- QME to Assign Percent Causation of Good Faith Personnel Action Eventon July 16, 2026 at 8:18 AM
Maria Lopez Rodriguez worked as a medical receptionist for Kern County Hospital Authority, permissibly self-insured and administered by Adminsure, Inc. She claimed a psychiatric injury arising out of and in the course of her employment on November 15, 2017, attributing her symptoms to ongoing conduct by her supervisor, Marie Ruffin.
A qualified medical evaluator (QME), Dr. Greg Hirokawa, took a history in which applicant described her supervisor searching for reasons to reprimand her, denying her a requested transfer, standing over her while giving instructions, and asking coworkers how often applicant used the restroom, among other incidents she said had gone on for roughly 18 to 24 months. Dr. Hirokawa diagnosed an anxiety disorder and opined that work stress was the predominant (greater than 50%) cause of applicant's psychological symptoms, and that personnel actions by her supervisor accounted for roughly 80% of that work stress — but he left it to the trier of fact to determine whether the supervisor's actions were lawful, nondiscriminatory, and in good faith
The workers' compensation administrative law judge (WCJ) found that applicant sustained a psychiatric injury arising out of and in the course of employment, and that her claim was not barred by the good faith personnel action defense under Labor Code section 3208.3(h). In the accompanying Opinion on Decision, the WCJ identified four incidents — the shoulder grab, the shortened lunch, the church-toys directive, and the yelling — and stated that, while defense witnesses had described other incidents that were good faith personnel actions, the incidents applicant testified to were not, and so did not bar her claim. The WCJ adopted Dr. Hirokawa's causation opinion in full. Kern County Hospital Authority filed a timely petition for reconsideration, arguing the WCJ misapplied the good faith personnel action defense and that the decision was not supported by substantial evidence.
In the appended Opinion on Decision (Opinion), the WCJ addressed the good faith personnel action defense by simply stating "While Defendant witnesses discussed other incidents that were good-faith personnel actions, those discussed by Applicant were are (sic) not good-faith- personnel actions. This defense does not bar the claim of Applicant based on the incidents Applicant testified to."
The WCJ adopted Dr. Hirokawa’s opinion on causation, stating: AOE/COE – Parts of the Body Injured "Dr. Hirokawa stated that the predominant cause of Applicant's symptoms were from work stress. Approximately 80 percent of that stress was due to personnel actions by Applicant’s supervisor. Dr. Hirokawa left it to the trier of fact to determine if the supervisor’s actions were legal, non-discriminatory, and non-retaliatory. These actions are being found not to be good-faith-personnel actions. Based on Dr. Hirokawa’s report, Applicant has suffered industrial injury to the psyche."
In the panel decision of Rodriguez v. Kern County Hospital Authority, ADJ11141161 (Cal. Workers' Comp. Appeals Bd., July 2026) — the WCAB granted reconsideration and rescinded the WCJ's Findings and Orders in their entirety, returning the matter to the trial level for further proceedings.
The panel applied the four-step framework the Board adopted in its en banc decision in Rolda v. Pitney Bowes, Inc. (2001) 66 Cal.Comp.Cases 241, for evaluating a psychiatric injury claim once an employer raises the good faith personnel action defense under Labor Code section 3208.3. Under Rolda, the WCJ must determine, in sequence: whether the claimed injury involves actual events of employment; whether those events were the predominant (over 50%) cause of the injury; whether any of those events were personnel actions that were lawful, nondiscriminatory, and in good faith; and, if so, whether those good faith personnel actions were a "substantial cause" — 35% to 40% of all causation — of the injury. The first two steps are applicant's burden; the latter two are the employer's. The panel found the first two steps effectively conceded, since defendant did not dispute that applicant's described incidents were actual events of employment or that Dr. Hirokawa had found predominant industrial causation.
The problem, the panel explained, arose at the third step. The point of that step is to sort the actual events of employment into those that were good faith personnel actions and those that were not, but the WCJ's Opinion on Decision never made clear which of applicant's described incidents — which the panel noted seemed to include more than the four specifically discussed — the WCJ was treating as the operative events, or why. Citing the Board's en banc decision in Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473, and Labor Code section 5313, the panel explained that a WCJ's opinion must refer with specificity to the evidence relied upon and clearly set out the reasons for the decision on each issue, so that the parties and the Board can meaningfully evaluate it on reconsideration; a decision must be based on admitted evidence in the record and supported by substantial evidence, citing Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162, among other cases.
That gap mattered because of what the fourth Rolda step requires. Unlike the "predominant cause" inquiry, which looks only at causation as to all events combined, the "substantial cause" inquiry requires the evaluating physician to parse out the individual events found to be good faith personnel actions and assign a percentage of causation to each. Dr. Hirokawa's report discussed several potential contributing factors but did not analyze each one individually or assign percentages, and the panel reasoned that any such breakdown would necessarily be unreliable if the physician did not know, because the WCJ had never clearly said, which events actually qualified as good faith personnel actions. The panel also noted, in a footnote, that whether a given event is a "personnel action" taken in "good faith" is a factual and legal determination for the WCJ to make, not the QME — so Dr. Hirokawa's own use of that label in his report, offered before the WCJ made any such finding, could not substitute for the missing determination, citing County of Sacramento v. Workers' Comp. Appeals Bd. (Brooks) (2013) 215 Cal.App.4th 785.
Concluding that the record could not currently support a finding either way on whether the good faith personnel action defense barred the claim, the panel held the correct course was to develop the record further rather than resolve the issue on an incomplete record, citing the Board's en banc decision in McDuffie v. Los Angeles County Metropolitan Transit Authority (2002) 67 Cal.Comp.Cases 138 and a recent panel decision reaching the same conclusion on similar facts, Silva v. Department of Transportation Headquarters Operations (2025, ADJ13014565). The Board directed that, on remand, the parties return to Dr. Hirokawa for supplemental reporting under Labor Code section 5701, or that the WCJ appoint a regular physician if his further reporting does not constitute substantial evidence, while noting the parties always retain the option of proceeding by agreed medical evaluator instead. On that basis, the panel rescinded the WCJ's Findings and Orders and returned the matter to the trial level.
- Grand Jury Says Ventura County Has Best in Class Claims Programon July 16, 2026 at 8:17 AM
The Ventura County Civil Grand Jury has released a new report, Setting the Record Straight on Presumptive Workers' Compensation Claims, examining how Ventura County processes "presumptive" workers' compensation claims for deputy sheriffs and firefighters — and largely vindicating the county's recent overhaul of that process while flagging structural problems baked into state law itself.
Presumptive claims exist for "safety workers," a category the Legislature created in 1937 for law enforcement officers, firefighters, and similar high-risk public employees (Cal. Gov. Code, §§ 20390–20416). For a defined list of conditions — including heart trouble, hernia, pneumonia, cancer, tuberculosis, and blood-borne infections — the law presumes the injury or illness arose out of employment, shifting the burden onto the employer to rebut that presumption rather than requiring the worker to prove causation (Cal. Lab. Code, §§ 3212–3214). The Grand Jury notes this framework traces to a genuine, decades-old scientific dispute over whether stress and physical exertion cause conditions like heart disease and cancer, a dispute it says has only been resolved by research in recent years; the report cites the California Supreme Court's 1978 decision in City and County of San Francisco v. Workers' Compensation Appeals Board, which addressed the "persisting cleavage in medical theory" that made these claims so contentious.
The Grand Jury's investigation was prompted by longstanding complaints from Ventura County Sheriff's Office (VCSO) deputies that presumptive claims were being denied without justification, that treatment was delayed, and that filing a claim effectively required hiring a lawyer. The jury found those perceptions were rooted in real problems, but concluded that Ventura County Risk Management has substantially fixed them since 2023 through a series of administrative changes: eliminating the requirement that injured workers choose a doctor from a restricted network; a "FastTrack" arrangement with Ventura Orthopedics that sends deputies straight to evaluation and treatment for duty-belt-related back injuries with no utilization review; automatic pre-approval of diagnostic tests ordered by a treating physician; guaranteed access to three major Southern California cancer centers (City of Hope, USC Norris, and UCLA Jonsson) for approved cancer claims; the option to substitute a chosen specialist's second opinion for a formal Qualified Medical Evaluator (QME) in some cases; and the addition of three claims examiners dedicated specifically to VCSO and Ventura County Fire Department (VCFD) claims.
The county's own data shows the payoff: the share of workers' comp claimants who retained a lawyer fell from 65% before 2023 to 22% between 2023 and the end of 2025, and insurance rates for the two safety departments have declined for three consecutive years.
Even so, the report identifies a structural flaw in state law that county-level administrative fixes cannot solve. When a QME's opinion is needed to resolve a disputed claim, the jury found, the examiner routinely cannot meet the 75-day statutory deadline, leaving both the county and the worker in limbo. The report also flags a related problem: California's QME system struggles to recruit specialists in fields like oncology and cardiology, and the jury cites an example of a Ventura County deputy with a serious back injury whose QME opinion came from a podiatrist, plus a case in which a claim was kicked back over a data-entry date error despite two accompanying documents showing the correct date.
The jury's numbers give a sense of scale: between January 2023 and October 2025, only 39 of VCSO's 578 workers' compensation claims were presumptive claims. Of those 39, only 10 were accepted quickly (an average of 13 days), 14 were accepted within the 75-day window, and 15 were denied within that window; of the denials, 8 were later reversed once new supporting evidence came in, and 7 remain denied and undisputed — five of those seven were COVID-19 claims, which are no longer covered by the presumption.
The report makes ten findings and ten recommendations, aimed mainly at the VCSO, County Risk Management, and the Board of Supervisors, with response deadlines running through the end of 2026. Among them: formalize regular communication between VCSO and Risk Management (R-01, R-02); train HR staff and supervisors on presumptive-claims rules (R-03); proactively educate deputies on their claims-process rights and responsibilities within three years of hire (R-04); create a dedicated advocate role within VCSO to guide injured deputies through the claims and treatment process, modeled on a similar role VCFD already uses (R-05); better publicize the state Division of Workers' Compensation's Information and Assistance Unit, a free advocacy resource for claimants that the jury found is underused (R-06); add preventive health screening and wellness programs for deputies similar to VCFD's (R-07); build out more substantive "light duty" assignments for recovering deputies (R-08); have the County Auditor-Controller finally audit the cost of covering deputies' leaves of absence with overtime, which the Sheriff's Office estimates runs into the millions annually but has never been formally measured (R-09); and, notably, petition state lawmakers to reconcile the mismatched 75-day and 90-plus-day statutory deadlines (R-10).
The Grand Jury closes by commending both Ventura County Risk Management and VCFD by name for building what it calls a "best-in-class" claims program, while cautioning that the county's improvements can't by themselves fix a claims timeline that state law itself sets up to fail. Responses are required from the Board of Supervisors within 90 days and from the Sheriff and County Auditor-Controller within 60 days; responses are invited but not required from the County Executive Officer and the VCFD Chief.
- California First State to Launch AI-Unemployment Tracker (CAIT)on July 15, 2026 at 10:20 AM
California has become the first state in the nation to launch a public tool tracking whether artificial intelligence is showing up in the unemployment line. The California AI-Unemployment Tracker (CAIT), unveiled June 25, 2026, links unemployment insurance claims data with occupational AI-exposure measures to monitor, in near real time, whether workers in AI-exposed jobs are losing work at elevated rates. The tracker was built through a partnership between the Governor's Office, the state's Employment Development Department (EDD), and the nonpartisan California Policy Lab at the University of California, and it is also hosted directly on the EDD's own website.
The tracker is accompanied by a detailed research report, Tracking AI-Related Job Loss Using Unemployment Insurance Claims Data in California, prepared by a team of researchers at the Policy Lab's UCLA site, along with a companion technical appendix laying out the underlying methodology. Governor Gavin Newsom framed the launch as part of a broader effort to get ahead of AI's labor-market effects, saying California intends to lead by "reimagining how we prepare" the state through governance and policy rather than simply watching from the sidelines.
At the center of the tool is a straightforward but data-intensive idea: take every initial unemployment insurance claim filed in California since January 2017, match each claimant's self-reported prior occupation to a score reflecting how exposed that occupation is to AI, and then track claim volumes over time by exposure level, education, age, gender, race and ethnicity, industry, and region. Claimants are sorted into three exposure tiers — high, moderate, and low — based on the top, middle, and bottom quartiles of the exposure scores. High-exposure occupations, the top 25%, include roles such as customer service representatives and software developers; low-exposure occupations, the bottom 25%, include jobs such as heavy truck drivers and nursing assistants.
