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Physicians’ Liens Fail for Lack of Causation Substantial Evidence

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Ann Lindley worked as an administrator for Golden State Manor/Tao Tai Homes. In 2017 she filed several workers’ compensation claims. Among them were specific injury claims for September 1, 2016 and October 1, 2016 involving her right arm, left foot, leg, and ankle, and a cumulative trauma claim for January 1, 2003 through October 17, 2016. In stipulations, the cumulative claim was described as covering her neck, arms, wrists, back, legs, and other orthopedic body parts. The claims involved several carriers, including Oak River Insurance Company (administered by Berkshire Hathaway HomeState Companies) and AIG Claims Services.

Lindley never obtained an award on these claims. She resolved them, along with two related claims, through compromise and release agreements approved in 2020 and 2021. The 2021 settlement cited a good faith dispute over liability. That left the liens of two physicians who had treated her: Edwin Haronian, M.D., whose lien was for $11,188.97, and Jonathan Kohan, M.D., a secondary treating physician in pain management.

Two orthopedic panel qualified medical evaluators (PQMEs) had examined Lindley. Dr. Schaffzin reviewed more than 7,500 pages of records. Both he and Dr. Halbrecht took detailed histories and concluded that her complaints were not industrial. Both attributed her right elbow and related upper extremity conditions to a July 18, 2007 motor vehicle accident and the elbow surgery that followed. Dr. Halbrecht described the 2007 accident as occurring while Lindley worked for a different employer.

The lien claims went to trial on June 16, 2022, on a single issue: whether Lindley sustained an injury arising out of and in the course of employment (AOE/COE). Testimony was not taken, and the matter was submitted on the documentary record. In a July 6, 2022 decision, the workers’ compensation judge (WCJ) found no industrial injury on any of the claimed dates or during the cumulative period. The WCJ found the PQME reports more reliable and concluded that the reports of Drs. Haronian and Kohan were not substantial medical evidence. Both liens were ordered to take nothing and dismissed with prejudice. Dr. Haronian petitioned for reconsideration, which the Board granted to allow further study.

In the WCAB panel decision of Lindley v. Golden State Manor/Tao Tai Homes, Nos. ADJ10895246, ADJ10895160, ADJ10629441 (October 2026), the Workers’ Compensation Appeals Board affirmed the WCJ’s decision. That left in place the findings that Lindley sustained no industrial injury and that the lien claimants – Drs. Haronian and Kohan – take nothing. Commissioner Jose H. Razo wrote the opinion. Deputy Commissioner Patricia A. Garcia and Commissioner Joseph V. Capurro concurred.

The Board started with the burden of proof. An applicant must prove industrial causation by a preponderance of the evidence under Labor Code sections 3202.5 and 3600. Citing South Coast Framing, Inc. v. Workers’ Comp. Appeals Bd. (2015) 61 Cal.4th 291, the panel addressed the standard for proving industrial causation. A lien claimant litigating its right to payment “stands in the shoes” of the employee, and under Labor Code § 5705 and the Board’s en banc decision in Kunz v. Patterson Floor Coverings, Inc. (2002) 67 Cal.Comp.Cases 1588, it must prove every element of its claim, including injury AOE/COE. Because Lindley settled without a finding of industrial injury, Drs. Haronian and Kohan had to establish industrial causation themselves.

The Board then applied the familiar standard for substantial medical evidence. A medical report does not qualify if it rests on an inadequate history or examination, an incorrect legal theory, or speculation, or if it fails to explain its reasoning. The panel cited E.L. Yeager Construction v. Workers’ Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, Braewood Convalescent Hospital v. Workers’ Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159, and Kaiser Foundation Hospitals v. Workers’ Comp. Appeals Bd. (Martin) (1985) 39 Cal.3d 57. It also cited Rosas v. Workers’ Comp. Appeals Bd. (1993) 16 Cal.App.4th 1692 and Kyle v. Workers’ Comp. Appeals Bd. (1987) 195 Cal.App.3d 614 for related principles governing the Board’s review of medical evidence.

Measured against that standard, Dr. Haronian’s October 2020 report fell short. The panel agreed with the WCJ that it did not fully review Lindley’s medical history. In particular, it did not discuss her prior injuries, including the 2007 car accident and resulting elbow surgery, and it appeared to include no review of records from before 2017. The report also did not explain why Dr. Haronian disagreed with the PQMEs. Dr. Kohan’s report likewise lacked a complete history and analysis and did not address causation for the cervical spine, right shoulder, left ankle, or right elbow.

By contrast, the panel found that both PQMEs had completed full evaluations, reviewed extensive records, taken detailed histories, and explained their conclusions. Their reports were therefore substantial medical evidence supporting the finding of no industrial injury. Dr. Haronian had argued that the PQMEs’ apportionment discussions, histories, and examinations were inadequate and had asked, in the alternative, for new PQME reports. Having found the PQME reports sufficient, the Board left the WCJ’s decision in place without ordering further development of the record.

