- Stepchild Entitled to Conclusive Presumption of Total Dependencyon May 20, 2026 at 1:11 PM
Scott Eskra was employed by AF Builders, Inc., when he was struck and killed by a falling tree on March 7, 2018. He was survived by his biological daughter, Ariana Eskra, then a minor, and his wife, Brandy Eskra. Also living in his household were Brandy's two children from a prior relationship: Jovie Fischer, who was nine years old and living with Scott and Brandy approximately 20 to 23 days per month, and Austin Evenson, who had graduated high school and joined the Marine Corps but still maintained a room at the family home.
Nearly five years after Scott's death, Ariana Eskra filed an application for death benefits. Brandy Eskra was later joined as an applicant, followed by Jovie Fischer and Austin Evenson. The case required three separate trials to resolve preliminary issues — including statute of limitations questions, evidentiary disputes over a premarital agreement, and the need for additional financial records — before the dependency determinations could be made.
At trial, the evidence established that Brandy Eskra earned approximately $14,000 per year working two to two-and-a-half days per week as a hairdresser. Coworkers at the same salon corroborated that she could not have earned $30,000 per year. Scott Eskra had paid for housing, food, utilities, and other household expenses. Jovie Fischer's biological father had been paying child support until late 2017, and a court-ordered support obligation was issued in December 2017. Austin Evenson was earning roughly $800 every two weeks in the Marine Corps but received occasional financial support from Scott, including gas money, hunting trip expenses, and a plane ticket to visit.
The WCJ issued findings on February 13, 2026, ruling that Brandy Eskra was a presumptive total dependent under Labor Code section 3501(b), which creates a conclusive presumption of total dependency for a surviving spouse who earned $30,000 or less in the twelve months before the employee's death. The WCJ found that both Jovie Fischer and Austin Evenson were partial dependents, reasoning that Jovie did not qualify for the conclusive presumption under section 3501(a) because she was not Scott Eskra's biological or adopted child, and because she had other sources of support including her biological father's child support payments.
The WCAB denied Ariana Eskra's petition for reconsideration and granted Brandy Eskra's petition in the panel decision of Eskra v. AF Builders, Inc., - ADJ17262790 (May 2026). The Board affirmed the WCJ's findings in all respects except one: it amended the decision to find that Jovie Fischer was a presumptive total dependent under Labor Code section 3501(a), not merely a partial dependent. The finding regarding Austin Evenson as a partial dependent was affirmed. Commissioner Razo dissented.
On Brandy Eskra's total dependency, the Board upheld the WCJ's finding without difficulty. The unrebutted evidence — Brandy's own testimony, corroborating testimony from two coworkers, and the 2017 tax return showing gross income of $20,695 — established that she earned well under $30,000 in the year before Scott's death. The Board rejected Ariana Eskra's challenge to the tax return's admission, noting that the WCJ had relied on both documentary evidence and consistent testimony from multiple witnesses.
On the premarital agreement, the Board affirmed its exclusion. The death benefits claim did not exist at the time the agreement was signed, the claim was not the decedent's property to dispose of, and in any event workers' compensation benefits cannot be released without a WCJ's order approving and finding adequacy of consideration — none of which occurred here.
On Jovie Fischer's dependency status, the Board broke from the WCJ. The central question was whether a non-biological, unadopted child living in the decedent's household qualifies as a "child" under section 3501(a), which creates a conclusive presumption of total dependency for a child under 18 living with a deceased employee-parent at the time of injury.
Following its own reasoning in the panel decision Franco, dec'd v. Orange County Plastering Co., Inc., 2025 Cal. Wrk. Comp. P.D. LEXIS 258 (Appeals Board Panel Decision, July 14, 2025), the Board held that the plain and ordinary meaning of "child" includes stepchildren. The Board drew support from section 3503, which lists stepchildren among those who may qualify as dependents, and from section 3202, which mandates liberal construction of workers' compensation law to extend benefits to injured workers and their dependents.
The Board also cited State Compensation Ins. Fund v. Workers' Comp. Appeals Bd. (Asher) (1993) 19 Cal.App.4th 1645, which applied similar reasoning to conclude that minor grandchildren are entitled to extended death benefits. Because Jovie was living with the decedent at the time of his fatal injury, section 3501(a) applied regardless of whether she sometimes visited her biological father or whether that father paid child support.
On Austin Evenson, the Board agreed with the WCJ that he was a partial dependent. Although Austin was a good-faith member of the household under section 3503 and received some financial support from the decedent, he was over 18 and earning his own income in the Marine Corps, so the conclusive presumption of section 3501(a) did not apply. The exact amount of his dependency was deferred.
Commissioner Razo dissented on the Jovie Fischer issue, adopting the WCJ's reasoning. He emphasized that Jovie was not living full-time with the decedent and that her biological father was paying child support, making a finding of total dependency inappropriate in his view. He would have left the WCJ's partial dependency finding in place.
- When Can Treating Physician Use Narrative Report for RFA Forms?on May 20, 2026 at 1:11 PM
The Division of Workers' Compensation (DWC) has adopted updated regulations regarding Utilization Review (UR), which became effective April 1, 2026. These regulations, designed to streamline and standardize the medical treatment authorization process, are available on the DWC website.
In light of these updates, the DWC has received several inquiries regarding whether the use of the DWC Form RFA (Request for Authorization) is mandatory for treating physicians.
Pursuant to California Code of Regulations, title 8, section 9792.6.1, a "Request for Authorization" is formally defined as a written request for a specific course of proposed medical treatment. The regulations mandate that this request be set forth on the DWC Form RFA (as found in section 9785.5) and completed by the treating physician.
The standardized use of the DWC Form RFA is a critical regulatory requirement intended to ensure clear, consistent communication between medical providers and claims administrators, thereby reducing delays in the delivery of necessary medical care.
While the DWC Form RFA is the primary standard, a narrative report may serve as a functional equivalent only under specific conditions outlined in CCR section 9792.9.1(b) and 9792.6.1(u):
- - Mutual Acceptance: The claims administrator (CA) must voluntarily agree to accept a narrative report in lieu of the formal DWC Form RFA.
- - Minimum Content Standards: To be deemed "completed," the narrative report must contain all essential data elements required by law, including:
- - Clear identification of both the employee and the requesting provider.
- - Specific identification of all recommended treatments on the first page of the narrative.
- - Substantiating documentation created no earlier than 30 days prior to the request.
- - Treating Physician’s Signature: The report must be signed by the physician (electronic signatures are permitted by agreement of the parties).
DWC reminds all stakeholders that failure to provide a "completed" request (one that lacks specificity or the required substantiating documentation) may impact the timelines for UR decisions and the overall adjudication of treatment requests.
- Eleven Insurance Commissioner Candidates on June 2 Primary Balloton May 19, 2026 at 4:12 PM
Eleven candidates are running in the top-two primary for insurance commissioner of California on June 2, 2026. Five have led in media attention: Stacy Korsgaden (R), Ben Allen (D), Steven Bradford (D), Jane Kim (D), and Patrick Wolff (D). Incumbent Ricardo Lara (D) is term-limited and is retiring from public office.
Stacy Korsgaden has warned she would crack down on insurance fraud and conduct a full audit of the California Department of Insurance if elected. Korsgaden is a licensed insurance professional (License #0750748) since 1988, small business owner, and lifelong Californian. And according to a report by the New York Post “[t]he reason that I’m running is that we have a situation that I cannot sit back anymore and watch, the inexperience in the policies that are being implemented throughout the state. That’s why I’m getting involved,” she said during a town hall in Tuolumne County.
Ben Allen is currently sitting on the California Senate. Allen wrote on his official candidate statement "I have a long track record of success working for the public interest: In the State Senate, I've taken on insurance industry lobbyists, passed some of the nation's strongest consumer protection laws, and led efforts to invest $10 billion in wildfire prevention, water infrastructure improvements, and climate resilience. As Insurance Commissioner, my #1 priority will be putting consumers first. That means: Holding polluters accountable: I'll make corporate polluters financially responsible for climate damages that drive up insurance costs."
Allen is frequently described as a strong contender or frontrunner. He has significant fundraising (~$1.5M+ raised), high-profile endorsements (e.g., Adam Schiff), and experience in wildfire-affected areas. Recent endorsements (e.g., from newspapers) position him as a top choice.
Steven Bradford is a former State Senator where he sat on the State Legislature's Insurance Committee where he helped build consensus on complex regulatory challenges. His plan "includes bringing transparency to insurance pricing, rewarding people who protect their homes, rebuilding the insurance market in high risk areas, and making rates make sense. Bradford will support safer moves for the most at-risk, modernize the Department of Insurance, and put equity front and center."
Jane Kim is a civil rights attorney, organizer and consumer advocate. "As Insurance Commissioner, I'll cap excessive profits and freeze your rates when you file a claim. I'll create a public Disaster Insurance for All program so we are protected when fires, floods or earthquakes strike. I'll crack down on illegal price-fixing, stop insurers from using credit scores to deny coverage, and fight for guaranteed healthcare for every child in California." Kim is backed by progressives (e.g., Bernie Sanders ties via Working Families Party)
Patrick Wolff wrote that "[f]rom 2001–2005, I worked at a major bank where I built a home and auto ins urance brokerage. Since 2005, I have worked as a financial analyst where, among other sectors, I analyzed insurance markets and companies." According to his website "I have a plan to solve our state’s insurance crisis by holding insurance companies accountable, increasing choice and competition, and improving transparency."
Lower profile candidates include Republican Sean Lee. Lee conducted scientific research at JPL / NASA through Caltech, developing a disciplined, data-driven approach to analyzing complex problems. He later applied those analytical skills in the insurance and financial services industries. He supports transparency, accountability, and effective oversight of insurance practices. Lee also supports the responsible use of emerging technologies, including artificial intelligence and lnsurTech, to improve efficiency and combat fraud.
Republican Robert P Howell unsuccessfully competed for Insurance Commissioner Ricardo Lara. He has been the CEO of a Silicon Valley cybersecurity manufacturing company. He wrote " I will hold insurance companies accountable to the rules and challenge abusive practices. I will implement an “Insurance Payers Bill of Rights” to protect policyholders from unfair cancellations and unjustified rate increases."
Eduardo “Lalo” Vargas is the Peace and Freedom party candidate. He wrote "I pledge to freeze insurance rates and lower premiums, to investigate and hold insurance executives accountable for exploitative claim procedures, and to fight for a public insurance system that guarantees full and fair coverage for all."