The researchers use two separate exposure measures rather than one. The first, called Potential AI Exposure, asks whether large language models are theoretically capable of cutting the time needed to complete an occupation's tasks by at least half; it comes from a widely cited 2024 study, GPTs Are GPTs, published in Science by a team of OpenAI and academic researchers. The second, called Observed AI Exposure, instead measures how often an occupation's tasks actually show up in real usage of Anthropic's Claude, drawing on the Anthropic Economic Index, a 2025 research effort analyzing millions of anonymized Claude conversations. The report notes that results are largely consistent whether the theoretical or the observed measure is used, and cautions that either measure captures only whether a job's tasks could be or have been touched by AI — not whether AI actually caused any particular layoff. The tracker also excludes the pandemic-era claims surge from March 2020 through January 2022 from its trend comparisons, since that spike would otherwise swamp any post-ChatGPT pattern.
The June 2026 release's first finding is, on its face, reassuring: looking at all unemployment claims statewide, there is no evidence of a broad-based surge in layoffs among AI-exposed workers since the release of ChatGPT-3.5 in late 2022, and the overall share of claims coming from AI-exposed occupations has not risen in a statistically meaningful way relative to before the pandemic. The report notes this lines up with existing national estimates, including Yale Budget Lab's analysis of Current Population Survey data, which similarly finds no nationwide link between AI exposure and unemployment so far.
But the tracker's second and third findings complicate that reassurance considerably. Unemployment claims among college-educated workers in highly AI-exposed occupations rose after ChatGPT-3.5's release and have stayed elevated through May 2026, even as claims among similarly educated workers in low-exposure jobs showed no comparable shift. The effect is sharpest at the top of the credential ladder: claims among workers with master's degrees or PhDs in highly AI-exposed occupations climbed from a baseline of about 13,000 per month in November 2022 to a range of 16,000 to 22,000 per month by mid-2023, and have remained in that elevated band since. Geographically and sectorally, the pattern concentrates where AI adoption itself has concentrated: claims from AI-exposed workers in the San Francisco Bay Area show a sharp, sustained increase relative to pre-pandemic levels, and claims in AI-exposed technology sectors — particularly Professional Services — have likewise stayed elevated, though the report notes claims in the Information sector spiked temporarily before settling back to pre-generative-AI levels in late 2025.
Report co-author Ben Hyman, a senior researcher at the Policy Lab, summed up the tension in the findings: the state is not seeing large-scale AI-related layoffs, but is seeing a real pattern among highly educated workers in the Bay Area and in tech-heavy sectors that will bear continued watching. Co-author Till von Wachter, a UCLA economics professor and the Policy Lab's UCLA faculty director, cast the tool's value as replacing speculation about AI's labor-market effects with an evidence base policymakers can act on before disruptions spread further.
The report is careful to flag the limits of what unemployment insurance data can show. UI claims miss workers who never file — because they are unaware of the program, land a new job quickly, leave the labor force, are ineligible because of immigration status or self-employment, or, for younger workers, have not yet accumulated enough qualifying earnings. Occupation codes are self-reported at the time of filing and unverified, small-count data cells are suppressed under standard confidentiality rules, and monthly figures are described as preliminary and subject to revision as late claims are processed. The authors are explicit that the tracker is a descriptive early-warning signal rather than causal proof that AI is driving any specific job loss.
Practically, the tracker itself is a public, interactive dashboard built on Tableau, embedded on the Policy Lab's site and mirrored on the EDD's, and it will be refreshed monthly. The underlying tabulated data are also released for public download in an accessibility-compliant Excel file, and the Policy Lab has published a separate FAQ document addressing common questions about definitions and methodology. For California employers and workers'-compensation professionals, the tracker offers an early, if imperfect, gauge of where AI-linked displacement is concentrating by sector and region — useful context for anticipating claims trends even though, as its own authors stress, it cannot yet say whether AI caused any individual worker's job loss.
- San Jose Road Rage Driver Sentenced for Insurance Fraudon July 15, 2026 at 10:19 AM
Kenneth Pham Tran, 54, of San Jose, was sentenced after dashcam footage showed him initiating a road rage incident, which resulted in him being rear-ended by a semi-truck. Tran attempted to hide his wrongdoing and profit from the accident he caused by filing a fraudulent insurance claim to collect an undeserved payout. Tran was sentenced to 60 days in county jail, two years of probation, and is ordered to pay over $4,000 in restitution.
On January 28, 2025,Tran was driving his white Jeep Wrangler Rubicon on Highway 101 near the Alum Rock Avenue onramp in San Jose. Furious because he felt he'd been cut off, Tran caught up to a semi-truck at the Story Road underpass and "brake checked" it twice, slamming on his brakes just in front of the truck. When the truck driver tried to change lanes to get away, Tran maneuvered back in front of the truck and brake-checked a third time — and this time the truck driver couldn't stop in time and rear-ended the Jeep
The Department of Insurance Task Force opened an investigation after receiving a referral from San Jose CHP who first investigated the collision and reported the incident. The initial investigation found Tran had filed a claim with Progressive Insurance alleging the back of his white Jeep Wrangler Rubicon was damaged after being rear-ended by a semi-truck while he was stopped in traffic. In his claim he also stated the driver of the semi-truck refused to pull over and exchange insurance information.
During the investigation, Task Force members discovered an independent witness who placed a separate 911 call reporting they had to swerve out of the way of a white Jeep Wrangler Rubicon that was driving recklessly and “break checking” a semi-truck on the 101 freeway in San Jose. According to the witness, the driver of the Jeep, Tran, began swerving in and out of lanes to keep the semi-truck behind his vehicle. Tran held the brakes several times before the semi-truck struck the back of his vehicle. The witness stated it looked as though the semi-truck would not have been able to prevent the collision.
The entire road rage incident was captured on the semi-truck’s dashcam. Investigators were able to obtain the footage and found evidence that Tran had initiated the crash because he felt he had been cut off by the semi-truck. The footage also corroborated the account of the witness who called 911.
Tran was found guilty by a jury on one count of felony insurance fraud, one count of felony vandalism, and one misdemeanor count of reckless driving. He was sentenced to 60 days in county jail, two years of probation, and ordered to pay over $4,000 in restitution — specifically $1,200 to Progressive Insurance and $3,000 to Morgan Hill-based Bill Jacobsen Trucking.
This case was prosecuted by the Santa Clara County District Attorney’s Office.“Road rage. Reckless driving. Insurance fraud. This person made a lot of bad decisions,” District Attorney Jeff Rosen said. “Count to 10 before you commit fraud in Santa Clara County.”
The Department of Insurance urges drivers who believe they may have been victims of a road rage incident to insist on a police report and document as much information about the collision as possible including using a cell phone to take photos or videos of the post-collision damage. If a dashcam was being used, save any footage of the incident and be sure to ask the peace officer at the scene to positively identify everyone involved. All suspicious collisions should be reported to your local law enforcement agency or to the California Department of Insurance by calling 800-927-4357 or visiting our website at insurance.ca.gov.
- 9th Circuit Reviews ADA Atty Fees in High Frequency Litigant Caseon July 14, 2026 at 7:20 AM
LaSandra Price has Parkinson's disease and uses a wheelchair for mobility. Between August and September 2021, she visited a Family Dollar store in Fontana, California, owned by Wael Diab, on four occasions and encountered accessibility barriers each time, including poorly marked disabled parking spaces, uneven walkways, and aisles that were too narrow. Price sued Diab and the store under the Americans with Disabilities Act (ADA) and California's Unruh Civil Rights Act, Cal. Civ. Code § 51. (The district court separately declined supplemental jurisdiction over the Unruh Act claim after finding Price to be a "high-frequency litigant," a ruling not at issue on appeal.) Neither Diab nor the store responded to the complaint, and the clerk entered defaults against both.
Price moved for default judgment and a specific injunction requiring accessible paths of travel, accessible parking spaces, compliant signage, and an accessible entrance within 180 days. The district court granted the motion, observing that Price's proposed order was, if anything, narrower than what her complaint had sought, and entered the injunction essentially as requested. Price then moved for $9,364 in attorney's fees and costs ($8,872 for 31.2 hours of work, plus $492 in costs) under the ADA's fee-shifting provision, 42 U.S.C. § 12205, supporting the motion with billing records, a declaration from counsel, and a third-party survey of prevailing rates.
The district court denied Price's fee motion in full, holding she was not a "prevailing party" under section 12205 because the injunction required Diab and the store to do only what the ADA already required them to do. The court acknowledged that courts routinely treat ADA plaintiffs who obtain default judgment and injunctive relief as prevailing parties, and that Ninth Circuit precedent "appear[s] to presume prevailing-party status" in that situation, but concluded that none of those precedents had squarely analyzed the question. The court further found that even if Price were a prevailing party, her requested fees were unreasonable: her motion appeared to be recycled nearly whole-cloth from a different case, resulting in incorrect male pronouns for Price throughout, and the court questioned the hours billed. The court did not reach what a reasonable fee would be if Price prevailed.
In the published case of Price v. Diab, No. 25-713 (9th Cir., July 2026) — the Ninth Circuit reversed the district court's order denying Price's motion for attorney's fees and remanded for further proceedings on the fee motion.
The panel held, after reviewing the prevailing-party question de novo, that Price prevailed by virtue of the final injunctive relief she obtained. Under Farrar v. Hobby (1992) 506 U.S. 103, a plaintiff prevails when relief on the merits materially alters the legal relationship between the parties by modifying the defendant's behavior in a way that directly benefits the plaintiff, and the Supreme Court has since confirmed in Lackey v. Stinnie (2025) 604 U.S. 192 that an enforceable court order conclusively resolving the parties' rights on the merits satisfies that test. Price's injunction, which forced Diab and the store to take specific, enforceable steps to improve accessibility, did exactly that.
The panel held the district court's contrary conclusion rested on a misreading of Fischer v. SJB-P.D. Inc. (9th Cir. 2000) 214 F.3d 1115. The district court had seized on language in Fischer stating that a plaintiff's legal relationship with a defendant changes because the plaintiff can force the defendant to do something it otherwise would not have to do, reading that to mean an injunction merely requiring compliance with preexisting law does not confer prevailing-party status. But the panel explained that sentence in Fischer referred back to the settled principle that a material alteration occurs when a plaintiff becomes entitled to enforce a judgment or settlement against a defendant — and Fischer itself rejected the same "the defendant already had to comply with the law" argument that the district court accepted here, holding that the Supreme Court has never framed the prevailing-party inquiry in terms of whether a defendant's underlying legal duty changed. The panel found this reasoning reinforced by the Supreme Court's per curiam decision in Lefemine v. Wideman (2012) 568 U.S. 1, which reversed a court of appeals that had denied fees on the theory that an injunction "merely ordered defendants to comply with the law."
The panel also rejected two narrower grounds the district court had invoked. First, relying on Fischer and on the Supreme Court's decision in Buckhannon Board & Care Home, Inc. v. West Virginia Department of Health and Human Resources (2001) 532 U.S. 598, the panel confirmed that a plaintiff can be a prevailing party based exclusively on injunctive relief, without any award of money damages. Second, the panel held that a default judgment is itself an enforceable judgment on the merits sufficient to confer prevailing-party status, citing Vogel v. Harbor Plaza Center, LLC (9th Cir. 2018) 893 F.3d 1152, and that the relief Price obtained was not the kind of merely technical, insignificant victory that Farrar found insufficient.
On the amount of fees, the panel left that determination to the district court in the first instance but addressed one argument along the way. Price's counsel had not disputed reusing a fee-motion template from a different case, but argued on appeal that the resulting errors, including the incorrect pronouns, were "irrelevant editing mistakes." The panel rejected that characterization, explaining that such errors reflect a lack of diligence relevant to the quality of representation courts may weigh in setting a reasonable fee. The panel noted its own precedent allows a reduced fee award in a "straightforward" ADA case with boilerplate pleadings and little opposition, citing Shayler v. 1310 PCH, LLC (9th Cir. 2022) 51 F.4th 1015, and left it to the district court to weigh those concerns in calculating a reasonable award now that Price has been confirmed as the prevailing party.
- WCIRB Reports Carriers Slipped Into Underwriting Loss in 2025on July 14, 2026 at 7:20 AM
The WCIRB has released its 2025 California Workers' Compensation Losses and Expenses Report pursuant to Section 11759.1 of the California Insurance Code. The report is WCIRB's annual accounting of what insurers actually paid out in benefits and expenses during the 2025 calendar year, and it includes payments made by the California Insurance Guarantee Association (CIGA) for calendar years 2013 through 2025.
