- Workers' Comp Claim Costs Increased Across 18 Study Stateson April 30, 2025 at 5:27 PM
Total costs per workers’ compensation claim rose between 2 and 14 percent annually from 2021 to 2023 across 18 states, according to a new set of studies from the Workers Compensation Research Institute (WCRI).
“Total cost per claim is a widely used measure for policymakers and system stakeholders to gauge how their system is performing compared to other states. It combines three components - indemnity benefits for lost wages, medical payments, and benefit delivery expenses per claim,” said Sebastian Negrusa, vice president of research at WCRI. “While it’s a key metric, it’s just one of many measures that these studies track to provide a comprehensive view of system performance.”
The increase across the board in total costs per claim reflects changes in access to medical services and labor market conditions since the early pandemic years, particularly the recent rise in short-tenure workers as a share of claims. Although all states showed an upward trend in total costs per claim, the measure masks important nuances:
- - Delaware: Total costs per claim increased 7 percent per year in Delaware from 2021 to 2023, primarily driven by rapid growth in wages and temporary disability duration.
- - Florida: Wage growth in Florida accelerated in 2022 and then moderated in 2023, cooling the increases in indemnity benefits and resulting in growth of 4.5 percent per year in total costs per claim.
- - Minnesota: Total costs per claim in Minnesota grew 10 percent per year from 2021 to 2023, mainly driven by increases in wages, duration of temporary disability, and medical payments per claim.
- - New Jersey: Costs per claim in New Jersey increased about 8 percent annually from 2021 to 2023, largely driven by wage growth, especially for new hires and short-tenure workers.
- - Virginia: The 7.4 percent average growth in Virginia total costs per claim since 2021 was driven by increasing indemnity benefits and benefit delivery expenses per claim, but partially offset by declining medical payments.
The studies, CompScope™ Benchmarks, 2025 Edition, provide ongoing annual monitoring of how indemnity benefits, medical payments, and benefit delivery expenses in 18 states compare and how they have changed over time. The 18 states in the study include California.
The studies cover claims through March 2024, focusing on non-COVID-19 claims, and track how pandemic-related disruptions and labor market shifts affected claims from 2019 to 2023. For more information on these studies or to download copies, visit www.wcrinet.org.
- Janitorial Services Owner Sentenced for Comp Premium Fraudon April 30, 2025 at 5:27 PM
On April 23, 2025, Martha Toro pled no contest to felony insurance fraud and felony tax evasion. The Honorable David Bonilla sentenced Toro to 270 days county jail and 2 years formal probation for each violation. The judge also ordered Toro to pay restitution, fines and interest totaling $1,454,130, of which $848,370 will go to Markel Insurance and $605,760 will go to the Franchise Tax Board.
In February 2020, the California Department of Insurance (CDI) opened an investigation into Toro, who is the owner of MT Janitorial Services. Markel Insurance provided information showing Toro was committing insurance fraud by under-reporting how many employees she had to illegally lower the amount of her workers’ compensation insurance premiums.
The investigation led by CDI and assisted by the Franchise Tax Board (FTB), determined that Toro misrepresented the number of employees working for MT Janitorial Services for each of the audit years between 2013 and 2020. This resulted in the insurance carrier losing over $800,000 in income for coverage of workers’ compensation insurance.
The FTB, with the assistance of CDI, also determined that Toro falsified her tax returns to avoid paying the taxes that she owed for tax years 2016 to 2020.
Tax evasion directly impacts Californians by jeopardizing the revenue crucial to sustaining essential services and programs. By identifying and stopping those who choose to operate in the underground economy, we can help close California’s tax gap.
Insurance fraud of this nature puts employees of the company at risk if they are injured on the job. It also illegally reduces costs for the fraudster, allowing them to undercut honest employers on job bids. This results in unfair competition and hurts not only other companies within the industry, but also consumers who have less choices in reputable companies.
- Amazon Driver Staged Robbery for Fraudulent Work Comp Claimon April 29, 2025 at 4:54 PM
The San Joaquin County District Attorney’s Office recently received a Felony Workers Compensation Fraud Conviction, highlighting the Office’s commitment to fighting Workers Compensation fraud and abuse in San Joaquin County.
Stacy Johnson, a male, pled guilty to two felonies: PC 487 Grand Theft and PC 550(b)(3), Insurance Fraud.
Johnson was sentenced to 4 months in County Jail, 2 years of Felony Probation and will have to pay $3,000 in investigative costs restitution, and $2,000 in restitution to his former employer, Amazon, to cover the stolen goods.
Prosecutors say Johnson conspired with other assailants to stage a robbery of an Amazon delivery truck that Johnson was driving for his employer Amazon.
Johnson then initiated a fraudulent Workers Compensation Claim stemming from the faked robbery, claiming “physiological injuries and stress”.
Had the fraud not been caught, the loss would have been an estimated $35,000, the cost of which, would most likely have been passed on to consumers.
“Workers Compensation Fraud is NOT a victimless crime, it affects all of us”, said San Joaquin County District Attorney Ron Freitas. It leads to increased costs on our local businesses, and increased costs for the goods we purchase on a daily basis."
"Combined with our ongoing Workers Compensation Fraud outreach campaign, we are making a point of making sure criminals know that San Joaquin County is not a safe haven for Workers Compensation Fraud, we will prosecute”.
- Fresno County Farmer Sentenced for Insurance Fraudon April 29, 2025 at 4:54 PM
Jatinderjeet “Jyoti” Sihota, 40, of Selma, was sentenced to to one year in prison for conspiring to commit crop insurance fraud, Acting U.S. Attorney Michele Beckwith announced.
According to court records, for many years, Sihota’s family’s farming operation produced table grapes and other crops in Fresno and Tulare Counties, and it sold many of those crops through a fruit packing company where Ralph Hackett, 69, of Clovis, was a member and manager.
Beginning in 2012, Sihota became involved with her family’s farming operation. Thereafter, from 2012 through 2016, she and Hackett carried out a fraud scheme to obtain more than $650,000 in crop insurance payments to which they were not entitled.
They caused altered records that underreported the amount of crops the farming operation sold through the fruit packing company to be provided to the insurance company to make it appear as though the farming operation had suffered significant crop losses when that was not true.
Emails and other evidence showed that the fraud was Sihota’s idea. She pleaded with Hackett to make the alterations, instructed him on the specific changes that needed to be made, and asked him to keep everything a secret. Sihota emailed other fruit brokers asking them to alter records for her, but they refused to do so.
Hackett was charged separately and has pleaded guilty for his role in the fraud. Hackett is scheduled to be sentenced on May 27, 2025. He faces a maximum statutory penalty of 20 years in federal prison and $250,000 fine. The actual sentence, however, will be determined at the discretion of the court after consideration of any applicable statutory factors and the Federal Sentencing Guidelines, which take into account a number of variables.
This case was the product of an investigation by the U.S. Department of Agriculture Office of Inspector General and Risk Management Agency Special Investigations Staff. Assistant U.S. Attorney Joseph Barton prosecuted the case.
- Injured LAPD Officer Pursues FEHA Claim for Subrosa Investigationon April 28, 2025 at 3:34 PM
James Cairns is a former Los Angeles Police Department (LAPD) officer. In August 2018, Cairns and his partner were in a car accident while on duty. Cairns was injured and took medical leave.