Republican candidate Merritt Farren is a California wildfire survivor, former Amazon lawyer, and former head of legal, guest claims, and security operations for the Disneyland Resort. He wrote " I want to bring the customer-centric innovation I've learned to California insurance regulation."
Keith Davis (American Independent) and Eric Aarnio do not have candidate statements on the official ballot. Both are lower-profile candidates compared to the leading Democrats and more prominent Republicans. Davis is an insurance agent from Riverside California. He emphasizes being a consumer advocate rather than aligned with big insurance companies. He has a campaign website (gokeithdavis.com) and has been active in interviews and outreach.
Eric Aarnio is a Republican, and a contractor from Sacramento with no prior elected office or formal insurance industry background. He has a very low-profile campaign (no website or social media listed in questionnaires) and minimal media presence.
- Owner of Health Care Software Company Convicted for $1B Fraudon May 19, 2026 at 4:12 PM
A federal jury convicted the founder and owner of HealthSplash for his role in operating a platform that generated false doctors’ orders and prescriptions to defraud Medicare and other federal health care benefit programs out of more than $1 billion.
According to court documents and evidence presented at trial, Brett Blackman, 42, of Johnson County, Kansas, and his co-conspirators aggressively targeted hundreds of thousands of Medicare beneficiaries to get them to accept medically unnecessary orthotic braces and other items. They then arranged for purported telemedicine doctors to sign bogus prescription orders for these items, so that their co-conspirators could bill Medicare for them. All told, Blackman and his co-conspirators billed Medicare and other federal health care benefit programs over $1 billion for this unnecessary equipment.
Blackman owned, controlled, and was the CEO of HealthSplash, which acquired Power Mobility Doctor Rx, LLC (DMERx) in September 2017. DMERx was an internet-based platform that generated false and fraudulent doctors’ orders for durable medical equipment (DME) and prescriptions for other items. As part of the scheme, Blackman and his co-conspirators connected pharmacies, DME suppliers, and marketers with telemedicine companies that would accept illegal kickbacks and bribes in exchange for signed doctors’ orders created using the DMERx platform. Blackman and his co-conspirators took a cut for themselves in exchange for the referrals.
The fraudulent doctors’ orders and prescriptions generated by DMERx falsely represented that a doctor had actually examined and treated the Medicare beneficiaries when, in fact, the doctors were simply paid to sign orders and prescriptions without any meaningful interaction with the beneficiary, and in some cases, no interaction at all. Doctors signed these orders and prescriptions without regard to whether the equipment was medically necessary. Testimony and evidence presented at trial from an undercover agent who posed as a Medicare beneficiary showed the scheme in action—starting with a foreign call center that pushed the undercover agent to agree to multiple braces to a doctor signing bogus orders for the braces using Blackman’s DMERx platform. The doctor’s order for one of these undercover agent beneficiaries claimed that the doctor conducted various tests that can only be performed in person even though the doctor never even spoke with the undercover agent “patient.”
The DME suppliers and pharmacies that were paying illegal kickbacks for these orders billed Medicare and other insurers for more than $1 billion. Medicare and the other insurers paid more than $450 million based on these claims. According to evidence presented at trial, Blackman and his co-conspirators concealed the scheme through sham contracts and by manipulating the doctors’ orders to avoid Medicare audits.
The jury convicted Blackman of conspiracy to commit health care fraud and wire fraud, conspiracy to pay and receive health care kickbacks, and conspiracy to defraud the United States and to make false statements in connection with health care matters. Blackman’s co-defendant, Gary Cox, was convicted in a prior trial and sentenced to 15 years in prison.
Blackman faces a maximum penalty of 20 years in prison for the conspiracy to commit health care fraud and wire fraud conviction, five years for the conspiracy to pay and receive health care kickbacks conviction, and five years for the conspiracy to defraud the United States and to make false statements in connection with health care matters conviction. A sentencing hearing has been scheduled for August 26, 2026. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
“The Department of Justice crushed one of the most egregious fraud schemes in Florida history,” said Acting Attorney General Todd Blanche. “This illegitimate operation stole more than $1 billion from American taxpayers — including hundreds of thousands of Medicare beneficiaries. This was cold, calculated, industrial-scale theft targeting the sick and elderly, coercing vulnerable people into buying unnecessary medical equipment. We will not rest until every fraudster ripping off the American people is held accountable.”
- Employer's $257K Attorney Fee Award Against Employee Affirmedon May 18, 2026 at 11:07 AM
Nick Miletak was hired to participate in Royal Coach Tours' student driver trainee program. On the day formal classroom instruction was set to begin, Miletak showed up, handed in his resignation, and demanded compensation for time he had been available before the formal training started. Royal Coach refused but still paid him for 11 hours of classroom time he had logged during informal training.
About a week after resigning, Miletak filed a civil lawsuit against Royal Coach alleging five causes of action. After Royal Coach demurred, Miletak filed an amended complaint asserting two claims: promissory estoppel and constructive discharge. Following a court trial, judgment was entered in Royal Coach's favor. Miletak appealed, and the Sixth District affirmed. Royal Coach then sued Miletak for malicious prosecution.
A bench trial was held on the malicious prosecution claim without a court reporter present. The trial court issued a statement of decision finding that Miletak's prior employment action had terminated in Royal Coach's favor, that Miletak lacked probable cause to bring the claims, that he pursued the action with malice, and that Royal Coach suffered damages. The court awarded Royal Coach $257,197.53, including punitive damages.
Miletak subsequently filed motions for a new trial, to dismiss, and to vacate the judgment. The trial court denied each one.
The Sixth District Court of Appeal affirmed the judgment in its entirety in the unpublished case of Royal Coach Tours, Inc. v. Miletak, -H052687 (May 2026). Miletak raised thirteen separate contentions on appeal; the court rejected all of them.
Miletak appealed in pro per. The court's analysis was shaped throughout by Miletak's repeated failure to meet basic appellate requirements — providing adequate record citations, presenting developed legal arguments, and confining his claims to matters in the record. The court invoked the principle from Jameson v. Desta (2018) 5 Cal.5th 594, 609, that the burden falls on the appellant to demonstrate error on the basis of the record presented.
On personal jurisdiction, Miletak argued the trial court lost jurisdiction when he relocated to Florida. The court held that once a trial court acquires jurisdiction over a party, that jurisdiction continues to final judgment and is not defeated by the party's relocation, citing Goldman v. Simpson (2008) 160 Cal.App.4th 255, 263–264. Miletak's reliance on Daimler AG v. Bauman (2014) 571 U.S. 117 was misplaced because that case addressed an entirely different question about claims by foreign plaintiffs against a foreign defendant.
On the absence of a court reporter, Miletak claimed he requested one at trial. But the settled statement, the order denying his new trial motion, and the trial court's own statements at the settled statement hearing all indicated that no such request was made. Without record evidence of a request, the court found no error.
On the denial of a jury trial, the record showed Miletak failed to timely request a jury or demonstrate that his partial fee waiver covered jury fees. The court applied TriCoast Builders, Inc. v. Fonnegra (2024) 15 Cal.5th 766, which holds that a litigant challenging the denial of relief from a jury waiver for the first time on appeal must show prejudice — something Miletak never attempted.
On probable cause, the central substantive issue, Miletak argued that the denial of Royal Coach's nonsuit motion in the underlying employment action conclusively established probable cause under the interim adverse judgment rule. The court disagreed. Drawing on Parrish v. Latham & Watkins (2017) 3 Cal.5th 767 and Wilson v. Parker, Covert & Chidester (2002) 28 Cal.4th 811, the court explained that the interim adverse judgment rule applies only to rulings on the merits, not those resting on procedural or technical grounds. Here, the nonsuit motion was denied based on Miletak's opening statement — before any evidence was presented — so the denial said nothing about the substantive merits of his promissory estoppel claim.
The court also noted that Miletak attributed a fabricated quotation to Parrish, claiming that probable cause for any single claim insulates the entire suit. The California Supreme Court has held precisely the opposite: a malicious prosecution suit may be maintained where even one of several claims in the prior action lacked probable cause. See Crowley v. Katleman (1994) 8 Cal.4th 666, 671.
On the remaining issues — evidentiary rulings, judicial bias, fraud on the court, the settled statement, denial of writ petitions, and the prior anti-SLAPP appeal — the court found each contention either unsupported by record citations, procedurally forfeited, or substantively without merit. Multiple claims were deemed waived under Duarte v. Chino Community Hospital (1999) 72 Cal.App.4th 849, 856, for failure to cite the record.
- Major Drug Maker to Pay $13.6M to Resolve Kickback Caseon May 18, 2026 at 11:07 AM
Takeda Pharmaceuticals U.S.A., Inc. is the U.S. subsidiary of Takeda Pharmaceutical Company Limited, a major global biopharmaceutical company headquartered in Osaka, Japan It is one of the world’s leading R&D-driven pharmaceutical companies, with a strong emphasis on oncology, rare diseases, neuroscience, gastroenterology (and inflammation), plasma-derived therapies, immunology, and vaccines.
The company has a major presence, including its global hub and research center in Cambridge, Massachusetts (making Takeda the largest life sciences employer in the state). It has sites in 39 states and employs more than 20,000 people in the U.S. (part of ~50,000 worldwide).
Takeda Pharmaceuticals, U.S.A., Inc. has agreed to pay $13,670,921 to resolve allegations that it knowingly caused the submission of false claims to Medicare and other federal health care programs by paying kickbacks to healthcare providers to induce prescriptions of Trintellix, an antidepressant medication that Takeda marketed and sold to treat major depressive disorder.
Trintellix (vortioxetine) is a prescription antidepressant medication used to treat Major Depressive Disorder (MDD) in adults. It is marketed in the U.S. by Takeda Pharmaceuticals (in collaboration with H. Lundbeck A/S, which originally developed it).
The civil settlement resolves allegations that, from January 2014 to October 2020, Takeda paid improper remuneration, including in the form of speaker honoraria and meals at high-end restaurants, to healthcare professionals to induce them to prescribe the antidepressant medication Trintellix in violation of the Anti-Kickback Statute.
The United States contends that Takeda selected certain healthcare providers to be part of the Trintellix speaker bureau and provided them paid speaking opportunities with the intent that the speaker honoraria and meals would induce them to prescribe Trintellix. The government further contends that certain prescribers who attended multiple programs on the same topic and received meals and drinks from Takeda received no educational benefit from attending duplicate programs.
