Author: WorkCompAcademy

The Division of Workers’ Compensation announced it will dismiss more than 292,000 unresolved liens by operation of law. The liens belong to claimants who did not properly file the required Supplemental Lien form and 4903.05(c) Declaration form.

Senate Bill 1160, which became effective January 1, required all lien claimants who filed a lien between January 1, 2013 and December 31, 2016, and paid a filing fee, to file the forms by July 1. Lien claimants who failed to file the forms as required will have their liens dismissed.

Labor Code section 4903.05(c) was amended as part of the bill’s reform measures to combat fraud in the workers’ compensation system. To comply with SB 1160’s requirements, DWC made available an e-form declaration and the Workers’ Compensation Appeals Board promulgated regulations requiring the use of this form.

Lien claimants should be aware that DWC will not send notification to claimants whose liens have been dismissed. DWC has posted frequently asked questions on the supplemental lien form online.

The Division of Workers’ Compensation previously reported that 441,070 supplemental lien declaration forms were filed as required by Labor Code section 4903.05(c). This represents half of the 882,648 liens filed in California’s workers’ compensation system between January 1, 2013 and December 31, 2016 for which a filing fee was paid.

Lien claimants who failed to file the “Supplemental Lien Form and 4903.05(c) Declaration” will have their liens dismissed. This would have been approximately 441,578 liens.

The announcement of the dismissal of 292,000 liens is somewhat short of the original estimate, but is nonetheless a significant development.

Actor Tom Cruise was injured after a stunt for his new “Mission Impossible 6” movie went awry. It’s not known how badly he was injured but footage of the accident shows him limping away and in evident pain. The stunt for the the latest installment of the long-running franchise was being filmed in London. It involved Cruise jumping between two buildings with the assistance of a safety harness.

The footage, published by TMZ, show the 55-year-old actor having problems with timing his leap and crashing into the side of the second building. The actor was able to pull himself up onto the roof of the building but was then seen limping heavily before collapsing next to members of the film’s crew.

Cruise is something of a rarity among Hollywood actors for insisting on performing many of his own stunts, the Guardian said. In 2011, the actor scaled the outside of Dubai’s Burj Khalifa, currently the world’s tallest building, for a scene from “Mission: Impossible – Ghost Protocol.” For 2015’s “Mission: Impossible – Rogue Nation,” he was attached to the exterior of an Airbus 400 as it took off. Cruise also performed inside a zero-gravity plane for the recent reboot of “The Mummy.”

And it seems that Tom Cruise has recently had more than his share of movie making safety problems.

American Made is an upcoming biographical crime film starring Tom Cruise. The film is based on the life of Barry Seal, a former TWA pilot who became a drug smuggler in the 1980s and was recruited later on by the DEA to provide intelligence. It is set to be released on September 29, 2017.

A twin-engine Piper Smith Aerostar 600, had been ferrying three pilots who were working on a film: Alan Purwin, 51, one of Hollywood’s most sought-after helicopter stunt operators; Carlos Berl, 58, a well-qualified airman who knew how to navigate the red tape of the plane import-export business; and Georgia native Jimmy Lee Garland, 55, who could fly and repair just about anything. The flight took off after a long day of filming underway for weeks in the hills in northeast Colombia, near the border with Panama. This early-evening flight  was supposed to be a short taxi ride home.

Instead it crashed in foggy and cloudy conditions in the Ciolombian mountains. The only person to survive the crash was Garland, who suffered injuries to his legs, arms, face and chest

Relatives of Purwin sued the movie’s production companies – including Imagine Entertainment and Cross Creek Pictures – as well as the estate of Berl. Their suit alleges that Berl was piloting the plane at the time of the crash even though he lacked the skills to do so.

Berl’s estate countersued, claiming Berl informed producers and other parties related to the film that he had insufficient experience to fly the aircraft. The estate also alleges that the flight wasn’t safely planned, prepared or supervised.

These accidents are the latest in a series of deadly tragedies that have occurred on film sets.

A Los Angeles Times report in March found a sharp rise in catastrophic injuries on film sets in recent years. There were 20 deaths in the U.S. related to motion picture and television production for the five years that ended in December 2014, double the number of fatalities during the previous five-year period.