In October 2019, the Special Operations Division notified Cairns that he was under investigation for workers’ compensation fraud. While the investigation did not uncover workers’ compensation fraud, it found that Cairns had engaged in six other types of misconduct.
The misconduct concerned Cairns’s romantic relationship with a convicted felon, which he carried out while on and off duty; Cairns’s use of the LAPD’s computer system to inquire about this individual; and an incident of unauthorized travel. Based on the results of the workers’ compensation fraud investigation, the LAPD ordered a supplemental investigation.
The investigations concluded Cairns had engaged in inappropriate behavior with a convicted felon while on duty, showing poor judgment. In July 2020, after several levels of administrative review, the LAPD determined it would pursue a Board of Rights hearing with a recommendation of termination. In August 2020, the LAPD filed Board of Rights charges.
In July 2021, Cairns filed a civil action against the City, the LAPD, the County of Los Angeles, and several individuals.
After a six-day hearing held in October 2021, November 2021, and January 2022, the Board of Rights recommended Cairns’s termination. Cairns resigned in lieu of termination.
In September 2022, Cairns filed his second amended complaint (SAC) against the City. The SAC asserts eight causes of action. The general gist of the 68-page SAC is that LAPD supervisors harassed, discriminated, and retaliated against Cairns based on race or for other reasons and, after the 2018 accident, when he failed to return to work because of his injuries and resulting disability. The SAC repeatedly alleges that the investigations themselves constituted retaliation and harassment. There are also allegations relating to LAPD’s surveillance of Cairns as part of the investigations.
Cairns "appears" to allege the workers’ compensation investigation, and statements made during the investigation, were acts of disability or race-based discrimination or harassment. For example, in the context of describing the messages asking when he would return to work, the SAC alleges that Cairns’s supervisors also “threatened [him] with prosecution or discipline” for workers’ compensation fraud. The harassment cause of action later alleges that while on leave, Cairns received persistent “threats from his superiors, or those that they directed,” and when he complained, was subjected to a “biased investigation that presented false statements . . . .”
The City filed a special motion to strike Cairns’s complaint pursuant to California’s anti-SLAPP statute (Code Civ. Proc., § 425.16), which the trial court partially granted.
The Court of Appeal reversed in the unpublished case of Cairns v. City of Los Angeles CA2/3 - B331127 (April 2025). It concluded that the court’s order did not strike claims consistent with California Supreme Court guidance regarding mixed causes of action.
Conduct protected by the anti-SLAPP statute includes, as relevant here, “any written or oral statement or writing made before a legislative, executive, or judicial proceeding, or any other official proceeding authorized by law” and “any written or oral statement or writing made in connection with an issue under consideration or review by a legislative, executive, or judicial body, or any other official proceeding authorized by law.” (§ 425.16, subd. (e)(1) & (2).)
Relying on Park v. Nazari (2023) 93 Cal.App.5th 1099 (Nazari), Cairns contends the trial court erred because the City moved only to strike the entire SAC, yet the court granted the motion in part rather than denying it in its entirety.
A claim arises from protected activity “when that activity underlies or forms the basis for the claim.” (Park, supra, 2 Cal.5th at p. 1062.) In some cases, a cause of action is “ ‘ “mixed,” ’ ” such that it “rests on allegations of multiple acts, some of which constitute protected activity and some of which do not.”
In Baral v. Schnitt (2016) 1 Cal.5th 376, 393 (Baral), the California Supreme Court held that “an anti-SLAPP motion, like a conventional motion to strike, may be used to attack parts of a count as pleaded.” Within a single cause of action, “allegations of protected activity that are asserted as grounds for relief” may be stricken unless the plaintiff shows a probability of prevailing. (Id. at p. 395, italics omitted; see id. at p. 393.)
The "trial court correctly determined that the SAC’s allegations relating to the internal investigations and Board of Rights proceeding could potentially constitute protected conduct." However "specificity in striking only a portion of a mixed cause of action is required."
"The SAC in this matter is a sprawling document that resists easy categorization. While some of the SAC’s allegations relating to the investigations and Board of Rights proceeding concern oral or written statements, some do not. .... For example, the SAC alleges the workers’ compensation investigation “was a retaliatory attempt” to terminate him. ... These allegations do not appear to concern written or oral statements or writings."
"Under these circumstances, the trial court’s ultimate order purporting to strike “only the allegations as to [Cairns] suffering the adverse employment action of a sham or unfair investigation and [Board of Rights] hearing” did not sufficiently distinguish between protected and unprotected activity. The order was not limited to claims based on written or oral communications. Further, it did not identify which allegations remained because they challenged the investigations themselves, or the decision that flowed from the Board of Rights hearing, and those which were stricken because they were based on protected written or oral statements."
"It may be that, if carefully parsed, the SAC’s claims arising from the internal investigations and Board of Rights hearing could have been separated into claims based on protected speech and properly subject to anti-SLAPP protection, and those reflecting only unprotected activity."
- Attorneys and Others Charged in $14.5M Unlawful WC Referral Fraudon April 28, 2025 at 3:34 PM
Four individuals, including attorneys, have been charged after a California Department of Insurance investigation revealed a large-scale workers’ compensation fraud scheme that allegedly targeted Spanish-speaking workers and involved the illegal sale of more than 1,100 clients generating over $550,000 in unlawful referral fees.
The Department launched its investigation in October 2022 after receiving reports that Spanish-speaking workers were being contacted by a call center operating in Mexico. The callers allegedly promised individuals they could receive money by filing a workers’ compensation claim. In many cases, workers were misled and unknowingly completed official claims paperwork, which was then unlawfully sold to attorneys in Southern California.
“This is a disturbing case of alleged fraud that preyed on vulnerable, hardworking people,” said Insurance Commissioner Ricardo Lara. “These crimes threaten the integrity of our workers’ compensation system and will not be tolerated.”
The four defendants include:
- - Antony Gluck, 55, of San Bernardino, who was arrested by Department detectives. He is charged with felony conspiracy and unlawful referrals and was booked at West Valley Detention Center on $500,000 bail.
- - Michael De La Garza, 41, of Fontana, was arrested by Department detectives and is charged with felony conspiracy and unlawful referrals. He was booked at West Valley Detention Center on $500,000 bail.
- - Arely Franco, 42, of San Diego, who was arrested last week, while attempting to enter the United States at a port of entry. Franco is charged with felony conspiracy and multiple counts of unlawful referrals of workers’ compensation claims. She was arraigned this week and released on her own recognizance.
- - Juan Leal, 57, of Riverside, has prior convictions for similar offenses. He surrendered to the court this week and was arraigned on charges of felony conspiracy and unlawful referrals.
From January 2022 to September 2023, Franco allegedly sold approximately 320 clients to attorney De La Garza and his business partner Leal for $168,750. From September 2021 to October 2024, Franco sold an additional 798 clients to attorney Gluck for $388,500.
According to a 2024 report from the Workers’ Compensation Insurance Rating Bureau, the average workers’ compensation claim costs approximately $13,000. Based on this figure, the estimated loss in this case exceeds $14.5 million.
The San Bernardino County District Attorney’s Office is prosecuting the case.