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Newsom Signs Three New Workplace A.I. Laws for 2027

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California employers will face three new sets of laws on artificial intelligence in the workplace beginning in 2027. Governor Gavin Newsom signed the bills on September 30, 2026. One requires human review before AI-driven discipline or termination. Another bans AI tools that read employees’ emotions or nervous-system activity. The third requires employers to say so in their layoff notices when AI or automation is behind a mass layoff. The bills were part of a package of 13 AI measures announced in a Governor’s press release that described several as first-in-the-nation worker protections. “AI should expand opportunity — not come at the expense of workers and families,” Newsom said in the release.

SB 947, by Senator Jerry McNerney (D-Pleasanton) and sponsored by the California Federation of Labor Unions, dubbed the “No Robo Bosses Act of 2026,” is a narrower version of SB 7, which Newsom vetoed in October 2025. In his veto message on SB 7, the Governor called its notice requirements “unfocused” and its restrictions “overly broad.” The new bill drops SB 7’s advance notice requirement for applicants and employees and concentrates on discipline and termination decisions. Its core requirements take effect July 1, 2027, according to several law firm analyses.

The law applies to “automated decision systems,” which it defines broadly as computational processes using machine learning, statistical modeling, data analytics, or AI that produce a score, classification, or recommendation used to assist or replace human discretionary decisions. Routine tools such as spam filters, firewalls, and calculators are excluded. Employers may not rely solely on such a system to discipline or fire an employee. When an employer primarily relies on a system’s output, a human must investigate and corroborate it. The employer may not act on output that cannot be corroborated or is inaccurate, incomplete, or misleading. The employer must then give the employee a written, plain-language notice stating that it relied on the system, that a person corroborated the output, and that the employee may request a description of the data analyzed. The law also bars using these systems to infer protected characteristics, to undermine compliance with workplace laws, or to retaliate against workers for exercising their rights.

The Labor Commissioner and public prosecutors enforce the law, with a $500 civil penalty per violation. Injunctive relief, punitive damages, and attorney fees are available in civil actions. Commentators note that the law creates no express private right of action, but they expect plaintiffs to seek the penalties through the Private Attorneys General Act (PAGA). Employees covered by a collective bargaining agreement that clearly waives the law and provides its own protection from algorithmic management are exempt. Independent contractors, who were covered in earlier drafts, are not.

McNerney said in a statement that “AI must remain a tool controlled by humans.” Management-side firms, while generally describing the laws as narrower than earlier proposals, have flagged undefined terms and the risk of PAGA exposure.

AB 1883, by Assemblymember Isaac Bryan (D-Los Angeles), takes effect January 1, 2027. It prohibits employers from using a “workplace surveillance tool” that incorporates AI to recognize, infer, or predict an employee’s emotional state, or to collect “neural data.” That term covers information from measuring activity of the central or peripheral nervous system, such as readings from an EEG headband, but not data merely inferred from other sources. A workplace surveillance tool is any system or device that collects data about employees’ activities, communications, biometrics, or behavior by means other than direct human observation. Examples include video, audio, time-tracking, and geolocation tools. According to Fisher Phillips, the ban could reach AI sentiment analysis of employee emails, chats, or call transcripts, and it applies even if the employer never uses the data for an employment decision.

The law covers private employers of every size and public employers, as well as labor contractors and their client employers. It does not prohibit using a surveillance tool “to ensure safety,” and commentators disagree about how broadly that exception reaches. A narrow exemption applies to certain federally required defense, aerospace, and national security work. Enforcement mirrors SB 947: the Labor Commissioner and public prosecutors may act, with penalties of up to $500 per violation and the possibility of injunctive relief and punitive damages. There is no express private right of action. Job applicants and independent contractors are not covered. A companion bill signed the same day, AB 1331, separately restricts workplace surveillance in bathrooms and similar private areas.

SB 951, by Senator Eloise Gomez Reyes (D-Colton), amends the California WARN Act, effective January 1, 2027. The Cal-WARN Act already requires covered establishments, those with 75 or more employees in the preceding 12 months, to give 60 days’ notice of a mass layoff, relocation, or termination. Under SB 951, when the action is caused “in whole or in substantial part” by AI or other automated technology, the notice must carry the statement “This notice is for a technology displacement” at the top. It must also identify the number of affected workers, their occupations and work locations, the job functions the technology will perform, and the type of technology involved.

The Employment Development Department must publish summaries of these notices and a quarterly statewide summary of technology-driven displacement. By January 1, 2028, it must also report to the Legislature on AI’s effects on hiring. Existing Cal-WARN remedies, back pay and benefits and a civil penalty of up to $500 per day, are unchanged. The amendments build on SB 617, which expanded required notice content as of January 1, 2026.

The new statutes add to obligations employers already face under the Civil Rights Council’s regulations on automated-decision systems under the Fair Employment and Housing Act. Employers will also face the California Privacy Protection Agency’s rules on automated decisionmaking technology, which begin to apply to significant employment decisions in 2027.

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Non-Opioid Pain Injection Beats Exparel in Phase 3 Trial

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The first few days after orthopedic surgery are when many injured workers receive their first opioid prescription, and research has long linked early opioid exposure in workers’ compensation claims to longer disability and higher claim costs. That makes any treatment that controls post-surgical pain without opioids worth watching for adjusters, utilization reviewers and attorneys.