Takeda (including its subsidiaries and predecessors like TAP) has faced other False Claims Act (FCA) allegations, Medicaid fraud claims, kickback-related matters, and similar government program issues in the U.S.
- - 2001 TAP Pharmaceuticals Settlement (Lupron): Takeda's former joint venture with Abbott (TAP) paid $875 million to resolve criminal and civil charges. Allegations included providing free drug samples to doctors who then billed Medicare/Medicaid, kickbacks, and improper pricing. This was one of the largest pharma fraud settlements at the time.
- - In 2023 Takeda subsidiaries (along with others from the Shire acquisition) agreed to pay a combined ~$42.7 million to resolve Texas Medicaid Fraud Prevention Act claims. Allegations involved providing improper nursing/reimbursement support and paying nurse educators to recommend Vyvanse to Medicaid providers (~2014–2015). This was a whistleblower-initiated case.
Takeda paid ~$2.4 billion in 2015 to settle thousands of U.S. lawsuits alleging the diabetes drug caused bladder cancer and that risks were inadequately disclosed. Some claims involved marketing practices, but these were primarily personal injury/product liability.
- Court Finds County Liable for Losing Personnel & CalPERS Recordson May 14, 2026 at 11:19 AM
Kay Marie Gibbs worked as a court reporter for the Humboldt County Superior Court for nearly 40 years, starting in June 1982. She became eligible for enrollment in the California Public Employees' Retirement System (CalPERS) in December 1983, but the county did not enroll her until November 1989 — a gap of roughly six years.
When Gibbs began preparing for retirement in 2019, she discovered she would not receive CalPERS service credit for those early years. CalPERS told her it could not adjust her benefits without a certification from the county of her full employment history. What followed was a prolonged and fruitless effort to get the county to produce those records. Gibbs alleged that three individual employees in the county's human resources department lost, destroyed, or failed to search for the requested records. After repeated promises, the county eventually sent CalPERS an incomplete compilation that was missing records for multiple periods spanning from 1982 to 1989.
Gibbs attempted to mitigate the damage by purchasing "prior service credit," but she could not do so without the county's certification of her employment history. She alleged she was forced to delay retirement and stood to lose hundreds of thousands of dollars in benefits.
Gibbs filed suit asserting four causes of action under Government Code section 815.6, each based on the county's alleged failure to discharge a mandatory statutory duty — specifically, duties to maintain CalPERS-related records, allow inspection of personnel records, timely enroll her in CalPERS, and properly maintain employment information. She also asserted a fifth cause of action for negligence against all defendants.
The trial court sustained the county's demurrers to all four statutory causes of action without leave to amend. It allowed Gibbs to amend only the negligence claim. She filed a second amended complaint focused on negligence, but the court sustained the demurrer to that claim as well, concluding that no statutory authority supported the duties Gibbs alleged. The court suggested that "a simple mandamus will suffice" if Gibbs wanted to review withheld records.
The First District Court of Appeal largely reversed in the partially published case of Gibbs v. County of Humboldt et al., -A173637 (May 2026). It found the trial court's result "untenable" — that Gibbs, who alleged the county failed to enroll her in CalPERS through no fault of her own, was left without a claim because the county also lost her records through no fault of hers.
The court reversed on three of Gibbs's causes of action. It affirmed on only one — the fourth cause of action under Government Code sections 26205 and 26205.1, which the court found authorizes destruction of certain records rather than mandating their retention.
On the personnel records claim, the court held that Government Code section 31011 and Labor Code section 1198.5 impose mandatory, nondiscretionary duties on public employers to let employees inspect their personnel records and to maintain those records for at least three years after employment ends. The court rejected the county's argument that the Trial Court Employment Protection and Governance Act (TCEPGA), which transferred court employees from county to court employment effective January 1, 2004, extinguished its obligations. Gibbs was never terminated — she continued the same work — and the Public Employees’ Retirement Law (PERL), Government Code § 20000 et seq., itself, provides that a contracting agency's obligations "continue through the memberships of the respective members." (Gov. Code, § 20164, subd. (a).) The court was guided by Thornburg v. El Centro Regional Medical Center (2006) 143 Cal.App.4th 198, which found a private right of action under similar record-inspection statutes.
On the failure to enroll claim, the court held that the PERL imposes a mandatory duty on contracting agencies to timely enroll employees in CalPERS, pointing to sections 20283, 20502, 20281, and 20028. The Supreme Court had already recognized a "duty to enroll employees in CalPERS" in Metropolitan Water Dist. v. Superior Court (2004) 32 Cal.4th 491, 506. Reading the enrollment obligation as discretionary, the court said, would render the statutes' benefits "illusory," citing Henderson v. Newport-Mesa Unified School Dist. (2013) 214 Cal.App.4th 478, 494–495.
On the negligence claim, in the unpublished portion of the opinion, the court concluded that Gibbs stated a viable claim against the individual defendants for breaching their duties of care, and the county could be held vicariously liable under Government Code section 815.2. The court rejected the defendants' invocations of discretionary-act immunity (§ 820.2) and the economic loss rule, finding neither applicable.
The court also rejected the argument that mandamus was Gibbs's exclusive remedy, distinguishing Crumpler v. Board of Administration (1973) 32 Cal.App.3d 567 and Metropolitan, neither of which held that a writ is the only available path when an employee was wrongfully denied CalPERS enrollment.
- Stanford Breakthrough Could Make Knee Replacement Obsoleteon May 14, 2026 at 11:19 AM
A study published in the journal Science by Stanford Medicine researchers has demonstrated something the orthopedic world has been chasing for decades: the ability to regrow cartilage that has been lost to aging or injury, using a simple injection rather than surgery. If the approach translates from the laboratory to clinical practice — and early signs suggest it may — the implications for workers' compensation claims involving knee and hip injuries would be profound.
Osteoarthritis is the single most common joint disease in the United States, affecting roughly one in five adults. It occurs when the cartilage that cushions joints wears away, leading to pain, stiffness, and progressive loss of function. There is currently no drug that can slow or reverse the disease. Every treatment available today — anti-inflammatory medications, corticosteroid injections, physical therapy, viscosupplementation — manages symptoms. When those fail, the endpoint is surgical joint replacement.
More than one million Americans undergo knee or hip replacement surgery each year, and workplace injuries are a significant driver of the demand. Workers who sustain knee injuries — meniscus tears, ligament damage, repetitive stress injuries — are at elevated risk for developing osteoarthritis in the affected joint. Roughly half of all people who suffer an ACL tear develop osteoarthritis within 10 to 20 years of the injury, even after successful surgical repair. For workers' compensation, that means an acute knee injury claim can evolve into a decades-long medical management case culminating in joint replacement.
The Stanford research offers the first realistic prospect of breaking that cycle. The research team, led by Drs. Helen Blau and Nidhi Bhutani, focused on a protein called 15-PGDH — classified as a "gerozyme," an enzyme whose levels increase as the body ages and which drives the gradual loss of tissue function. Higher levels of 15-PGDH are linked to declining muscle strength, reduced bone repair, and diminished nerve regeneration in older animals. The Stanford team hypothesized that the same protein might be responsible for the cartilage loss that underlies osteoarthritis.
They were right. In aged mice, knee cartilage that had naturally thinned and deteriorated — the animal equivalent of age-related osteoarthritis — thickened and regenerated after the mice received injections of a small-molecule drug that blocks 15-PGDH activity. The treated cartilage closely resembled the cartilage of young, healthy animals.
The researchers then tested whether the treatment could prevent arthritis after a traumatic injury. They induced ACL-like knee injuries in young mice — the kind of injury that reliably leads to osteoarthritis in both mice and humans — and administered the 15-PGDH inhibitor. Untreated mice developed arthritis within four weeks. Treated mice did not. They avoided cartilage breakdown, moved more normally, and placed more weight on the injured limb.
Critically, the treatment also worked in human tissue. When the researchers applied the 15-PGDH inhibitor to human cartilage samples in the laboratory, the cartilage cells responded by shifting their gene expression toward a younger, healthier profile.
Previous attempts at cartilage regeneration have relied on stem cell transplantation — harvesting cells from one part of the body, cultivating them, and surgically implanting them into the damaged joint. These procedures are complex, expensive, and have produced inconsistent results. The Stanford approach is fundamentally different: it does not introduce new cells. Instead, it causes the existing cartilage cells — the chondrocytes already present in the joint — to change their behavior. The drug essentially reprograms aged, deteriorating cartilage cells to act like younger, healthier versions of themselves, without requiring stem cells or surgery.
The mechanism works through prostaglandin E2, a naturally occurring molecule. While prostaglandin E2 is commonly associated with inflammation and pain, the researchers found that small, controlled increases — achieved by blocking the enzyme that breaks it down — actually promote tissue regeneration rather than inflammation.
How close is this to clinical use? Closer than one might expect for a laboratory breakthrough. A version of the 15-PGDH inhibitor has already completed Phase 1 safety testing in humans for a different age-related condition — muscle weakness — and did not raise safety concerns. That existing safety data could significantly accelerate the pathway to human trials for joint applications. The researchers have indicated they are moving toward clinical trials for cartilage regeneration.
However, important caveats remain. The current results are in mice and in human tissue samples in the laboratory, not yet in human patients with osteoarthritis. The transition from animal models to human clinical practice is uncertain, and even with fast-tracked development, it would likely be several years before a treatment could reach clinical use. The therapy would also need to demonstrate that regenerated cartilage is durable and functionally equivalent to native cartilage over the long term.
Even at this early stage, the research is worth tracking for several reasons. Knee injuries are among the most common and costly workers' comp claims. Any development that could reduce the long-term progression from acute knee injury to osteoarthritis to joint replacement has the potential to significantly alter the lifetime cost trajectory of these claims. Joint replacement surgery, with its associated surgical costs, hospitalization, rehabilitation, temporary disability, and potential complications, is one of the most expensive procedures in the workers' comp system.
- Employers File More RICO Actions Against Plaintiff Lawyerson May 13, 2026 at 3:19 PM
Plaintiff Lawyers are now calling the RICO cases filed in several states, including California, by employers against plaintiff lawfirms for filing alleged exaggerated claims a "Very Dangerous Trend." Ostensibly, this "trend" became of interest recently when Uber Technologies, Inc. filed three racketeering lawsuits recently against lawyers and medical providers for alleged fraudulent insurance claims, with a California lawsuit against Downtown LA Law Group et al.being the third.