- State Farm, Farmers and 25 Top California Carriers Sued for "Collusion"on April 24, 2025 at 1:22 PM
Two lawsuits were filed in Los Angeles County this April against major California insurance carriers on behalf of property owners impacted by the wildfires that devastated the Pacific Palisades, Malibu, and Altadena areas in January.
The lawsuits allege violations of California’s antitrust and unfair competition laws through a conspiracy which eliminated existing and standard property policies and forced homeowners to accept, as their only available coverage, the state’s insurance plan of last resort, the California FAIR Plan.
The California FAIR (Fair Access to Insurance Requirements) Plan was created to offer insurance to property owners who cannot get coverage due to wildfire or other risks. It provides limited coverage compared to traditional insurance, and payouts are capped at $3 million. On average, premiums are more than double the cost of a typical home insurance policy in the state.
The lawsuits allege that California insurance companies, including State Farm, Farmers, and the top 25 insurance companies (who together enjoy approximately 75% of the market share) began limiting their coverage in the Pacific Palisades, Malibu, and Altadena areas. By colluding together to cancel existing policies and refusing to write new ones, the insurers were able to force property owners onto the FAIR Plan with its drastically lower coverage limits. This left homeowners woefully underinsured, resulting in many suffering massive uncovered losses from January’s wildfire disaster.
Every insurance carrier licensed to operate in the state of California must fund the FAIR Plan proportionally according to their market share. At the time of the January wildfires, the plan had significantly inadequate reserves to cover a catastrophic wildfire – funding levels that were determined by the insurance companies as the only voting members of the FAIR Plan’s Governing Committee. The California Department of Insurance agreed in 2024 to allow insurers to pass 50% or more of any additional funds required for coverage to customers in unaffected areas in the form of higher premiums, further incentivizing the insurers’ push to force homeowners onto the FAIR Plan.
According to one of the two cases, plaintiff attorneys claim each of the homeowners in Todd Ferrier et al. v. State Farm Group et al., found themselves underinsured with pricier policies providing far less coverage for properties they had previously been able to adequately insure. After the fires, the gap between their actual property losses and the limits of their FAIR Plan policies amounts to millions of dollars that would have been covered under their previous, dropped policies.
The second lawsuit, Anthony Canzoneri v. State Farm Group et al., asserts claims on behalf of a class of insurance consumers who were forced to pay exorbitant rates for inferior coverage after the insurers’ misconduct forced them to obtain limited coverage from the FAIR Plan.
“Insurance is a product that homeowners hope never to need, but rely on for peace of mind in normal times and for critical help rebuilding after a catastrophe,” said Michael J. Bidart of Shernoff Bidart Echeverria LLP. “The complaints allege that, by colluding to push plaintiffs and so many like them to the FAIR Plan, the defendants have reaped the benefits of high premiums while depriving homeowners of coverage that they were ready, willing, and able to purchase to ensure that they could recover after a disaster like January’s wildfires.”
The homeowners represented by Larson LLP and Shernoff Bidart Echeverria LLP are seeking compensatory and treble damages, as well as an injunction preventing insurance companies from engaging in further anticompetitive behavior.
- AI Discussed at Orthopedic Surgeon San Diego Town Hallon April 24, 2025 at 1:22 PM
The claim that AI creates "unprecedented opportunities" in health care, was discussed at the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting town hall in March 2025 held at the San Diego Convention Center in San Diego, reflects a growing consensus among medical professionals about AI's transformative potential.
Key A-1 Medical Topics:
- - Diagnostics: AI is revolutionizing diagnostics by enabling faster and more accurate analysis of medical imaging, such as X-rays, MRIs, and CT scans, which are critical in orthopaedics for assessing fractures, joint conditions, and spinal deformities. Machine learning models can detect subtle patterns in imaging that may elude human eyes, improving early diagnosis and treatment planning. For example, a 2023 study in The Lancet Digital Health demonstrated that AI algorithms achieved a 94% accuracy rate in detecting hip fractures from X-rays, surpassing the average performance of radiologists (89%). This precision reduces misdiagnoses and optimizes patient outcomes.
Additionally, AI-powered predictive analytics can forecast patient outcomes, such as the likelihood of postoperative complications or the success of joint replacements. A 2024 report by the Journal of Orthopaedic Research highlighted AI models that predict periprosthetic joint infections with 87% accuracy, allowing surgeons to tailor preoperative strategies.
- - Personalized Treatment Plans: AI enables personalized medicine by analyzing vast datasets, including patient genetics, medical history, and lifestyle factors, to recommend tailored treatment plans. In orthopaedics, this is particularly valuable for optimizing surgical approaches, such as selecting the best implant for a knee replacement based on patient-specific biomechanics. A 2025 article in Nature Medicine described AI-driven platforms that integrate 3D modeling and patient data to simulate surgical outcomes, improving implant fit and reducing revision rates by 15%. At the AAOS 2025 Annual Meeting, sessions like the Innovation Theater likely showcased such advancements, emphasizing AI's role in customizing care.
- - Surgical Assistance and Robotics.AI is enhancing surgical precision through integration with robotic systems, which are increasingly common in orthopaedic procedures like total knee and hip arthroplasties. AI-guided robots, such as those displayed in the AAOS Exhibit Hall, use real-time data to assist surgeons in achieving optimal alignment and minimizing tissue damage. A 2024 study in The Journal of Bone and Joint Surgery found that AI-assisted robotic surgeries reduced operative time by 12% and improved implant placement accuracy by 18% compared to traditional methods. The AAOS 2025 OrthoDome, an immersive theater showcasing surgical techniques in 4K resolution, likely highlighted such AI-driven innovations, aligning with the town hall's optimism about AI's impact.
- - Postoperative Care and Rehabilitation: AI is transforming postoperative care by powering remote monitoring tools and wearable devices that track patient recovery in real time. These tools can detect early signs of complications, such as infection or implant failure, and alert clinicians. A 2025 Health Affairs study reported that AI-enabled wearables reduced hospital readmissions for orthopaedic patients by 22% through continuous monitoring of mobility and vital signs. Furthermore, AI-driven rehabilitation platforms, like those discussed at the AAOS 2025 meeting, use gamified interfaces and machine learning to personalize physical therapy regimens, improving patient adherence and functional outcomes.
- - Administrative Efficiency and Cost Reduction: Beyond clinical applications, AI streamlines administrative tasks, such as scheduling, billing, and electronic health record management, freeing up time for clinicians to focus on patient care. A 2024 McKinsey & Company report estimated that AI could save the U.S. health care system $350 billion annually by automating routine processes and optimizing resource allocation. In orthopaedics, this translates to more efficient practice management, as highlighted in AAOS sessions on health policy and practice optimization.
While AI offers immense potential, it’s not a panacea. Challenges include data privacy concerns, algorithmic bias, and the need for robust validation to ensure AI tools are safe and equitable. For instance, a 2023 NEJM article cautioned that AI models trained on non-diverse datasets may underperform for underrepresented populations, potentially exacerbating health disparities.