The headline result is that California's workers' compensation insurers slipped into an underwriting loss for 2025. Direct earned premium totaled $15.4 billion, essentially flat with 2024's $15.6 billion. Against that premium, insurers' total incurred losses and expenses came to $15.7 billion, or 101.8% of earned premium, up from 98.6% in 2024. After accounting for an estimated 1.0% of premium in policyholder dividends, the report puts insurers' pretax underwriting result at a loss of $430 million, or 2.8% of premium — a reversal from 2024, when insurers posted a modest underwriting profit of $118 million, or 0.8% of premium. (These figures reflect underwriting results only; they exclude investment income and taxes, so they understate insurers' overall profitability.)
On the loss side, insurers' incurred losses (paid losses plus the change in reserves, excluding CIGA) were $9.5 billion, or 62.1% of earned premium, up from 60.9% in 2024. Loss adjustment expenses — the cost of investigating, defending and settling claims — rose more sharply, to $2.7 billion or 17.5% of premium, up from 15.7% in 2024. Of that, allocated loss adjustment expense (costs tied to specific claims, largely defense and litigation costs) was 12.7% of premium and unallocated loss adjustment expense (general claims-handling overhead) was 4.9%. Combined with commissions, other acquisition costs, general expenses and premium taxes, insurers' total expenses reached $6.1 billion, or 39.7% of premium, up from 37.7% in 2024.
Within total loss payments, the split between medical and indemnity benefits continued to shift toward indemnity. Medical benefits accounted for $5.2 billion, or 52% of total loss payments in 2025, versus $5.2 billion and 54% in 2024 — a flat dollar figure but a shrinking share. Indemnity (wage-replacement) benefits were $4.7 billion, or 48% of total loss payments, up from $4.4 billion and 46% in 2024; the 2025 indemnity figure includes $36 million in payments on COVID-19 claims.
Within the $5.2 billion in medical payments, physician services remained the largest component at $1.37 billion, though down slightly from $1.39 billion in 2024. Payments made directly to injured workers were essentially flat at $1.69 billion. Hospital payments (inpatient and outpatient combined) slipped to $0.55 billion from $0.57 billion. The standout mover was medical-legal evaluations, which rose to $0.48 billion from $0.45 billion, continuing a multi-year climb: medical-legal payments have grown from 6.4% of total medical payments in 2020 to 9.3% in 2025. The average cost of a medical-legal evaluation was $2,220 in 2025, up modestly from $2,219 in 2024 but well above the $2,037 average in 2022. Orthopedic evaluations make up roughly half of all medical-legal costs, but psychiatric and psychological/behavioral health evaluations remain the most expensive on a per-evaluation basis, averaging $3,778 in 2025. Pharmaceutical costs continued their long decline, falling to $0.05 billion, while medical cost containment program costs reported as medical loss held at $0.11 billion — though the report notes that a much larger and growing share of those program costs, $347 million in 2025, is now reported as loss adjustment expense rather than medical loss, up from $305 million in 2019.
On the provider side, the report's medical transaction data shows hospital-based providers' share of medical service payments continuing to shrink, from 19.6% in 2024 to 18.5% in 2025 (and from 21.7% as recently as 2020), while physical therapists, MD general practitioners and psychology/psychiatry/neurology providers each gained share. Among physician services specifically, evaluation and management services held steady at just over a third of physician payments, while physical medicine's share continued to ease down, from 28.5% in 2024 to 27.3% in 2025.
On the indemnity side, $4.7 billion was paid out in 2025, dominated by temporary disability benefits (59.2% of indemnity paid) and permanent partial disability benefits (31.6%, split across the 0.25%–24.75%, 25%–69.75% and 70%–99.75% disability rating bands). Permanent total disability, death benefits, life pensions and vocational rehabilitation/education vouchers each accounted for roughly 2% or less of total indemnity. Vocational rehabilitation-related payments totaled $88 million, or 1.9% of all indemnity paid, essentially unchanged from 2024's $85 million and 1.9% share, with about 90% of that spending going toward education-related benefits.
One figure likely to draw attention from claims and defense professionals: fees paid to applicant attorneys jumped to $506 million in 2025 from $420 million in 2024, an increase of roughly 20%. The report notes these fees are typically embedded within indemnity awards or settlements and cannot always be broken out separately, so this figure is derived from a subset of insurers able to report a comprehensive breakdown.
The report's injury-detail exhibits, based on 2023 policy year data, reinforce a theme WCIRB has flagged in its other recent publications: cumulative trauma claims are disproportionately costly. Claims coded as cumulative injury, not otherwise classified, made up just 6.9% of claims by cause of injury but 9.9% of total incurred losses. Among permanent disability claims specifically, slip-and-fall injuries were both the most frequent and the most expensive injury category, accounting for 27.9% of total incurred losses on permanent disability claims and averaging $105,965 per claim — well above back injuries ($64,506 average) and other cumulative trauma categories such as carpal tunnel and repetitive motion injuries ($41,501 average) or other cumulative injuries generally ($34,757 average). By nature of injury, strains and tears remained the single largest category, accounting for 26.7% of total incurred losses, and by body part, injuries involving multiple body parts (15.7%) and the lower back (11.1%) topped the list.
Taken as a whole, the 2025 report depicts a system where premium has plateaued but claim costs have not: rising loss adjustment expenses, a growing medical-legal cost component, a sharp jump in applicant attorney fees, and continued indemnity severity growth combined to push insurers into their first underwriting loss in several years. That trajectory is consistent with the rate increases the California Department of Insurance has approved and WCIRB has since proposed for the September 2026 filing.
This summary is provided for general informational purposes only. Readers should consult the full WCIRB report for complete data, methodology and the standard conditions and limitations that accompany all WCIRB publications; the WCIRB cautions that the report reflects only the experience of insured employers and cannot guarantee the accuracy of underlying data submitted by individual insurers.
- WCAB Seeks Sanctions For Use of Legal Treatise Publisher's AIon July 13, 2026 at 9:34 AM
Gilberto Lopez Mendoza worked as a prepper/painter for SWI Finishing, Inc. He alleged a cumulative trauma injury to his neck, upper extremities, back, lower extremities, legs, feet, and psyche, pled for the period from August 1, 1998 through October 1, 2017. In April 2017, Mendoza sought treatment after removing wet socks pulled a scab off a preexisting wound on his foot; the wound worsened, and by February 2018 he was hospitalized with a rapidly progressing infection that led to a below-the-knee amputation. None of his 2017 or 2018 medical records addressed whether his condition was related to his work. Mendoza did not file a claim for workers' compensation benefits until June 29, 2023, and SWI Finishing denied the claim as untimely.
At trial, the parties disputed whether Mendoza's claim was barred by the statute of limitations and whether he had failed to timely report his injury under Labor Code sections 5400 and 5403. Mendoza testified that he had reported his symptoms to Alex Mendez, a coworker he believed to be his supervisor because Mendez served as the "right hand man" of the actual supervisor and was the only one at the worksite who spoke Spanish with him. Mendez testified that he was not a supervisor, that it would not have been proper for other employees to report injuries to him, and that he did not recognize or recall Mendoza. Panel qualified medical evaluators in internal medicine and orthopedics both later opined that Mendoza's foot infection and resulting amputation were work-related, with the internist assigning a 28% whole-person impairment, 35% of which was apportioned to the industrial cumulative trauma.
The workers' compensation administrative law judge (WCJ) found that Mendoza did not have notice of a cumulative trauma work injury in 2017, and that although he had reported his symptoms to Mendez, whom he believed to be his supervisor, neither Mendez nor the actual supervisor ever provided him a claim form or notice of how to report a workplace injury. On that basis, the WCJ found the statute of limitations was tolled and the claim was not time-barred, and issued Findings of Fact including a finding that Mendoza had sustained an industrial injury through the cumulative period ending October 1, 2017.
SWI Finishing petitioned the WCAB for reconsideration, arguing the WCJ erred in finding the statute of limitations tolled because Mendoza's subjective belief that Mendez was a supervisor could not toll the statute where that belief was contradicted by substantial evidence. In support, the petition cited two cases for the proposition that a worker's subjective belief about a coworker's supervisory status cannot toll the statute of limitations when contradicted by substantial evidence, repeating the citations a second time later in the same petition.
In the panel decision of Gilberto Lopez Mendoza v. SWI Finishing, Inc., ADJ17889413 (Cal. Workers' Comp. Appeals Bd., Dec. 2025) — the WCAB granted SWI Finishing's petition for reconsideration and vacated the WCJ's Findings of Fact in their entirety, but deferred a final decision on the merits pending further proceedings and issued a Notice of Intention to impose sanctions of up to $2,500 against SWI Finishing, its insurer, its claims administrator, and its attorneys.
Before reaching the merits, the WCAB addressed a threshold problem with the Petition for Reconsideration itself. In a Report and Recommendation, the WCJ identified that one of the two cases SWI Finishing cited for its subjective-belief argument, described as "Olson v. Workers' Comp. Appeals Bd. (1997) 62 Cal.Comp.Cases 334," does not exist at that citation; a real case bearing a similar name exists, but at a different citation and addressing unrelated issues of permanent disability and apportionment. The WCJ further found that the second citation, Reynolds v. Workmen's Comp. Appeals Bd. (1974) 12 Cal.3d 726, is a real decision but does not support the proposition SWI Finishing attributed to it; in fact, Reynolds held the opposite, ruling that an employer with a duty to notify an injured worker of his rights cannot invoke the statute of limitations as a defense if it fails to do so. In a supplemental petition, SWI Finishing's counsel admitted that he had used an artificial-intelligence legal research tool called ChatSOC, offered by a legal treatise publisher, and that the tool had generated the fabricated case and the mischaracterized holding, which counsel then included in the petition without independently verifying them.
The WCAB held this conduct sanctionable under Labor Code section 5813, which authorizes sanctions of up to $2,500 for bad-faith actions or tactics that are frivolous or intended to cause delay, and under WCAB Rule 10421, which lists filing a document misstating the law or presenting a position not warranted by existing law as sanctionable conduct. The Board emphasized that an attorney who delegates legal research to a non-attorney tool, including an AI program, remains responsible for supervising that work and verifying its accuracy before filing, citing its own en banc decision in Ledezma v. Kareem Cart Commissary and Mfg. (2024) 89 Cal.Comp.Cases 462, as well as an attorney's duties of candor and competence under Business and Professions Code section 6068 and rules 3.3 and 5.3 of the California Rules of Professional Conduct. The Board found no excuse for filing a petition containing fabricated citations and misrepresented holdings, regardless of the tool's own limitations, and directed that the sanctions run jointly and severally against the employer, its insurer, its administrator, and its attorneys, with a separate response due from the firm's managing partner describing any firmwide policies on the use of AI research tools.
Turning to the merits, the WCAB agreed with the WCJ's recommendation that the finding of industrial injury should be vacated because the issue of injury itself, as opposed to the timeliness of the claim, had never been raised as a triable issue at trial. But the Board went further, vacating the entire Findings of Fact, explaining that a statute-of-limitations analysis must begin with a finding of the date of cumulative injury under Labor Code section 5412, and that the WCJ's decision never made that finding. The Board reiterated the settled framework for cumulative-trauma date-of-injury disputes: the employer bears the burden of proving the claim is untimely, medical treatment alone does not establish disability under section 5412, and a worker generally will not be charged with knowledge that a disability is job-related absent medical advice to that effect, citing City of Fresno v. Workers' Comp. Appeals Bd. (1985) 163 Cal.App.3d 467 and State Comp. Ins. Fund v. Workers' Comp. Appeals Bd. (2004) 119 Cal.App.4th 998. Only after a date of injury is established, and only if the employer shows the claim was filed outside the resulting limitations period, does the burden shift to the worker to establish tolling. Because that sequence was never completed below, the Board returned the matter to the trial level, suggesting the WCJ may wish to consider bifurcating the statute-of-limitations issue, and invited the parties to meet and confer on a stipulated date of injury. The Board stated it would issue its decision on the merits together with its ruling on sanctions once the sanctions process concludes.
- Remaining Defendants Settle Health Coverage Fraud Caseon July 13, 2026 at 9:34 AM
The California Attorney General announced that the Los Angeles Superior Court approved a settlement with Shelley Steele, Timothy Candace “Tim” Moses, Chase Moses (collectively, the Moses family), and First Call Telemedicine, LLC (First Call), the remaining defendants in a matter involving the alleged sale of sham health coverage to California consumers.
The case began in January 2022, when the Attorney General filed a lawsuit against The Aliera Companies, Inc. (Aliera), Trinity HealthShare (Trinity), and other defendants, including those who are the subject of this settlement.
