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SCIF Moratorium on Policy Cancellations and Late Penalties

The State Compensation Insurance Fund just announced that it is taking several steps to support its policyholders during the COVID-19 crisis.

State Fund has placed a moratorium on policy cancellations and late payment penalties.

It will also extend credit to any business negatively impacted by COVID-19 events and offer businesses the ability to adjust their payroll reporting.

Because the health and safety of California business owners, workers, and its own employees is its highest priority, State Fund is postponing all site visits.

State Fund has also executed a work-at-home program that is allowing the vast majority of its employees to work remotely–it remains open for business and ready to assist policyholders with all of their workers’ compensation needs.

“We’re adapting quickly to this new environment and doing what we need to do to protect our employees and our customers,” said State Fund President & CEO Vern Steiner. “We’ve been serving California for 106 years and we’re in a strong position to continuing doing so now and into the future.”

To ask questions, adjust payroll or request a credit extension, State Fund policyholders can call (888) 782-8338. For more information about State Fund, visit www.StateFundCA.com.

March 16, 2020 – News Podcast


Rene Thomas Folse, JD, Ph.D. is the host for this edition which reports on the following news stories: Feds Pursue Another Spinal Implant Company for Kickbacks, L.A. Restaurant Fined $2.1M for Wage Theft, Stanislaus Poultry Worker Convicted in Comp Fraud Case, SB 1039 Claims “Binary” Classification of Workers is “Outdated”, Cal/OSHA Interim Guidelines for Coronavirus Disease (COVID-19), NCCI Reports on Effects of COVID-19 in WC Industry, Coventry Outlines Benefits of a Pharmacy Nurse, Governor Newsom Appoints New DIR Director, Zurich Selects Santa Barbara Company for Fraud Assessments, Updated FAQs For Employers On The COVID-19 Coronavirus.

DWC Announces QME Telehealth Policy

The Division of Workers’ Compensation (DWC) appreciates the efforts of the workers’ compensation community to provide care for injured workers during the COVID-19 pandemic. Of paramount importance is that everyone follow all guidance from the Governor as well as federal, state and local public health agencies regarding COVID-19.

After adherence to all public health guidance and orders, DWC encourages all parties to consider creative solutions appropriate to providing care to injured workers. The increased use of telehealth services for medical treatment may be appropriate.

The California Business and Professions Code section 2290.5 requires that – “the health care provider initiating the use of telehealth shall inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services and public health. The consent shall be documented.”

DWC is currently evaluating the feasibility of telemedicine for QME evaluations and will continue to do so.

The use of telemedicine for a QME evaluation may be appropriate where all parties agree that there is a medical issue in dispute which involves whether or not the injury is AOE/COE (Arising Out of Employment / Course of Employment), and all parties to the action, including the physician, agree to a telemedicine evaluation in order to resolve this dispute.

Although DWC is not authorizing any particular course of action, the division recognizes that in this time of medical emergency, creative delivery methods of essential medical treatment and evaluation services may be needed.

DWC realizes that QME appointments may be affected. When cancelling or rescheduling an appointment, please document the reason in the file and inform all parties as soon as possible. Given the current COVID-19 emergency, QMEs that cancel appointments fewer than 6 business days before an appointment may assert that they had good cause to do so.

The current state of emergency regarding the COVID-19 pandemic presents serious public health concerns, and parties and evaluators are encouraged to work together to take any action that may be necessary to protect the health of doctors, their staff and injured workers.

The QME examination scheduled for April 18, 2020 will be postponed. The exam will be rescheduled and a new date will be announced.

U.S. Attorney’s Office Tracking COVID-19 Scams

The U.S. Attorney’s Office will remain vigilant in detecting, investigating and prosecuting fraud schemes related to the COVID-19 crisis.

There have been reports of individuals and businesses selling fake cures for COVID-19 online and engaging in other forms of fraud; reports of phishing emails from entities posing as the World Health Organization or the Centers for Disease Control and Prevention; and reports of malware being inserted onto mobile apps designed to track the spread of the virus.

