Case Law Update - June 2021
Introduction
Below please find the title of articles we have written summarizing select workers' compensation related cases over the last few years.
These are organized by topic. If you click on any of the titles, your browser should open the case summary. Within that summary will be another link to the full opinion. This document will be updated as new cases are published.
- Exclusions to Comp Policy Requires an Explicit Endorsement (June, 2021)
- Unapproved Comp Policy Arbitration "Side Agreements" Unenforceable (Jan, 2021)
- Comp Policy Rates Cannot be Altered by Oral Prior Assurances (Nov, 2020)
- Successor Corporation Not Insured by Existing Comp Policy (Oct, 2020)
- Unsigned Policy Limiting Endorsement was "Equitable" (Sep, 2019)
- $13.4 M Restitution Affirmed in Largest Premium Fraud Scam (2019)
- 9th Circuit Clarifies Employer Liability Provision of Comp Policy (2019)
- EquityComp Arbitration Agreement is Unenforceable (2018)
- Uninsured Subcontractor Must Repay Contract Payments (2018)
- Punitive Damages Upheld Against Uninsured Employer (2018)
- DCA Limits City's Indemnification for Comp Loss (2018)
- Liability Policy has “No Potential” Comp Coverage (2017)
- Carrier has Right to "Retroactively" Rescind Policy (2017)
- DCA Affirms $180K Penalty for Uninsured Employer (2016)
- SB 863 Temp Agency Insurance Requirement Constitutional (2015)
- DCA Rules Carriers May Rescind Policies for Misrepresentation (2015)
- Federal Court Invalidates Unapproved Large Deductible Comp Policies (2015)
- Safety Shoe Policy Rebate Violates Comp Law (2015)
- Intoxication No Defense to Claim Against Uninsured Employer (2014)
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- Texas Trucker Loses 5th Circuit Battle Over Cal/OSHA Jurisdiction" (June, 2021)
- Worker's Injury Suit Against Employer Dismissed (May, 2021)
- Exclusive Remedy Dues Not Require Actual Receipt of Benefits (March, 2021)
- Exclusive Remedy Ends Suit for Employee Suicide (March, 2021)
- Court Rules Exclusive Remedy Applies to COVID-19 Civil Action (Sep, 2020)
- Restaurant Server Encouraged to Drink Within Exclusive Remedy (Sep, 2020)
- Tort Claim Rejected for SCIF Refusal to Pay WCAB Order (July, 2020)
- Court of Appeal Resolves WCAB Concurrent Jurisdiction Issue (Dec, 2019)
- No Jurisdiction for Applicant Civil Case Against WCAB, WCJ and SCIF (Nov, 2019)
- Exclusivity Rule Bars Suit for Lead Poisoning (2019)
- No Jurisdiction for Applicant Civil Case Against WCAB, WCJ and SCIF (2019)
- No WCAB Exclusive Jurisdiction Over AOE-COE in CIGA Case (2019)
- SCOTUS Affirms Employers Arbitration Rights (2019)
- Arbitration Agreement Must Explicitly Include FEHA (2019)
- Worker Must Prove Injury in Uninsured Employer Tort Claim (2019)
- Supreme Court Rules Exclusive Remedy Protects UR Physician (2018)
- Exclusive Remedy No Protection for Uninsured Employer (2018)
- Employer Has Only 30 Days to Appeal DOSH Citation (2018)
- DCA Affirms No Jurisdiction Over NFL Player’s Injuries (2018)
- Exclusive Remedy Exception Requires Extreme and Outrageous Conduct (2018)
- Civil Qui Tam Action Affirmed Against Applicant for Fraudulent C&R (2018)
- Qui Tam IFPA Litigation Available for Comp Fraud (2018)
- Homeowner Protected by Exclusive Remedy Rule (2018)
- No Evidence of Equitable Estoppel in Volunteer's Injury Claim (2018)