The lawsuit alleged that the Moses family created and controlled Trinity, falsely presenting it as a legitimate health care sharing ministry (HCSM), and used Aliera, a for-profit company they also controlled, to market and administer the health plans to consumers.
HCSMs are 501(c)(3) nonprofit organizations historically comprised of members of a particular religious community who contribute money to share catastrophic or unexpected healthcare costs. HCSMs are often marketed as lower-cost alternatives to traditional health insurance, but they generally do not pay for all essential health benefits such as prescriptions, preexisting conditions, birth control, or mental healthcare, and do not guarantee payment for medical expenses.
According to the complaint, Trinity was not a legitimate HCSM, and Aliera retained a significant portion of members’ contributions rather than using those funds to pay healthcare costs, leaving many consumers with unpaid medical bills. The lawsuit also alleged that, after the collapse of Aliera, Shelley Steele continued selling health plans in California through First Call without the required state authorization and directed millions of dollars from Trinity membership funds to First Call.
In 2025, the Attorney General reached a settlement with Aliera, Trinity, and additional defendants. This new settlement resolves the matter with the remaining defendants: the Moses family and First Call.
“Californians deserve honest information when making decisions about their health coverage,” said the Attorney General. “More than 14,000 Californians were allegedly misled into paying for health plans that did not provide the protection they expected, while those behind the scheme profited from their trust. After holding other defendants accountable last year, this settlement finishes the job by securing penalties against the remaining defendants and barring them from doing business in California.”
Consumers were allegedly led to believe their monthly payments were being used to pay healthcare expenses, but Aliera retained nearly 84% of those funds and routinely rejected requests for payment of medical expenses. Under the settlement:
- - Shelley Steele, Tim Moses, and First Call Telemedicine are permanently barred from conducting business in California, directing business toward California residents, serving in leadership positions at companies doing business in California, or owning more than a 25% interest in businesses operating in California.
- - Chase Moses is prohibited from conducting business in California for 10 years and is permanently barred from marketing, selling, administering, or otherwise operating any HCSM in California.
- - These remaining defendants must pay more than $5.1 million in civil penalties. Portions of those penalties are suspended based on the defendants’ sworn financial disclosures and continued compliance with the judgment and may be reinstated if the defendants are found to have materially misrepresented their financial condition or violate the settlement.
Californians who believe an HCSM used deceptive marketing or misrepresented its services are encouraged to file a complaint at oag.ca.gov/report.
- Lawyers Held to State Bar Ethics Civility Provisions in Pro-Per Caseson July 9, 2026 at 10:12 AM
Aziz Damak, representing himself, sued Satraj Hospitality LLC and Sangita and Sanjeev Khanna, who own and operate the Cozy Inn motel in Costa Mesa, alleging wage and hour, meal and rest period, retaliation, and wrongful discharge claims arising from his employment as a receptionist.
In July 2024, Damak served extensive discovery on each defendant, including interrogatories, requests for admission, and document production requests. After receiving no responses and no communication from defendants' attorney, Hitendra Bhakta, despite repeated calls and a written 21-day notice warning that he would seek sanctions, Damak filed fifteen motions to compel in November 2024, each requesting monetary sanctions of "at least $1,000." Defendants never opposed any of the motions, and neither Bhakta nor anyone from the defense side communicated with Damak about the outstanding discovery during the roughly ten months before the motions were heard.
The Court granted all of Damak's motions to compel and the nonmonetary relief he requested, but denied monetary sanctions. The court recognized that the applicable Civil Discovery Act provisions made some sanction mandatory, but explained that such sanctions are limited to a party's "reasonable expenses actually incurred."
Because Damak was self-represented, had a fee waiver, and did not claim he had incurred any out-of-pocket expenses in bringing the motions, the court concluded it could not award any sanctions and denied that portion of his requests outright. Damak petitioned for a writ of mandate challenging that denial, arguing the court was required to award at least a nominal sanction and that the ruling undercut the deterrent purpose of the discovery sanctions scheme by letting represented parties stonewall self-represented opponents without consequence.
In the published case Damak v. Superior Court, No. G065583 (Cal. Ct. App., 4th Dist., Div. 3, July 2026) — the Court of Appeal granted Damak's petition for writ of mandate in part and denied it in part, directing the trial court to vacate the portion of its order denying monetary sanctions and to reconsider that request.
The panel first agreed with the trial court that the Civil Discovery Act's method-specific sanctions provisions — covering interrogatories, document production, and requests for admission — direct that sanctions be imposed under a companion provision authorizing "reasonable expenses, including attorney's fees, incurred by anyone as a result" of the discovery misuse. Relying on the California Supreme Court's decisions in Trope v. Katz (1995) 11 Cal.4th 274 and Musaelian v. Adams (2009) 45 Cal.4th 512, and the Court of Appeal's own decision in Argaman v. Rutan (1999) 73 Cal.App.4th 1173, the court explained that a self-represented litigant, including a self-represented attorney, cannot "incur" attorney fees for his own time, and so cannot recover compensation for the hours he personally spent preparing the motions or for business opportunities forgone.
The court found Kravitz v. Superior Court (2001) 91 Cal.App.4th 1015 persuasive on this point, and acknowledged that court's own description of the resulting rule as "wholly inadequate" for self-represented litigants facing discovery abuse, since a represented opponent who never incurs identifiable costs effectively gets, in that court's words, one free bite at ignoring discovery obligations. Damak's reliance on Appleton v. Superior Court (1988) 206 Cal.App.3d 632 did not change this outcome, the panel explained, because that case addressed only whether a sanction was mandatory in amount, not what the sanction could permissibly compensate.
The panel found, however, that the trial court's analysis stopped short. A separate, more recently enacted provision of the Civil Discovery Act, Code of Civil Procedure section 2023.050, requires a court to impose a flat $1,000 sanction against a party or attorney — regardless of any expenses incurred by the other side — if it finds the party or attorney failed to respond in good faith to a document production request or failed to confer in a good faith attempt to resolve the dispute informally. The court explained that this provision, drawing on legislative history describing it as a "stronger . . . hammer on discovery abuse," is aimed at deterring the offending party's conduct rather than merely compensating the other side, and applies "notwithstanding any other law."
Because Damak's motions concerning document production requests were governed by a Discovery Act provision that in turn incorporates section 2023.050, and because the trial court's order never mentioned that section or made any finding on whether defendants had responded in good faith or conferred with Damak, the panel held the trial court's failure to even consider it was an abuse of discretion, citing City of Los Angeles v. PricewaterhouseCoopers, LLP (2024) 17 Cal.5th 46. The panel emphasized that nothing in the record suggested defendants had responded in good faith or conferred with Damak about the document requests, but declined to make those factual findings itself, remanding for the trial court to consider in the first instance whether a section 2023.050 sanction was warranted.
The court closed with an extended discussion of civility, noting that attorneys owe self-represented litigants the same dignity, courtesy, and integrity due to opposing counsel and the court itself, an obligation reflected in the civility oath every California attorney must now take and annually reaffirm under California Rules of Court, rule 9.7. Citing recent decisions admonishing incivility in litigation, including Masimo Corp. v. The Vanderpool Law Firm, Inc. (2024) 101 Cal.App.5th 902 and Karton v. Ari Design & Construction, Inc. (2021) 61 Cal.App.5th 734, the panel described defendants' ten months of silence in response to Damak's repeated, documented attempts to follow up on outstanding discovery as falling far short of that standard, regardless of any underlying intent. The court also noted, in a footnote, that defendants' counsel made an unsupported factual assertion at oral argument about the record that the court could not verify, and reminded counsel of an attorney's duty of candor to the court.
- 9th Circuit Interprets the EFAA's Application Timing Provisionson July 9, 2026 at 10:12 AM
Jessica Combs began working at Netflix, Inc. in May 2017 under an employment agreement containing a broad arbitration clause covering all employment-related disputes. She alleges that soon after starting, Netflix fostered a sexualized office culture, including one-on-one meetings that took on a flirtatious, dating-like tone and encouraged unwanted advances from male colleagues. At a September 2018 company offsite, Combs was required to participate in team-building exercises she considered sexualized, including exercises resembling "forced speed dating," and she says a stairwell was used by male employees to look under female colleagues' dresses. During an October 2018 work trip to Singapore, a male colleague made unwanted sexual advances toward her. Combs alleges that between 2017 and 2021 she repeatedly complained to her supervisors and to Netflix management about this sexually charged environment and about specific incidents, but that Netflix ignored her complaints and took no corrective action. In December 2021, Netflix fired Combs; the company cited her noncompliance with its COVID-19 vaccination policy, but Combs alleges the real reason was retaliation for her complaints.
In August 2023, Combs filed an administrative complaint with California's Department of Fair Employment and Housing and received an immediate right-to-sue letter. In July 2024, she sued Netflix in California state court on various state-law discrimination, harassment, and hostile-work-environment theories. Netflix removed the case to federal court based on diversity of citizenship and moved to compel arbitration under the parties' agreement. Combs did not dispute that a valid arbitration agreement existed or that her claims fell within it; instead, she argued that the Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act of 2021 (EFAA; 9 U.S.C. §401–402), which lets a person alleging sexual harassment elect to proceed in court despite a predispute arbitration agreement, exempted her case from arbitration.
The United States District Court for the Central District of California granted Netflix's motion to compel arbitration. The court concluded that, even though Combs's complaint alleged conduct constituting sexual harassment, her claims accrued and her dispute with Netflix arose before the EFAA's March 3, 2022 effective date, so the statute's timing provision took her case outside the Act's reach and the parties' arbitration agreement controlled.
In the published case of Combs v. Netflix, Inc., No. 25-3164 (9th Cir., July 2026) — the Ninth Circuit affirmed the district court's order compelling arbitration.
The panel first agreed that Combs's complaint alleged conduct constituting unlawful sexual harassment, so her claims presumptively fell within the EFAA. The dispositive question, one of first impression in the circuit, was how to interpret the EFAA's timing provision, a statutory note stating that the Act applies to any "dispute or claim that arises or accrues" on or after its March 3, 2022 enactment date. The court held that this phrase describes two distinct concepts — "claims that accrue" and "disputes that arise" — agreeing with the Sixth Circuit's reasoning in Memmer v. United Wholesale Mortgage, LLC (2025) 135 F.4th 398 that Congress used the disjunctive "or" to differentiate them.
On claim accrual, the court applied the settled common-law rule, drawn from Corner Post, Inc. v. Board of Governors of the Federal Reserve System (2024) 603 U.S. 799, which in turn cited Green v. Brennan (2016) 578 U.S. 547, that a claim accrues when a plaintiff has a complete and present cause of action allowing her to file suit and obtain relief. Under that standard, Combs's claims accrued well before March 3, 2022, since she alleges harassment and a termination that occurred between 2017 and 2021.
The harder question was when a "dispute" arises. The court rejected Combs's argument that no dispute arises until a formal external complaint is filed with a court or administrative agency, finding that reading too narrow. It also rejected the opposite extreme, urged in similar cases by other employers, that a dispute arises whenever the underlying harassing conduct occurs, since that would collapse the distinct concepts of "dispute" and "claim" into one and render Congress's use of both terms superfluous. Instead, following the Third Circuit's decision in Cornelius v. CVS Pharmacy Inc. (2025) 133 F.4th 240 and the Eighth Circuit's decision in Famuyide v. Chipotle Mexican Grill, Inc. (2024) 111 F.4th 895, the panel held that a dispute arises under the EFAA when an employee registers disagreement with her employer, through an internal complaint, an external complaint, or otherwise, and the employer expressly or constructively opposes that position. The court noted this same formulation had already been adopted by a California appellate court applying the EFAA, in Kader v. Southern California Medical Center, Inc. (2024) 99 Cal.App.5th 214.
Applying that standard, the panel held that a dispute arose between Combs and Netflix well before the EFAA's effective date. By the complaint's own allegations, Combs repeatedly complained to Netflix between 2017 and 2021 about the sexualized culture and specific incidents, and Netflix consistently ignored those complaints and took no corrective action; that pattern of complaint met with inaction showed Netflix had, at minimum, constructively opposed her position. The court found the case closely analogous to Cornelius, where an employee's repeated written complaints that her employer dismissed and failed to remedy were likewise sufficient to show a pre-2022 dispute. The panel further noted that Netflix's alleged decision to fire Combs in December 2021 in retaliation for her complaints put the point beyond doubt, since firing an employee for raising a complaint is itself a clear act of opposition to her position. Because both Combs's claims and her dispute with Netflix arose before March 3, 2022, the EFAA did not apply, and the panel affirmed the order compelling her case to arbitration.