On October 19, 2026, TLC BioSciences, a company based in Taipei and South San Francisco, announced positive topline results from a pivotal Phase 3 trial of TLC590, an injectable, extended-release local anesthetic. In patients recovering from bunion surgery, a single dose reduced pain and opioid use compared with both a placebo and Exparel, the long-acting local anesthetic that is now the market leader in this category.

A local anesthetic numbs the tissue where it is injected. Surgeons commonly infiltrate the surgical site with one at the end of an operation, but standard formulations wear off within hours, which is often when patients reach for opioids. Extended-release products are designed to stretch that numbing effect across the first several days, the period of most intense post-surgical pain.

TLC590 uses ropivacaine, a widely used anesthetic, packaged in the company’s proprietary liposomes, tiny fat-based particles that form a depot at the injection site and release the drug slowly. Exparel, made by Pacira BioSciences, uses a similar liposomal approach with a different drug, bupivacaine. TLC has long pointed to earlier research finding that ropivacaine carries less cardiovascular and central nervous system toxicity than bupivacaine, though the new announcement makes no safety comparison beyond reporting similar side-effect profiles. The product has been in development for years; TLC began human trials in hernia repair patients in 2018 and moved to bunion surgery with a Phase 2 study in 2019.

The Phase 3 trial, registered as NCT07222748, enrolled 304 adults at U.S. sites who underwent bunionectomy, a surgery to correct a bony deformity at the base of the big toe that involves cutting and fixing bone. Patients were randomly assigned in equal numbers to TLC590 (100 patients), Exparel (102) or saline placebo (102), with neither patients nor investigators knowing which they received. Bunion surgery is a standard testing ground for post-surgical pain drugs because it is reliably painful and fairly uniform from patient to patient.

According to the company, TLC590 met the trial’s primary goal, significantly reducing cumulative pain with movement over the first 72 hours compared with placebo (p=0.0024), and patients also used significantly fewer rescue opioids during that period (p=0.0109). In the head-to-head comparison, TLC590 was statistically superior to Exparel on both cumulative pain (p=0.0202) and opioid consumption (p=0.0177). The company reported that the pain advantage over both comparators held through 168 hours, or seven days. It described TLC590 as generally well tolerated, with a safety profile similar to placebo and Exparel and no drug-related serious adverse events.

TLC chief executive George Yeh called the results a potential “paradigm shift in postsurgical care,” and a trial investigator said the data suggest pain control through the first postoperative week with less reliance on opioids. The company said it will complete the full analysis and prepare a New Drug Application to the U.S. Food and Drug Administration.

Several cautions apply. These are topline results announced by the drug’s maker in a press release; they have not been peer reviewed or published, and the release reports p-values without the actual pain scores or opioid amounts in each group, so the size of the advantage cannot yet be judged. Statistical significance is not the same as a difference patients would notice. The study covered one procedure in relatively healthy adults, and the eligibility criteria excluded patients with positive urine drug screens, a group that is not rare among injured workers with chronic pain. TLC590 is not approved, and any FDA label would initially be tied to the evidence submitted.

TLC590 joins a broader push toward non-opioid pain control that already includes Exparel and Vertex’s oral drug Journavx (suzetrigine). The next milestones are publication of the full trial data, the FDA submission and review, and results in other surgical models; the company has run a separate Phase 2 study that includes total knee replacement. Pricing will matter as much as performance for payers. Claims professionals should treat the current results as promising but preliminary, and look for peer-reviewed data on opioid reduction, function and return to work before treating this or any extended-release anesthetic as a cost saver.

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Instacart to Pay $5M to Settle DOJ, EEOC Claims

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Maplebear Inc., the San Francisco company that does business as Instacart, has agreed to pay up to $5 million to resolve federal allegations that its recruitment for green card sponsorship favored foreign workers on temporary visas over U.S. workers. The Justice Department’s Civil Rights Division and the U.S. Equal Employment Opportunity Commission (EEOC) announced the joint settlement in an October 20, 2026 press release. Instacart has not admitted wrongdoing.

The case involves the Permanent Labor Certification, or PERM, process, the first step for many employers sponsoring a foreign worker for permanent residence. Before the Department of Labor will certify that no qualified U.S. worker is available for a position, the employer must test the labor market by advertising the job and considering U.S. applicants under 20 C.F.R. § 656.17. According to the Justice Department, Instacart required applicants for jobs advertised through PERM to mail in paper applications, even though its standard recruitment process accepted applications electronically. The department said that requirement burdened U.S. workers and that many who did apply were not considered in a timely way. The EEOC said its own investigation turned up similar evidence.

The agencies alleged that the practice amounted to citizenship status discrimination under the anti-discrimination provision of the Immigration and Nationality Act, 8 U.S.C. § 1324b, and to national origin discrimination against American workers under Title VII of the Civil Rights Act of 1964, 42 U.S.C. § 2000e-2. The government characterized the preference for visa holders as intentional. Those are the agencies’ allegations; the matter was resolved by agreement, and no court has made findings.