President Trump says he is ready to declare the nation’s opioid crisis a national emergency. “It is a serious problem the likes of which we have never had. You know when I was growing up, they had the LSD and they had certain generations of drugs. There’s never been anything like what’s happened to this country over the last four or five years. And I have to say this in all fairness, this is a worldwide problem, not just a United States problem. This is happening worldwide. But this is a national emergency.”

A few hours after this announcement, the White House in a statement said Trump has “instructed his administration to use all appropriate emergency and other authorities to respond to the crisis caused by the opioid epidemic.”

The president’s Commission on Combating Drug Addiction and the Opioid Crisis had recommended in an interim report released July 31 that the president immediately declare a national emergency, citing an overdose death rate of 142 a day.

The chairman of the president’s opioid commission, New Jersey Gov. Chris Christie, thanked the president “for accepting the first recommendation” of the commission’s report. “It is a national emergency and the president has confirmed that through his words and actions today, and he deserves great credit for doing so,” Christie said.

The commission’s report to the president said a declaration “would empower your cabinet to take bold steps and would force Congress to focus on funding and empowering the Executive Branch even further to deal with this loss of life.”

The report also called on Washington to grant waiver approvals to all 50 states to eliminate barriers and allow treatment at Medicaid-funded residential facilities, a move it said would rapidly increase treatment capacity.

Trump’s statement was welcomed by members of Congress. Sen. Rob Portman, R-Ohio, said Washington “must continue to fully fund important programs on prevention, treatment, and recovery.” Portman also called for Congress to pass laws to “help stop overprescribing, increase the number of treatment beds covered by Medicaid at residential treatment facilities and help stop the flow of synthetic opioids that are shipped into this country through the postal service.”

Rep. Marcy Kaptur D-Ohio, called the president’s remarks “a good step,” adding, “I will remind the President’s team as they move forward, that Medicaid provides the bulk of addiction treatment and is a key partner in providing much-needed care to those in need.”

Health and Human Services Secretary Tom Price said such a declaration is usually reserved for “time-limited” problems such as the Zika outbreak and that the administration believed they already had the resources and focus needed to tackle the problem. But he did add that “all things are on the table for the president.”

So far, six states have declared statewide emergencies for the opioid epidemic and used the declaration to help increase access to the opioid overdose reversal medication, naloxone.

Melony Light began working as a seasonal Park Aide at the California Department of Parks and Recreations’s Ocotillo Wells District in San Diego County in 2010. In 2011 she was promoted to a permanent position as an Office Assistant.

Kathy Dolinar was the Superintendent of the Ocotillo Wells District and Leda Seals’s supervisor. Seals and Dolinar were close friends.

In fall 2011, Seals recommended Light for an “out-of-class” assignment as an Office Technician. An “out-of-class” assignment is a temporary assignment to a position in a higher classification with an accompanying increase in pay. Before the end of that assignment, in approximately February 2012, Seals recommended Light for a second out-of-class assignment as a Management Services Technician.

Melony Light was friends with a coworker, Delane Hurley. Seals believed Hurley to be a lesbian. Seals repeatedly made comments to Light intended to make her uncomfortable about her friendship with Hurley, to enlist Light in Seals’s harassment of Hurley based on her sexual orientation, and to encourage Light to cease all contact with Hurley. Seals’s actions allegedly caused Light to suffer emotional distress.

Hurley eventually took medical leave for stress. While she was absent, Seals asked Light to go through Hurley’s workspace and remove any personal items. Light objected because she did not feel comfortable going through Hurley’s things, but Seals insisted. Seals also told Light to move into Hurley’s office because Hurley would not be coming back to the District. Light again objected, but Seals told her the move was nonnegotiable. This situation escalated ultimately involving Kathy Dolinar as Superintendent and a convoluted series of related events.

Ultimately Light filed civil litigation against the Department for retaliation, disability discrimination, and failure to prevent retaliation and discrimination, all in violation of the Fair Employment and Housing Act. The trial court ruled in favor of the Recreation Department, and her former supervisors, defendants Leda Seals and Kathy Dolinar, following orders granting defendants’ motions for summary judgment. The Court of Appeal reversed in the partially published case of Light v Calif. Dept. of Parks and Recreation.

As to Seals and Dolinar, the court concluded contrary to the trial court that workers’ compensation exclusivity does not bar Light’s claim for intentional infliction of emotional distress under the circumstances here. As to the Department, the court concluded that triable issues of material fact preclude summary adjudication of Light’s retaliation claim, but not her disability discrimination claim.