- QME to Assign Percent Causation of Good Faith Personnel Action Eventon July 16, 2026 at 8:18 AM
Maria Lopez Rodriguez worked as a medical receptionist for Kern County Hospital Authority, permissibly self-insured and administered by Adminsure, Inc. She claimed a psychiatric injury arising out of and in the course of her employment on November 15, 2017, attributing her symptoms to ongoing conduct by her supervisor, Marie Ruffin.
A qualified medical evaluator (QME), Dr. Greg Hirokawa, took a history in which applicant described her supervisor searching for reasons to reprimand her, denying her a requested transfer, standing over her while giving instructions, and asking coworkers how often applicant used the restroom, among other incidents she said had gone on for roughly 18 to 24 months. Dr. Hirokawa diagnosed an anxiety disorder and opined that work stress was the predominant (greater than 50%) cause of applicant's psychological symptoms, and that personnel actions by her supervisor accounted for roughly 80% of that work stress — but he left it to the trier of fact to determine whether the supervisor's actions were lawful, nondiscriminatory, and in good faith
The workers' compensation administrative law judge (WCJ) found that applicant sustained a psychiatric injury arising out of and in the course of employment, and that her claim was not barred by the good faith personnel action defense under Labor Code section 3208.3(h). In the accompanying Opinion on Decision, the WCJ identified four incidents — the shoulder grab, the shortened lunch, the church-toys directive, and the yelling — and stated that, while defense witnesses had described other incidents that were good faith personnel actions, the incidents applicant testified to were not, and so did not bar her claim. The WCJ adopted Dr. Hirokawa's causation opinion in full. Kern County Hospital Authority filed a timely petition for reconsideration, arguing the WCJ misapplied the good faith personnel action defense and that the decision was not supported by substantial evidence.
In the appended Opinion on Decision (Opinion), the WCJ addressed the good faith personnel action defense by simply stating "While Defendant witnesses discussed other incidents that were good-faith personnel actions, those discussed by Applicant were are (sic) not good-faith- personnel actions. This defense does not bar the claim of Applicant based on the incidents Applicant testified to."
The WCJ adopted Dr. Hirokawa’s opinion on causation, stating: AOE/COE – Parts of the Body Injured "Dr. Hirokawa stated that the predominant cause of Applicant's symptoms were from work stress. Approximately 80 percent of that stress was due to personnel actions by Applicant’s supervisor. Dr. Hirokawa left it to the trier of fact to determine if the supervisor’s actions were legal, non-discriminatory, and non-retaliatory. These actions are being found not to be good-faith-personnel actions. Based on Dr. Hirokawa’s report, Applicant has suffered industrial injury to the psyche."
In the panel decision of Rodriguez v. Kern County Hospital Authority, ADJ11141161 (Cal. Workers' Comp. Appeals Bd., July 2026) — the WCAB granted reconsideration and rescinded the WCJ's Findings and Orders in their entirety, returning the matter to the trial level for further proceedings.
The panel applied the four-step framework the Board adopted in its en banc decision in Rolda v. Pitney Bowes, Inc. (2001) 66 Cal.Comp.Cases 241, for evaluating a psychiatric injury claim once an employer raises the good faith personnel action defense under Labor Code section 3208.3. Under Rolda, the WCJ must determine, in sequence: whether the claimed injury involves actual events of employment; whether those events were the predominant (over 50%) cause of the injury; whether any of those events were personnel actions that were lawful, nondiscriminatory, and in good faith; and, if so, whether those good faith personnel actions were a "substantial cause" — 35% to 40% of all causation — of the injury. The first two steps are applicant's burden; the latter two are the employer's. The panel found the first two steps effectively conceded, since defendant did not dispute that applicant's described incidents were actual events of employment or that Dr. Hirokawa had found predominant industrial causation.
The problem, the panel explained, arose at the third step. The point of that step is to sort the actual events of employment into those that were good faith personnel actions and those that were not, but the WCJ's Opinion on Decision never made clear which of applicant's described incidents — which the panel noted seemed to include more than the four specifically discussed — the WCJ was treating as the operative events, or why. Citing the Board's en banc decision in Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473, and Labor Code section 5313, the panel explained that a WCJ's opinion must refer with specificity to the evidence relied upon and clearly set out the reasons for the decision on each issue, so that the parties and the Board can meaningfully evaluate it on reconsideration; a decision must be based on admitted evidence in the record and supported by substantial evidence, citing Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162, among other cases.
That gap mattered because of what the fourth Rolda step requires. Unlike the "predominant cause" inquiry, which looks only at causation as to all events combined, the "substantial cause" inquiry requires the evaluating physician to parse out the individual events found to be good faith personnel actions and assign a percentage of causation to each. Dr. Hirokawa's report discussed several potential contributing factors but did not analyze each one individually or assign percentages, and the panel reasoned that any such breakdown would necessarily be unreliable if the physician did not know, because the WCJ had never clearly said, which events actually qualified as good faith personnel actions. The panel also noted, in a footnote, that whether a given event is a "personnel action" taken in "good faith" is a factual and legal determination for the WCJ to make, not the QME — so Dr. Hirokawa's own use of that label in his report, offered before the WCJ made any such finding, could not substitute for the missing determination, citing County of Sacramento v. Workers' Comp. Appeals Bd. (Brooks) (2013) 215 Cal.App.4th 785.
Concluding that the record could not currently support a finding either way on whether the good faith personnel action defense barred the claim, the panel held the correct course was to develop the record further rather than resolve the issue on an incomplete record, citing the Board's en banc decision in McDuffie v. Los Angeles County Metropolitan Transit Authority (2002) 67 Cal.Comp.Cases 138 and a recent panel decision reaching the same conclusion on similar facts, Silva v. Department of Transportation Headquarters Operations (2025, ADJ13014565). The Board directed that, on remand, the parties return to Dr. Hirokawa for supplemental reporting under Labor Code section 5701, or that the WCJ appoint a regular physician if his further reporting does not constitute substantial evidence, while noting the parties always retain the option of proceeding by agreed medical evaluator instead. On that basis, the panel rescinded the WCJ's Findings and Orders and returned the matter to the trial level. - Grand Jury Says Ventura County Has Best in Class Claims Programon July 16, 2026 at 8:17 AM
The Ventura County Civil Grand Jury has released a new report, Setting the Record Straight on Presumptive Workers' Compensation Claims, examining how Ventura County processes "presumptive" workers' compensation claims for deputy sheriffs and firefighters — and largely vindicating the county's recent overhaul of that process while flagging structural problems baked into state law itself.
Presumptive claims exist for "safety workers," a category the Legislature created in 1937 for law enforcement officers, firefighters, and similar high-risk public employees (Cal. Gov. Code, §§ 20390–20416). For a defined list of conditions — including heart trouble, hernia, pneumonia, cancer, tuberculosis, and blood-borne infections — the law presumes the injury or illness arose out of employment, shifting the burden onto the employer to rebut that presumption rather than requiring the worker to prove causation (Cal. Lab. Code, §§ 3212–3214). The Grand Jury notes this framework traces to a genuine, decades-old scientific dispute over whether stress and physical exertion cause conditions like heart disease and cancer, a dispute it says has only been resolved by research in recent years; the report cites the California Supreme Court's 1978 decision in City and County of San Francisco v. Workers' Compensation Appeals Board, which addressed the "persisting cleavage in medical theory" that made these claims so contentious.
The Grand Jury's investigation was prompted by longstanding complaints from Ventura County Sheriff's Office (VCSO) deputies that presumptive claims were being denied without justification, that treatment was delayed, and that filing a claim effectively required hiring a lawyer. The jury found those perceptions were rooted in real problems, but concluded that Ventura County Risk Management has substantially fixed them since 2023 through a series of administrative changes: eliminating the requirement that injured workers choose a doctor from a restricted network; a "FastTrack" arrangement with Ventura Orthopedics that sends deputies straight to evaluation and treatment for duty-belt-related back injuries with no utilization review; automatic pre-approval of diagnostic tests ordered by a treating physician; guaranteed access to three major Southern California cancer centers (City of Hope, USC Norris, and UCLA Jonsson) for approved cancer claims; the option to substitute a chosen specialist's second opinion for a formal Qualified Medical Evaluator (QME) in some cases; and the addition of three claims examiners dedicated specifically to VCSO and Ventura County Fire Department (VCFD) claims.
The county's own data shows the payoff: the share of workers' comp claimants who retained a lawyer fell from 65% before 2023 to 22% between 2023 and the end of 2025, and insurance rates for the two safety departments have declined for three consecutive years.
Even so, the report identifies a structural flaw in state law that county-level administrative fixes cannot solve. When a QME's opinion is needed to resolve a disputed claim, the jury found, the examiner routinely cannot meet the 75-day statutory deadline, leaving both the county and the worker in limbo. The report also flags a related problem: California's QME system struggles to recruit specialists in fields like oncology and cardiology, and the jury cites an example of a Ventura County deputy with a serious back injury whose QME opinion came from a podiatrist, plus a case in which a claim was kicked back over a data-entry date error despite two accompanying documents showing the correct date.
The jury's numbers give a sense of scale: between January 2023 and October 2025, only 39 of VCSO's 578 workers' compensation claims were presumptive claims. Of those 39, only 10 were accepted quickly (an average of 13 days), 14 were accepted within the 75-day window, and 15 were denied within that window; of the denials, 8 were later reversed once new supporting evidence came in, and 7 remain denied and undisputed — five of those seven were COVID-19 claims, which are no longer covered by the presumption.
The report makes ten findings and ten recommendations, aimed mainly at the VCSO, County Risk Management, and the Board of Supervisors, with response deadlines running through the end of 2026. Among them: formalize regular communication between VCSO and Risk Management (R-01, R-02); train HR staff and supervisors on presumptive-claims rules (R-03); proactively educate deputies on their claims-process rights and responsibilities within three years of hire (R-04); create a dedicated advocate role within VCSO to guide injured deputies through the claims and treatment process, modeled on a similar role VCFD already uses (R-05); better publicize the state Division of Workers' Compensation's Information and Assistance Unit, a free advocacy resource for claimants that the jury found is underused (R-06); add preventive health screening and wellness programs for deputies similar to VCFD's (R-07); build out more substantive "light duty" assignments for recovering deputies (R-08); have the County Auditor-Controller finally audit the cost of covering deputies' leaves of absence with overtime, which the Sheriff's Office estimates runs into the millions annually but has never been formally measured (R-09); and, notably, petition state lawmakers to reconcile the mismatched 75-day and 90-plus-day statutory deadlines (R-10).
The Grand Jury closes by commending both Ventura County Risk Management and VCFD by name for building what it calls a "best-in-class" claims program, while cautioning that the county's improvements can't by themselves fix a claims timeline that state law itself sets up to fail. Responses are required from the Board of Supervisors within 90 days and from the Sheriff and County Auditor-Controller within 60 days; responses are invited but not required from the County Executive Officer and the VCFD Chief. - California First State to Launch AI-Unemployment Tracker (CAIT)on July 15, 2026 at 10:20 AM
California has become the first state in the nation to launch a public tool tracking whether artificial intelligence is showing up in the unemployment line. The California AI-Unemployment Tracker (CAIT), unveiled June 25, 2026, links unemployment insurance claims data with occupational AI-exposure measures to monitor, in near real time, whether workers in AI-exposed jobs are losing work at elevated rates. The tracker was built through a partnership between the Governor's Office, the state's Employment Development Department (EDD), and the nonpartisan California Policy Lab at the University of California, and it is also hosted directly on the EDD's own website.
The tracker is accompanied by a detailed research report, Tracking AI-Related Job Loss Using Unemployment Insurance Claims Data in California, prepared by a team of researchers at the Policy Lab's UCLA site, along with a companion technical appendix laying out the underlying methodology. Governor Gavin Newsom framed the launch as part of a broader effort to get ahead of AI's labor-market effects, saying California intends to lead by "reimagining how we prepare" the state through governance and policy rather than simply watching from the sidelines.
At the center of the tool is a straightforward but data-intensive idea: take every initial unemployment insurance claim filed in California since January 2017, match each claimant's self-reported prior occupation to a score reflecting how exposed that occupation is to AI, and then track claim volumes over time by exposure level, education, age, gender, race and ethnicity, industry, and region. Claimants are sorted into three exposure tiers — high, moderate, and low — based on the top, middle, and bottom quartiles of the exposure scores. High-exposure occupations, the top 25%, include roles such as customer service representatives and software developers; low-exposure occupations, the bottom 25%, include jobs such as heavy truck drivers and nursing assistants.