Under the settlement summary, Instacart will establish a fund of up to $4 million to compensate people who applied for its PERM positions, or were deterred from applying, between December 2023 and February 2026. A claims administrator will contact eligible claimants and decide eligibility for back pay and compensatory damages. The company will also pay a $1 million civil penalty to the United States. Instacart must post PERM positions on its public careers website and accept electronic applications, revise its PERM-related policies, and train personnel annually on the anti-discrimination rules. It must also appoint a monitor to oversee its PERM program and submit compliance reports. The summary does not state how long the monitoring and reporting obligations last. Workers who believe they were affected can email Instacart@eeoc.gov so the agencies can pass their information to the administrator.

An Instacart spokesperson told Fox News Digital that “we maintain that our practices complied with all applicable laws and regulations.” The spokesperson said the company was pleased to resolve the matter.

Assistant Attorney General Harmeet K. Dhillon said in the release that the division “will not stop fighting for U.S. workers until there is a fair playing field.” EEOC Chair Andrea Lucas said that discrimination based on American national origin “has no place in our economy.”

The Justice Department said the agreement is the fifteenth reached since it relaunched its Protecting U.S. Workers Initiative in 2025. It said the initiative has produced more than $34 million in back pay and more than $16 million in civil penalties since its original launch. The Instacart allegations closely track those in an August 2026 settlement with OpenAI and its subsidiary Statsig. In that case, the companies agreed to a $1.2 million civil penalty and a $2 million back pay fund over allegations that they kept PERM postings off their careers site, required paper applications, and advertised the jobs on late-night radio.

For the EEOC, the release describes the Instacart deal as its fourth public settlement since 2025 involving discrimination against workers because they are American. It also says five such lawsuits are pending in federal court under Project Firewall. The Department of Labor launched that initiative in September 2025 to investigate H-1B program abuse, and the EEOC has since joined it. In November 2025, the EEOC issued technical assistance stating that favoring foreign or visa-holding workers over Americans can violate Title VII. Commentators have tracked a growing number of EEOC actions on this theory, including settlements with an agricultural employer and a Guam hospitality company, according to Today’s General Counsel.

For employers that sponsor foreign workers, the settlement is the latest sign that PERM recruitment is getting close scrutiny from two agencies at once, under both immigration and Title VII law. Steps that diverge from an employer’s normal hiring process can draw allegations of intentional discrimination, as the Instacart and OpenAI cases show. Examples include requiring paper or mailed applications, keeping postings off the company’s own careers page, or running ads in hard-to-find outlets. For employers and their employment practices liability carriers, the combination of a back pay fund, a civil penalty, and an outside monitor is worth noting. Policies commonly exclude fines and penalties, so coverage for a resolution of this kind depends on the specific policy wording.

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Public Money for Materials Triggers Prevailing Wages on Project

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The California Attorney General has concluded that when a private nonprofit uses public money only to buy construction materials, the project generally becomes a “public work.” The nonprofit must then pay prevailing wages to the workers it hires, even if their wages come entirely from private funds. The conclusion appears in Opinion No. 26-201, issued October 13, 2026, and marked for publication in the official reports. Formal Attorney General opinions are advisory and do not bind the courts. California courts, however, generally treat them as entitled to considerable weight, see Freedom Newspapers, Inc. v. Orange County Employees Retirement System (1993) 6 Cal.4th 821, 829.

The request came from San Joaquin County Counsel Edward J. Kiernan, who posed a hypothetical. A county gives a nonprofit public funds to purchase flooring for a construction project. The nonprofit’s own workers install the flooring, and their wages are paid from non-public sources. The public money pays for materials only, not labor.

California’s prevailing wage law requires that all workers employed on public works be paid the prevailing rate of per diem wages (Labor Code § 1771). Labor Code § 1720, subdivision (a)(1), defines public works as construction, alteration, demolition, installation, or repair work done under contract and “paid for in whole or in part out of public funds.” The county counsel noted that the ordinary reading of “work” might not reach a purchase of materials, though materials could also be viewed as part of the cost of construction.

The question was whether a nonprofit that accepts and uses public funds to buy materials must pay prevailing wages to the workers it hires onto the project, when those workers are paid with other, non-public money. Under Busker v. Wabtec Corp. (2021) 11 Cal.5th 1147, coverage under § 1720(a)(1) requires (1) construction, (2) done under contract, (3) paid for at least in part with public funds. Only the third element was in question.

In the formal opinion of the California Attorney General, Opinion No. 26-201 (October 2026), to be published in the Opinions of the California Attorney General, the Attorney General concluded that, as a general rule, the answer is yes. The hypothetical would involve a public work, and nothing suggested it fell within an exception such as the de minimis subsidy exception. The prevailing wage law would therefore cover the workers hired by the nonprofit. Deputy Attorney General Ryan B. McCarroll prepared the opinion.