- Employee Waiver of Meal Breaks for 6 Hour Shifts are Validon April 23, 2025 at 3:02 PM
In 2014, La Kimba Bradsbery and Cheri Brakensiek filed a putative class action against their former employer, Vicar Operating, Inc.,alleging claims on behalf of “[a]ll individuals who worked for [Vicar] in California as a veterinary assistant, veterinary technician, surgery technician, kennel technician, client service representative, or similar position” in the four years before the complaint was filed.
Plaintiffs alleged Vicar failed to provide them with the meal periods required by section 512 and IWC Wage Order Nos. 4-2001 (Wage Order No. 4) and 5-2001 (Wage Order No. 5).
In April 2009, Plaintiffs each signed a written meal period waiver with Vicar. The waiver stated: "I hereby voluntarily waive my right to a meal break when my shift is 6 hours or less. I understand that I am entitled to take an unpaid 30-minute meal break within my first five hours of work; however, I am voluntarily waiving that meal break. I understand that I can revoke this waiver at any time by giving written revocation to my manager."
Vicar moved for summary adjudication regarding the validity of this waiver under section 512 and the wage orders. Vicar argued the prospective meal period waiver was valid because “neither the Labor Code nor the wage orders specify what form the waiver must take, or when or how it may be obtained.”
Plaintiffs opposed, arguing prospective waivers were prohibited under Wage Order Nos. 4 and 5 (together, the “wage orders”), an opinion letter from the Division of Labor Standards Enforcement (DLSE) interpreting an agricultural wage order, and Brinker Restaurant Corp. v. Superior Court (2012) 53 Cal.4th 1004. Plaintiffs further argued employees could waive a meal period for a given shift only after they were scheduled to work that shift.
The trial court agreed with defendants and determined the waivers were valid and ruled for Vicar.The Court of Appeal affirmed in the published case of Bradsbery v. Vicar Operating, Inc. - B322799 (April 2025).
At issue in this case is the meaning of the phrase “waived by mutual consent” of the employer and employee in section 512 and the two wage orders, and whether that meaning prohibits the prospective written waivers Vicar had its employees sign.
The Court of Appeal noted that the text of section 512 and the text of the wage orders are all silent regarding the timing (prospective or as-accrued) and form (written or oral) of a meal period waiver for shifts between five and six hours. The text also does not define “waived” or “waiver.” The meal period waiver provisions at issue here in section 512 and section 11(A) of the wage orders do not require a written waiver (let alone in mandatory language).
"The administrative history of the wage orders reflects the IWC has not viewed prospective written waivers as negatively as Plaintiffs suggest. The waiver of off-duty meal periods in a prospective written agreement instituted in 1976 was at the request of employees on wage boards and was seen by the IWC as protecting employees and employers. Similarly, in promulgating the waiver provisions for health care employees working eight-hour shifts in 1993, the IWC characterized the use of waivers as a 'protective condition[]” for employers and employees.' "
"In short, we believe it is reasonable to infer the Legislature and IWC wanted to be more protective of employees who worked longer shifts and for that reason spelled out in detail what is required to waive a right to a meal break for shifts over eight hours for health care employees and over 12 hours for all other covered employees. But it does not follow that when employees work fewer hours, here between five and six hours, that there was also an intent to prohibit a prospective written waiver."
Plaintiffs relied heavily on their reading of Brinker. In their view, Brinker, supra, 53 Cal.4th 1004, interpreted the same meal period waiver provisions at issue in this case and supports their reading of the statute and wage orders. In Brinker, the California Supreme Court considered, as relevant here, “(1) the nature of an employer’s duty to provide employees with meal periods; and (2) the timing requirements applicable to the provision of meal periods.”
However "Brinker did not address the requirements for the waiver of rest breaks. (See Brinker, at p. 1033.) For these reasons, we do not find Plaintiffs’ reading of this passage from Brinker persuasive."
- PAGA One Year Statute of Limitations Applies to Penaltieson April 23, 2025 at 3:02 PM
Corbin Williams worked as an insurance adjuster for Alacrity Solutions Group, LLC starting in 2014. While employed, Williams “typically” worked 84-hour weeks - that is, 12 hours a day, seven days a week. He was an hourly employee. As a result, he was entitled to overtime pay whenever he worked more than eight hours in a day or 40 hours in a workweek, and was also entitled to overtime pay whenever he worked a seventh consecutive day.
But defendant did not pay Williams any overtime pay. As a result, defendant violated the Labor Code by not paying Williams all the wages he was owed and by issuing Williams inaccurate wage statements. (§§ 201- 203, 510 et seq., 226, 1174, 1174.5.
Williams’s employment with defendant ended in January 2022.It was not until March 7, 2023 - more than a year after his employment ended - that Williams provided written notice to California’s Labor & Workforce Development Agency (the Agency) of his intent to pursue a PAGA action for defendant’s Labor Code violations.
A few days later, on March 10, 2023, Williams sued defendant. In the operative first amended complaint, Williams asserted a single claim under PAGA seeking civil penalties “on behalf of the State of California and other current and former employees” - but, critically, not on his own behalf - for the alleged overtime and wage statement violations occurring in the “one year prior” to the written notice Williams filed with the Agency on March 7, 2023.
Defendant demurred to the complaint, arguing Williams failed to state a cause of action because (1) his PAGA action was barred by the one-year statute of limitations, and (2) he lacked standing to assert a PAGA action.
In his opposition, Williams effectively conceded that any individual claim he might assert under PAGA was “barred by the statute of limitations,” but maintained that this untimeliness was irrelevant because the PAGA action he alleged sought only to recover civil penalties on behalf of other aggrieved employees and the State.
The trial court issued an order sustaining the demurrer without leave to amend. The Court of Appeal affirmed in the Published case of Williams v. Alacrity Solutions Grp. - B335445 (April 2025).
The Private Attorneys General Act (PAGA) (Lab. Code, § 2698 et seq.) authorizes an “aggrieved employee” to step into the shoes of the State of California and sue for civil penalties premised on certain violations of the Labor Code “on behalf of himself or herself and other current or former employees.”
In this case, a former employee was barred by the statute of limitations from suing his former employer for civil penalties on his own behalf under PAGA. (Code Civ. Proc., § 340, subd. (a) [one-year limitations period].) So the former employee sued solely to recover penalties “on behalf of . . . other current and former employees.”
Is this allowed? The Court of Appeal held it is not. To be a PAGA plaintiff (under the statutes in effect prior to July 1, 2024), a private individual must, among other things, seek to recover civil penalties on his own behalf for that violation (Leeper v. Shipt, Inc. (2024) 107 Cal.App.5th 1001, 1008-1010 (Leeper), review granted Feb. 18, 2025), and must establish that this so-called “individual claim” is timely as to at least one Labor Code violation (Arce v. The Ensign Group, Inc. (2023) 96 Cal.App.5th 622, 630 (Arce); LaCour v. Marshalls of California, LLC (2023) 94 Cal.App.5th 1172, 1184- 1185 (LaCour); Hutcheson v. Superior Court (2022) 74 Cal.App.5th 932, 939 (Hutcheson); Esparza v. Safeway, Inc. (2019) 36 Cal.App.5th 42, 59 (Esparza); Brown v. Ralphs Grocery Co. (2018) 28 Cal.App.5th 824, 839 (Brown)).
"Because the employee in this case has not and cannot satisfy these requirements, the trial court properly sustained a demurrer to the PAGA action without leave to amend."