The researchers use two separate exposure measures rather than one. The first, called Potential AI Exposure, asks whether large language models are theoretically capable of cutting the time needed to complete an occupation's tasks by at least half; it comes from a widely cited 2024 study, GPTs Are GPTs, published in Science by a team of OpenAI and academic researchers. The second, called Observed AI Exposure, instead measures how often an occupation's tasks actually show up in real usage of Anthropic's Claude, drawing on the Anthropic Economic Index, a 2025 research effort analyzing millions of anonymized Claude conversations. The report notes that results are largely consistent whether the theoretical or the observed measure is used, and cautions that either measure captures only whether a job's tasks could be or have been touched by AI — not whether AI actually caused any particular layoff. The tracker also excludes the pandemic-era claims surge from March 2020 through January 2022 from its trend comparisons, since that spike would otherwise swamp any post-ChatGPT pattern.
The June 2026 release's first finding is, on its face, reassuring: looking at all unemployment claims statewide, there is no evidence of a broad-based surge in layoffs among AI-exposed workers since the release of ChatGPT-3.5 in late 2022, and the overall share of claims coming from AI-exposed occupations has not risen in a statistically meaningful way relative to before the pandemic. The report notes this lines up with existing national estimates, including Yale Budget Lab's analysis of Current Population Survey data, which similarly finds no nationwide link between AI exposure and unemployment so far.
But the tracker's second and third findings complicate that reassurance considerably. Unemployment claims among college-educated workers in highly AI-exposed occupations rose after ChatGPT-3.5's release and have stayed elevated through May 2026, even as claims among similarly educated workers in low-exposure jobs showed no comparable shift. The effect is sharpest at the top of the credential ladder: claims among workers with master's degrees or PhDs in highly AI-exposed occupations climbed from a baseline of about 13,000 per month in November 2022 to a range of 16,000 to 22,000 per month by mid-2023, and have remained in that elevated band since. Geographically and sectorally, the pattern concentrates where AI adoption itself has concentrated: claims from AI-exposed workers in the San Francisco Bay Area show a sharp, sustained increase relative to pre-pandemic levels, and claims in AI-exposed technology sectors — particularly Professional Services — have likewise stayed elevated, though the report notes claims in the Information sector spiked temporarily before settling back to pre-generative-AI levels in late 2025.
Report co-author Ben Hyman, a senior researcher at the Policy Lab, summed up the tension in the findings: the state is not seeing large-scale AI-related layoffs, but is seeing a real pattern among highly educated workers in the Bay Area and in tech-heavy sectors that will bear continued watching. Co-author Till von Wachter, a UCLA economics professor and the Policy Lab's UCLA faculty director, cast the tool's value as replacing speculation about AI's labor-market effects with an evidence base policymakers can act on before disruptions spread further.
The report is careful to flag the limits of what unemployment insurance data can show. UI claims miss workers who never file — because they are unaware of the program, land a new job quickly, leave the labor force, are ineligible because of immigration status or self-employment, or, for younger workers, have not yet accumulated enough qualifying earnings. Occupation codes are self-reported at the time of filing and unverified, small-count data cells are suppressed under standard confidentiality rules, and monthly figures are described as preliminary and subject to revision as late claims are processed. The authors are explicit that the tracker is a descriptive early-warning signal rather than causal proof that AI is driving any specific job loss.
Practically, the tracker itself is a public, interactive dashboard built on Tableau, embedded on the Policy Lab's site and mirrored on the EDD's, and it will be refreshed monthly. The underlying tabulated data are also released for public download in an accessibility-compliant Excel file, and the Policy Lab has published a separate FAQ document addressing common questions about definitions and methodology. For California employers and workers'-compensation professionals, the tracker offers an early, if imperfect, gauge of where AI-linked displacement is concentrating by sector and region — useful context for anticipating claims trends even though, as its own authors stress, it cannot yet say whether AI caused any individual worker's job loss.
- San Jose Road Rage Driver Sentenced for Insurance Fraudon July 15, 2026 at 10:19 AM
Kenneth Pham Tran, 54, of San Jose, was sentenced after dashcam footage showed him initiating a road rage incident, which resulted in him being rear-ended by a semi-truck. Tran attempted to hide his wrongdoing and profit from the accident he caused by filing a fraudulent insurance claim to collect an undeserved payout. Tran was sentenced to 60 days in county jail, two years of probation, and is ordered to pay over $4,000 in restitution.
On January 28, 2025,Tran was driving his white Jeep Wrangler Rubicon on Highway 101 near the Alum Rock Avenue onramp in San Jose. Furious because he felt he'd been cut off, Tran caught up to a semi-truck at the Story Road underpass and "brake checked" it twice, slamming on his brakes just in front of the truck. When the truck driver tried to change lanes to get away, Tran maneuvered back in front of the truck and brake-checked a third time — and this time the truck driver couldn't stop in time and rear-ended the Jeep
The Department of Insurance Task Force opened an investigation after receiving a referral from San Jose CHP who first investigated the collision and reported the incident. The initial investigation found Tran had filed a claim with Progressive Insurance alleging the back of his white Jeep Wrangler Rubicon was damaged after being rear-ended by a semi-truck while he was stopped in traffic. In his claim he also stated the driver of the semi-truck refused to pull over and exchange insurance information.
During the investigation, Task Force members discovered an independent witness who placed a separate 911 call reporting they had to swerve out of the way of a white Jeep Wrangler Rubicon that was driving recklessly and “break checking” a semi-truck on the 101 freeway in San Jose. According to the witness, the driver of the Jeep, Tran, began swerving in and out of lanes to keep the semi-truck behind his vehicle. Tran held the brakes several times before the semi-truck struck the back of his vehicle. The witness stated it looked as though the semi-truck would not have been able to prevent the collision.
The entire road rage incident was captured on the semi-truck’s dashcam. Investigators were able to obtain the footage and found evidence that Tran had initiated the crash because he felt he had been cut off by the semi-truck. The footage also corroborated the account of the witness who called 911.
Tran was found guilty by a jury on one count of felony insurance fraud, one count of felony vandalism, and one misdemeanor count of reckless driving. He was sentenced to 60 days in county jail, two years of probation, and ordered to pay over $4,000 in restitution — specifically $1,200 to Progressive Insurance and $3,000 to Morgan Hill-based Bill Jacobsen Trucking.
This case was prosecuted by the Santa Clara County District Attorney’s Office.“Road rage. Reckless driving. Insurance fraud. This person made a lot of bad decisions,” District Attorney Jeff Rosen said. “Count to 10 before you commit fraud in Santa Clara County.”
The Department of Insurance urges drivers who believe they may have been victims of a road rage incident to insist on a police report and document as much information about the collision as possible including using a cell phone to take photos or videos of the post-collision damage. If a dashcam was being used, save any footage of the incident and be sure to ask the peace officer at the scene to positively identify everyone involved. All suspicious collisions should be reported to your local law enforcement agency or to the California Department of Insurance by calling 800-927-4357 or visiting our website at insurance.ca.gov. - 9th Circuit Reviews ADA Atty Fees in High Frequency Litigant Caseon July 14, 2026 at 7:20 AM
LaSandra Price has Parkinson's disease and uses a wheelchair for mobility. Between August and September 2021, she visited a Family Dollar store in Fontana, California, owned by Wael Diab, on four occasions and encountered accessibility barriers each time, including poorly marked disabled parking spaces, uneven walkways, and aisles that were too narrow. Price sued Diab and the store under the Americans with Disabilities Act (ADA) and California's Unruh Civil Rights Act, Cal. Civ. Code § 51. (The district court separately declined supplemental jurisdiction over the Unruh Act claim after finding Price to be a "high-frequency litigant," a ruling not at issue on appeal.) Neither Diab nor the store responded to the complaint, and the clerk entered defaults against both.
Price moved for default judgment and a specific injunction requiring accessible paths of travel, accessible parking spaces, compliant signage, and an accessible entrance within 180 days. The district court granted the motion, observing that Price's proposed order was, if anything, narrower than what her complaint had sought, and entered the injunction essentially as requested. Price then moved for $9,364 in attorney's fees and costs ($8,872 for 31.2 hours of work, plus $492 in costs) under the ADA's fee-shifting provision, 42 U.S.C. § 12205, supporting the motion with billing records, a declaration from counsel, and a third-party survey of prevailing rates.
The district court denied Price's fee motion in full, holding she was not a "prevailing party" under section 12205 because the injunction required Diab and the store to do only what the ADA already required them to do. The court acknowledged that courts routinely treat ADA plaintiffs who obtain default judgment and injunctive relief as prevailing parties, and that Ninth Circuit precedent "appear[s] to presume prevailing-party status" in that situation, but concluded that none of those precedents had squarely analyzed the question. The court further found that even if Price were a prevailing party, her requested fees were unreasonable: her motion appeared to be recycled nearly whole-cloth from a different case, resulting in incorrect male pronouns for Price throughout, and the court questioned the hours billed. The court did not reach what a reasonable fee would be if Price prevailed.
In the published case of Price v. Diab, No. 25-713 (9th Cir., July 2026) — the Ninth Circuit reversed the district court's order denying Price's motion for attorney's fees and remanded for further proceedings on the fee motion.
The panel held, after reviewing the prevailing-party question de novo, that Price prevailed by virtue of the final injunctive relief she obtained. Under Farrar v. Hobby (1992) 506 U.S. 103, a plaintiff prevails when relief on the merits materially alters the legal relationship between the parties by modifying the defendant's behavior in a way that directly benefits the plaintiff, and the Supreme Court has since confirmed in Lackey v. Stinnie (2025) 604 U.S. 192 that an enforceable court order conclusively resolving the parties' rights on the merits satisfies that test. Price's injunction, which forced Diab and the store to take specific, enforceable steps to improve accessibility, did exactly that.
The panel held the district court's contrary conclusion rested on a misreading of Fischer v. SJB-P.D. Inc. (9th Cir. 2000) 214 F.3d 1115. The district court had seized on language in Fischer stating that a plaintiff's legal relationship with a defendant changes because the plaintiff can force the defendant to do something it otherwise would not have to do, reading that to mean an injunction merely requiring compliance with preexisting law does not confer prevailing-party status. But the panel explained that sentence in Fischer referred back to the settled principle that a material alteration occurs when a plaintiff becomes entitled to enforce a judgment or settlement against a defendant — and Fischer itself rejected the same "the defendant already had to comply with the law" argument that the district court accepted here, holding that the Supreme Court has never framed the prevailing-party inquiry in terms of whether a defendant's underlying legal duty changed. The panel found this reasoning reinforced by the Supreme Court's per curiam decision in Lefemine v. Wideman (2012) 568 U.S. 1, which reversed a court of appeals that had denied fees on the theory that an injunction "merely ordered defendants to comply with the law."
The panel also rejected two narrower grounds the district court had invoked. First, relying on Fischer and on the Supreme Court's decision in Buckhannon Board & Care Home, Inc. v. West Virginia Department of Health and Human Resources (2001) 532 U.S. 598, the panel confirmed that a plaintiff can be a prevailing party based exclusively on injunctive relief, without any award of money damages. Second, the panel held that a default judgment is itself an enforceable judgment on the merits sufficient to confer prevailing-party status, citing Vogel v. Harbor Plaza Center, LLC (9th Cir. 2018) 893 F.3d 1152, and that the relief Price obtained was not the kind of merely technical, insignificant victory that Farrar found insufficient.
On the amount of fees, the panel left that determination to the district court in the first instance but addressed one argument along the way. Price's counsel had not disputed reusing a fee-motion template from a different case, but argued on appeal that the resulting errors, including the incorrect pronouns, were "irrelevant editing mistakes." The panel rejected that characterization, explaining that such errors reflect a lack of diligence relevant to the quality of representation courts may weigh in setting a reasonable fee. The panel noted its own precedent allows a reduced fee award in a "straightforward" ADA case with boilerplate pleadings and little opposition, citing Shayler v. 1310 PCH, LLC (9th Cir. 2022) 51 F.4th 1015, and left it to the district court to weigh those concerns in calculating a reasonable award now that Price has been confirmed as the prevailing party. - WCIRB Reports Carriers Slipped Into Underwriting Loss in 2025on July 14, 2026 at 7:20 AM
The WCIRB has released its 2025 California Workers' Compensation Losses and Expenses Report pursuant to Section 11759.1 of the California Insurance Code. The report is WCIRB's annual accounting of what insurers actually paid out in benefits and expenses during the 2025 calendar year, and it includes payments made by the California Insurance Guarantee Association (CIGA) for calendar years 2013 through 2025.