The opinion acknowledged support for the county’s narrower reading. “Work” typically means labor, and the Supreme Court in City of Long Beach v. Department of Industrial Relations (2004) 34 Cal.4th 942 held that public funds earmarked for preconstruction work did not, at the time, trigger coverage. A 1987 opinion of the U.S. Justice Department’s Office of Legal Counsel (11 Op. O.L.C. 92) had also read a federal prevailing wage provision, 42 U.S.C. § 5310, as not reaching federal money spent only on materials. The opinion noted, however, that the federal opinion construed different statutory language, and that Congress has since used broader, project-based wording in several statutes.

The opinion then reasoned that installing flooring cannot happen until the flooring is bought. Because § 1720(a)(1) requires payment only “in part” from public funds, buying the materials arguably pays for part of the installation work itself.

More decisive, in the Attorney General’s view, was the Legislature’s 2001 amendment adding § 1720(b), which defines “paid for in whole or in part out of public funds” to include direct and indirect subsidies. These include a payment of money “to or on behalf of” the contractor or developer, a transfer of an asset for less than fair market price, and the public payment of costs normally required to carry out the contract. Courts have read these provisions broadly, as in Cinema West, LLC v. Baker (2017) 13 Cal.App.5th 194 and Hensel Phelps Construction Co. v. San Diego Unified Port Dist. (2011) 197 Cal.App.4th 1020. The opinion concluded that a county payment for flooring fits comfortably within this definition. Drawing on the constitutional bar on gifts of public funds (Cal. Const., art. XVI, § 6) by way of comparison, the opinion added that the county’s payment would serve no public purpose apart from helping the nonprofit build the project.

The opinion also relied on the narrow de minimis exception in § 1720(c)(3), which, after a 2020 amendment, applies only when public funding is both under $600,000 and under 2 percent of total project cost. The $600,000 cap does not apply to projects made up entirely of single-family dwellings. Allowing agencies to earmark money for materials would let them sidestep those limits. Citing federal labor statistics, the opinion noted that materials regularly exceed 2 percent of construction costs.

The conclusion is consistent with recent positions of the Department of Industrial Relations. In its October 2024 EnergIIZE coverage determination, the DIR Director found that electric vehicle charger installations were partly publicly funded even though the state grants excluded installation costs. The opinion also cites a June 1, 2026 letter from DIR’s Chief Counsel reaching the same result on the county’s hypothetical. The opinion pointed to appellate decisions rejecting efforts to “carve up” projects into public and private pieces to avoid coverage, including Azusa Land Partners v. Department of Industrial Relations (2010) 191 Cal.App.4th 1, Oxbow Carbon & Minerals, LLC v. Department of Industrial Relations (2011) 194 Cal.App.4th 538, and Lusardi Construction Co. v. Aubry (1992) 1 Cal.4th 976. Quoting Azusa, it noted that once a project is a public work, the entire project is subject to the prevailing wage law.

The opinion is limited to the hypothetical presented. It answers the question “as a general rule” and does not address other exemptions in § 1720 that could apply on different facts.

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California DOI Adds Optional Pre-Filing Rate Review Process

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California insurers can now have the Department of Insurance (CDI) review a proposed rate change before they formally file it. If they then file a qualifying application, they get a faster, more predictable approval process. The new Comprehensiveness Review regulation, announced by Insurance Commissioner Ricardo Lara on October 19, 2026, applies to personal and commercial lines rate changes. Under it, the department’s view of the permissible rate range, and the full record of the review, will be available for public inspection.

According to the final regulation and filing documents, the rule (CDI file REG-2025-00024) adopts new sections 2644.29 and 2648.2.2 and amends sections 2648.2 and 2648.4 of Title 10 of the California Code of Regulations. The Office of Administrative Law (OAL) accepted it as a “file and print” action, and it was filed with the Secretary of State and took effect on October 15, 2026. OAL’s notice states that the action is exempt from the Administrative Procedure Act under Government Code § 11340.9, subdivision (g). OAL was therefore asked only to file and publish it, not to review it under the act’s usual rulemaking standards.

Under Proposition 103, codified at Insurance Code § 1861.05, most property and casualty rate changes must be approved by the commissioner before use. The new section 2644.29 creates an optional step in front of that process. An insurer begins a comprehensiveness review by giving CDI’s Rate Regulation Branch everything it believes the commissioner would require for a complete rate application. An insurer may start a review for any one line of insurance no more than once every 180 days, though it can run reviews on different lines at the same time.

The branch first decides whether the submittal is sufficient to analyze. If it is, the branch issues an “affirmative evaluation of sufficiency” setting the maximum and minimum earned premium that would be permissible if the submittal were filed as a formal application. That range is the rate indication CDI’s announcement referred to. The branch must generally issue it within 90 days of the review’s start. The insurer then has 10 days to either revise its submittal to a rate within the range or withdraw. If the revised submittal contains everything needed for approval, the branch issues an “affirmative evaluation of comprehensiveness,” generally within 17 days. If something is missing, the branch issues one request for clarification, and the review ends if the insurer’s cure falls short. The branch may extend these deadlines by up to 60 days in total, in increments of no more than 30 days, with a written explanation of the deficiencies.