- Exclusive Remedy Not Applicable to Employer Assault (2017)
- Exclusive Remedy Bars Workplace Safety Fraud Claim (2017)
- Court Limits Exclusive Remedy Protection for Co-workers (2017)
- Exclusive Remedy Protects General and Special Employer (2017)
- SC Employer Liable for Asbestos Injury to Household (2016)
- Exclusive Remedy Not Applicable to “Training” Robbery (2016)
- DCA Affirms Dismissal of City of LA Employee Hazing Lawsuit (2016)
- Injured Worker Cannot Assign Structured Settlement for Cash (2016)
- DCA Says WCAB Has Jurisdiction Over CHP 4800.5 Benefits (2016)
- Exclusive Remedy Bars Claim for Asbestos Taken Home (2015)
- Excess Carrier Not Bound by WCAB Decision (2015)
- WCAB Claims Jurisdiction Over New York State Insurance Fund (2015)
- CA Rules on WCAB Jurisdiction Over NBA Team (2015)
- WCAB Panel Rejects Jurisdiction Over Hospital Lien Claim (2014)
- SC Limits Recovery of Injured Caregiver to Workers’ Comp (2014)
- DCA Rejects Worker’s Fraudulent Concealment Case (2014)
- DCA Limits Definition of LC 4558 Power Press Exception (2014)
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- Injury While on Personal Errand in “Mobile Office” is AOE-COE (June, 2021)
- Waiver Signed by Injured Worker on Volunteer Job Limits Liability (June, 2021)
- Sexual Exploitation by PTP Causes New Compensable Injury (May, 2021)
- Sheriff's Failure of Fitness-for-Duty Test Not a Psychological "Injury" (Nov, 2020)
- WCAB Rules Tree Trimmer Amputation "Sudden and Extraordinary" (Oct, 2020)
- Newsom Signs COVID-19 Presumption Law (Sept, 2020)
- Stipulation to "Upper Extremity" Includes Thoracic Outlet Syndrome (June, 2020)
- En Banc WCAB Defines "Catastrophic Injury" (2019)
- Worker Must Prove Injury in Uninsured Employer Tort Claim (2019)
- DCA - Consideration of Cancer "Latency Period" Required for AOE-COE (2018)
- DCA - Overturned Compactor Injury Not Sudden or Extraordinary (2018)
- WCAB Reversed on Deputy Sheriff AOE-COE Finding (2017)
- DCA Interprets Volunteer Firefighter Cancer Presumption (2017)
- Filmmaker Sentenced for Manslaughter – Then Awarded Psyche Benefits? (2016)
- Failure to Provide DWC-1 Limits Carriers’ Laches Defense (2016)
- DCA Reverses Denial of Death Benefits (2016)
- DCA Rejects “Daubert” Evidentiary Standard in Comp Death Case (2016)
- Supreme Court Clarifies Differences Between Tort and Comp Causation (2015)
- DCA Reverses Psyche Award (2015)
- Psych AME Must Separately List Each Stressfull Event (2014)
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- Lyft Employee Classification Suit Favors State Over Federal Law (June, 2021)
- Federal Appellate Court Orders Trucking Companies to Comply AB-5 (April, 2021)
- Supreme Court ends Practice of Rounding Time Clock Punches (Feb, 2021)
- Federal Trucking Law Preempts More Stringent CA Break Law (Feb, 2021)
- Supreme Court Denies Union Effort to Invalidate Prop 22 (Feb, 2021)
- Supreme Court Rules Dynamax Decision Applies Retroactively (Jan, 2021)
- Supreme Court Rules Workers Must be Paid for Security Checks (Feb, 2020)
- ABC Employment Test Limited to "Wage and Hour Laws" (Nov, 2019)
- Filing Comp Claim Not Necessarily a FEHA "Protected Activity" (Oct, 2019)
- Governor Signs AB 5 - Gig Workers Become Employees (Sep, 2019)
- ABC Employment Test Limited to "Wage and Hour Laws" (2019)