The the first was filed in New York in 2025 targeting a group of lawyers and medical providers in New York for allegedly exploiting Uber’s state-mandated $1 million rideshare insurance policy to file fraudulent personal injury claims. The scheme allegedly involved directing claimants to pre-selected medical providers who produced fraudulent medical records and bills to inflate settlement demands.
The second was filed in South Florida (Uber v. Law Group of South Florida et al., Case No. 25-cv-22635-CMA) and Uber accused the defendants of staging car accidents, manufacturing damages, and pursuing unnecessary medical procedures to exploit insurance policies between 2023 and 2024.
Uber Technologies filed another lawsuit in the United States District Court for the Central District of California alleging a fraudulent scheme involving personal injury claims filed against them in California. The complaint alleges that this “scheme begins when Defendants (Igor) Fradkin, Downtown LA Law Group, Emrani, and Law Offices of Jacob Emrani identify individuals with potential personal injury claims against rideshare companies such as Uber.” And goes on to allege “Both firms aggressively pursue clients to sue Uber, as shown in this online advertisement by Emrani” which appears to be screen grab of an advertisement showing Jacob Emrani next to an UBER/Lyft logo above the words “Uber or Lyft Accident?” followed by a banner that reads “Call Jacob.com.”
Uber then alleges that a “key repeat participant in this fraud is Defendant Greg Khounganian, a spinal surgeon who owns and controls GSK Spine, an orthopedics practice. Working with personal injury coordinators at Defendant Radiance Surgery Center, a surgery center which specializes in treating patients with pending personal injury lawsuits and which also does business as Sherman Oaks Surgery Center.
Following these three RICO cases, there were more to come, with Federal Express joining as a plaintiff, when Uber Technologies and Federal Express sued Philadelphia personal injury attorney Marc Simon, his firm Simon & Simon P.C., and several medical professionals — chiropractors Ethel Harvey and Daniel Piccillo of Philadelphia Spine Associates, pain management physician Clifton Burt of Premier Pain & Rehab Center, and medical examiner Lance Yarus — under the federal Racketeer Influenced and Corrupt Organizations Act (RICO). The companies alleged the defendants ran a coordinated fraud scheme spanning dozens of lawsuits filed over the past four years in Philadelphia County courts.
According to the complaint, the scheme worked like a conveyor belt. Simon & Simon would sign up clients involved in motor vehicle accidents with Uber or FedEx drivers — clients who typically suffered minimal or no injuries and often carried limited-tort insurance. The firm then directed those clients to the same small group of medical providers. Drs. Harvey and Piccillo administered extensive chiropractic treatments and ordered MRIs that came back negative or showed only mild degenerative changes unrelated to the accidents. Despite those results, the chiropractors continued treatment at the lawyers' direction, generating voluminous records that in some cases reflected care that was allegedly never actually delivered or was documented using cut-and-paste boilerplate.
On May 11, 2026 the court denied the defendants' motion to dismiss in its entirety in the case of Uber Technologies v. Simon & Simon P.C., Case No. 25-5365 (E.D. Pa.) (May 2026) allowing all of Uber's RICO claims to proceed to discovery. Every defense raised — Noerr-Pennington immunity, res judicata, the Rooker-Feldman doctrine, and challenges to the sufficiency of the RICO allegations — was rejected at this stage.
Noerr-Pennington immunity is a common defense raised in these cases. The defendants argue their conduct was protected petitioning activity under the First Amendment. The Philadelphia court acknowledged that filing and serving lawsuits is classic petitioning activity, but held the alleged pre-filing conduct — directing doctors to create false medical records and manufacture evidence — was not "incidental" to petitioning.
Even assuming the conduct could qualify as petitioning, the court found Uber plausibly invoked the sham litigation exception. Under the series-of-petitions framework from California Motor Transportation Co. v. Trucking Unlimited, 404 U.S. 508 (1972), the allegations supported an inference the lawyers filed cases without regard to merit and to extract settlement value through the litigation process itself. The abrupt dismissal of claims once discovery threatened to expose the scheme was particularly telling.
Ford Motor Company v. Knight Law Group LLP et al., 2:25-cv-04550, was filed May 21, 2025 in the Central District of California. Plaintiff alleged that attorneys with Knight Law Group, Altman Law Group, and Wirtz Law APC submitted thousands of fictitious time entries in Lemon Law cases over the past decade to extract more than $100 million in inflated legal fees. The legal hook is California's Song-Beverly Consumer Warranty Act (the state's Lemon Law), which is fee-shifting — prevailing consumer plaintiffs recover their attorneys' fees from the manufacturer.
Ford's audit allegedly identified 34 days in which a lawyer claimed more than 24 hours of work and 66 entries showing over 20 hours in a single day, including one entry for "an ostensibly heroic but physically impossible 57.5-hour workday in November 2016." Ford also cited instances where attorneys billed for multiple full-day depositions in different locations on the same day.
On November 24, 2025 the court granted Knight's motions to dismiss with leave to amend. The dismissal turned on the Noerr-Pennington doctrine — the First Amendment-rooted rule shielding petitioning activity from liability. The court reasoned that Ford was attempting to impose RICO liability "for conduct connected to Defendants' fee petitions," and that a successful RICO claim would "quite plainly" burden defendants' ability to seek fees for their litigation activity, since seeking fees is at least "incidental to the prosecution of the suit". This is the same doctrinal wall the Gori firm is now invoking against J-M, and the same wall that defeated parts of J-M's earlier suit against Simmons Hanly Conroy.
Ford did not appeal; it pivoted. In an amended complaint filed January 5, 2026, Ford withdrew its RICO claims against Knight Law Group as an entity, along with Altman Law Group, Wirtz Law APC, and several attorneys and a former paralegal, and instead strengthened its case against three individual attorneys formerly associated with Knight Law — founding partner Steve B. Mikhov, managing partner Roger Kirnos, and partner Amy Morse — alleging perjury and obstruction of justice for submitting false statements to courts about how legal fee records were created.
And another case recently filed case by a California employer adds asbestos claims instead of Uber type automobile type litigation. J-M Manufacturing (the Los Angeles-based pipe maker that does business as JM Eagle) filed its federal RICO complaint against The Gori Law Firm on January 29, 2026 in the U.S. District Court for the Southern District of Illinois, asserting claims under RICO along with common-law fraud, unjust enrichment, and civil conspiracy. It's based on information from a "whistleblower" attorney who formerly worked at the Gori firm.
J-M accuses the Gori firm of establishing a "bounty" system since at least 2018, in which "depo attorneys" who took clients' depositions could earn up to 2% of total settlement proceeds if they successfully coached clients to testify they were exposed to J-M's (and other companies') products. The complaint alleges depo attorneys were trained to tell plaintiffs that even if they couldn't recall the products, "the Gori Firm had done lots of research, and based on their research, the plaintiff was exposed to the products of the defendants recommended for inclusion by the attorney" Gori named J-M in more than 400 asbestos lawsuits since 2018, mostly in Madison and St. Clair counties in southern Illinois.
- Sutter Health Resolves ERISA Class Action for $4.3Mon May 13, 2026 at 3:19 PM
A class action under ERISA was filed U.S. District Court for the Eastern District of California on behalf of participants and beneficiaries of the Sutter Health 403(b) Savings Plan. The claims alleged breaches of fiduciary duty in the management of the retirement plan.The case was filed in 2020 (case number 1:20-cv-01007). The class was certified by stipulation on January 26, 2024.
Specifically the Plaintiffs allege that Defendants breached their fiduciary duties of prudence and loyalty under ERISA by retaining underperforming funds with excessive fees, instead of offering less expensive, readily available prudent alternative investments. Specifically, Plaintiffs assert Defendants were imprudent in offering the Fidelity Freedom Funds target date series, the Parnassus Core Equity Fund, the Dodge & Cox Stock Fund, and the Lazard Emerging Markers Equity Fund. Plaintiffs also argue that Plan participants paid excessive recordkeeping and administrative fees and the Plan’s total plan cost was too high.
This case falls within a large wave of ERISA excessive-fee lawsuits targeting 403(b) retirement plans at nonprofit hospital systems and universities — cases that accelerated after the Supreme Court's 2015 decision in Tibble v. Edison International 135 S.Ct. 1823 (2015) 575 U.S. 523, which clarified fiduciaries' ongoing duty to monitor plan investments. The Uniform Prudent Investor Act confirms that "[m]anaging embraces monitoring" and that a trustee has "continuing responsibility for oversight of the suitability of the investments already made." § 2, Comment, 7B U.L.A. 21 (1995) (internal quotation marks omitted)."
These are the standard categories of claims in the 403(b) excessive-fee litigation wave, and the Sutter Health case fits squarely within that pattern. Similar cases were filed against Dignity Health, Providence Health, Kaiser Permanente, and many other large nonprofit health systems during the same period.
A settlement was reached through mediation with an experienced neutral mediator, after the parties had sufficient information to evaluate the case's settlement value.The fairness hearing was held April 10, 2026, and final approval was entered May 11, 2026 by Judge Lee H. Rosenthal.
The Settlement Class includes all participants and beneficiaries of the Plan at any time during the Class Period, including beneficiaries of deceased participants and Alternate Payees under QDROs. Excluded are Sutter Health itself, the Defined Contribution Oversight Committee, the Board of Directors, and their individual members and beneficiaries.
The Settlement Amount was $4,300,000. The court found this amount fair, reasonable, and adequate given the costs, risks, and delay of continued litigation. Distribution requires no claim filing for participants with active accounts; former participants without active accounts need only submit a modest claim form.
The court awarded Class Counsel attorneys' fees of $1,433,333.33 (approximately one-third of the settlement fund), plus applicable interest and litigation expenses. Class Representatives were awarded $12,500 each as compensatory awards for costs and expenses related to their representation of the class. All amounts are payable from the settlement fund within 35 business days of the Effective Date.
Upon entry of the order, all class members fully and permanently release the Defendant Released Parties from all Released Claims, regardless of whether a class member received notice, filed a claim, objected, or received any monetary benefit.
The court retains exclusive jurisdiction over disputes related to the settlement's performance, interpretation, or enforcement. If the Settlement Agreement is terminated, the order becomes void and the case reverts to its pre-settlement status. The Settlement Administrator has final authority over allocation decisions, and unresolved distribution questions for active account holders are referred to the Plan's fiduciaries.