All submittals, determinations, requests, and other communications must be made through the industry’s electronic filing system, SERFF. The regulation provides that all information given to the department during a review is available for public inspection through SERFF. In its announcement, CDI said it would also publicly release the rate savings its staff projects, which it called unprecedented. Lara said in the release that “every dollar Californians pay for insurance should be justified.”

The payoff for insurers comes in new section 2648.2.2. An insurer that receives an affirmative evaluation of comprehensiveness, and files a formal application within 16 days that simply incorporates its reviewed submittal, gets an “inference of comprehensiveness.” The department’s usual 30-day completeness review under section 2648.2 is skipped. Public notice must issue within 10 days of filing, and the application must be approved no sooner than 47 days and no later than 60 days after notice. The 60-day deadline does not apply if a timely petition for a hearing is filed and either the commissioner grants it or the requested change exceeds 7 percent for personal lines or 15 percent for commercial lines. Those thresholds mirror the statutory triggers for a hearing on request under § 1861.05(c). The inference can be lost if facts unknown to CDI staff later show the submittal was incomplete.

Several categories are excluded. A submittal may not include specialty insurance rates, auto class plan revisions, or models used for segmentation, underwriting, or risk scoring. Catastrophe models projecting aggregate losses are allowed only when the model already has a valid pre-application determination under section 2648.5 or is used solely for earthquake, fire following earthquake, flood, or terrorism coverage. The commissioner may reject a submittal if the insurer has a formal application pending on the same line, if it contains an excluded item, or for good cause.

The regulation’s treatment of public participation differs somewhat from CDI’s framing. The department’s announcement said the regulation continues the intervenor process, under which consumer representatives may challenge rate requests and seek compensation under Insurance Code § 1861.10. The text of section 2644.29, however, states that a comprehensiveness review is not a “proceeding” for any purpose under Proposition 103. It also provides that CDI’s intervenor participation and compensation rules do not apply to the review itself. Intervenors can still petition for a hearing once a formal application is noticed, but the pre-filing review, where the rate range is set, takes place without them. CDI contrasts the public rate indications with intervenor negotiations it says previously occurred behind closed doors.

That distinction may draw attention given recent history. CDI’s separate intervenor regulation, in effect since August 2026, tightened standards for intervenor participation and compensation. Consumer Watchdog and a coalition of consumer groups opposed that rule. As of this writing, we found no public statement from consumer groups or insurer trade associations on the comprehensiveness review. Insurance Journal reported that the American Property Casualty Insurance Association had been contacted for comment.

The rule also tightens the department’s existing Complete Rate Application requirements, first proposed in 2024. Under the amendments to sections 2648.2 and 2648.4, an application is not complete, and the statutory review clock does not start, until the insurer also delivers “reconciled data.” That data must be reconciled consistently with applicable Actuarial Standards of Practice. The change builds on the data reconciliation tool CDI introduced in its August 2024 Bulletin 2024-7. The regulation is part of Lara’s Sustainable Insurance Strategy. CDI cites as authority Insurance Code sections 1861.01 and 1861.07 and 20th Century Ins. Co. v. Garamendi (1994) 8 Cal.4th 216.

For carriers, including those writing commercial coverage for employers, the trade-off is speed and certainty against early public disclosure. A carrier that accepts CDI’s range up front can expect approval within a fixed window. In exchange, the department’s view of its rate need, and how far it differs from the carrier’s original request, becomes part of the public record.

This summary is for general informational purposes only; readers should consult the full regulation text and CDI’s statement of reasons for complete details.

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Walmart Settles Single Store Heat-Recovery/PAGA Case for $400K

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A federal judge in San Diego has preliminarily approved a $400,000 class and Private Attorneys General Act (PAGA) settlement resolving claims that Walmart failed to give heat-recovery breaks to hourly workers at its El Centro superstore.

In this case plaintiff Mark Hendrickson has worked for Wal-Mart Associates, Inc. since 1997 and works both indoors and outdoors at the company’s El Centro store in Imperial County. The court’s order notes that El Centro has a hot desert climate, with temperatures regularly topping 80 degrees from March through October and average summer highs above 100 degrees.

Hendrickson alleged that Walmart did not provide the cool-down recovery periods required under California’s heat illness rules and did not pay the extra hour of premium pay owed under Labor Code § 226.7 when those periods were missed. Since a 2013 amendment, § 226.7 has expressly covered recovery periods mandated by Cal/OSHA regulations, such as the cool-down rests required by Title 8, § 3395, California’s outdoor heat illness standard. He also alleged inadequate shade, water, and air conditioning; inaccurate itemized wage statements under Labor Code § 226; a representative claim under PAGA (Labor Code § 2699); and an Unfair Competition Law claim under Business and Professions Code § 17200. Walmart denies the allegations and maintains that it complied with California law, and no court has found otherwise.

Hendrickson filed suit in San Diego County Superior Court on December 14, 2022. Walmart removed the case to the U.S. District Court for the Southern District of California in January 2023 under the Class Action Fairness Act, according to the court docket. After several rounds of pleading challenges, including a June 2023 order granting in part Walmart’s motion to dismiss the first amended complaint, the Fourth Amended Complaint became the operative pleading.

