California’s troubled unemployment benefits department will soon have its third director in the past two years. Gov Newsom announced the appointment of Employment Development Department Chief Deputy Director of External Affairs, Legislation and Policy Nancy Farias as Director of EDD, filling the role held by outgoing Director Rita Saenz since 2020.

Director Saenz will continue to serve the Administration by resuming her role as a Commissioner on the California Commission on Aging.

Farias has served as Chief Deputy Director of External Affairs, Legislation and Policy at the California Employment Development Department since 2020. Farias was Director of Government Relations at SEIU Local 1000 from 2017 to 2020. She was Deputy Chief of Staff in the Office of Senator Henry Stern from 2016 to 2017 and District Director at the Office of Assemblymember Mike Gatto from 2015 to 2016.

Saenz was appointed by Newsom back in 2020 to help turn the department around. This after it was dealing with a record number of unemployment claims as well as fraud claims. Since the pandemic EDD has been dealing with fraud, long wait times and frozen accounts, among other issues.

Saenz, who led the California Department of Social Services in the early 2000s and is a former executive with Xerox Corp., came out of retirement to lead the department in 2021 as it was plagued by fraud and a backlog of payments.

Since then, the agency has received 26.4 million claims and paid $180 billion in benefits. But about $20 billion of those payments went to scammers who posed as prison inmates and, in one instance, U.S. Sen. Dianne Feinstein to fool state officials into sending them checks.

The department recently uncovered another fraud scheme as scammers were posing as doctors to trick state officials into issuing them disability checks.

As director, Saenz sought to implement 21 recommendations from the California state auditor. The department has implemented five of those recommendations so far, while the rest are in various stages of implementation. In a memo announcing her resignation, Saenz said she had only planned to stay with the department for a short time.

Also Jeffrey T. Killip of Olympia, WA, has been appointed Chief of the Division of Occupational Safety and Health at the California Department of Industrial Relations. Killip has served as Acting Deputy Assistant Director of the Division of Occupational Safety and Health at the Washington State Department of Labor and Industries since 2021.

He served in several positions at the Division from 2012 to 2017, including Industrial Hygiene and Laboratory Manager for Technical Services and Rules Manager. He was a Policy Health Analyst at the Washington State Healthcare Authority in 2010 and a Public Health Law Consultant at the Northwest Center for Public Health Practice at the University of Washington from 2009 to 2012.

The Employment Development Department announced earlier this month that they had halted payments on 345,000 disability claims associated with 27,000 suspicious doctors.

According to it’s January 26 update press release, EDD continues to confirm that most of the suspect disability insurance medical provider accounts it flagged as suspicious were fraud attempts. The few providers that were not fraud – but instead victims of identity theft – are completing verification along with their patients to then resume certifying claims.

To date, EDD has confirmed that approximately 98 percent of the 27,000 medical provider accounts it initially flagged as suspicious were likely fraudulent. Specifically, 485 providers have verified their identity at this point and the rest did not.

As EDD separates out the suspected fraudulent accounts it is then verifying the claimants who were suspended when their medical provider’s information was compromised. These claimants received notices this week to verify their identity with ID.me as quickly as possible to help in resuming payments.

In addition, other claimants have received different notices with other verification requirements specific to their claim. To avoid tipping off fraudsters, further details about the various verification procedures will not be released.

But according to a story in the Sacramento Bee most of the 1.4 million people asked last year to prove they properly received federally-funded unemployment benefits have not responded to the state’s request and could eventually face penalties and repayments.

The state first sought the information in November.  In some cases, it said, it could seek a potential repayment of all benefits received. It talked about penalties. The EDD said it would add a 30% penalty “if we determine that you intentionally gave false information or withheld information to receive benefits.”

So far, about 280,000 people have responded. Of those, about 90% were found eligible for the benefits. The others will see further reminders about the importance of the federal requirement. They’re being given time to appeal and submit further documentation.

If they don’t respond to that notice, they could be deemed ineligible for the benefits they were paid. They would have the chance to appeal, but could have to pay back what they’ve received if they don’t qualify for a waiver.

Those who were not notified have already provided proof of employment or were not subject to the requirement.

The Division of Workers’ Compensation has issued a Notice of Public Hearing to amend the Copy Service Fee Schedule. The Zoom public hearing is scheduled for Friday, February 25, 2022 at 10 a.m. A previous public hearing was held on August 30, 2021.

The proposed updates to the regulations include:

– – An increase of the flat rate for copy services from $180 to $230 (a slight increase from the first proposal of $225) for records up to 500 pages, and includes all associated services such as pagination, witness fees for delivery of records, and subpoena preparation.
– – A new provision providing that claims administrators are not liable for payment for duplicative records sent to the Independent Medical Review Organization.

The proposed amendments to the Copy Service Fee Schedule are exempt from the rulemaking provisions of the Administrative Procedure Act. DWC is required to have a 30-day public comment period, hold a public hearing, respond to all the comments received during the public comment period, and publish the order adopting the regulations online. Members of the public may review and comment on the proposal until February 25, 2022.

