Author: WorkCompAcademy

Dr. Jennings Ryan Staley, a licensed physician and the operator of Skinny Beach Med Spa in San Diego, was charged with mail fraud in connection with the sale of what he described as a “100%” cure for COVID-19 that he said would render customers immune to the virus for at least six weeks.

FBI Agents began investigating this COVID-19 related fraud immediately upon receiving a tip from the public and shortly thereafter introduced an undercover agent. FBI Agents also executed a search warrant at the business of Skinny Beach Med Spa located in Carmel Valley. Skinny Beach Med Spa, offered a range of beauty-related services such as botox, hair removal, and fat transfer.

In late March, Skinny Beach allegedly began sending emails advertising “COVID-19 treatment packs,” described as a “concierge medicine experience” priced at $3,995 for a family of four, that included among other things access to Dr. Staley, the medications hydroxychloroquine and azithromycin, and “anti-anxiety treatments to help you avoid panic if needed and help you sleep.”

In a recorded call in which Dr. Staley was selling his services to a would-be customer – in fact, the undercover FBI agent – Dr. Staley described the medication he was offering as “an amazing cure” and a “miracle cure” that would cure COVID-19 “100%.” He added that if you take the medication without having the disease, “you’re immune for at least 6 weeks.”

Staley referred to medication he offered as a “magic bullet,” and said, “It’s preventative and curative. It’s hard to believe, it’s almost too good to be true. But it’s a remarkable clinical phenomenon.”

Staley also stated, “I’ve never seen anything like this in medicine, just so you know. Really, I can’t think of anything. That, you’ve got a disease that literally disappears in hours.”

Dr. Staley was interviewed a week later by the FBI as part of the overt investigation. When Dr. Staley was asked by agents whether Skinny Beach has told patients that the treatments are a 100% effective cure for COVID-19, Dr. Staley said, “No, that would be foolish. We would never say anything like that.” He also told the FBI that it was “not definitive” that the medication he offered cures COVID-19.

As set out in the complaint, Dr. Staley also offered the would-be customer Xanax (alprazolam) – a Schedule IV controlled substance – as part of his concierge package, and shipped the drug without conducting any sort of medical examination. He claimed that his broker was smuggling hydroxychloroquine from China to make his own pills, and had concealed the shipment from customs authorities by describing it as sweet potato extract. Shipping records confirmed that Dr. Staley was indeed importing a shipment of “yam extract,” scheduled to arrive in the U.S. in a matter of days.

“The sale of false cures, especially by a medical professional, will be vigorously investigated by the FBI,” said Omer Meisel, the Acting Special Agent in Charge of the FBI’s San Diego Field Office. “The FBI is using a variety of tools to identify anyone who exploits the current crisis with fraudulent scams or a variety of cyber schemes – and is proactively warning the public about products claiming to save lives, before losing their money or creating false hope. Scammers seeking to profit by exploiting fear and uncertainty during this COVID-19 pandemic will be brought to justice.”

The Press Democrat reports that law enforcement, firefighters and other first responders are raising alarms about the unique threat posed by the novel coronavirus to their health – and the need to protect personnel who get sick.

Some states have changed regulations to provide swifter access to workers’ compensation coverage for essential workers in the community during the coronavirus pandemic. These employee- funded benefits can cover lost wages, additional sick leave, job protections and death benefits.

Not yet in California, where lawmakers and Gov. Gavin Newsom have not taken up the issue, leaving each claim to be evaluated on a case- by-case by employers and insurance carriers.

Nine Santa Rosa police officers and one Sonoma County sheriff’s lieutenant have so far tested positive for the coronavirus, including longtime Santa Rosa Detective Marylou Armer, who died March 31 of complications from COVID-19, a respiratory disease caused by the disease. One Santa Rosa firefighter has tested positive for the virus.

The state must act – and soon – to assure these front-line workers don’t have to worry about lost wages, benefits and time away from work if they get sick, said Stephen Bussell, president of the Santa Rosa Police Officers’ Association. “We definitely have a higher risk level than the general public,” Bussell said.

Employees seeking workers’ compensation generally must prove they acquired the illness or got hurt on the job in order for their claims to be approved. There are exceptions for law enforcement and firefighters in California. State law provides automatic workers’ compensation eligibility if they get diseases like tuberculosis, cancer and pneumonia.