“The pandemic is dangerous enough without greedy lawbreakers seeking to profit from public panic,” said U.S. Attorney Robert Brewer. “This office will make the investigation and prosecution of all criminal conduct related to the current pandemic a top priority. It is important that criminals know that this national crisis offers no safe harbor for them. We will work together to ensure that those who violate federal law will be brought to justice.”

The U.S. Attorney’s Office will work closely with the Department of Justice as well state and local authorities to both ensure that we hear about misconduct as quickly as possible and that all appropriate enforcement tools are available to punish it.

Additionally the Federal Trade Commission has a page dedicated to Coronavirus Scams – What the FTC is Doing.

The Electronic Frontier Foundation has created a pagePhishing in the Time of COVID-19: How to Recognize Malicious Coronavirus Phishing Scams.

WCAB En Bank Decision Suspends Rules

Upon a unanimous vote of its members, the Appeals Board just issued this en banc decision.

On March 4, 2020, the State of California’s Governor, Gavin Newsom, declared a state of emergency in response to the spread of the novel coronavirus (now known as COVID-19).3 As of the date of this decision, several counties in the State of California, within which district offices of the WCAB are located, have issued a shelter-in-place order in response to COVID-19.

In light of this state of emergency and pursuant to its authority per WCAB Rule 10370, the Appeals Board is temporarily suspending specific WCAB Rules of Practice and Procedure contained in Title 8 of the California Code of Regulations. (Cal. Code Regs., tit. 8, § 10370.) This suspension is applicable to all district offices in the State and applies to the following Rules:

— 1)Cal. Code Regs., tit. 8, former §§ 10562, 10563, 10563.1, now §§ 10755, 10756, 10888 (eff. Jan. 1, 2020): Dismissal of an application or lien claim for failure to appear is suspended.

— 2) Cal. Code Regs., tit. 8, former §§ 10860, 10865, 10866, now §§ 10961(a), 10962(c), 10990(f)(3)(E), 10995(c)(3) (eff. Jan. 1, 2020): Workers’ compensation judges (WCJs) and arbitrators shall have an unlimited extension of time within which to issue reports in response to petitions for reconsideration or removal.

— 3) Cal. Code Regs., tit. 8, former § 10408, now § 10500(b)(6) (eff. Jan. 1, 2020): Suspension of the requirement in the Compromise and Release agreements (DWC-CA forms 10214(c)- (e)) for signatures from two witnesses. Signatures on the forms from all parties may be electronic.

— 4) Cal. Code Regs., tit. 8, former § 10500, now § 10628 (eff. Jan. 1, 2020): Suspension of the requirement for service by the WCAB by mail. Service by the WCAB may be made electronically with or without parties’ consent.

On March 16, 2020, the Division of Workers’ Compensation (DWC) issued Newsline Release No. 2020-18 providing in pertinent part that the DWC’s district offices are currently closed for filing from March 17 through April 3.6 (See Code Civ. Proc., § 12(a); Cal. Code Regs., tit. 8, former §§ 10507, 10508, now §§ 10600, 10605 (eff. Jan. 1, 2020); Pa’u v. Department of Forestry, et al. (2019) (ADJ9159725, ADJ7757931, ADJ9640668). In accordance with this, all filing deadlines are extended to the next day when the district offices reopen for filing.

EEOC – Employers May Now Take Employee Temperatures

The Equal Employment Opportunity Commission (EEOC) gave employers the green light to take employees’ temperatures to try and ward off the spread of the coronavirus in guidance updated March 18.

Generally, measuring an employee’s body temperature is a medical examination,” the EEOC stated. The Americans with Disabilities Act (ADA) prohibits medical examinations unless they are job-related and consistent with business necessity.

Because the Centers for Disease Control and Prevention (CDC) and state and local health authorities have acknowledged community spread of COVID-19, the respiratory illness caused by the coronavirus, and have issued related precautions, “employers may measure employees’ body temperature. However, employers should be aware that some people with COVID-19 do not have a fever,” the agency stated. And some people with a fever do not have COVID-19.

Jeff Nowak, an attorney with Littler in Chicago, added that if employers want to take workers’ temperatures, they should pay employees sent home for high temperatures to limit any legal risk, if they can afford to do so.