- “ABC” Dynamex Employment Test is Retroactive (2019)
- DCA Rules “On-Call” Scheduling Requires 2 Hours Pay (2019)
- Supreme Court Uses “ABC” Test for Employment Finding (2018)
- Unlicensed Tree Trimmer v. Homeowner Suit Affirmed (2018)
- DCA - Couple Checking on Neighbor Was "Active Law Enforcement" (2018)
- Federal Court Says Grubhub Driver is Independent Contractor (2018)
- Going and Coming Rule Precludes Employer Tort Liability (2017)
- North Hollywood Cab Driver was Employee (2017)
- Going and Coming Rule Clarified (2017)
- Going and Coming Rule is More Restrictive in Tort Cases (2016)
- Trucker Not Independent Contractor Despite Contract Language (2015)
- Bunkhouse Rule and Voluntary Rental Housing is Triable Issue (2015)
- Registry Nurses are Independent Contractors (2015)
- DCA Rejects Death Benefits in “Special Mission” Case (2014)
- Employment Presumption Inapplicable in “Small Jobs” (2014)
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- WCAB Clarifies 20 Day Time Limit to Schedule Medical Appointment (June, 2021)
- U.S. Supreme Court Allows States to Regulate PBM Drug Prices (Dec, 2020)
- Texas Supreme Court Approves Limits on Air Ambulance Costs (June, 2020)
- WCAB Clarifies MPN Access Standards for PTPs (2016)
- Stipulation Binds Employer to Non-MPN Physician (2015)
- WCAB Panel Defines Housekeeping as “Medical Care” (2015)
- No Requirement to Advance Payment For Surgery (2015)
- WCAB Limits MPN Second/Third Opinion Process (2015)
- WCAB Defines Housekeeping as “Medical Care” (2015)
- Citation to Treatment Guideline Required to Award Home Health Care (2014)
- WCAB Panel Rules UR Decision Effective For 12 Months (2014)
- WCAB Broadly Interprets a “Prescription” for Home Care. (2014)
- WCAB Reverses Case Law OMFS for Denied Cases (2014)
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- WCAB Declines Jurisdiction Over UR/IMR Dispute (May, 2021)
- WCAB Panel Says 5814 Penalties Inapplicable to Timely UR (May, 2020)
- Saturday is Not a “Working Day” for UR Time Limits (2019)
- WCAB Says "No Alternative Track" to Dispute UR (2019)
- Jurisdiction Over Home Health Care Limited to UR/IMR (2019)
- WCAB Rejects AD Limits on Documents Sent to IMR (2019)
- WCAB Says UR Time Limits are Mandatory (2019)
- Court of Appeal Rejects Zuniga IMR Constitutional Challenge (2018)
- IMR Opinion Valid Despite Time Limit Violations (2017)
- WCAB Rules of Practice and Procedure Not Applicable to UR Process (2016)
- Court of Appeal Says Late IMR Decision is Still Valid (2016)
- WCAB Panel Reverses IMR for “Plainly Erroneous Finding” (2016)
- WCAB Panel Affirms “Untimely” IMR Decision (2016)
- Split Panel Decision Continues UR/IMR Erosion (2016)
- Split Panel Decision Gives 24 Hours to Communicate UR Decision (2016)
- WCAB Panel Decision Continues Erosion of UR/IMR Jurisdiction(2016)
- IMR Survives Constitutional Challenge(2015)
- WCAB En Banc Extends IMR Appeal Time Limit to 35 Days (2015)
- WCAB Rejects IMR Determination and Orders New IMR (2015)
- UR and IMR – Death by a Thousand Cuts (2015)
- WCAB Upholds Validity of Untimely IMR (2015)
- WCAB Panel Defines Housekeeping as “Medical Care” (2015)
- Citation to Treatment Guideline Required to Award Home Health Care (2014)
- Failure to Properly Communicate Invalidates UR (2014)