In November 2024, Judge Anthony J. Battaglia addressed Walmart’s motion to dismiss the UCL claim in a written order. Hendrickson sought UCL restitution only for the fourth year preceding the three-year Labor Code limitations period. Relying on Guzman v. Polaris Industries Inc. (9th Cir. 2022) 49 F.4th 1308, the court held that a shorter limitations period does not make a legal remedy inadequate. That meant the federal court lacked equitable jurisdiction over the UCL claim. Rather than dismiss it, the court severed the claim and sent it back to the superior court, reasoning that dismissal risked an endless loop of refiling and removal. The motion to dismiss was denied as moot.

After eight continuances, the court in a January 2026 order refused to push back the remaining deadlines to accommodate mediation. The parties settled at a full-day mediation on February 12, 2026, and jointly asked the court to conditionally certify a settlement class and preliminarily approve the agreement under Federal Rule of Civil Procedure 23.

In the case of Hendrickson v. Wal-Mart Associates, Inc., No. 23-cv-00110-AJB-BJW (October 2026), the U.S. District Court for the Southern District of California granted the parties’ joint motion for preliminary approval of the class and PAGA settlement and conditionally certified a settlement class.

The settlement class covers roughly 1,082 hourly, non-exempt employees who worked at the El Centro store from June 19, 2018, through April 24, 2026, and who worked at least one shift on a day when the outdoor temperature hit 80 degrees or higher. A separate group of about 787 “PAGA Employees” covers non-exempt workers at the store from August 19, 2021, through April 24, 2026.

Of the $400,000 gross settlement, class counsel may seek up to $133,333.33 in fees (one-third) and up to $40,000 in costs. Up to $12,500 goes to the settlement administrator and up to $10,000 to Hendrickson as a service award. The PAGA allocation is $30,000, split 75 percent ($22,500) to the Labor and Workforce Development Agency and 25 percent ($7,500) to PAGA Employees. At least $174,166.67 remains for the class, distributed by qualifying workweeks. The parties estimate about $1.52 per workweek, which works out to an average of roughly $161 per class member. No claim form is required. Unclaimed funds go to the State Controller’s Unclaimed Property Fund rather than back to Walmart. The settlement includes no injunctive or workplace-practice changes.

Class members have 45 days after notice to opt out, object, or dispute their workweek count. PAGA Employees cannot opt out of the PAGA portion. Motions for final approval and fees are due January 21, 2027, and the final approval hearing is set for April 15, 2027.

Judge Battaglia did not approve everything outright. He flagged the $10,000 service award as potentially excessive next to awards of $2,000 to $7,500 approved in other cases in the district, and directed Hendrickson to document his time and explain whether the award affects his ability to judge the class recovery. The court was also concerned that fees and costs together would consume about 43 percent of the fund. It noted the presence of a “clear sailing” clause, under which Walmart agreed not to oppose the fee request, a feature the Ninth Circuit has said calls for heightened scrutiny under In re Bluetooth Headset Products Liability Litigation (9th Cir. 2011) 654 F.3d 935 and BriseÑo v. Henderson (9th Cir. 2021) 998 F.3d 1014. The court warned that it will closely review counsel’s billing records, rate support, and itemized costs before final approval.

For employers, the case is a reminder that heat-recovery premiums under § 226.7 can be pursued alongside wage-statement and PAGA claims, even at a single location. Since July 2024, California’s indoor heat standard, Title 8, § 3396, has also required cool-down rests in indoor workplaces at 82 degrees or above. That standard was adopted under Labor Code § 6720, which the settlement release also references, potentially widening exposure for retail and warehouse operations.

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Cal/OSHA Cites Employers $212,500 for Fatal Tunnel Collapse

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Cal/OSHA has proposed $212,500 in penalties against two employers — the tunneling contractor and the engineering firm that designed the project — after an April collapse inside an irrigation tunnel under construction near Knights Ferry killed a 35-year-old geologist and seriously injured a second worker. Both companies drew willful-serious, accident-related citations, among the most severe classifications in California’s civil workplace-safety enforcement scheme, according to a news release issued by the Department of Industrial Relations (DIR) on October 15, 2026.

According to DIR, on April 14, 2026, a collapse roughly 200 feet inside the Canyon Tunnel construction project trapped two employees. Twyla Capurro, a 35-year-old geologist, was killed, and a second worker was seriously injured. In a statement issued the day after the incident, the South San Joaquin Irrigation District (SSJID) and Oakdale Irrigation District (OID) described the event as a rock fall, said rescue crews recovered Capurro that evening, and announced that all work on the project had been suspended. The districts’ statement described the second worker’s injuries as minor to moderate, a characterization that differs from DIR’s later description of a serious injury.

DIR describes the project as an irrigation water diversion tunnel more than 12,000 feet long, designed by Provost & Pritchard Engineering Group, Inc. and being built by Drill Tech Drilling & Shoring, Inc. for SSJID. Local reporting by the Oakdale Leader identifies the project as a joint SSJID-OID effort to bypass the districts’ aging Joint Supply Canal, with a cost of more than $80 million split 72 percent to SSJID and 28 percent to OID. Trade press reported that SSJID awarded the construction contract to Drill Tech in July 2025, according to Smart Water Magazine. Capurro was a member of the Provost & Pritchard team, according to the districts’ statement and local press.