“[T]he exclusive remedy provisions are not applicable under various circumstances, sometimes various identified as ‘conduct where the employer or insurer stepped out of their proper roles’ [citations], or ‘conduct of an employer having a “questionable” relationship to the employment’ [citations], but which may be essentially defined as not stemming from a risk reasonably encompassed within the compensation bargain.”

“Because our discussion of the interplay between workers’ compensation exclusivity and intentional infliction of emotional distress addresses an important legal issue, and our interpretation differs from a recent opinion by our colleagues in Division Three of this court (Yau v. Santa Margarita Ford, Inc. (2014) 229 Cal.App.4th 144) , we will publish that discussion, as well as our discussion of the FEHA retaliation claim on which it relies.”

Yau interpreted the California Supreme Court’s 2008 opinion in Miklosy v. Regents of the University of Cal. (2008) 44 Cal.4th 876, 902 to allow only a single exception to the workers’ compensation exclusivity rule and concluded,that the “exception does not, however, allow a ‘distinct cause of action, not dependent upon the violation of an express statute or violation of a fundamental public policy.’ ” (Ibid., quoting Miklosy, supra 44 Cal.4th at p. 902.).

“We believe Yau reads Miklosy too narrowly……..In sum, absent further guidance from our Supreme Court, we are unwilling to abandon the longstanding view that unlawful discrimination and retaliation in violation of FEHA falls outside the compensation bargain and therefore claims of intentional infliction of emotional distress based on such discrimination and retaliation are not subject to workers’ compensation exclusivity.”

Sovereign Health is a mental health and addiction provider with a footprint throughout Southern California, several states and India. Tonmoy Sharma is its chief executive.

Sharma started Sovereign the year after he lost his license in the UK. He was a psychiatrist in the UK, until his license was revoked for conduct deemed dishonest, unprofessional and misleading, according to documents from the General Medical Council of the UK, which licenses physicians there. There is no record that he holds a license as a physician in California.

One center with six beds grew to 17 centers with 743 beds. A giant map hanging on the conference room wall details another 851 beds in development across the nation, which would bring the total to 1,594 beds.

Last year, his company sued Health Net , one of the nation’s largest insurers, for failing to pay $55 million for medical services rendered by Sovereign-related companies. Sovereign Health’s claims were routinely denied, according to the Los Angeles Superior Court complaint. In 2015, only 36 percent of Sovereign Health’s claims were paid. In 2016 only 3 percent of its claims were paid.

In a counter-suit Health Net argued that Sharma and his companies are engaged in massive fraud that harms all consumers. Sovereign-related companies – and many other addiction-treatment providers – “have abused the Affordable Care Act in a manner that threatens the ongoing viability of health insurers,” Health Net’s suit said. “This scheme, which involves fraudulently obtaining insurance policies and the submission of thousands of false and fraudulent claims, also raises the costs of healthcare coverage to consumers, who ultimately will have to pay higher insurance premiums.”

Sovereign and its affiliates comprise one of the largest groups of fraudulent providers, Health Net charged. Within the span of a single year, Sovereign’s companies went from billing Health Net less than $50,000 a month to more than $13 million a month, Health Net’s counter-suit said. How can that happen? Many clinics – including Sovereign’s – “have been engaged in a sophisticated fraud involving paying kick-backs to ‘buy’ hundreds of patients from teams of brokers, or ‘cappers,’ who find the patients in 12-step programs, AA meetings, homeless shelters and jails, often from outside California, and then ‘sell’ them for cash to the highest-bidding clinic,” its suit said.

What Health Net describes echoes a recent investigation of the industry by the Southern California News Group. Though many legitimate centers remain, critics and long-time insiders say a darker version of the industry is emerging, built around an illicit world of patient recruiters, fraud-driven clinics and drug-testing mills. Southern California, where the implementation of Obamacare makes it easy for recent arrivals to sign on for insurance, is on the front line of the conflict.

This summer federal and state agents raided several locations of Sovereign Health as part of an ongoing probe. No arrests were made when officials executed search warrants at sites in Culver City, Palm Desert, San Clemente and San Juan Capistrano. The search warrants were filed under seal, and officials were barred from discussing the extent of the investigation.

Litigation and FBI probes are not the least of Sharma’s worries. The article in the Orange County Register also reports that “body brokers” from other providers are in his parking lots trying to steal away his patients – and their insurance coverage ‘ every day.