- Workers' Comp Claim Costs Increased Across 18 Study Stateson April 30, 2025 at 5:27 PM
Total costs per workers’ compensation claim rose between 2 and 14 percent annually from 2021 to 2023 across 18 states, according to a new set of studies from the Workers Compensation Research Institute (WCRI).
“Total cost per claim is a widely used measure for policymakers and system stakeholders to gauge how their system is performing compared to other states. It combines three components - indemnity benefits for lost wages, medical payments, and benefit delivery expenses per claim,” said Sebastian Negrusa, vice president of research at WCRI. “While it’s a key metric, it’s just one of many measures that these studies track to provide a comprehensive view of system performance.”
The increase across the board in total costs per claim reflects changes in access to medical services and labor market conditions since the early pandemic years, particularly the recent rise in short-tenure workers as a share of claims. Although all states showed an upward trend in total costs per claim, the measure masks important nuances:
- - Delaware: Total costs per claim increased 7 percent per year in Delaware from 2021 to 2023, primarily driven by rapid growth in wages and temporary disability duration.
- - Florida: Wage growth in Florida accelerated in 2022 and then moderated in 2023, cooling the increases in indemnity benefits and resulting in growth of 4.5 percent per year in total costs per claim.
- - Minnesota: Total costs per claim in Minnesota grew 10 percent per year from 2021 to 2023, mainly driven by increases in wages, duration of temporary disability, and medical payments per claim.
- - New Jersey: Costs per claim in New Jersey increased about 8 percent annually from 2021 to 2023, largely driven by wage growth, especially for new hires and short-tenure workers.
- - Virginia: The 7.4 percent average growth in Virginia total costs per claim since 2021 was driven by increasing indemnity benefits and benefit delivery expenses per claim, but partially offset by declining medical payments.
The studies, CompScope™ Benchmarks, 2025 Edition, provide ongoing annual monitoring of how indemnity benefits, medical payments, and benefit delivery expenses in 18 states compare and how they have changed over time. The 18 states in the study include California.
The studies cover claims through March 2024, focusing on non-COVID-19 claims, and track how pandemic-related disruptions and labor market shifts affected claims from 2019 to 2023. For more information on these studies or to download copies, visit www.wcrinet.org. - Janitorial Services Owner Sentenced for Comp Premium Fraudon April 30, 2025 at 5:27 PM
On April 23, 2025, Martha Toro pled no contest to felony insurance fraud and felony tax evasion. The Honorable David Bonilla sentenced Toro to 270 days county jail and 2 years formal probation for each violation. The judge also ordered Toro to pay restitution, fines and interest totaling $1,454,130, of which $848,370 will go to Markel Insurance and $605,760 will go to the Franchise Tax Board.
In February 2020, the California Department of Insurance (CDI) opened an investigation into Toro, who is the owner of MT Janitorial Services. Markel Insurance provided information showing Toro was committing insurance fraud by under-reporting how many employees she had to illegally lower the amount of her workers’ compensation insurance premiums.
The investigation led by CDI and assisted by the Franchise Tax Board (FTB), determined that Toro misrepresented the number of employees working for MT Janitorial Services for each of the audit years between 2013 and 2020. This resulted in the insurance carrier losing over $800,000 in income for coverage of workers’ compensation insurance.
The FTB, with the assistance of CDI, also determined that Toro falsified her tax returns to avoid paying the taxes that she owed for tax years 2016 to 2020.
Tax evasion directly impacts Californians by jeopardizing the revenue crucial to sustaining essential services and programs. By identifying and stopping those who choose to operate in the underground economy, we can help close California’s tax gap.
Insurance fraud of this nature puts employees of the company at risk if they are injured on the job. It also illegally reduces costs for the fraudster, allowing them to undercut honest employers on job bids. This results in unfair competition and hurts not only other companies within the industry, but also consumers who have less choices in reputable companies. - Amazon Driver Staged Robbery for Fraudulent Work Comp Claimon April 29, 2025 at 4:54 PM
The San Joaquin County District Attorney’s Office recently received a Felony Workers Compensation Fraud Conviction, highlighting the Office’s commitment to fighting Workers Compensation fraud and abuse in San Joaquin County.
Stacy Johnson, a male, pled guilty to two felonies: PC 487 Grand Theft and PC 550(b)(3), Insurance Fraud.
Johnson was sentenced to 4 months in County Jail, 2 years of Felony Probation and will have to pay $3,000 in investigative costs restitution, and $2,000 in restitution to his former employer, Amazon, to cover the stolen goods.
Prosecutors say Johnson conspired with other assailants to stage a robbery of an Amazon delivery truck that Johnson was driving for his employer Amazon.
Johnson then initiated a fraudulent Workers Compensation Claim stemming from the faked robbery, claiming “physiological injuries and stress”.
Had the fraud not been caught, the loss would have been an estimated $35,000, the cost of which, would most likely have been passed on to consumers.
“Workers Compensation Fraud is NOT a victimless crime, it affects all of us”, said San Joaquin County District Attorney Ron Freitas. It leads to increased costs on our local businesses, and increased costs for the goods we purchase on a daily basis."
"Combined with our ongoing Workers Compensation Fraud outreach campaign, we are making a point of making sure criminals know that San Joaquin County is not a safe haven for Workers Compensation Fraud, we will prosecute”. - Fresno County Farmer Sentenced for Insurance Fraudon April 29, 2025 at 4:54 PM
Jatinderjeet “Jyoti” Sihota, 40, of Selma, was sentenced to to one year in prison for conspiring to commit crop insurance fraud, Acting U.S. Attorney Michele Beckwith announced.
According to court records, for many years, Sihota’s family’s farming operation produced table grapes and other crops in Fresno and Tulare Counties, and it sold many of those crops through a fruit packing company where Ralph Hackett, 69, of Clovis, was a member and manager.
Beginning in 2012, Sihota became involved with her family’s farming operation. Thereafter, from 2012 through 2016, she and Hackett carried out a fraud scheme to obtain more than $650,000 in crop insurance payments to which they were not entitled.
They caused altered records that underreported the amount of crops the farming operation sold through the fruit packing company to be provided to the insurance company to make it appear as though the farming operation had suffered significant crop losses when that was not true.
Emails and other evidence showed that the fraud was Sihota’s idea. She pleaded with Hackett to make the alterations, instructed him on the specific changes that needed to be made, and asked him to keep everything a secret. Sihota emailed other fruit brokers asking them to alter records for her, but they refused to do so.
Hackett was charged separately and has pleaded guilty for his role in the fraud. Hackett is scheduled to be sentenced on May 27, 2025. He faces a maximum statutory penalty of 20 years in federal prison and $250,000 fine. The actual sentence, however, will be determined at the discretion of the court after consideration of any applicable statutory factors and the Federal Sentencing Guidelines, which take into account a number of variables.
This case was the product of an investigation by the U.S. Department of Agriculture Office of Inspector General and Risk Management Agency Special Investigations Staff. Assistant U.S. Attorney Joseph Barton prosecuted the case. - Injured LAPD Officer Pursues FEHA Claim for Subrosa Investigationon April 28, 2025 at 3:34 PM
James Cairns is a former Los Angeles Police Department (LAPD) officer. In August 2018, Cairns and his partner were in a car accident while on duty. Cairns was injured and took medical leave.
