

California Senate Bill 632, authored by Senator Jesse Arreguín, seeks to expand workers’ compensation protections for hospital employees who provide direct patient care in acute care hospitals. The bill specifically defines “injury” to include a range of conditions—infectious diseases (including COVID-19), cancer, musculoskeletal injuries, post-traumatic stress disorder (PTSD), and respiratory diseases. For these conditions, S.B. 632 establishes a rebuttable presumption that the injury or illness arose out of and in the course of employment, making it easier for affected hospital workers to access workers’ compensation benefits.

Currently, California law provides similar presumptions for certain first responders, such as police officers and firefighters, but not for nurses or other hospital staff. S.B. 632 aims to correct this disparity, especially given the high rates of workplace injury and illness among nurses compared to other professions.

Key Provisions of S.B. 632

• Expanded Definition of Injury: Includes infectious diseases (like COVID-19), cancer (with demonstrated exposure to carcinogens), musculoskeletal injuries, PTSD, and respiratory diseases.
• Rebuttable Presumption: If a hospital employee providing direct patient care develops one of these conditions, it is presumed to be work-related unless the employer can prove otherwise.
• Post-Employment Coverage: The presumption extends for a specified period after employment ends (e.g., up to 60 months for infectious diseases, up to 120 months for cancer).
• Alignment with First Responder Protections: Brings hospital workers’ protections in line with those already provided to other high-risk, often male-dominated, professions.

Supporters of S.B. 632

• California Nurses Association (CNA): The CNA is the primary sponsor, arguing that the bill will help retain skilled nurses, address gender disparities in workers’ compensation law, and ensure frontline healthcare workers receive timely support and care.
• Nurses and Healthcare Worker Advocates: Many nurses and advocacy groups support the bill, highlighting the high rates of injury and illness among nurses and the need for equitable treatment compared to other frontline professions.

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Opponents of S.B. 632

• California Chamber of Commerce: The Chamber opposes S.B. 632, arguing that it would significantly increase workers’ compensation costs for both public and private hospitals. They warn that the bill sets a precedent for expanding presumptions into the private sector and note that similar proposals have failed multiple times in the past.
• Hospital and Business Groups: These groups, including the California Hospital Association, oppose the bill and are concerned about the financial impact and potential for increased litigation, as the presumption shifts the burden of proof to employers.

How Other States Are Addressing Similar Issues

Some other states have taken steps to provide presumptive workers’ compensation coverage for certain occupational diseases, especially in response to the COVID-19 pandemic:

• Minnesota: Passed legislation granting a presumption of COVID-19 causation for first responders, corrections officers, and some healthcare workers. The presumption can be rebutted only if the employer proves the disease was not work-related. This law had a sunset provision.
• Illinois: Issued an emergency rule (later repealed) that created a presumption for all essential workers, including healthcare staff, that COVID-19 was work-related.
• New Jersey and Washington: Expanded presumptions to a broader range of occupations, including teachers and retail workers, not just healthcare and first responders.
• Other States: Some, like Alaska and Kentucky, used executive orders to create presumptions for healthcare workers and first responders, while others have not enacted such changes.

What This Bill Means for Nurses

S.B. 632 represents a significant effort to provide California’s hospital workers—especially nurses—with the same presumptive workers’ compensation protections already afforded to other high-risk professions. 

While strongly supported by nursing organizations and labor advocates, it faces opposition from business and hospital groups concerned about increased costs. Other states have adopted similar presumptions, particularly in response to COVID-19, but the scope and permanence of these protections vary widely. 

S.B. 632 would place California among the states leading in comprehensive occupational health protections for healthcare workers.

🤔 What do you think about S.B. 632 and presumptive workers’ compensation protections? Tell us your thoughts in the discussion forum below.