- Stepchild Entitled to Conclusive Presumption of Total Dependencyon May 20, 2026 at 1:11 PM
Scott Eskra was employed by AF Builders, Inc., when he was struck and killed by a falling tree on March 7, 2018. He was survived by his biological daughter, Ariana Eskra, then a minor, and his wife, Brandy Eskra. Also living in his household were Brandy's two children from a prior relationship: Jovie Fischer, who was nine years old and living with Scott and Brandy approximately 20 to 23 days per month, and Austin Evenson, who had graduated high school and joined the Marine Corps but still maintained a room at the family home.
Nearly five years after Scott's death, Ariana Eskra filed an application for death benefits. Brandy Eskra was later joined as an applicant, followed by Jovie Fischer and Austin Evenson. The case required three separate trials to resolve preliminary issues — including statute of limitations questions, evidentiary disputes over a premarital agreement, and the need for additional financial records — before the dependency determinations could be made.
At trial, the evidence established that Brandy Eskra earned approximately $14,000 per year working two to two-and-a-half days per week as a hairdresser. Coworkers at the same salon corroborated that she could not have earned $30,000 per year. Scott Eskra had paid for housing, food, utilities, and other household expenses. Jovie Fischer's biological father had been paying child support until late 2017, and a court-ordered support obligation was issued in December 2017. Austin Evenson was earning roughly $800 every two weeks in the Marine Corps but received occasional financial support from Scott, including gas money, hunting trip expenses, and a plane ticket to visit.
The WCJ issued findings on February 13, 2026, ruling that Brandy Eskra was a presumptive total dependent under Labor Code section 3501(b), which creates a conclusive presumption of total dependency for a surviving spouse who earned $30,000 or less in the twelve months before the employee's death. The WCJ found that both Jovie Fischer and Austin Evenson were partial dependents, reasoning that Jovie did not qualify for the conclusive presumption under section 3501(a) because she was not Scott Eskra's biological or adopted child, and because she had other sources of support including her biological father's child support payments.
The WCAB denied Ariana Eskra's petition for reconsideration and granted Brandy Eskra's petition in the panel decision of Eskra v. AF Builders, Inc., - ADJ17262790 (May 2026). The Board affirmed the WCJ's findings in all respects except one: it amended the decision to find that Jovie Fischer was a presumptive total dependent under Labor Code section 3501(a), not merely a partial dependent. The finding regarding Austin Evenson as a partial dependent was affirmed. Commissioner Razo dissented.
On Brandy Eskra's total dependency, the Board upheld the WCJ's finding without difficulty. The unrebutted evidence — Brandy's own testimony, corroborating testimony from two coworkers, and the 2017 tax return showing gross income of $20,695 — established that she earned well under $30,000 in the year before Scott's death. The Board rejected Ariana Eskra's challenge to the tax return's admission, noting that the WCJ had relied on both documentary evidence and consistent testimony from multiple witnesses.
On the premarital agreement, the Board affirmed its exclusion. The death benefits claim did not exist at the time the agreement was signed, the claim was not the decedent's property to dispose of, and in any event workers' compensation benefits cannot be released without a WCJ's order approving and finding adequacy of consideration — none of which occurred here.
On Jovie Fischer's dependency status, the Board broke from the WCJ. The central question was whether a non-biological, unadopted child living in the decedent's household qualifies as a "child" under section 3501(a), which creates a conclusive presumption of total dependency for a child under 18 living with a deceased employee-parent at the time of injury.
Following its own reasoning in the panel decision Franco, dec'd v. Orange County Plastering Co., Inc., 2025 Cal. Wrk. Comp. P.D. LEXIS 258 (Appeals Board Panel Decision, July 14, 2025), the Board held that the plain and ordinary meaning of "child" includes stepchildren. The Board drew support from section 3503, which lists stepchildren among those who may qualify as dependents, and from section 3202, which mandates liberal construction of workers' compensation law to extend benefits to injured workers and their dependents.
The Board also cited State Compensation Ins. Fund v. Workers' Comp. Appeals Bd. (Asher) (1993) 19 Cal.App.4th 1645, which applied similar reasoning to conclude that minor grandchildren are entitled to extended death benefits. Because Jovie was living with the decedent at the time of his fatal injury, section 3501(a) applied regardless of whether she sometimes visited her biological father or whether that father paid child support.
On Austin Evenson, the Board agreed with the WCJ that he was a partial dependent. Although Austin was a good-faith member of the household under section 3503 and received some financial support from the decedent, he was over 18 and earning his own income in the Marine Corps, so the conclusive presumption of section 3501(a) did not apply. The exact amount of his dependency was deferred.
Commissioner Razo dissented on the Jovie Fischer issue, adopting the WCJ's reasoning. He emphasized that Jovie was not living full-time with the decedent and that her biological father was paying child support, making a finding of total dependency inappropriate in his view. He would have left the WCJ's partial dependency finding in place. - When Can Treating Physician Use Narrative Report for RFA Forms?on May 20, 2026 at 1:11 PM
The Division of Workers' Compensation (DWC) has adopted updated regulations regarding Utilization Review (UR), which became effective April 1, 2026. These regulations, designed to streamline and standardize the medical treatment authorization process, are available on the DWC website.
In light of these updates, the DWC has received several inquiries regarding whether the use of the DWC Form RFA (Request for Authorization) is mandatory for treating physicians.
Pursuant to California Code of Regulations, title 8, section 9792.6.1, a "Request for Authorization" is formally defined as a written request for a specific course of proposed medical treatment. The regulations mandate that this request be set forth on the DWC Form RFA (as found in section 9785.5) and completed by the treating physician.
The standardized use of the DWC Form RFA is a critical regulatory requirement intended to ensure clear, consistent communication between medical providers and claims administrators, thereby reducing delays in the delivery of necessary medical care.
While the DWC Form RFA is the primary standard, a narrative report may serve as a functional equivalent only under specific conditions outlined in CCR section 9792.9.1(b) and 9792.6.1(u):
- - Mutual Acceptance: The claims administrator (CA) must voluntarily agree to accept a narrative report in lieu of the formal DWC Form RFA.
- - Minimum Content Standards: To be deemed "completed," the narrative report must contain all essential data elements required by law, including:
- - Clear identification of both the employee and the requesting provider.
- - Specific identification of all recommended treatments on the first page of the narrative.
- - Substantiating documentation created no earlier than 30 days prior to the request.
- - Treating Physician’s Signature: The report must be signed by the physician (electronic signatures are permitted by agreement of the parties).
DWC reminds all stakeholders that failure to provide a "completed" request (one that lacks specificity or the required substantiating documentation) may impact the timelines for UR decisions and the overall adjudication of treatment requests. - Eleven Insurance Commissioner Candidates on June 2 Primary Balloton May 19, 2026 at 4:12 PM
Eleven candidates are running in the top-two primary for insurance commissioner of California on June 2, 2026. Five have led in media attention: Stacy Korsgaden (R), Ben Allen (D), Steven Bradford (D), Jane Kim (D), and Patrick Wolff (D). Incumbent Ricardo Lara (D) is term-limited and is retiring from public office.
Stacy Korsgaden has warned she would crack down on insurance fraud and conduct a full audit of the California Department of Insurance if elected. Korsgaden is a licensed insurance professional (License #0750748) since 1988, small business owner, and lifelong Californian. And according to a report by the New York Post “[t]he reason that I’m running is that we have a situation that I cannot sit back anymore and watch, the inexperience in the policies that are being implemented throughout the state. That’s why I’m getting involved,” she said during a town hall in Tuolumne County.
Ben Allen is currently sitting on the California Senate. Allen wrote on his official candidate statement "I have a long track record of success working for the public interest: In the State Senate, I've taken on insurance industry lobbyists, passed some of the nation's strongest consumer protection laws, and led efforts to invest $10 billion in wildfire prevention, water infrastructure improvements, and climate resilience. As Insurance Commissioner, my #1 priority will be putting consumers first. That means: Holding polluters accountable: I'll make corporate polluters financially responsible for climate damages that drive up insurance costs."
Allen is frequently described as a strong contender or frontrunner. He has significant fundraising (~$1.5M+ raised), high-profile endorsements (e.g., Adam Schiff), and experience in wildfire-affected areas. Recent endorsements (e.g., from newspapers) position him as a top choice.
Steven Bradford is a former State Senator where he sat on the State Legislature's Insurance Committee where he helped build consensus on complex regulatory challenges. His plan "includes bringing transparency to insurance pricing, rewarding people who protect their homes, rebuilding the insurance market in high risk areas, and making rates make sense. Bradford will support safer moves for the most at-risk, modernize the Department of Insurance, and put equity front and center."
Jane Kim is a civil rights attorney, organizer and consumer advocate. "As Insurance Commissioner, I'll cap excessive profits and freeze your rates when you file a claim. I'll create a public Disaster Insurance for All program so we are protected when fires, floods or earthquakes strike. I'll crack down on illegal price-fixing, stop insurers from using credit scores to deny coverage, and fight for guaranteed healthcare for every child in California." Kim is backed by progressives (e.g., Bernie Sanders ties via Working Families Party)
Patrick Wolff wrote that "[f]rom 2001–2005, I worked at a major bank where I built a home and auto ins urance brokerage. Since 2005, I have worked as a financial analyst where, among other sectors, I analyzed insurance markets and companies." According to his website "I have a plan to solve our state’s insurance crisis by holding insurance companies accountable, increasing choice and competition, and improving transparency."
Lower profile candidates include Republican Sean Lee. Lee conducted scientific research at JPL / NASA through Caltech, developing a disciplined, data-driven approach to analyzing complex problems. He later applied those analytical skills in the insurance and financial services industries. He supports transparency, accountability, and effective oversight of insurance practices. Lee also supports the responsible use of emerging technologies, including artificial intelligence and lnsurTech, to improve efficiency and combat fraud.
Republican Robert P Howell unsuccessfully competed for Insurance Commissioner Ricardo Lara. He has been the CEO of a Silicon Valley cybersecurity manufacturing company. He wrote " I will hold insurance companies accountable to the rules and challenge abusive practices. I will implement an “Insurance Payers Bill of Rights” to protect policyholders from unfair cancellations and unjustified rate increases."
Eduardo “Lalo” Vargas is the Peace and Freedom party candidate. He wrote "I pledge to freeze insurance rates and lower premiums, to investigate and hold insurance executives accountable for exploitative claim procedures, and to fight for a public insurance system that guarantees full and fair coverage for all."