Those are just some of the ailments on a list of conditions that, if acquired while employed, allow police and firefighters to receive workers’ compensation benefits without having to document where they got sick or injured. Last year, that list was expanded to include post-traumatic stress syndrome, a change made to acknowledge the heavy and growing toll of wildfires.

“That gets them treatment and paid time-off faster,” said Laura Rosenthal, a Santa Rosa attorney who specializes in workers’ comp claims for law enforcement.

As a new disease, COVID-19 is not included on the list of conditions that make it easier for police officers and firefighters to file a workers’ comp claim.

But those employees who develop pneumonia while battling COVID-19 may have an easier time accessing workers’ compensation benefits because the lung infection is part of the state exemption, Rosenthal said.

No such protections for any workplace-acquired diseases or injuries exist yet for nurses or health care workers. Rosenthal said she hopes the pandemic pushes the state to consider adding protections for health care workers.

“You have law enforcement transporting an individual with a staph infection to the hospital, and he’s covered if he gets it,” Rosenthal said. “But the minute you drop them off at hospital, the workers there don’t get the same protection.”

Bussell said the Santa Rosa Police Department has so far been supportive of employees with coronavirus who are filing workers’ compensation claims, but it’s no easy task to document where they got it. Officers are in the community on patrol and various assignments, they often take individuals to hospitals and are in a variety of settings where they may come in close contact with people carrying the virus.

“Right now we’re doing our best to document exposures. It’s challenging to document it and be accurate,” Bussell said. “But the likelihood that it happened at work is greater than not.”

The WCIRB’s Classification and Rating Committee is considering three rule changes that WCIRB staff are recommending in response to the impact of the coronavirus disease 2019 (COVID-19) pandemic on California employers and workers. The Committee is considering changes that, if approved by the Insurance Commissioner, would:

Exclude Payments to Employees Who Continue to Be Paid While Not Working

The Committee will review a proposal to exclude from reported payroll the payments made to employees who are continuing to be paid while not engaged in any work activities. This exclusion would apply while California’s stay-at-home order is in place and for up to 30 days thereafter if the employee continues not to work. Excluding this payroll recognizes the extraordinary circumstances resulting from the stay-at-home order and the fact that employees not engaged in work activities have virtually no work-related exposure. Allow Assignment of Classification 8810 for Temporary Change in Duties

The Committee will review a proposal to allow the assignment of Classification 8810, Clerical Office Employees, to the payroll of employees whose job duties, during California’s stay-at-home order, meet the definition of a Clerical Office Employee. This provision would apply while California’s stay-at-home order is in place and for up to 30 days thereafter if the employee continues to meet the definition of a Clerical Office Employee, but does not apply to the payroll of employees whose payroll is otherwise assignable to a standard classification that specifically includes Clerical Office Employees.

Exclude COVID-19 Claims from Experience Rating

The Committee will review a proposal to exclude claims with a diagnosis of COVID-19 and an accident date on or after December 1, 2019 from the experience rating calculations of individual employers. Since the occurrence of COVID-19 workers’ compensation claims are unlikely to be a strong predictor of future claim costs incurred by an employer, their inclusion in an experience modification calculation would not meet the intended goal of experience rating.

This is a high-level summary of the proposed regulatory changes. Details regarding the proposed changes and the full agenda, including the teleconference login information, are available on the Committee Documents page in the Filings and Plans section of the WCIRB’s website.

Anthony Dennis sustained an injury in 2013 to his right wrist while working as an inmate for the California Department of Corrections and Rehabilitation. The parties stipulated to an award in 2017. This did not include his claim for a SJDB voucher.

Prior to the stipulation, defendant sent Dennis a Notice of Offer of Regular, Modified, or Alternative Work. The Notice also stated “SUBJECT TO APPLICANT VERIFYING THEY ARE LAWFULLY QUALIFIED TO ACCEPT EMPLOYMENT AS AN INMATE LABORER, YOU HAVE VOLUNTARILY TERMINATED YOUR EMPLOYMENT DUE TO YOUR RELEASE FROM PRISON AND ARE NO LONGER AVAILABLE FOR EMPLOYMENT[sic].”

Dennis filed a Request for Dispute Resolution Before Administrative Director, to resolve the issue of entitlement to a SJDB voucher. the AD did not issue a determination, and pursuant to the Rules, the request was therefore deemed denied.

Dennis then filed a DOR with the Sacramento District Office asking it to adjudicate his claim to this benefit. The WCAB rescinded the Award, and substituted a new Finding that applicant is entitled to a SJDB voucher.

