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.

United States Attorney Michael Bailey and Arizona Attorney General Mark Brnovich launched a joint federal, state, and local task force to combat coronavirus-related fraud.

The COVID-19 Fraud Task Force brings together a dozen partners from across the state, with the goal of combining resources and information to better investigate and prosecute wrongdoers that seek to profit from the public health crisis.

Assistant United States Attorney Jim Knapp, recently appointed as the United States Attorney’s Office COVID-19 Fraud Coordinator, and Joseph Sciarrotta, Civil Division Chief for the Attorney General’s Office, are leading the Arizona COVID-19 Fraud Task Force. Other members include: Maricopa County Attorney’s Office, the Federal Bureau of Investigation, the Food and Drug Administration, the Internal Revenue Service Investigation Division, Health and Human Services, the United States Postal Inspection Service, the Treasury Inspector General for Tax Administration, the United States Secret Service, the United States Army Criminal Investigation Division, and the Defense Criminal Investigative Services.

In recent weeks, stories of fraud related to the coronavirus have increased across the nation. In times of uncertainty, consumers are often more vulnerable to scams as they seek answers and a sense of security. Fake texts, emails, and social media posts that might normally be ignored may now be enticing if they offer COVID-19 tests, miracle cures, medical products, or financial windfall.

On April 6, the Federal Trade Commission reported that it had received almost 12,000 consumer complaints related to COVID-19 in just three months. Well over half of those complaints were fraud-related, with a total loss to consumers of $8.39 million.

The Arizona Attorney General’s Office has also experienced a spike in COVID-19-related consumer fraud complaints. The office already sent cease-and-desist letters to local businesses (YiLo Superstore Dispensary and Prepper’s Discount) that were offering COVID-19-related products alleged to be in violation of the Arizona Consumer Fraud Act. To help keep Arizonans informed of the latest scams and to provide tips to consumers, the Attorney General’s Office recently launched a COVID-19 scam information page: www.AZAG.gov/COVID-19.

In light of these reports, consumers are urged to consider the following to protect yourself from COVID-19 fraud:

— Do not respond to texts, emails, or calls requesting your personal information in exchange for a COVID-19 stimulus check. If you receive one of these requests, immediately report it to the hotline. COVID-19 economic impact checks will be delivered based on 2018 or 2019 tax return information, so no action is required for most people.
— Ignore offers for a COVID-19 vaccine, cure, or treatment. Remember, if there is a medical breakthrough, you won’t hear about it for the first time through an email, online ad, or unsolicited sales pitch.
— Research any charities or crowdfunding sites soliciting donations in connection with COVID-19 before giving. An organization may not be legitimate even if it uses words like “CDC” or “government” in its name.
— Be cautious of purchasing personal protective equipment (PPE) from unknown third party vendors. Verify that the company is legitimate before ordering their products or sending money.
— Never click on a link or open an email attachment from an unknown or unverified source. Links and attachments may be embedded with a virus that will infect your computer or mobile device. To better protect yourself against malware, make sure your anti-virus software is operating and up-to-date.
— Do not be convinced by sales pitches for COVID-19 tests that promise to give results in as little as 24 hours. If an effective, quick-results test becomes widely available, you will find out through news sources and government reporting, not a sales pitch.

If you believe you have been a target of a coronavirus-related scam, or know someone else who has been, please report the fraud. Reports can be made to the Task Force at:

National Center for Disaster Fraud Hotline: 1-800-720-5721 or disaster@leo.gov
FBI’s IC3 (for internet related scams): www.IC3.gov