Republican candidate Merritt Farren is a California wildfire survivor, former Amazon lawyer, and former head of legal, guest claims, and security operations for the Disneyland Resort. He wrote " I want to bring the customer-centric innovation I've learned to California insurance regulation."
Keith Davis (American Independent) and Eric Aarnio do not have candidate statements on the official ballot. Both are lower-profile candidates compared to the leading Democrats and more prominent Republicans. Davis is an insurance agent from Riverside California. He emphasizes being a consumer advocate rather than aligned with big insurance companies. He has a campaign website (gokeithdavis.com) and has been active in interviews and outreach.
Eric Aarnio is a Republican, and a contractor from Sacramento with no prior elected office or formal insurance industry background. He has a very low-profile campaign (no website or social media listed in questionnaires) and minimal media presence. - Owner of Health Care Software Company Convicted for $1B Fraudon May 19, 2026 at 4:12 PM
A federal jury convicted the founder and owner of HealthSplash for his role in operating a platform that generated false doctors’ orders and prescriptions to defraud Medicare and other federal health care benefit programs out of more than $1 billion.
According to court documents and evidence presented at trial, Brett Blackman, 42, of Johnson County, Kansas, and his co-conspirators aggressively targeted hundreds of thousands of Medicare beneficiaries to get them to accept medically unnecessary orthotic braces and other items. They then arranged for purported telemedicine doctors to sign bogus prescription orders for these items, so that their co-conspirators could bill Medicare for them. All told, Blackman and his co-conspirators billed Medicare and other federal health care benefit programs over $1 billion for this unnecessary equipment.
Blackman owned, controlled, and was the CEO of HealthSplash, which acquired Power Mobility Doctor Rx, LLC (DMERx) in September 2017. DMERx was an internet-based platform that generated false and fraudulent doctors’ orders for durable medical equipment (DME) and prescriptions for other items. As part of the scheme, Blackman and his co-conspirators connected pharmacies, DME suppliers, and marketers with telemedicine companies that would accept illegal kickbacks and bribes in exchange for signed doctors’ orders created using the DMERx platform. Blackman and his co-conspirators took a cut for themselves in exchange for the referrals.
The fraudulent doctors’ orders and prescriptions generated by DMERx falsely represented that a doctor had actually examined and treated the Medicare beneficiaries when, in fact, the doctors were simply paid to sign orders and prescriptions without any meaningful interaction with the beneficiary, and in some cases, no interaction at all. Doctors signed these orders and prescriptions without regard to whether the equipment was medically necessary. Testimony and evidence presented at trial from an undercover agent who posed as a Medicare beneficiary showed the scheme in action—starting with a foreign call center that pushed the undercover agent to agree to multiple braces to a doctor signing bogus orders for the braces using Blackman’s DMERx platform. The doctor’s order for one of these undercover agent beneficiaries claimed that the doctor conducted various tests that can only be performed in person even though the doctor never even spoke with the undercover agent “patient.”
The DME suppliers and pharmacies that were paying illegal kickbacks for these orders billed Medicare and other insurers for more than $1 billion. Medicare and the other insurers paid more than $450 million based on these claims. According to evidence presented at trial, Blackman and his co-conspirators concealed the scheme through sham contracts and by manipulating the doctors’ orders to avoid Medicare audits.
The jury convicted Blackman of conspiracy to commit health care fraud and wire fraud, conspiracy to pay and receive health care kickbacks, and conspiracy to defraud the United States and to make false statements in connection with health care matters. Blackman’s co-defendant, Gary Cox, was convicted in a prior trial and sentenced to 15 years in prison.
Blackman faces a maximum penalty of 20 years in prison for the conspiracy to commit health care fraud and wire fraud conviction, five years for the conspiracy to pay and receive health care kickbacks conviction, and five years for the conspiracy to defraud the United States and to make false statements in connection with health care matters conviction. A sentencing hearing has been scheduled for August 26, 2026. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
“The Department of Justice crushed one of the most egregious fraud schemes in Florida history,” said Acting Attorney General Todd Blanche. “This illegitimate operation stole more than $1 billion from American taxpayers — including hundreds of thousands of Medicare beneficiaries. This was cold, calculated, industrial-scale theft targeting the sick and elderly, coercing vulnerable people into buying unnecessary medical equipment. We will not rest until every fraudster ripping off the American people is held accountable.” - Employer's $257K Attorney Fee Award Against Employee Affirmedon May 18, 2026 at 11:07 AM
Nick Miletak was hired to participate in Royal Coach Tours' student driver trainee program. On the day formal classroom instruction was set to begin, Miletak showed up, handed in his resignation, and demanded compensation for time he had been available before the formal training started. Royal Coach refused but still paid him for 11 hours of classroom time he had logged during informal training.
About a week after resigning, Miletak filed a civil lawsuit against Royal Coach alleging five causes of action. After Royal Coach demurred, Miletak filed an amended complaint asserting two claims: promissory estoppel and constructive discharge. Following a court trial, judgment was entered in Royal Coach's favor. Miletak appealed, and the Sixth District affirmed. Royal Coach then sued Miletak for malicious prosecution.
A bench trial was held on the malicious prosecution claim without a court reporter present. The trial court issued a statement of decision finding that Miletak's prior employment action had terminated in Royal Coach's favor, that Miletak lacked probable cause to bring the claims, that he pursued the action with malice, and that Royal Coach suffered damages. The court awarded Royal Coach $257,197.53, including punitive damages.
Miletak subsequently filed motions for a new trial, to dismiss, and to vacate the judgment. The trial court denied each one.
The Sixth District Court of Appeal affirmed the judgment in its entirety in the unpublished case of Royal Coach Tours, Inc. v. Miletak, -H052687 (May 2026). Miletak raised thirteen separate contentions on appeal; the court rejected all of them.
Miletak appealed in pro per. The court's analysis was shaped throughout by Miletak's repeated failure to meet basic appellate requirements — providing adequate record citations, presenting developed legal arguments, and confining his claims to matters in the record. The court invoked the principle from Jameson v. Desta (2018) 5 Cal.5th 594, 609, that the burden falls on the appellant to demonstrate error on the basis of the record presented.
On personal jurisdiction, Miletak argued the trial court lost jurisdiction when he relocated to Florida. The court held that once a trial court acquires jurisdiction over a party, that jurisdiction continues to final judgment and is not defeated by the party's relocation, citing Goldman v. Simpson (2008) 160 Cal.App.4th 255, 263–264. Miletak's reliance on Daimler AG v. Bauman (2014) 571 U.S. 117 was misplaced because that case addressed an entirely different question about claims by foreign plaintiffs against a foreign defendant.
On the absence of a court reporter, Miletak claimed he requested one at trial. But the settled statement, the order denying his new trial motion, and the trial court's own statements at the settled statement hearing all indicated that no such request was made. Without record evidence of a request, the court found no error.
On the denial of a jury trial, the record showed Miletak failed to timely request a jury or demonstrate that his partial fee waiver covered jury fees. The court applied TriCoast Builders, Inc. v. Fonnegra (2024) 15 Cal.5th 766, which holds that a litigant challenging the denial of relief from a jury waiver for the first time on appeal must show prejudice — something Miletak never attempted.
On probable cause, the central substantive issue, Miletak argued that the denial of Royal Coach's nonsuit motion in the underlying employment action conclusively established probable cause under the interim adverse judgment rule. The court disagreed. Drawing on Parrish v. Latham & Watkins (2017) 3 Cal.5th 767 and Wilson v. Parker, Covert & Chidester (2002) 28 Cal.4th 811, the court explained that the interim adverse judgment rule applies only to rulings on the merits, not those resting on procedural or technical grounds. Here, the nonsuit motion was denied based on Miletak's opening statement — before any evidence was presented — so the denial said nothing about the substantive merits of his promissory estoppel claim.
The court also noted that Miletak attributed a fabricated quotation to Parrish, claiming that probable cause for any single claim insulates the entire suit. The California Supreme Court has held precisely the opposite: a malicious prosecution suit may be maintained where even one of several claims in the prior action lacked probable cause. See Crowley v. Katleman (1994) 8 Cal.4th 666, 671.
On the remaining issues — evidentiary rulings, judicial bias, fraud on the court, the settled statement, denial of writ petitions, and the prior anti-SLAPP appeal — the court found each contention either unsupported by record citations, procedurally forfeited, or substantively without merit. Multiple claims were deemed waived under Duarte v. Chino Community Hospital (1999) 72 Cal.App.4th 849, 856, for failure to cite the record. - Major Drug Maker to Pay $13.6M to Resolve Kickback Caseon May 18, 2026 at 11:07 AM
Takeda Pharmaceuticals U.S.A., Inc. is the U.S. subsidiary of Takeda Pharmaceutical Company Limited, a major global biopharmaceutical company headquartered in Osaka, Japan It is one of the world’s leading R&D-driven pharmaceutical companies, with a strong emphasis on oncology, rare diseases, neuroscience, gastroenterology (and inflammation), plasma-derived therapies, immunology, and vaccines.
The company has a major presence, including its global hub and research center in Cambridge, Massachusetts (making Takeda the largest life sciences employer in the state). It has sites in 39 states and employs more than 20,000 people in the U.S. (part of ~50,000 worldwide).
Takeda Pharmaceuticals, U.S.A., Inc. has agreed to pay $13,670,921 to resolve allegations that it knowingly caused the submission of false claims to Medicare and other federal health care programs by paying kickbacks to healthcare providers to induce prescriptions of Trintellix, an antidepressant medication that Takeda marketed and sold to treat major depressive disorder.
Trintellix (vortioxetine) is a prescription antidepressant medication used to treat Major Depressive Disorder (MDD) in adults. It is marketed in the U.S. by Takeda Pharmaceuticals (in collaboration with H. Lundbeck A/S, which originally developed it).
The civil settlement resolves allegations that, from January 2014 to October 2020, Takeda paid improper remuneration, including in the form of speaker honoraria and meals at high-end restaurants, to healthcare professionals to induce them to prescribe the antidepressant medication Trintellix in violation of the Anti-Kickback Statute.
The United States contends that Takeda selected certain healthcare providers to be part of the Trintellix speaker bureau and provided them paid speaking opportunities with the intent that the speaker honoraria and meals would induce them to prescribe Trintellix. The government further contends that certain prescribers who attended multiple programs on the same topic and received meals and drinks from Takeda received no educational benefit from attending duplicate programs.