Members of the public may attend the public meeting: on Friday, February 25, 2022 between 10 a.m. to 5 p.m., or until conclusion of business.  Participants can join from PC, Mac, Linux, iOS or Android: using this Zoom URL: https://dir-ca-gov.zoom.us/j/86980035677

If you wish to speak at the public hearing, please submit your notice of intent to speak to DWCRules@dir.ca.gov by 5:00 p.m. Thursday, February 24, 2022 indicating Request to Speak in the subject line and provide your name, organization and phone number and your intent to speak at the Copy Service Fee Schedule public hearing. If you submit written comments by 5:00 p.m. Thursday, February 24, 2022, you can note your intent to speak with written comments.

Advance notice of your intent to speak will help DWC’s record-keeping and you will not need to spell your name for the record. Speakers that do not provide advance notice will have the opportunity to register to speak at 10:05 on the day of the hearing.

The U.S. Occupational Health and Safety Administration announced it is ending the COVID-19 vaccination and testing rules that were struck down by the Supreme Court but vowed to continue efforts to make the rules permanent in the future.

“The U.S. Department of Labor’s Occupational Safety and Health Administration is withdrawing the vaccination and testing emergency temporary standard issued on Nov. 5, 2021, to protect unvaccinated employees of large employers with 100 or more employees from workplace exposure to coronavirus. The withdrawal is effective January 26, 2022.”

“Although OSHA is withdrawing the vaccination and testing ETS as an enforceable emergency temporary standard, the agency is not withdrawing the ETS as a proposed rule. The agency is prioritizing its resources to focus on finalizing a permanent COVID-19 Healthcare Standard.”

“OSHA strongly encourages vaccination of workers against the continuing dangers posed by COVID-19 in the workplace.”

“The Supreme Court made it clear that the President Biden administration’s attempt to federalize the nation’s workforce is blatantly unconstitutional,” First Liberty Institute president, CEO and chief counsel Kelly Shackelford said of the announcement in a statement.

“OSHA had no choice but to withdraw its unlawful ETS, but it needs to completely put an end to this dangerous government overreach. We will continue to fight on behalf of our clients and the American people to protect them from being forced to violate their faith.”

RAND Corporation recently released a new Perspectives Report that examines policymakers’ initial efforts and reasoning around enabling access to workers’ compensation benefits for employees who are required to work outside their homes during the COVID-19 pandemic.

They briefly assess the potential impacts of continuing to expand such access on workers, employers, and insurers. And finally, they pose further questions that policymakers and others may want to consider when evaluating past policies and crafting new ones to meet future public health emergencies.

The coronavirus disease 2019 (COVID-19) pandemic has posed incredible challenges to the U.S. workforce. Although many businesses have transitioned employees from on-site work to telework, frontline employees in certain sectors deemed “essential” (e.g., hospitals and other health care facilities, public safety agencies such as police and fire departments, critical infrastructure such as electric and water utilities, or the food supply chain) must continue to work on-site.

Depending on the specific public health restrictions in place, many “nonessential” businesses have also operated in a manner that requires employees to work on-site and, in some instances, to have extensive contact with customers, vendors, and suppliers.

As of July 31, 2021, 36 states, the District of Columbia, and Puerto Rico have either implemented or are considering changes to make it easier for some classes of workers who contract COVID-19 while working outside the home to obtain benefits.

In a majority of states that have expanded workers’ compensation presumptions, the presumption takes effect upon either a positive COVID-19 test result or physician’s diagnosis. In Mississippi, North Dakota, and Washington, the presumption takes effect once a worker is ordered to quarantine by an employer because of suspected COVID-19 exposure.

Workers’ compensation actuaries in a majority of states have adopted regulations excluding COVID-19 from experience rating. NCCI proposed a rule change omitting COVID-19 claims from experience rating calculations. To date, 34 out of the 36 states (excepting Alaska and Nebraska) within NCCI have approved the rule change. Additionally, all states not covered by NCCI have approved similar rule changes.

The COVID-19 pandemic has, so far, not had dramatic impacts on the profitability of the workers’ compensation insurance market. Far from the dire predictions at the start of the public health emergency, many employees who have contracted COVID-19 have recovered relatively quickly, without the need for long-term, costly medical care or time off from work. And although numerous laws and regulations have been enacted across many states, many of the COVID-19 claims have not ultimately met the requirements for compensability.

Additionally, some observers have noted that overall claims frequency in 2020 declined in many states. A study by the Workers’ Compensation Research Institute found that in the second quarter of 2020, “the volume of non–COVID-19 WC [workers’ compensation] claims . . . [dropped] by at least 30 percent in the vast majority of the states and by as much as 50 percent in Massachusetts” (Fomenko and Ruser, 2021, p. 8).

The biggest risk that insurers now face is the unknown long-term health implications for people who have recovered from a serious COVID-19 infection. Patients admitted to intensive care units are generally at greater risk of long-term adverse health outcomes. Some experts also anticipate that “in addition to claims for occupational exposure to COVID-19, an influx of posttraumatic stress and mental health claims could also be on the way” (Marsh, 2020, p. 5).

It will take decades to fully understand what, if any, serious long-term side effects patients who have recovered from COVID-19 will face. Insurers face uncertain risk around tail costs, which include the potential for latent claims filed for lifetime medical, permanent disability, or death benefits.

The RAND Researchers conclude by saying “The effects of the COVID-19 pandemic on the U.S. business and labor market will last far beyond an official declaration that the pandemic has ended.”