The headline result is that California's workers' compensation insurers slipped into an underwriting loss for 2025. Direct earned premium totaled $15.4 billion, essentially flat with 2024's $15.6 billion. Against that premium, insurers' total incurred losses and expenses came to $15.7 billion, or 101.8% of earned premium, up from 98.6% in 2024. After accounting for an estimated 1.0% of premium in policyholder dividends, the report puts insurers' pretax underwriting result at a loss of $430 million, or 2.8% of premium — a reversal from 2024, when insurers posted a modest underwriting profit of $118 million, or 0.8% of premium. (These figures reflect underwriting results only; they exclude investment income and taxes, so they understate insurers' overall profitability.)
On the loss side, insurers' incurred losses (paid losses plus the change in reserves, excluding CIGA) were $9.5 billion, or 62.1% of earned premium, up from 60.9% in 2024. Loss adjustment expenses — the cost of investigating, defending and settling claims — rose more sharply, to $2.7 billion or 17.5% of premium, up from 15.7% in 2024. Of that, allocated loss adjustment expense (costs tied to specific claims, largely defense and litigation costs) was 12.7% of premium and unallocated loss adjustment expense (general claims-handling overhead) was 4.9%. Combined with commissions, other acquisition costs, general expenses and premium taxes, insurers' total expenses reached $6.1 billion, or 39.7% of premium, up from 37.7% in 2024.
Within total loss payments, the split between medical and indemnity benefits continued to shift toward indemnity. Medical benefits accounted for $5.2 billion, or 52% of total loss payments in 2025, versus $5.2 billion and 54% in 2024 — a flat dollar figure but a shrinking share. Indemnity (wage-replacement) benefits were $4.7 billion, or 48% of total loss payments, up from $4.4 billion and 46% in 2024; the 2025 indemnity figure includes $36 million in payments on COVID-19 claims.
Within the $5.2 billion in medical payments, physician services remained the largest component at $1.37 billion, though down slightly from $1.39 billion in 2024. Payments made directly to injured workers were essentially flat at $1.69 billion. Hospital payments (inpatient and outpatient combined) slipped to $0.55 billion from $0.57 billion. The standout mover was medical-legal evaluations, which rose to $0.48 billion from $0.45 billion, continuing a multi-year climb: medical-legal payments have grown from 6.4% of total medical payments in 2020 to 9.3% in 2025. The average cost of a medical-legal evaluation was $2,220 in 2025, up modestly from $2,219 in 2024 but well above the $2,037 average in 2022. Orthopedic evaluations make up roughly half of all medical-legal costs, but psychiatric and psychological/behavioral health evaluations remain the most expensive on a per-evaluation basis, averaging $3,778 in 2025. Pharmaceutical costs continued their long decline, falling to $0.05 billion, while medical cost containment program costs reported as medical loss held at $0.11 billion — though the report notes that a much larger and growing share of those program costs, $347 million in 2025, is now reported as loss adjustment expense rather than medical loss, up from $305 million in 2019.
On the provider side, the report's medical transaction data shows hospital-based providers' share of medical service payments continuing to shrink, from 19.6% in 2024 to 18.5% in 2025 (and from 21.7% as recently as 2020), while physical therapists, MD general practitioners and psychology/psychiatry/neurology providers each gained share. Among physician services specifically, evaluation and management services held steady at just over a third of physician payments, while physical medicine's share continued to ease down, from 28.5% in 2024 to 27.3% in 2025.
On the indemnity side, $4.7 billion was paid out in 2025, dominated by temporary disability benefits (59.2% of indemnity paid) and permanent partial disability benefits (31.6%, split across the 0.25%–24.75%, 25%–69.75% and 70%–99.75% disability rating bands). Permanent total disability, death benefits, life pensions and vocational rehabilitation/education vouchers each accounted for roughly 2% or less of total indemnity. Vocational rehabilitation-related payments totaled $88 million, or 1.9% of all indemnity paid, essentially unchanged from 2024's $85 million and 1.9% share, with about 90% of that spending going toward education-related benefits.
One figure likely to draw attention from claims and defense professionals: fees paid to applicant attorneys jumped to $506 million in 2025 from $420 million in 2024, an increase of roughly 20%. The report notes these fees are typically embedded within indemnity awards or settlements and cannot always be broken out separately, so this figure is derived from a subset of insurers able to report a comprehensive breakdown.
The report's injury-detail exhibits, based on 2023 policy year data, reinforce a theme WCIRB has flagged in its other recent publications: cumulative trauma claims are disproportionately costly. Claims coded as cumulative injury, not otherwise classified, made up just 6.9% of claims by cause of injury but 9.9% of total incurred losses. Among permanent disability claims specifically, slip-and-fall injuries were both the most frequent and the most expensive injury category, accounting for 27.9% of total incurred losses on permanent disability claims and averaging $105,965 per claim — well above back injuries ($64,506 average) and other cumulative trauma categories such as carpal tunnel and repetitive motion injuries ($41,501 average) or other cumulative injuries generally ($34,757 average). By nature of injury, strains and tears remained the single largest category, accounting for 26.7% of total incurred losses, and by body part, injuries involving multiple body parts (15.7%) and the lower back (11.1%) topped the list.
Taken as a whole, the 2025 report depicts a system where premium has plateaued but claim costs have not: rising loss adjustment expenses, a growing medical-legal cost component, a sharp jump in applicant attorney fees, and continued indemnity severity growth combined to push insurers into their first underwriting loss in several years. That trajectory is consistent with the rate increases the California Department of Insurance has approved and WCIRB has since proposed for the September 2026 filing.
This summary is provided for general informational purposes only. Readers should consult the full WCIRB report for complete data, methodology and the standard conditions and limitations that accompany all WCIRB publications; the WCIRB cautions that the report reflects only the experience of insured employers and cannot guarantee the accuracy of underlying data submitted by individual insurers. - WCAB Seeks Sanctions For Use of Legal Treatise Publisher's AIon July 13, 2026 at 9:34 AM
Gilberto Lopez Mendoza worked as a prepper/painter for SWI Finishing, Inc. He alleged a cumulative trauma injury to his neck, upper extremities, back, lower extremities, legs, feet, and psyche, pled for the period from August 1, 1998 through October 1, 2017. In April 2017, Mendoza sought treatment after removing wet socks pulled a scab off a preexisting wound on his foot; the wound worsened, and by February 2018 he was hospitalized with a rapidly progressing infection that led to a below-the-knee amputation. None of his 2017 or 2018 medical records addressed whether his condition was related to his work. Mendoza did not file a claim for workers' compensation benefits until June 29, 2023, and SWI Finishing denied the claim as untimely.
At trial, the parties disputed whether Mendoza's claim was barred by the statute of limitations and whether he had failed to timely report his injury under Labor Code sections 5400 and 5403. Mendoza testified that he had reported his symptoms to Alex Mendez, a coworker he believed to be his supervisor because Mendez served as the "right hand man" of the actual supervisor and was the only one at the worksite who spoke Spanish with him. Mendez testified that he was not a supervisor, that it would not have been proper for other employees to report injuries to him, and that he did not recognize or recall Mendoza. Panel qualified medical evaluators in internal medicine and orthopedics both later opined that Mendoza's foot infection and resulting amputation were work-related, with the internist assigning a 28% whole-person impairment, 35% of which was apportioned to the industrial cumulative trauma.
The workers' compensation administrative law judge (WCJ) found that Mendoza did not have notice of a cumulative trauma work injury in 2017, and that although he had reported his symptoms to Mendez, whom he believed to be his supervisor, neither Mendez nor the actual supervisor ever provided him a claim form or notice of how to report a workplace injury. On that basis, the WCJ found the statute of limitations was tolled and the claim was not time-barred, and issued Findings of Fact including a finding that Mendoza had sustained an industrial injury through the cumulative period ending October 1, 2017.
SWI Finishing petitioned the WCAB for reconsideration, arguing the WCJ erred in finding the statute of limitations tolled because Mendoza's subjective belief that Mendez was a supervisor could not toll the statute where that belief was contradicted by substantial evidence. In support, the petition cited two cases for the proposition that a worker's subjective belief about a coworker's supervisory status cannot toll the statute of limitations when contradicted by substantial evidence, repeating the citations a second time later in the same petition.
In the panel decision of Gilberto Lopez Mendoza v. SWI Finishing, Inc., ADJ17889413 (Cal. Workers' Comp. Appeals Bd., Dec. 2025) — the WCAB granted SWI Finishing's petition for reconsideration and vacated the WCJ's Findings of Fact in their entirety, but deferred a final decision on the merits pending further proceedings and issued a Notice of Intention to impose sanctions of up to $2,500 against SWI Finishing, its insurer, its claims administrator, and its attorneys.
Before reaching the merits, the WCAB addressed a threshold problem with the Petition for Reconsideration itself. In a Report and Recommendation, the WCJ identified that one of the two cases SWI Finishing cited for its subjective-belief argument, described as "Olson v. Workers' Comp. Appeals Bd. (1997) 62 Cal.Comp.Cases 334," does not exist at that citation; a real case bearing a similar name exists, but at a different citation and addressing unrelated issues of permanent disability and apportionment. The WCJ further found that the second citation, Reynolds v. Workmen's Comp. Appeals Bd. (1974) 12 Cal.3d 726, is a real decision but does not support the proposition SWI Finishing attributed to it; in fact, Reynolds held the opposite, ruling that an employer with a duty to notify an injured worker of his rights cannot invoke the statute of limitations as a defense if it fails to do so. In a supplemental petition, SWI Finishing's counsel admitted that he had used an artificial-intelligence legal research tool called ChatSOC, offered by a legal treatise publisher, and that the tool had generated the fabricated case and the mischaracterized holding, which counsel then included in the petition without independently verifying them.
The WCAB held this conduct sanctionable under Labor Code section 5813, which authorizes sanctions of up to $2,500 for bad-faith actions or tactics that are frivolous or intended to cause delay, and under WCAB Rule 10421, which lists filing a document misstating the law or presenting a position not warranted by existing law as sanctionable conduct. The Board emphasized that an attorney who delegates legal research to a non-attorney tool, including an AI program, remains responsible for supervising that work and verifying its accuracy before filing, citing its own en banc decision in Ledezma v. Kareem Cart Commissary and Mfg. (2024) 89 Cal.Comp.Cases 462, as well as an attorney's duties of candor and competence under Business and Professions Code section 6068 and rules 3.3 and 5.3 of the California Rules of Professional Conduct. The Board found no excuse for filing a petition containing fabricated citations and misrepresented holdings, regardless of the tool's own limitations, and directed that the sanctions run jointly and severally against the employer, its insurer, its administrator, and its attorneys, with a separate response due from the firm's managing partner describing any firmwide policies on the use of AI research tools.
Turning to the merits, the WCAB agreed with the WCJ's recommendation that the finding of industrial injury should be vacated because the issue of injury itself, as opposed to the timeliness of the claim, had never been raised as a triable issue at trial. But the Board went further, vacating the entire Findings of Fact, explaining that a statute-of-limitations analysis must begin with a finding of the date of cumulative injury under Labor Code section 5412, and that the WCJ's decision never made that finding. The Board reiterated the settled framework for cumulative-trauma date-of-injury disputes: the employer bears the burden of proving the claim is untimely, medical treatment alone does not establish disability under section 5412, and a worker generally will not be charged with knowledge that a disability is job-related absent medical advice to that effect, citing City of Fresno v. Workers' Comp. Appeals Bd. (1985) 163 Cal.App.3d 467 and State Comp. Ins. Fund v. Workers' Comp. Appeals Bd. (2004) 119 Cal.App.4th 998. Only after a date of injury is established, and only if the employer shows the claim was filed outside the resulting limitations period, does the burden shift to the worker to establish tolling. Because that sequence was never completed below, the Board returned the matter to the trial level, suggesting the WCJ may wish to consider bifurcating the statute-of-limitations issue, and invited the parties to meet and confer on a stipulated date of injury. The Board stated it would issue its decision on the merits together with its ruling on sanctions once the sanctions process concludes. - Remaining Defendants Settle Health Coverage Fraud Caseon July 13, 2026 at 9:34 AM
The California Attorney General announced that the Los Angeles Superior Court approved a settlement with Shelley Steele, Timothy Candace “Tim” Moses, Chase Moses (collectively, the Moses family), and First Call Telemedicine, LLC (First Call), the remaining defendants in a matter involving the alleged sale of sham health coverage to California consumers.
The case began in January 2022, when the Attorney General filed a lawsuit against The Aliera Companies, Inc. (Aliera), Trinity HealthShare (Trinity), and other defendants, including those who are the subject of this settlement.