Takeda (including its subsidiaries and predecessors like TAP) has faced other False Claims Act (FCA) allegations, Medicaid fraud claims, kickback-related matters, and similar government program issues in the U.S.
- - 2001 TAP Pharmaceuticals Settlement (Lupron): Takeda's former joint venture with Abbott (TAP) paid $875 million to resolve criminal and civil charges. Allegations included providing free drug samples to doctors who then billed Medicare/Medicaid, kickbacks, and improper pricing. This was one of the largest pharma fraud settlements at the time.
- - In 2023 Takeda subsidiaries (along with others from the Shire acquisition) agreed to pay a combined ~$42.7 million to resolve Texas Medicaid Fraud Prevention Act claims. Allegations involved providing improper nursing/reimbursement support and paying nurse educators to recommend Vyvanse to Medicaid providers (~2014–2015). This was a whistleblower-initiated case.
Takeda paid ~$2.4 billion in 2015 to settle thousands of U.S. lawsuits alleging the diabetes drug caused bladder cancer and that risks were inadequately disclosed. Some claims involved marketing practices, but these were primarily personal injury/product liability. - Court Finds County Liable for Losing Personnel & CalPERS Recordson May 14, 2026 at 11:19 AM
Kay Marie Gibbs worked as a court reporter for the Humboldt County Superior Court for nearly 40 years, starting in June 1982. She became eligible for enrollment in the California Public Employees' Retirement System (CalPERS) in December 1983, but the county did not enroll her until November 1989 — a gap of roughly six years.
When Gibbs began preparing for retirement in 2019, she discovered she would not receive CalPERS service credit for those early years. CalPERS told her it could not adjust her benefits without a certification from the county of her full employment history. What followed was a prolonged and fruitless effort to get the county to produce those records. Gibbs alleged that three individual employees in the county's human resources department lost, destroyed, or failed to search for the requested records. After repeated promises, the county eventually sent CalPERS an incomplete compilation that was missing records for multiple periods spanning from 1982 to 1989.
Gibbs attempted to mitigate the damage by purchasing "prior service credit," but she could not do so without the county's certification of her employment history. She alleged she was forced to delay retirement and stood to lose hundreds of thousands of dollars in benefits.
Gibbs filed suit asserting four causes of action under Government Code section 815.6, each based on the county's alleged failure to discharge a mandatory statutory duty — specifically, duties to maintain CalPERS-related records, allow inspection of personnel records, timely enroll her in CalPERS, and properly maintain employment information. She also asserted a fifth cause of action for negligence against all defendants.
The trial court sustained the county's demurrers to all four statutory causes of action without leave to amend. It allowed Gibbs to amend only the negligence claim. She filed a second amended complaint focused on negligence, but the court sustained the demurrer to that claim as well, concluding that no statutory authority supported the duties Gibbs alleged. The court suggested that "a simple mandamus will suffice" if Gibbs wanted to review withheld records.
The First District Court of Appeal largely reversed in the partially published case of Gibbs v. County of Humboldt et al., -A173637 (May 2026). It found the trial court's result "untenable" — that Gibbs, who alleged the county failed to enroll her in CalPERS through no fault of her own, was left without a claim because the county also lost her records through no fault of hers.
The court reversed on three of Gibbs's causes of action. It affirmed on only one — the fourth cause of action under Government Code sections 26205 and 26205.1, which the court found authorizes destruction of certain records rather than mandating their retention.
On the personnel records claim, the court held that Government Code section 31011 and Labor Code section 1198.5 impose mandatory, nondiscretionary duties on public employers to let employees inspect their personnel records and to maintain those records for at least three years after employment ends. The court rejected the county's argument that the Trial Court Employment Protection and Governance Act (TCEPGA), which transferred court employees from county to court employment effective January 1, 2004, extinguished its obligations. Gibbs was never terminated — she continued the same work — and the Public Employees’ Retirement Law (PERL), Government Code § 20000 et seq., itself, provides that a contracting agency's obligations "continue through the memberships of the respective members." (Gov. Code, § 20164, subd. (a).) The court was guided by Thornburg v. El Centro Regional Medical Center (2006) 143 Cal.App.4th 198, which found a private right of action under similar record-inspection statutes.
On the failure to enroll claim, the court held that the PERL imposes a mandatory duty on contracting agencies to timely enroll employees in CalPERS, pointing to sections 20283, 20502, 20281, and 20028. The Supreme Court had already recognized a "duty to enroll employees in CalPERS" in Metropolitan Water Dist. v. Superior Court (2004) 32 Cal.4th 491, 506. Reading the enrollment obligation as discretionary, the court said, would render the statutes' benefits "illusory," citing Henderson v. Newport-Mesa Unified School Dist. (2013) 214 Cal.App.4th 478, 494–495.
On the negligence claim, in the unpublished portion of the opinion, the court concluded that Gibbs stated a viable claim against the individual defendants for breaching their duties of care, and the county could be held vicariously liable under Government Code section 815.2. The court rejected the defendants' invocations of discretionary-act immunity (§ 820.2) and the economic loss rule, finding neither applicable.
The court also rejected the argument that mandamus was Gibbs's exclusive remedy, distinguishing Crumpler v. Board of Administration (1973) 32 Cal.App.3d 567 and Metropolitan, neither of which held that a writ is the only available path when an employee was wrongfully denied CalPERS enrollment. - Stanford Breakthrough Could Make Knee Replacement Obsoleteon May 14, 2026 at 11:19 AM
A study published in the journal Science by Stanford Medicine researchers has demonstrated something the orthopedic world has been chasing for decades: the ability to regrow cartilage that has been lost to aging or injury, using a simple injection rather than surgery. If the approach translates from the laboratory to clinical practice — and early signs suggest it may — the implications for workers' compensation claims involving knee and hip injuries would be profound.
Osteoarthritis is the single most common joint disease in the United States, affecting roughly one in five adults. It occurs when the cartilage that cushions joints wears away, leading to pain, stiffness, and progressive loss of function. There is currently no drug that can slow or reverse the disease. Every treatment available today — anti-inflammatory medications, corticosteroid injections, physical therapy, viscosupplementation — manages symptoms. When those fail, the endpoint is surgical joint replacement.
More than one million Americans undergo knee or hip replacement surgery each year, and workplace injuries are a significant driver of the demand. Workers who sustain knee injuries — meniscus tears, ligament damage, repetitive stress injuries — are at elevated risk for developing osteoarthritis in the affected joint. Roughly half of all people who suffer an ACL tear develop osteoarthritis within 10 to 20 years of the injury, even after successful surgical repair. For workers' compensation, that means an acute knee injury claim can evolve into a decades-long medical management case culminating in joint replacement.
The Stanford research offers the first realistic prospect of breaking that cycle. The research team, led by Drs. Helen Blau and Nidhi Bhutani, focused on a protein called 15-PGDH — classified as a "gerozyme," an enzyme whose levels increase as the body ages and which drives the gradual loss of tissue function. Higher levels of 15-PGDH are linked to declining muscle strength, reduced bone repair, and diminished nerve regeneration in older animals. The Stanford team hypothesized that the same protein might be responsible for the cartilage loss that underlies osteoarthritis.
They were right. In aged mice, knee cartilage that had naturally thinned and deteriorated — the animal equivalent of age-related osteoarthritis — thickened and regenerated after the mice received injections of a small-molecule drug that blocks 15-PGDH activity. The treated cartilage closely resembled the cartilage of young, healthy animals.
The researchers then tested whether the treatment could prevent arthritis after a traumatic injury. They induced ACL-like knee injuries in young mice — the kind of injury that reliably leads to osteoarthritis in both mice and humans — and administered the 15-PGDH inhibitor. Untreated mice developed arthritis within four weeks. Treated mice did not. They avoided cartilage breakdown, moved more normally, and placed more weight on the injured limb.
Critically, the treatment also worked in human tissue. When the researchers applied the 15-PGDH inhibitor to human cartilage samples in the laboratory, the cartilage cells responded by shifting their gene expression toward a younger, healthier profile.
Previous attempts at cartilage regeneration have relied on stem cell transplantation — harvesting cells from one part of the body, cultivating them, and surgically implanting them into the damaged joint. These procedures are complex, expensive, and have produced inconsistent results. The Stanford approach is fundamentally different: it does not introduce new cells. Instead, it causes the existing cartilage cells — the chondrocytes already present in the joint — to change their behavior. The drug essentially reprograms aged, deteriorating cartilage cells to act like younger, healthier versions of themselves, without requiring stem cells or surgery.
The mechanism works through prostaglandin E2, a naturally occurring molecule. While prostaglandin E2 is commonly associated with inflammation and pain, the researchers found that small, controlled increases — achieved by blocking the enzyme that breaks it down — actually promote tissue regeneration rather than inflammation.
How close is this to clinical use? Closer than one might expect for a laboratory breakthrough. A version of the 15-PGDH inhibitor has already completed Phase 1 safety testing in humans for a different age-related condition — muscle weakness — and did not raise safety concerns. That existing safety data could significantly accelerate the pathway to human trials for joint applications. The researchers have indicated they are moving toward clinical trials for cartilage regeneration.
However, important caveats remain. The current results are in mice and in human tissue samples in the laboratory, not yet in human patients with osteoarthritis. The transition from animal models to human clinical practice is uncertain, and even with fast-tracked development, it would likely be several years before a treatment could reach clinical use. The therapy would also need to demonstrate that regenerated cartilage is durable and functionally equivalent to native cartilage over the long term.
Even at this early stage, the research is worth tracking for several reasons. Knee injuries are among the most common and costly workers' comp claims. Any development that could reduce the long-term progression from acute knee injury to osteoarthritis to joint replacement has the potential to significantly alter the lifetime cost trajectory of these claims. Joint replacement surgery, with its associated surgical costs, hospitalization, rehabilitation, temporary disability, and potential complications, is one of the most expensive procedures in the workers' comp system. - Employers File More RICO Actions Against Plaintiff Lawyerson May 13, 2026 at 3:19 PM
Plaintiff Lawyers are now calling the RICO cases filed in several states, including California, by employers against plaintiff lawfirms for filing alleged exaggerated claims a "Very Dangerous Trend." Ostensibly, this "trend" became of interest recently when Uber Technologies, Inc. filed three racketeering lawsuits recently against lawyers and medical providers for alleged fraudulent insurance claims, with a California lawsuit against Downtown LA Law Group et al.being the third.