It concluded that the WCAB maintains exclusive jurisdiction to adjudicate SJDB disputes irrespective of AD Rule 10133.54, which provides that the parties may request a dispute resolution with the Administrative Director before appealing the Administrative Director’s decision to the WCAB.

The Defendant, newly aggrieved, sought reconsideration of the new decision, which the WCAB granted. In the tentative En Banc decision it concluded that AD Rule 10133.54 exceeds the authority granted in sections 4658.5(c) and 4658.7(h), which authorizes the Administrative Director to adopt regulations for the administration of the supplemental job displacement benefits program. Neither statute authorizes the Administrative Director to adjudicate SJDB disputes.

It went on to note that it was “cognizant that employment in a prison setting is unique in that inmate workers cannot return to an inmate job once they are released from prison, making it impossible for a prison employer to make a bona fide job offer. Our review of statutes and case law, however, leads us to conclude that an employer’s inability to offer regular, modified, or alternative work does not release an employer from the statutory obligation to provide a SJDB voucher.”

In concluding, the WCAB issued its notice of intent to issue a decision after affording the Administrative Director 30 days to file a response to this Notice of Intention.

The Administrative Director responded contending that: (1) it has the adjudicatory authority to resolve disputes over the SJDB and that its dispute resolution process is valid; (2) its dispute resolution process is voluntary and does not usurp the jurisdiction of the WCAB; and (3) the WCAB cannot invalidate AD Rule 10133.54 because the issue is not ripe since applicant did not properly file his Request for Dispute Resolution Before Administrative Director.

Nothing in the Administrative Director’s Response changed the views as expressed in the Notice of Intention.  Its. final En Bank decision of Dennis v Department of Corrections, the WCAB provided a thorough and detailed iustification of this position.  

The FBI uncovered an international coronavirus-fueled fraud scheme after more than 39 million masks promised to a powerful California union representing health-care workers were never delivered to hospitals and other medical groups in the state, according to a report published Saturday.

Service Employees International Union-United Healthcare Workers West announced on March 26 it had identified a distributor overseas who was willing to sell 39 million critically needed N95 masks, a press release said. The union said it secured the deal after 48 hours calling leads and potential suppliers to help find personal protective equipment for health-care workers on the front lines of the crisis.

An unidentified businessman in Pittsburgh reportedly was helping the union contact a broker in Australia and a distributor in Kuwait on WhatsApp to secure the deal, U.S. Attorney Scott Brady of the Western District of Pennsylvania told the Los Angeles Times.

“We believe we disrupted fraud,” Brady said. “We are seeing fraud in every variation, but mostly in respect to N95 masks. We have an anxious public, and resources are strained.”

As part of the deal, Kaiser Permanente said they planned to purchase 6 million masks. Sutter Health officials also placed an order for 2 million masks, the Times reported.

Meanwhile, SEIU 121RN, Southern California’s Union of Registered Nurses, launched an online petition accusing hospitals who did not agree to take part in the deal of “putting bottom line profits over your safety.”

The FBI initially began to track the deal to determine if the 39 million masks should be intercepted for the Federal Emergency Management Agency under the Defense Production Act. That’s when the investigators found fraud had been committed.

Kaiser Permanente said the seller had “repeatedly failed to provide reliable information about where we could verify and inspect the shipment.” Brady added that the broker in Australia told the middleman in Pittsburgh there was a warehouse in Georgia filled with 2 million of the masks.

The FBI found no such warehouse with the alleged stockpile. Meanwhile, the seller demanded a 40 percent payment upfront and planned to send Kaiser Permanente details on how to send the funds.

“We learned shortly afterward that the supplier never had possession of the masks,” a Kaiser spokesman Marc Brown said in an emailed statement to the Times. “We are cooperating with federal law enforcement in their investigation of suspected fraud in this case.”

Neither the union nor the Pittsburgh businessman are under investigation and appear to have been fooled by the international scammers, Brady said. No money was exchanged as part of the deal.

SEIU initially said the stockpile of masks available for purchase was made by American manufacturer 3M. But, 3M told federal investigators the company manufactured only 20 million masks last year, signaling that the stockpile overseas was likely counterfeit if it existed at all.

“As far as we knew, he had legitimate masks,” Steve Trossman, spokesman for SEIU-UHW, said of the supplier. “The people who were going to purchase those masks were going to fully vet it and check it out and do their due diligence.”

Union officials were “trying to save the lives of health-care workers and patients” and “were proud of having made that attempt,” Trossman told the Times.