In October 2019, the Special Operations Division notified Cairns that he was under investigation for workers’ compensation fraud. While the investigation did not uncover workers’ compensation fraud, it found that Cairns had engaged in six other types of misconduct.
The misconduct concerned Cairns’s romantic relationship with a convicted felon, which he carried out while on and off duty; Cairns’s use of the LAPD’s computer system to inquire about this individual; and an incident of unauthorized travel. Based on the results of the workers’ compensation fraud investigation, the LAPD ordered a supplemental investigation.
The investigations concluded Cairns had engaged in inappropriate behavior with a convicted felon while on duty, showing poor judgment. In July 2020, after several levels of administrative review, the LAPD determined it would pursue a Board of Rights hearing with a recommendation of termination. In August 2020, the LAPD filed Board of Rights charges.
In July 2021, Cairns filed a civil action against the City, the LAPD, the County of Los Angeles, and several individuals.
After a six-day hearing held in October 2021, November 2021, and January 2022, the Board of Rights recommended Cairns’s termination. Cairns resigned in lieu of termination.
In September 2022, Cairns filed his second amended complaint (SAC) against the City. The SAC asserts eight causes of action. The general gist of the 68-page SAC is that LAPD supervisors harassed, discriminated, and retaliated against Cairns based on race or for other reasons and, after the 2018 accident, when he failed to return to work because of his injuries and resulting disability. The SAC repeatedly alleges that the investigations themselves constituted retaliation and harassment. There are also allegations relating to LAPD’s surveillance of Cairns as part of the investigations.
Cairns "appears" to allege the workers’ compensation investigation, and statements made during the investigation, were acts of disability or race-based discrimination or harassment. For example, in the context of describing the messages asking when he would return to work, the SAC alleges that Cairns’s supervisors also “threatened [him] with prosecution or discipline” for workers’ compensation fraud. The harassment cause of action later alleges that while on leave, Cairns received persistent “threats from his superiors, or those that they directed,” and when he complained, was subjected to a “biased investigation that presented false statements . . . .”
The City filed a special motion to strike Cairns’s complaint pursuant to California’s anti-SLAPP statute (Code Civ. Proc., § 425.16), which the trial court partially granted.
The Court of Appeal reversed in the unpublished case of Cairns v. City of Los Angeles CA2/3 - B331127 (April 2025). It concluded that the court’s order did not strike claims consistent with California Supreme Court guidance regarding mixed causes of action.
Conduct protected by the anti-SLAPP statute includes, as relevant here, “any written or oral statement or writing made before a legislative, executive, or judicial proceeding, or any other official proceeding authorized by law” and “any written or oral statement or writing made in connection with an issue under consideration or review by a legislative, executive, or judicial body, or any other official proceeding authorized by law.” (§ 425.16, subd. (e)(1) & (2).)
Relying on Park v. Nazari (2023) 93 Cal.App.5th 1099 (Nazari), Cairns contends the trial court erred because the City moved only to strike the entire SAC, yet the court granted the motion in part rather than denying it in its entirety.
A claim arises from protected activity “when that activity underlies or forms the basis for the claim.” (Park, supra, 2 Cal.5th at p. 1062.) In some cases, a cause of action is “ ‘ “mixed,” ’ ” such that it “rests on allegations of multiple acts, some of which constitute protected activity and some of which do not.”
In Baral v. Schnitt (2016) 1 Cal.5th 376, 393 (Baral), the California Supreme Court held that “an anti-SLAPP motion, like a conventional motion to strike, may be used to attack parts of a count as pleaded.” Within a single cause of action, “allegations of protected activity that are asserted as grounds for relief” may be stricken unless the plaintiff shows a probability of prevailing. (Id. at p. 395, italics omitted; see id. at p. 393.)
The "trial court correctly determined that the SAC’s allegations relating to the internal investigations and Board of Rights proceeding could potentially constitute protected conduct." However "specificity in striking only a portion of a mixed cause of action is required."
"The SAC in this matter is a sprawling document that resists easy categorization. While some of the SAC’s allegations relating to the investigations and Board of Rights proceeding concern oral or written statements, some do not. .... For example, the SAC alleges the workers’ compensation investigation “was a retaliatory attempt” to terminate him. ... These allegations do not appear to concern written or oral statements or writings."
"Under these circumstances, the trial court’s ultimate order purporting to strike “only the allegations as to [Cairns] suffering the adverse employment action of a sham or unfair investigation and [Board of Rights] hearing” did not sufficiently distinguish between protected and unprotected activity. The order was not limited to claims based on written or oral communications. Further, it did not identify which allegations remained because they challenged the investigations themselves, or the decision that flowed from the Board of Rights hearing, and those which were stricken because they were based on protected written or oral statements."
"It may be that, if carefully parsed, the SAC’s claims arising from the internal investigations and Board of Rights hearing could have been separated into claims based on protected speech and properly subject to anti-SLAPP protection, and those reflecting only unprotected activity." - Attorneys and Others Charged in $14.5M Unlawful WC Referral Fraudon April 28, 2025 at 3:34 PM
Four individuals, including attorneys, have been charged after a California Department of Insurance investigation revealed a large-scale workers’ compensation fraud scheme that allegedly targeted Spanish-speaking workers and involved the illegal sale of more than 1,100 clients generating over $550,000 in unlawful referral fees.
The Department launched its investigation in October 2022 after receiving reports that Spanish-speaking workers were being contacted by a call center operating in Mexico. The callers allegedly promised individuals they could receive money by filing a workers’ compensation claim. In many cases, workers were misled and unknowingly completed official claims paperwork, which was then unlawfully sold to attorneys in Southern California.
“This is a disturbing case of alleged fraud that preyed on vulnerable, hardworking people,” said Insurance Commissioner Ricardo Lara. “These crimes threaten the integrity of our workers’ compensation system and will not be tolerated.”
The four defendants include:
- - Antony Gluck, 55, of San Bernardino, who was arrested by Department detectives. He is charged with felony conspiracy and unlawful referrals and was booked at West Valley Detention Center on $500,000 bail.
- - Michael De La Garza, 41, of Fontana, was arrested by Department detectives and is charged with felony conspiracy and unlawful referrals. He was booked at West Valley Detention Center on $500,000 bail.
- - Arely Franco, 42, of San Diego, who was arrested last week, while attempting to enter the United States at a port of entry. Franco is charged with felony conspiracy and multiple counts of unlawful referrals of workers’ compensation claims. She was arraigned this week and released on her own recognizance.
- - Juan Leal, 57, of Riverside, has prior convictions for similar offenses. He surrendered to the court this week and was arraigned on charges of felony conspiracy and unlawful referrals.
From January 2022 to September 2023, Franco allegedly sold approximately 320 clients to attorney De La Garza and his business partner Leal for $168,750. From September 2021 to October 2024, Franco sold an additional 798 clients to attorney Gluck for $388,500.
According to a 2024 report from the Workers’ Compensation Insurance Rating Bureau, the average workers’ compensation claim costs approximately $13,000. Based on this figure, the estimated loss in this case exceeds $14.5 million.