The the first was filed in New York in 2025 targeting a group of lawyers and medical providers in New York for allegedly exploiting Uber’s state-mandated $1 million rideshare insurance policy to file fraudulent personal injury claims. The scheme allegedly involved directing claimants to pre-selected medical providers who produced fraudulent medical records and bills to inflate settlement demands.
The second was filed in South Florida (Uber v. Law Group of South Florida et al., Case No. 25-cv-22635-CMA) and Uber accused the defendants of staging car accidents, manufacturing damages, and pursuing unnecessary medical procedures to exploit insurance policies between 2023 and 2024.
Uber Technologies filed another lawsuit in the United States District Court for the Central District of California alleging a fraudulent scheme involving personal injury claims filed against them in California. The complaint alleges that this “scheme begins when Defendants (Igor) Fradkin, Downtown LA Law Group, Emrani, and Law Offices of Jacob Emrani identify individuals with potential personal injury claims against rideshare companies such as Uber.” And goes on to allege “Both firms aggressively pursue clients to sue Uber, as shown in this online advertisement by Emrani” which appears to be screen grab of an advertisement showing Jacob Emrani next to an UBER/Lyft logo above the words “Uber or Lyft Accident?” followed by a banner that reads “Call Jacob.com.”
Uber then alleges that a “key repeat participant in this fraud is Defendant Greg Khounganian, a spinal surgeon who owns and controls GSK Spine, an orthopedics practice. Working with personal injury coordinators at Defendant Radiance Surgery Center, a surgery center which specializes in treating patients with pending personal injury lawsuits and which also does business as Sherman Oaks Surgery Center.
Following these three RICO cases, there were more to come, with Federal Express joining as a plaintiff, when Uber Technologies and Federal Express sued Philadelphia personal injury attorney Marc Simon, his firm Simon & Simon P.C., and several medical professionals — chiropractors Ethel Harvey and Daniel Piccillo of Philadelphia Spine Associates, pain management physician Clifton Burt of Premier Pain & Rehab Center, and medical examiner Lance Yarus — under the federal Racketeer Influenced and Corrupt Organizations Act (RICO). The companies alleged the defendants ran a coordinated fraud scheme spanning dozens of lawsuits filed over the past four years in Philadelphia County courts.
According to the complaint, the scheme worked like a conveyor belt. Simon & Simon would sign up clients involved in motor vehicle accidents with Uber or FedEx drivers — clients who typically suffered minimal or no injuries and often carried limited-tort insurance. The firm then directed those clients to the same small group of medical providers. Drs. Harvey and Piccillo administered extensive chiropractic treatments and ordered MRIs that came back negative or showed only mild degenerative changes unrelated to the accidents. Despite those results, the chiropractors continued treatment at the lawyers' direction, generating voluminous records that in some cases reflected care that was allegedly never actually delivered or was documented using cut-and-paste boilerplate.
On May 11, 2026 the court denied the defendants' motion to dismiss in its entirety in the case of Uber Technologies v. Simon & Simon P.C., Case No. 25-5365 (E.D. Pa.) (May 2026) allowing all of Uber's RICO claims to proceed to discovery. Every defense raised — Noerr-Pennington immunity, res judicata, the Rooker-Feldman doctrine, and challenges to the sufficiency of the RICO allegations — was rejected at this stage.
Noerr-Pennington immunity is a common defense raised in these cases. The defendants argue their conduct was protected petitioning activity under the First Amendment. The Philadelphia court acknowledged that filing and serving lawsuits is classic petitioning activity, but held the alleged pre-filing conduct — directing doctors to create false medical records and manufacture evidence — was not "incidental" to petitioning.
Even assuming the conduct could qualify as petitioning, the court found Uber plausibly invoked the sham litigation exception. Under the series-of-petitions framework from California Motor Transportation Co. v. Trucking Unlimited, 404 U.S. 508 (1972), the allegations supported an inference the lawyers filed cases without regard to merit and to extract settlement value through the litigation process itself. The abrupt dismissal of claims once discovery threatened to expose the scheme was particularly telling.
Ford Motor Company v. Knight Law Group LLP et al., 2:25-cv-04550, was filed May 21, 2025 in the Central District of California. Plaintiff alleged that attorneys with Knight Law Group, Altman Law Group, and Wirtz Law APC submitted thousands of fictitious time entries in Lemon Law cases over the past decade to extract more than $100 million in inflated legal fees. The legal hook is California's Song-Beverly Consumer Warranty Act (the state's Lemon Law), which is fee-shifting — prevailing consumer plaintiffs recover their attorneys' fees from the manufacturer.
Ford's audit allegedly identified 34 days in which a lawyer claimed more than 24 hours of work and 66 entries showing over 20 hours in a single day, including one entry for "an ostensibly heroic but physically impossible 57.5-hour workday in November 2016." Ford also cited instances where attorneys billed for multiple full-day depositions in different locations on the same day.
On November 24, 2025 the court granted Knight's motions to dismiss with leave to amend. The dismissal turned on the Noerr-Pennington doctrine — the First Amendment-rooted rule shielding petitioning activity from liability. The court reasoned that Ford was attempting to impose RICO liability "for conduct connected to Defendants' fee petitions," and that a successful RICO claim would "quite plainly" burden defendants' ability to seek fees for their litigation activity, since seeking fees is at least "incidental to the prosecution of the suit". This is the same doctrinal wall the Gori firm is now invoking against J-M, and the same wall that defeated parts of J-M's earlier suit against Simmons Hanly Conroy.
Ford did not appeal; it pivoted. In an amended complaint filed January 5, 2026, Ford withdrew its RICO claims against Knight Law Group as an entity, along with Altman Law Group, Wirtz Law APC, and several attorneys and a former paralegal, and instead strengthened its case against three individual attorneys formerly associated with Knight Law — founding partner Steve B. Mikhov, managing partner Roger Kirnos, and partner Amy Morse — alleging perjury and obstruction of justice for submitting false statements to courts about how legal fee records were created.
And another case recently filed case by a California employer adds asbestos claims instead of Uber type automobile type litigation. J-M Manufacturing (the Los Angeles-based pipe maker that does business as JM Eagle) filed its federal RICO complaint against The Gori Law Firm on January 29, 2026 in the U.S. District Court for the Southern District of Illinois, asserting claims under RICO along with common-law fraud, unjust enrichment, and civil conspiracy. It's based on information from a "whistleblower" attorney who formerly worked at the Gori firm.
J-M accuses the Gori firm of establishing a "bounty" system since at least 2018, in which "depo attorneys" who took clients' depositions could earn up to 2% of total settlement proceeds if they successfully coached clients to testify they were exposed to J-M's (and other companies') products. The complaint alleges depo attorneys were trained to tell plaintiffs that even if they couldn't recall the products, "the Gori Firm had done lots of research, and based on their research, the plaintiff was exposed to the products of the defendants recommended for inclusion by the attorney" Gori named J-M in more than 400 asbestos lawsuits since 2018, mostly in Madison and St. Clair counties in southern Illinois. - Sutter Health Resolves ERISA Class Action for $4.3Mon May 13, 2026 at 3:19 PM
A class action under ERISA was filed U.S. District Court for the Eastern District of California on behalf of participants and beneficiaries of the Sutter Health 403(b) Savings Plan. The claims alleged breaches of fiduciary duty in the management of the retirement plan.The case was filed in 2020 (case number 1:20-cv-01007). The class was certified by stipulation on January 26, 2024.
Specifically the Plaintiffs allege that Defendants breached their fiduciary duties of prudence and loyalty under ERISA by retaining underperforming funds with excessive fees, instead of offering less expensive, readily available prudent alternative investments. Specifically, Plaintiffs assert Defendants were imprudent in offering the Fidelity Freedom Funds target date series, the Parnassus Core Equity Fund, the Dodge & Cox Stock Fund, and the Lazard Emerging Markers Equity Fund. Plaintiffs also argue that Plan participants paid excessive recordkeeping and administrative fees and the Plan’s total plan cost was too high.
This case falls within a large wave of ERISA excessive-fee lawsuits targeting 403(b) retirement plans at nonprofit hospital systems and universities — cases that accelerated after the Supreme Court's 2015 decision in Tibble v. Edison International 135 S.Ct. 1823 (2015) 575 U.S. 523, which clarified fiduciaries' ongoing duty to monitor plan investments. The Uniform Prudent Investor Act confirms that "[m]anaging embraces monitoring" and that a trustee has "continuing responsibility for oversight of the suitability of the investments already made." § 2, Comment, 7B U.L.A. 21 (1995) (internal quotation marks omitted)."
These are the standard categories of claims in the 403(b) excessive-fee litigation wave, and the Sutter Health case fits squarely within that pattern. Similar cases were filed against Dignity Health, Providence Health, Kaiser Permanente, and many other large nonprofit health systems during the same period.
A settlement was reached through mediation with an experienced neutral mediator, after the parties had sufficient information to evaluate the case's settlement value.The fairness hearing was held April 10, 2026, and final approval was entered May 11, 2026 by Judge Lee H. Rosenthal.
The Settlement Class includes all participants and beneficiaries of the Plan at any time during the Class Period, including beneficiaries of deceased participants and Alternate Payees under QDROs. Excluded are Sutter Health itself, the Defined Contribution Oversight Committee, the Board of Directors, and their individual members and beneficiaries.
The Settlement Amount was $4,300,000. The court found this amount fair, reasonable, and adequate given the costs, risks, and delay of continued litigation. Distribution requires no claim filing for participants with active accounts; former participants without active accounts need only submit a modest claim form.
The court awarded Class Counsel attorneys' fees of $1,433,333.33 (approximately one-third of the settlement fund), plus applicable interest and litigation expenses. Class Representatives were awarded $12,500 each as compensatory awards for costs and expenses related to their representation of the class. All amounts are payable from the settlement fund within 35 business days of the Effective Date.
Upon entry of the order, all class members fully and permanently release the Defendant Released Parties from all Released Claims, regardless of whether a class member received notice, filed a claim, objected, or received any monetary benefit.
The court retains exclusive jurisdiction over disputes related to the settlement's performance, interpretation, or enforcement. If the Settlement Agreement is terminated, the order becomes void and the case reverts to its pre-settlement status. The Settlement Administrator has final authority over allocation decisions, and unresolved distribution questions for active account holders are referred to the Plan's fiduciaries.