- WCAB Says Failure to Sign UR Report Invalidates UR Procedure(2014)
- WCAB Reverses Itself in Dubon En Banc IMR Case (2014)
- WCAB Rules Parties May Stipulate to Use AME Instead of IMR Process (2014)
- WCAB Clarifies UR Time Limits and That UR Not Required For Denied Body Parts (2014)
- WCAB Rules UR Process Applies to MPN Physicians (2014)
- WCAB Panel Rules UR Decision Effective For 12 Months (2014)
- WCAB Broadly Interprets a “Prescription” for Home Care. (2014)
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- WCAB Panel Allows New QME to Review Retired QME Reports (June, 2021)
- New Med-Legal Fee Schedule Effective April 1 (March, 2021)
- WCAB En Banc Guidance on QME Communication/Information Question (2018)
- Applicant Waived Right to New Panel for Untimely QME Eval (2018)
- Parties Have no Unconditional Right to PQME (2018)
- No Consent Needed to Sent “Advocacy Letter” to AME (2017)
- Each Defendant May Seek PQME in Multi-Party Case (2015)
- WCAB Says Applicant Gets One QME Panel at a Time (2015)
- WCAB Rules “Messelle” QME Time Limits Changed by SB 863 (2015)
- QME Panel Ordered in Psyche Add-On Case (2015)
- En Banc WCAB Declares QME Rule 35.3(e) Invalid (2014)
- WCAB Says SB 863 Allows Five Extra Days to Strike QME From Panel (2014)
- WCAB Panel Says Suspended QME Reports Are Admissible (2014)
- WCAB Rules Parties May Stipulate to Use AME Instead of IMR Process (2014)
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- WCAB Panel Specifies Requirements for 4903.8(d) Lien Declaration (Jan, 2020)
- Failure to Request Second Review Limits Award to Lien Claimant (Nov, 2019)
- WCAB Decides Objections Not Waived by Failure to Raise in EOB (Nov, 2019)
- Failure to Request Second Review Limits Award to Lien Claimant (2019)
- WCAB Rules “De Facto” Ownership Triggers 4615 Stay (2019)
- Vanguard Dismisses Lien Stay Law Challenge (2018)
- Court of Appeal Denies Tristar Lien Law Challenge (2018)
- WCAB En Banc Approves Electronic Signatures on Lien Forms (2018)
- En Banc WCAB Moves 1200 Lien Cases to Hearing (2017)
- Court of Appeal Rejects Interpreter's SB 1160 Challenge (2017)
- DCA Rejects Constitutional Challenge to Lien Filing Fee (2016)
- Comp Photocopiers Not Required to be Registered (2016)
- County Hospital Can Sue to Enforce Lien Rights (2016)
- 9th Circuit Rejects Challenge to Lien Activation Fees (2015)
- WCAB Affirms WCJ Order For Lien Claimant to Appear (2014)
- WCAB Panel Rejects Jurisdiction Over Hospital Lien Claim (2014)
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- Medical Evidence Required to Add Rather Than Use CVC (June, 2021)
- WCAB Reversed for Ignoring Supreme Court COLA Case (May 2021)
- Amended DEU Regs Include 5% Commutation Increase (March, 2021)
- TD Required if Modified Work Limited by COVID Restrictions (Sept, 2020)
- Lack of Overlap no Justification for Adding Disabilities (April, 2020)
- VR Expert Opinion Justifies Total Disability Award (April, 2020)
- WCAB Reverses Two Concurrent 100% Awards to Same Worker (March, 2020)
- Requirements for SIBTF Benefits Unchanged After SB 899 (2019)
- WCAB Panel Circumvents CA Fitzpatrick Rating Standards (2019)
- TD Not Required for Medical Appointments after RTW (2019)
- SJDV - Employer Has Burden to Obtain Physicians RTW Form (2019)
- WCAB Panel Rejects Combined Values Chart (2019)