The San Bernardino County District Attorney’s Office is prosecuting the case. - State Farm, Farmers and 25 Top California Carriers Sued for "Collusion"on April 24, 2025 at 1:22 PM
Two lawsuits were filed in Los Angeles County this April against major California insurance carriers on behalf of property owners impacted by the wildfires that devastated the Pacific Palisades, Malibu, and Altadena areas in January.
The lawsuits allege violations of California’s antitrust and unfair competition laws through a conspiracy which eliminated existing and standard property policies and forced homeowners to accept, as their only available coverage, the state’s insurance plan of last resort, the California FAIR Plan.
The California FAIR (Fair Access to Insurance Requirements) Plan was created to offer insurance to property owners who cannot get coverage due to wildfire or other risks. It provides limited coverage compared to traditional insurance, and payouts are capped at $3 million. On average, premiums are more than double the cost of a typical home insurance policy in the state.
The lawsuits allege that California insurance companies, including State Farm, Farmers, and the top 25 insurance companies (who together enjoy approximately 75% of the market share) began limiting their coverage in the Pacific Palisades, Malibu, and Altadena areas. By colluding together to cancel existing policies and refusing to write new ones, the insurers were able to force property owners onto the FAIR Plan with its drastically lower coverage limits. This left homeowners woefully underinsured, resulting in many suffering massive uncovered losses from January’s wildfire disaster.
Every insurance carrier licensed to operate in the state of California must fund the FAIR Plan proportionally according to their market share. At the time of the January wildfires, the plan had significantly inadequate reserves to cover a catastrophic wildfire – funding levels that were determined by the insurance companies as the only voting members of the FAIR Plan’s Governing Committee. The California Department of Insurance agreed in 2024 to allow insurers to pass 50% or more of any additional funds required for coverage to customers in unaffected areas in the form of higher premiums, further incentivizing the insurers’ push to force homeowners onto the FAIR Plan.
According to one of the two cases, plaintiff attorneys claim each of the homeowners in Todd Ferrier et al. v. State Farm Group et al., found themselves underinsured with pricier policies providing far less coverage for properties they had previously been able to adequately insure. After the fires, the gap between their actual property losses and the limits of their FAIR Plan policies amounts to millions of dollars that would have been covered under their previous, dropped policies.
The second lawsuit, Anthony Canzoneri v. State Farm Group et al., asserts claims on behalf of a class of insurance consumers who were forced to pay exorbitant rates for inferior coverage after the insurers’ misconduct forced them to obtain limited coverage from the FAIR Plan.
“Insurance is a product that homeowners hope never to need, but rely on for peace of mind in normal times and for critical help rebuilding after a catastrophe,” said Michael J. Bidart of Shernoff Bidart Echeverria LLP. “The complaints allege that, by colluding to push plaintiffs and so many like them to the FAIR Plan, the defendants have reaped the benefits of high premiums while depriving homeowners of coverage that they were ready, willing, and able to purchase to ensure that they could recover after a disaster like January’s wildfires.”
The homeowners represented by Larson LLP and Shernoff Bidart Echeverria LLP are seeking compensatory and treble damages, as well as an injunction preventing insurance companies from engaging in further anticompetitive behavior. - AI Discussed at Orthopedic Surgeon San Diego Town Hallon April 24, 2025 at 1:22 PM
The claim that AI creates "unprecedented opportunities" in health care, was discussed at the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting town hall in March 2025 held at the San Diego Convention Center in San Diego, reflects a growing consensus among medical professionals about AI's transformative potential.
Key A-1 Medical Topics:
- - Diagnostics: AI is revolutionizing diagnostics by enabling faster and more accurate analysis of medical imaging, such as X-rays, MRIs, and CT scans, which are critical in orthopaedics for assessing fractures, joint conditions, and spinal deformities. Machine learning models can detect subtle patterns in imaging that may elude human eyes, improving early diagnosis and treatment planning. For example, a 2023 study in The Lancet Digital Health demonstrated that AI algorithms achieved a 94% accuracy rate in detecting hip fractures from X-rays, surpassing the average performance of radiologists (89%). This precision reduces misdiagnoses and optimizes patient outcomes.
Additionally, AI-powered predictive analytics can forecast patient outcomes, such as the likelihood of postoperative complications or the success of joint replacements. A 2024 report by the Journal of Orthopaedic Research highlighted AI models that predict periprosthetic joint infections with 87% accuracy, allowing surgeons to tailor preoperative strategies.
- - Personalized Treatment Plans: AI enables personalized medicine by analyzing vast datasets, including patient genetics, medical history, and lifestyle factors, to recommend tailored treatment plans. In orthopaedics, this is particularly valuable for optimizing surgical approaches, such as selecting the best implant for a knee replacement based on patient-specific biomechanics. A 2025 article in Nature Medicine described AI-driven platforms that integrate 3D modeling and patient data to simulate surgical outcomes, improving implant fit and reducing revision rates by 15%. At the AAOS 2025 Annual Meeting, sessions like the Innovation Theater likely showcased such advancements, emphasizing AI's role in customizing care.
- - Surgical Assistance and Robotics.AI is enhancing surgical precision through integration with robotic systems, which are increasingly common in orthopaedic procedures like total knee and hip arthroplasties. AI-guided robots, such as those displayed in the AAOS Exhibit Hall, use real-time data to assist surgeons in achieving optimal alignment and minimizing tissue damage. A 2024 study in The Journal of Bone and Joint Surgery found that AI-assisted robotic surgeries reduced operative time by 12% and improved implant placement accuracy by 18% compared to traditional methods. The AAOS 2025 OrthoDome, an immersive theater showcasing surgical techniques in 4K resolution, likely highlighted such AI-driven innovations, aligning with the town hall's optimism about AI's impact.
- - Postoperative Care and Rehabilitation: AI is transforming postoperative care by powering remote monitoring tools and wearable devices that track patient recovery in real time. These tools can detect early signs of complications, such as infection or implant failure, and alert clinicians. A 2025 Health Affairs study reported that AI-enabled wearables reduced hospital readmissions for orthopaedic patients by 22% through continuous monitoring of mobility and vital signs. Furthermore, AI-driven rehabilitation platforms, like those discussed at the AAOS 2025 meeting, use gamified interfaces and machine learning to personalize physical therapy regimens, improving patient adherence and functional outcomes.
- - Administrative Efficiency and Cost Reduction: Beyond clinical applications, AI streamlines administrative tasks, such as scheduling, billing, and electronic health record management, freeing up time for clinicians to focus on patient care. A 2024 McKinsey & Company report estimated that AI could save the U.S. health care system $350 billion annually by automating routine processes and optimizing resource allocation. In orthopaedics, this translates to more efficient practice management, as highlighted in AAOS sessions on health policy and practice optimization.
While AI offers immense potential, it’s not a panacea. Challenges include data privacy concerns, algorithmic bias, and the need for robust validation to ensure AI tools are safe and equitable. For instance, a 2023 NEJM article cautioned that AI models trained on non-diverse datasets may underperform for underrepresented populations, potentially exacerbating health disparities. - Employee Waiver of Meal Breaks for 6 Hour Shifts are Validon April 23, 2025 at 3:02 PM
In 2014, La Kimba Bradsbery and Cheri Brakensiek filed a putative class action against their former employer, Vicar Operating, Inc.,alleging claims on behalf of “[a]ll individuals who worked for [Vicar] in California as a veterinary assistant, veterinary technician, surgery technician, kennel technician, client service representative, or similar position” in the four years before the complaint was filed.