Employers also should consider what they’d do if employees refuse to have their temperatures taken. Would employers send these workers home without pay?

The temperature reading should be kept confidential and the person administering the temperature check should be trained on the procedure, Nowak said. He expressed skepticism that a lawsuit would result from taking workers’ temperatures.

Christine Walters, J.D., SHRM-SCP, an independent consultant with FiveL Co. in Westminster, Md., cautioned employers against using oral thermometers, which are more invasive than infrared digital thermometers.

Jonathan Segal, an attorney with Duane Morris in Philadelphia and New York City, said there may be an obligation to pay employees for time spent waiting to have their temperatures checked.

When an employee returns to work, under the ADA employers can require a doctor’s note certifying his or her fitness for duty, the EEOC said.

The EEOC guidance also provided that:

— An employer may take an applicant’s temperature as part of a post-offer, pre-employment medical examination.
— An employer may screen applicants for symptoms of COVID-19 after making a conditional job offer.
— An employer may delay the start date of an applicant who has COVID-19 or symptoms associated with it.
— An employer may withdraw a job offer when it needs the applicant to start immediately but the individual has COVID-19 or symptoms of it. Based on current CDC guidance, the individual cannot safely enter the workplace, and therefore the employer may withdraw the job offer, the EEOC explained.

At Least two States to Provide Corona Virus Comp Benefits

The Insurance Journal reports that workers’ compensation insurers in at least two states have decided that they will guarantee workers’ compensation benefits for health care workers and first responders.

Kentucky Employers Mutual Insurance Co. announced Friday that effective immediately it will pay wage-replacement benefits for any first responder or employee in the medical field who is quarantined because of direct exposure to a person diagnosed with COVID-19.

Ryan Worthern, communications director for KEMI, said the insurer’s staff decided to adopt the policy, but informed its board of directors and Gov. Andy Beshear of the decision.

KEMI’s announcement follows a decision March 5 by the Washington state Department of Labor and Industries to pay wage-loss and medical treatment expenses for any health care worker or first responder who is quarantined because of coronavirus exposure.

Washington operates a monopoly workers’ comp system, so that policy impacts every employee in the state who is covered by the state system.

L&I spokesman Tim Church said the department has already received several workers’ compensation claims due to coronavirus exposure, but he did not know if they were filed by medical or health care workers. Church said a quarantine normally would not be covered by workers’ comp unless the worker was made ill by workplace exposure.

Church said coronavirus claims by Washington workers outside of health care or emergency services will be decided on a case-by-case basis according to the state workers’ compensation statutes.

The National Council on Compensation Insurance, a rate advisory organization for most U.S. states, said last week that it remains to be seen whether other states will follow Washington state’s lead. NCCI said that many state workers’ comp statutes exclude “ordinary diseases of life” such as the common cold or flu.

However, NCCI said at least 10 states have issued mandates for coverage of coronavirus by health insurers. The directives vary, but include coverage for testing and visits to emergency rooms or urgent care facilities without deductibles or copays, NCCI said. “These measures, if expanded to more states, could have the impact of limiting claim activity in the WC market in those cases where only testing or quarantine are necessary,” NCCI said.

Two insurance carriers gave notice of their stand toward the coming workers’ comp claims in notices last week: Texas Mutual Insurance Co. and SAIF, Oregon’s state-chartered workers’ comp insurer, both issued bulletins that said they will decide whether coronavirus exposure is compensable on a case-by-case basis.

Texas Mutual added this caveat: “However, the more widespread COVID-19 becomes, the more difficult it may be for the employee to show that it is work related rather than an ordinary disease of life to which the general public is exposed.”

DWC Closes Headquarters and Three WCAB Offices

The Division of Workers’ Compensation (DWC) will temporarily close its San Jose, Oakland and San Francisco district offices to protect the health of the public and our staff and to comply with shelter-in-place orders.

The Division’s headquarters office, which includes the Medical Unit, Return-to-Work Supplement Program, Uninsured Employers Benefit Trust Fund and Legal Unit, will also close temporarily.

Staff will work remotely and are available by phone at 1-800-736-7401.

DWC is closely monitoring the situation and will update the public of any changes.