- WCAB Must Follow Rating Schedule Steps (2018)
- WCAB Adds Instead of Combining PD Ratings (2018)
- Court of Appeal Reverses WCAB on TD Past 5 Years (2018)
- DCA - Convicted Fraudulent Claimant May be Awarded Benefits (2017)
- TD and PD Awarded For Outcome of UR/IMR Denied Treatment (2017)
- SIBTF Benefits Begin When TD Ends (2017)
- WCAB Rejects SB 863 Limits on Psychiatric PD (2017)
- DCA Limits VR Rating Methods (2015)
- DCA Clarifies Limitation to Work at Home Not Always Total (2015)
- Supreme Court: Salaried Peace Officers Not Entitled to 4458.2 Rates (2015)
- WCAB Rejects Use of Figure 15-19 to Rate Impairment (2014)
- 100% PD and COLA Starts When TD Ends (2014)
- No Differential Pay to Sheriff After Return to Light Duty (2014)
- DCA Affirms “Dual Occupation Rule” for Rating Formula (2014)
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- Court of Appeal Clarifies Hikida Limits on PD Apportionment (May, 2020)
- Apportionment of PD on Pathology Affirmed (2018)
- PD Apportionment Has Two-Prong Burden (2018)
- No Apportionment Allowed for Failed Surgery (2017)
- 3rd DCA Reinstates Apportionment Based on Genetics (2017)
- WCAB Apportions CT Award Across Two Cases (2017)
- Psychiatric AME Must Separately List and Assess Each Claimed Stressfull Event (2014)
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- New WCAB Tool - "Commissioner's Settlement Conference" (June, 2021)
- Psyche Symptoms Before Award Does Not Preclude Reopening (June, 2021)
- "Equitable Tolling" Doctrine Applies to Appeal of Cal/OSHA Citation (Dec, 2020)
- Compromise and Release Resignation Letter Bars FEHA Claim (Nov, 2020)
- LC 5500.5 Contribution Can Be Timely Initiated by DOR (Oct, 2020)
- New Law Allows Workers' Compensation Remote Depositions (Oct, 2020)
- MSP Reimbursement Not Time Barred 6 Years Post Settlement (Jul, 2021)
- Judge Rules OSHA Injury Report Form 300 is Not Confidential (July, 2020)
- WCAB Panel Elaborates on SIBTF Eligibility Requirements (April, 2020)
- En Banc WCAB Invalidates AD Rule 10133.54 on SJDB Jurisdiction (April, 2020)
- WCAB Allows Non-Comp Evaluations Into Evidence (Feb, 2020)
- Substantial Evidence Standard Applies to OSHA Appeals (Jan, 2020)
- DWD Unit Must Show No Dependents Exist (Oct 2019)
- Findings in WCAB Psyche Case Binding in FEHA Claim (2019)
- C&R Only Releases Items Listed in Paragraph One (2019)
- Written Consent Required for Comp Attorney Referral Fee (2018)
- WCAB Invalidates AD Dispute Resolution Regulation (2018)
- Properly Worded C&R Also Releases FEHA Claims (2018)
- C&R Addendum Did Not Release Civil Liability (2018)
- Subrogation Includes "All Benefits" Paid by Employer (2017)
- Panel Allows "Interrogatory" in Comp Litigation (2017)
- Newly Joined Defendants Protected by Statute of Limitation (2017)
- Take Nothing in Comp Psyche Case Binding in FEHA Claim (2017)
- Applicants Must Show "Competency" to Mange MSA (2017)
- CIGA Defeats CMS “Excessive Demands” – So Far (2017)
- L.C. 5500.5 Does Not Set Statute of Limitations (2017)
- Supreme Court Limits Interest on Late Disability (2017)
- WCAB Orders Electronic Out-of-State Testimony (2017)
- Refusal to Strike AME Report “Without Prejudice” Not Appealable (2016)
- WCAB Permits Settlement of SJDB With “Thomas” Finding (2016)
- DCA Rejects “Daubert” Evidentiary Standard in Comp Death Case (2016)