The lawsuit alleged that the Moses family created and controlled Trinity, falsely presenting it as a legitimate health care sharing ministry (HCSM), and used Aliera, a for-profit company they also controlled, to market and administer the health plans to consumers.
HCSMs are 501(c)(3) nonprofit organizations historically comprised of members of a particular religious community who contribute money to share catastrophic or unexpected healthcare costs. HCSMs are often marketed as lower-cost alternatives to traditional health insurance, but they generally do not pay for all essential health benefits such as prescriptions, preexisting conditions, birth control, or mental healthcare, and do not guarantee payment for medical expenses.
According to the complaint, Trinity was not a legitimate HCSM, and Aliera retained a significant portion of members’ contributions rather than using those funds to pay healthcare costs, leaving many consumers with unpaid medical bills. The lawsuit also alleged that, after the collapse of Aliera, Shelley Steele continued selling health plans in California through First Call without the required state authorization and directed millions of dollars from Trinity membership funds to First Call.
In 2025, the Attorney General reached a settlement with Aliera, Trinity, and additional defendants. This new settlement resolves the matter with the remaining defendants: the Moses family and First Call.
“Californians deserve honest information when making decisions about their health coverage,” said the Attorney General. “More than 14,000 Californians were allegedly misled into paying for health plans that did not provide the protection they expected, while those behind the scheme profited from their trust. After holding other defendants accountable last year, this settlement finishes the job by securing penalties against the remaining defendants and barring them from doing business in California.”
Consumers were allegedly led to believe their monthly payments were being used to pay healthcare expenses, but Aliera retained nearly 84% of those funds and routinely rejected requests for payment of medical expenses. Under the settlement:
- - Shelley Steele, Tim Moses, and First Call Telemedicine are permanently barred from conducting business in California, directing business toward California residents, serving in leadership positions at companies doing business in California, or owning more than a 25% interest in businesses operating in California.
- - Chase Moses is prohibited from conducting business in California for 10 years and is permanently barred from marketing, selling, administering, or otherwise operating any HCSM in California.
- - These remaining defendants must pay more than $5.1 million in civil penalties. Portions of those penalties are suspended based on the defendants’ sworn financial disclosures and continued compliance with the judgment and may be reinstated if the defendants are found to have materially misrepresented their financial condition or violate the settlement.
Californians who believe an HCSM used deceptive marketing or misrepresented its services are encouraged to file a complaint at oag.ca.gov/report. - Lawyers Held to State Bar Ethics Civility Provisions in Pro-Per Caseson July 9, 2026 at 10:12 AM
Aziz Damak, representing himself, sued Satraj Hospitality LLC and Sangita and Sanjeev Khanna, who own and operate the Cozy Inn motel in Costa Mesa, alleging wage and hour, meal and rest period, retaliation, and wrongful discharge claims arising from his employment as a receptionist.
In July 2024, Damak served extensive discovery on each defendant, including interrogatories, requests for admission, and document production requests. After receiving no responses and no communication from defendants' attorney, Hitendra Bhakta, despite repeated calls and a written 21-day notice warning that he would seek sanctions, Damak filed fifteen motions to compel in November 2024, each requesting monetary sanctions of "at least $1,000." Defendants never opposed any of the motions, and neither Bhakta nor anyone from the defense side communicated with Damak about the outstanding discovery during the roughly ten months before the motions were heard.
The Court granted all of Damak's motions to compel and the nonmonetary relief he requested, but denied monetary sanctions. The court recognized that the applicable Civil Discovery Act provisions made some sanction mandatory, but explained that such sanctions are limited to a party's "reasonable expenses actually incurred."
Because Damak was self-represented, had a fee waiver, and did not claim he had incurred any out-of-pocket expenses in bringing the motions, the court concluded it could not award any sanctions and denied that portion of his requests outright. Damak petitioned for a writ of mandate challenging that denial, arguing the court was required to award at least a nominal sanction and that the ruling undercut the deterrent purpose of the discovery sanctions scheme by letting represented parties stonewall self-represented opponents without consequence.
In the published case Damak v. Superior Court, No. G065583 (Cal. Ct. App., 4th Dist., Div. 3, July 2026) — the Court of Appeal granted Damak's petition for writ of mandate in part and denied it in part, directing the trial court to vacate the portion of its order denying monetary sanctions and to reconsider that request.
The panel first agreed with the trial court that the Civil Discovery Act's method-specific sanctions provisions — covering interrogatories, document production, and requests for admission — direct that sanctions be imposed under a companion provision authorizing "reasonable expenses, including attorney's fees, incurred by anyone as a result" of the discovery misuse. Relying on the California Supreme Court's decisions in Trope v. Katz (1995) 11 Cal.4th 274 and Musaelian v. Adams (2009) 45 Cal.4th 512, and the Court of Appeal's own decision in Argaman v. Rutan (1999) 73 Cal.App.4th 1173, the court explained that a self-represented litigant, including a self-represented attorney, cannot "incur" attorney fees for his own time, and so cannot recover compensation for the hours he personally spent preparing the motions or for business opportunities forgone.
The court found Kravitz v. Superior Court (2001) 91 Cal.App.4th 1015 persuasive on this point, and acknowledged that court's own description of the resulting rule as "wholly inadequate" for self-represented litigants facing discovery abuse, since a represented opponent who never incurs identifiable costs effectively gets, in that court's words, one free bite at ignoring discovery obligations. Damak's reliance on Appleton v. Superior Court (1988) 206 Cal.App.3d 632 did not change this outcome, the panel explained, because that case addressed only whether a sanction was mandatory in amount, not what the sanction could permissibly compensate.
The panel found, however, that the trial court's analysis stopped short. A separate, more recently enacted provision of the Civil Discovery Act, Code of Civil Procedure section 2023.050, requires a court to impose a flat $1,000 sanction against a party or attorney — regardless of any expenses incurred by the other side — if it finds the party or attorney failed to respond in good faith to a document production request or failed to confer in a good faith attempt to resolve the dispute informally. The court explained that this provision, drawing on legislative history describing it as a "stronger . . . hammer on discovery abuse," is aimed at deterring the offending party's conduct rather than merely compensating the other side, and applies "notwithstanding any other law."
Because Damak's motions concerning document production requests were governed by a Discovery Act provision that in turn incorporates section 2023.050, and because the trial court's order never mentioned that section or made any finding on whether defendants had responded in good faith or conferred with Damak, the panel held the trial court's failure to even consider it was an abuse of discretion, citing City of Los Angeles v. PricewaterhouseCoopers, LLP (2024) 17 Cal.5th 46. The panel emphasized that nothing in the record suggested defendants had responded in good faith or conferred with Damak about the document requests, but declined to make those factual findings itself, remanding for the trial court to consider in the first instance whether a section 2023.050 sanction was warranted.
The court closed with an extended discussion of civility, noting that attorneys owe self-represented litigants the same dignity, courtesy, and integrity due to opposing counsel and the court itself, an obligation reflected in the civility oath every California attorney must now take and annually reaffirm under California Rules of Court, rule 9.7. Citing recent decisions admonishing incivility in litigation, including Masimo Corp. v. The Vanderpool Law Firm, Inc. (2024) 101 Cal.App.5th 902 and Karton v. Ari Design & Construction, Inc. (2021) 61 Cal.App.5th 734, the panel described defendants' ten months of silence in response to Damak's repeated, documented attempts to follow up on outstanding discovery as falling far short of that standard, regardless of any underlying intent. The court also noted, in a footnote, that defendants' counsel made an unsupported factual assertion at oral argument about the record that the court could not verify, and reminded counsel of an attorney's duty of candor to the court. - 9th Circuit Interprets the EFAA's Application Timing Provisionson July 9, 2026 at 10:12 AM
Jessica Combs began working at Netflix, Inc. in May 2017 under an employment agreement containing a broad arbitration clause covering all employment-related disputes. She alleges that soon after starting, Netflix fostered a sexualized office culture, including one-on-one meetings that took on a flirtatious, dating-like tone and encouraged unwanted advances from male colleagues. At a September 2018 company offsite, Combs was required to participate in team-building exercises she considered sexualized, including exercises resembling "forced speed dating," and she says a stairwell was used by male employees to look under female colleagues' dresses. During an October 2018 work trip to Singapore, a male colleague made unwanted sexual advances toward her. Combs alleges that between 2017 and 2021 she repeatedly complained to her supervisors and to Netflix management about this sexually charged environment and about specific incidents, but that Netflix ignored her complaints and took no corrective action. In December 2021, Netflix fired Combs; the company cited her noncompliance with its COVID-19 vaccination policy, but Combs alleges the real reason was retaliation for her complaints.
In August 2023, Combs filed an administrative complaint with California's Department of Fair Employment and Housing and received an immediate right-to-sue letter. In July 2024, she sued Netflix in California state court on various state-law discrimination, harassment, and hostile-work-environment theories. Netflix removed the case to federal court based on diversity of citizenship and moved to compel arbitration under the parties' agreement. Combs did not dispute that a valid arbitration agreement existed or that her claims fell within it; instead, she argued that the Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act of 2021 (EFAA; 9 U.S.C. §401–402), which lets a person alleging sexual harassment elect to proceed in court despite a predispute arbitration agreement, exempted her case from arbitration.
The United States District Court for the Central District of California granted Netflix's motion to compel arbitration. The court concluded that, even though Combs's complaint alleged conduct constituting sexual harassment, her claims accrued and her dispute with Netflix arose before the EFAA's March 3, 2022 effective date, so the statute's timing provision took her case outside the Act's reach and the parties' arbitration agreement controlled.
In the published case of Combs v. Netflix, Inc., No. 25-3164 (9th Cir., July 2026) — the Ninth Circuit affirmed the district court's order compelling arbitration.
The panel first agreed that Combs's complaint alleged conduct constituting unlawful sexual harassment, so her claims presumptively fell within the EFAA. The dispositive question, one of first impression in the circuit, was how to interpret the EFAA's timing provision, a statutory note stating that the Act applies to any "dispute or claim that arises or accrues" on or after its March 3, 2022 enactment date. The court held that this phrase describes two distinct concepts — "claims that accrue" and "disputes that arise" — agreeing with the Sixth Circuit's reasoning in Memmer v. United Wholesale Mortgage, LLC (2025) 135 F.4th 398 that Congress used the disjunctive "or" to differentiate them.
On claim accrual, the court applied the settled common-law rule, drawn from Corner Post, Inc. v. Board of Governors of the Federal Reserve System (2024) 603 U.S. 799, which in turn cited Green v. Brennan (2016) 578 U.S. 547, that a claim accrues when a plaintiff has a complete and present cause of action allowing her to file suit and obtain relief. Under that standard, Combs's claims accrued well before March 3, 2022, since she alleges harassment and a termination that occurred between 2017 and 2021.
The harder question was when a "dispute" arises. The court rejected Combs's argument that no dispute arises until a formal external complaint is filed with a court or administrative agency, finding that reading too narrow. It also rejected the opposite extreme, urged in similar cases by other employers, that a dispute arises whenever the underlying harassing conduct occurs, since that would collapse the distinct concepts of "dispute" and "claim" into one and render Congress's use of both terms superfluous. Instead, following the Third Circuit's decision in Cornelius v. CVS Pharmacy Inc. (2025) 133 F.4th 240 and the Eighth Circuit's decision in Famuyide v. Chipotle Mexican Grill, Inc. (2024) 111 F.4th 895, the panel held that a dispute arises under the EFAA when an employee registers disagreement with her employer, through an internal complaint, an external complaint, or otherwise, and the employer expressly or constructively opposes that position. The court noted this same formulation had already been adopted by a California appellate court applying the EFAA, in Kader v. Southern California Medical Center, Inc. (2024) 99 Cal.App.5th 214.
Applying that standard, the panel held that a dispute arose between Combs and Netflix well before the EFAA's effective date. By the complaint's own allegations, Combs repeatedly complained to Netflix between 2017 and 2021 about the sexualized culture and specific incidents, and Netflix consistently ignored those complaints and took no corrective action; that pattern of complaint met with inaction showed Netflix had, at minimum, constructively opposed her position. The court found the case closely analogous to Cornelius, where an employee's repeated written complaints that her employer dismissed and failed to remedy were likewise sufficient to show a pre-2022 dispute. The panel further noted that Netflix's alleged decision to fire Combs in December 2021 in retaliation for her complaints put the point beyond doubt, since firing an employee for raising a complaint is itself a clear act of opposition to her position. Because both Combs's claims and her dispute with Netflix arose before March 3, 2022, the EFAA did not apply, and the panel affirmed the order compelling her case to arbitration.