Plaintiffs alleged Vicar failed to provide them with the meal periods required by section 512 and IWC Wage Order Nos. 4-2001 (Wage Order No. 4) and 5-2001 (Wage Order No. 5).
In April 2009, Plaintiffs each signed a written meal period waiver with Vicar. The waiver stated: "I hereby voluntarily waive my right to a meal break when my shift is 6 hours or less. I understand that I am entitled to take an unpaid 30-minute meal break within my first five hours of work; however, I am voluntarily waiving that meal break. I understand that I can revoke this waiver at any time by giving written revocation to my manager."
Vicar moved for summary adjudication regarding the validity of this waiver under section 512 and the wage orders. Vicar argued the prospective meal period waiver was valid because “neither the Labor Code nor the wage orders specify what form the waiver must take, or when or how it may be obtained.”
Plaintiffs opposed, arguing prospective waivers were prohibited under Wage Order Nos. 4 and 5 (together, the “wage orders”), an opinion letter from the Division of Labor Standards Enforcement (DLSE) interpreting an agricultural wage order, and Brinker Restaurant Corp. v. Superior Court (2012) 53 Cal.4th 1004. Plaintiffs further argued employees could waive a meal period for a given shift only after they were scheduled to work that shift.
The trial court agreed with defendants and determined the waivers were valid and ruled for Vicar.The Court of Appeal affirmed in the published case of Bradsbery v. Vicar Operating, Inc. - B322799 (April 2025).
At issue in this case is the meaning of the phrase “waived by mutual consent” of the employer and employee in section 512 and the two wage orders, and whether that meaning prohibits the prospective written waivers Vicar had its employees sign.
The Court of Appeal noted that the text of section 512 and the text of the wage orders are all silent regarding the timing (prospective or as-accrued) and form (written or oral) of a meal period waiver for shifts between five and six hours. The text also does not define “waived” or “waiver.” The meal period waiver provisions at issue here in section 512 and section 11(A) of the wage orders do not require a written waiver (let alone in mandatory language).
"The administrative history of the wage orders reflects the IWC has not viewed prospective written waivers as negatively as Plaintiffs suggest. The waiver of off-duty meal periods in a prospective written agreement instituted in 1976 was at the request of employees on wage boards and was seen by the IWC as protecting employees and employers. Similarly, in promulgating the waiver provisions for health care employees working eight-hour shifts in 1993, the IWC characterized the use of waivers as a 'protective condition[]” for employers and employees.' "
"In short, we believe it is reasonable to infer the Legislature and IWC wanted to be more protective of employees who worked longer shifts and for that reason spelled out in detail what is required to waive a right to a meal break for shifts over eight hours for health care employees and over 12 hours for all other covered employees. But it does not follow that when employees work fewer hours, here between five and six hours, that there was also an intent to prohibit a prospective written waiver."
Plaintiffs relied heavily on their reading of Brinker. In their view, Brinker, supra, 53 Cal.4th 1004, interpreted the same meal period waiver provisions at issue in this case and supports their reading of the statute and wage orders. In Brinker, the California Supreme Court considered, as relevant here, “(1) the nature of an employer’s duty to provide employees with meal periods; and (2) the timing requirements applicable to the provision of meal periods.”
However "Brinker did not address the requirements for the waiver of rest breaks. (See Brinker, at p. 1033.) For these reasons, we do not find Plaintiffs’ reading of this passage from Brinker persuasive." - PAGA One Year Statute of Limitations Applies to Penaltieson April 23, 2025 at 3:02 PM
Corbin Williams worked as an insurance adjuster for Alacrity Solutions Group, LLC starting in 2014. While employed, Williams “typically” worked 84-hour weeks - that is, 12 hours a day, seven days a week. He was an hourly employee. As a result, he was entitled to overtime pay whenever he worked more than eight hours in a day or 40 hours in a workweek, and was also entitled to overtime pay whenever he worked a seventh consecutive day.
But defendant did not pay Williams any overtime pay. As a result, defendant violated the Labor Code by not paying Williams all the wages he was owed and by issuing Williams inaccurate wage statements. (§§ 201- 203, 510 et seq., 226, 1174, 1174.5.
Williams’s employment with defendant ended in January 2022.It was not until March 7, 2023 - more than a year after his employment ended - that Williams provided written notice to California’s Labor & Workforce Development Agency (the Agency) of his intent to pursue a PAGA action for defendant’s Labor Code violations.
A few days later, on March 10, 2023, Williams sued defendant. In the operative first amended complaint, Williams asserted a single claim under PAGA seeking civil penalties “on behalf of the State of California and other current and former employees” - but, critically, not on his own behalf - for the alleged overtime and wage statement violations occurring in the “one year prior” to the written notice Williams filed with the Agency on March 7, 2023.
Defendant demurred to the complaint, arguing Williams failed to state a cause of action because (1) his PAGA action was barred by the one-year statute of limitations, and (2) he lacked standing to assert a PAGA action.
In his opposition, Williams effectively conceded that any individual claim he might assert under PAGA was “barred by the statute of limitations,” but maintained that this untimeliness was irrelevant because the PAGA action he alleged sought only to recover civil penalties on behalf of other aggrieved employees and the State.
The trial court issued an order sustaining the demurrer without leave to amend. The Court of Appeal affirmed in the Published case of Williams v. Alacrity Solutions Grp. - B335445 (April 2025).
The Private Attorneys General Act (PAGA) (Lab. Code, § 2698 et seq.) authorizes an “aggrieved employee” to step into the shoes of the State of California and sue for civil penalties premised on certain violations of the Labor Code “on behalf of himself or herself and other current or former employees.”
In this case, a former employee was barred by the statute of limitations from suing his former employer for civil penalties on his own behalf under PAGA. (Code Civ. Proc., § 340, subd. (a) [one-year limitations period].) So the former employee sued solely to recover penalties “on behalf of . . . other current and former employees.”
Is this allowed? The Court of Appeal held it is not. To be a PAGA plaintiff (under the statutes in effect prior to July 1, 2024), a private individual must, among other things, seek to recover civil penalties on his own behalf for that violation (Leeper v. Shipt, Inc. (2024) 107 Cal.App.5th 1001, 1008-1010 (Leeper), review granted Feb. 18, 2025), and must establish that this so-called “individual claim” is timely as to at least one Labor Code violation (Arce v. The Ensign Group, Inc. (2023) 96 Cal.App.5th 622, 630 (Arce); LaCour v. Marshalls of California, LLC (2023) 94 Cal.App.5th 1172, 1184- 1185 (LaCour); Hutcheson v. Superior Court (2022) 74 Cal.App.5th 932, 939 (Hutcheson); Esparza v. Safeway, Inc. (2019) 36 Cal.App.5th 42, 59 (Esparza); Brown v. Ralphs Grocery Co. (2018) 28 Cal.App.5th 824, 839 (Brown)).
"Because the employee in this case has not and cannot satisfy these requirements, the trial court properly sustained a demurrer to the PAGA action without leave to amend."