- Medical Reports Outside of AME/QME Process Inadmissible (2015)
- DCA Reverses Total PD Award – Orders Cross-Ex of Applicant (2015)
- WCAB Limits Discovery of Psychiatric Records (2014)
- DCA - Privileges Apply to WCAB and Limit Discovery (2014)
- WCAB - Sub-Rosa Admissible Despite “No Trespassing” Signs. (2014)
- WCAB Panel Says No to Joint and Several CT Award (2014)
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- 132a Not Released by Civil Settlement Without WCAB Approval (Feb, 2021)
- Injured Worker $575K Discrimination Jury Verdict Affirmed (Dec, 2020)
- WC Claim, and CalPERS Retirement Defeats FEHA Claim (Dec, 2020)
- Failure to Warn Teacher Supports Serious and Willful Award (July, 2020)
- En Banc WCAB Adds Disabilities for SIBTF Calculation (June, 2020)
- $1M Fees and Costs Awarded in FEHA Claim Following Industrial Injury (June, 2020)
- Penalty for Failure to Carry Comp Insurance Affirmed (April, 2020)
- WCAB Claim Tolls Statute of Limitations for FEHA Action (Jan, 2021)
- C&R Resignation Resolves Wrongful Termination Claim (Jan, 2020)
- 9th Circuit Sets Higher Standard for ADA Liability Thu, 10 Oct 2019 11:03:45 -0700 (Oct, 2019)
- Requirements for SIBTF Benefits Unchanged After SB 899 (Oct, 2019)
- Filing Comp Claim Not Necessarily a FEHA “Protected Activity” (2019)
- LC 5814.5 Attorney Fee Requires Specific Award (2019)
- Panel Affirms 132a Award and Clarifies "Lauher" Standard (2019)
- Comp RICO Fails in California Federal Court (2018)
- Supreme Ct. Allows Big Fines for Workplace Safety Violations (2018)
- Union Agreement Does Not Limit 132a Authority (2016)
- 6th Circuit Rejects RICO in Workers’ Compensation (2014)
- 5814 Penalties for Peace Officer Disability (2016)
- WCAB Has Jurisdiction Over UR Penalties and Sanctions (2016)
- WCAB - 5814 Penalties for Following “Unreasonable” UR. (2014)
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- Physician Not Protected by Anti-SLAPP in Allstate’s Fraud Action (July, 2021)
- Employers/Carriers Recover Fraud Investigative Costs (Apr, 2021)
- Court of Appeal Affirms Prison Nurse Conviction for Comp Fraud (Mar, 2021)
- 5 Year Sentence for Dr. Grusd Office Administrator Affirmed (Feb, 2021)
- Appeals Court Affirms Claimant's Fraud Conviction (Dec, 2020)
- 9th Circuit Affirms Dismissal of SCIF RICO Litigation (2018)
- 6th DCA Dismisses Injured Worker RICO and Qui Tam Claims (2018)
- Civil Qui Tam Action Affirmed for Fraudulent C&R (2018)
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- No WCAB Exclusive Jurisdiction Over AOE-COE in CIGA Case (Oct. 2019)
- 9th DCA Rules CIGA Need Not Reimburse Medicare (Oct. 2019)
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- 9th Circuit Affirms $25M Roundup Pesticide Award in California Case (Ma y, 2021)
- Privette Rule Limits Installer's Action Against Homeowner (March, 2021)
- Employer's Vendor Has No Duty to Injured Worker (March, 2021)
- Sub-Contractor Lacks Standing to Challenge Privette Doctrine Dismissal (Jan, 2021)
- Court Jurisdiction in Subrogation Action Ends When Case Dismissed (July 2021)
- Privette Doctrine Tested Again in Roofer Fall Claim (July, 2020)
- Non-utilization of Comp Admissible to Limit Damages in Tort Case (May 2020)
- Privette Doctrine Precludes Security Guard's Suit (Dec. 2019)
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