DWC and WCAB announced March 16 that they are limiting court appearances to protect the health and safety of our staff and the community, in accordance with numerous public health orders suggesting that public gatherings be limited.

Floyd Skeren Announces Free HR Webinar on COVID–19

Bernadette M. O’Brien is a Partner at Floyd Skeren Manukian Langevin, LLP, and an SPHR/SHRM-SCP certified Human Resources Consultant.

Ms. O’Brien is author of the LexisNexis publication Labor and Employment in California: A Guide to Employment Laws, Regulations and Practices, co-author of California Leave Law: A Practical Guide for Employers, and co-author of California Unemployment Insurance and Disability Compensation Programs.

She has now scheduled a free, informative live-webinar covering important topics for employers, HR and Risk Managers on employment law aspects triggered by the COVID-19 virus. Her topics include:

What workplace laws may be triggered by COVID-19?
— What leave may an employee entitled to who is ill, or who needs to care for a family member?
— What leave may be required for parents with children home from school?
— Can employers require a diagnosis from an employee if COVID-19 is suspected?
— Can employers send employees who appear sick home from work?
— If the workforce shuts down, must employees be paid, and what about benefits?
— If the proposed federal paid sick leave law passes, what is required?
— What should employers tell workers who are 65 and older?
— Guidance on responding to employees who do not want to report to work.
— Guidance on responding to employees who are concerned that a co-worker has COVID-19.
— If an employee is out sick, can a release to return to work be required?

This webinar will take place on Friday, March 27, 2020 from 10:00 am until 12:00. If you would like to attend, please use this registration page.

Ms. O’Brien is the editor of Floyd Skeren Manukian Langevin’s employment related websites: www.employmentlawweekly.com, www.worklawreport.com, and www.floydskerenhrtraining.com.

Ms. O’Brien represents employers in employment related disputes before the Department of Fair Employment and Housing (DFEH), the Equal Employment Opportunity Commission (EEOC), and the California Labor Commissioner, including claims related to discrimination, harassment, retaliation, and wage and hour violations.

Ms. O’Brien also provides HR consultation to employers, human resource administrators, and risk managers on a myriad of HR topics including compliance with federal, state and local employment related laws; EEO compliance; AB 1825 Sexual Harassment training; managing leaves of absence pursuant to FMLA/CFRA, PDL and paid sick time; disability, accommodation and the interactive process; and performance, discipline and termination.

Ms. O’Brien also conducts management and employee training sessions throughout California on numerous workplace topics.

San Francisco Acupuncturist Sentenced in Fraud Case

46 year old Haichao Huang, of San Francisco, was sentenced to 12 months in prison for committing health care fraud and making false statements relating to health care matters. He pleaded guilty on December 6, 2019, to health care fraud and making false statement relating to health care matters.

Huang was a health care provider who offered acupuncture, physical therapy, massage, and other services to patients in and around San Francisco, Calif.

Huang knowingly and willfully executed a scheme to defraud healthcare benefit programs. Huang submitted and caused to be submitted false claims for reimbursement from health care benefit programs that he knew were not properly payable, including from programs provided through federal government and labor union healthcare plans. Huang included false and inaccurate billing codes that artificially inflated both the type of service the patient received and the time he spent with the patient.

The plea agreement gives examples. Huang submitted requests for reimbursement for acupuncture treatment when, in fact, the patient had received much shorter periods of treatment, no acupuncture treatment, or no care of any kind at all. Huang also submitted claims for services rendered on days when patients had not been seen by him at all – including days when Huang was not in California.

Further, after a patient reached the limit of acupuncture sessions allowed by the relevant insurance program or plan, Huang falsely and inaccurately billed for other types of treatments and services that were not provided, or billed under a patient’s family member’s health plan who never received treatment through his practice, in order to continue receiving improper reimbursements.

In addition to the prison term, Judge Illston ordered Huang to serve two years of supervised release to begin after his prison term has concluded and to pay restitution of $807,785.38 and a $10,000 fine.

Huang had been released on a $100,000 bond, which remains in place until he surrenders to begin serving his prison term on or before May 29, 2020.