Cal/OSHA’s investigation concluded that both employers let work go forward without removing or adequately supporting ground that had already been identified as dangerous, and that both failed to securely support the section of tunnel where employees were working — failures DIR says resulted in the collapse. On September 30, 2026, Cal/OSHA’s Mining and Tunneling Unit issued the citations.

Drill Tech, based in Antioch, faces $95,000 in proposed penalties for one serious accident-related ground control violation and one willful-serious accident-related tunnel support violation. Provost & Pritchard, based in Clovis, faces the larger total, $117,500, for the same two categories of violation plus a serious violation related to training.

The DIR release does not cite specific regulation numbers, but the requirements it describes track California’s Tunnel Safety Orders in Title 8 of the California Code of Regulations. Title 8, § 8440 requires a competent person to inspect the roof, face, walls, and ground support system of underground work areas on initial entry and frequently afterward, and requires that loose or dangerous ground be taken down or adequately supported before any other activity proceeds. Title 8, § 8441 requires that all underground working places be kept securely supported with steel sets, timber, rock bolts, shotcrete, mesh, or similar methods. Title 8, § 8407 requires the person in charge, when an employee is first hired or assigned a new task, to determine the extent of that employee’s experience and instruct the employee on recognizing hazards — including ground control hazards — and the measures needed to eliminate them.

Under Labor Code § 6432, a violation is presumed “serious” when Cal/OSHA shows a realistic possibility that death or serious physical harm could result from the hazard, a presumption the employer may rebut. Willful violations are penalized under Labor Code § 6429, which carries substantially higher per-violation maximums and a mandatory minimum.

Cal/OSHA Chief Debra Lee said in the release that “Deaths and serious injuries from tunnel collapses are entirely preventable,” adding that the agency regularly reminds employers to provide support systems that protect workers from being buried or crushed.

The penalties are proposed, and the violations have not been adjudicated. Employers may appeal a Cal/OSHA citation to the Occupational Safety and Health Appeals Board within 15 working days of receiving it. DIR reports that Provost & Pritchard has appealed; the release does not say whether Drill Tech has done so.

DIR also notes that Cal/OSHA’s Bureau of Investigations is conducting a separate investigation that remains open. Under Labor Code § 6315 and Title 8, § 344.51, the Bureau is the unit within Cal/OSHA that conducts criminal investigations; it must investigate cases involving a workplace death and refer the results to the appropriate prosecutor unless it finds the evidence legally insufficient. DIR has not indicated what, if any, referral may result here.

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Grocery Chain Manager Convicted in Fraud and Wage Theft Case

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A federal jury in Sacramento has convicted the general manager of the Viva Supermarkets grocery chain of conspiracy, immigration document fraud, and obstructing two U.S. Department of Labor wage investigations, according to the U.S. Attorney’s Office for the Eastern District of California announcement on October 14, 2026. The verdict makes Karla Montoya, 45, of Sacramento, the only defendant in the long-running Viva case to be found guilty at trial; the chain’s owner and two other company officials have already pleaded guilty.

According to the government, Montoya worked with Viva owner Shahriar “Sean” Loloee, a former Sacramento City Councilmember, to staff the chain’s Sacramento-area stores with workers who were not authorized to work in the United States. Prosecutors said she knowingly accepted counterfeit Permanent Resident cards and Social Security cards from numerous employees during hiring, used false immigration documents herself, and helped run off-the-books pay practices that denied workers overtime.

The obstruction counts stem from two Wage and Hour Division investigations the Labor Department opened in 2020. Prosecutors said Montoya and Loloee hid employees who were likely to give investigators unfavorable information and interfered with investigators at the stores. Earlier charging documents alleged that the defendants made false statements to investigators, listened in on an employee interview to influence the testimony, told an employee to lie about her hire date, and had workers hide from investigators. The government says that obstruction caused the earlier investigation to substantially understate the back wages owed to workers. The releases do not say how many workers were involved or put a dollar figure on the unpaid wages.

The jury returned its verdict after an 11-day trial before U.S. District Judge Troy L. Nunley, who set sentencing for January 7, 2027. According to the U.S. Attorney’s Office, Montoya faces a maximum of five years in prison on the conspiracy count, 10 years on each false immigration document count, and five years on the obstruction count, plus fines of up to $250,000 per count. The case was investigated by IRS Criminal Investigation and Homeland Security Investigations, with help from California’s Tax Recovery in the Underground Economy (TRUE) Task Force, a joint effort of state tax, labor, and justice agencies.

The case dates to December 2023, when a federal grand jury indicted Loloee and Montoya on 25 counts, alleging a conspiracy stretching back to 2008. Loloee was then a sitting city councilmember. A 58-count superseding indictment in March 2024 added tax, money laundering, and COVID-19 relief charges and two new defendants: Viva controller Mirwais Shams and Ahmad “Shah” Shams, who worked in roles including human resources director. Prosecutors alleged the two altered employee time records tens of thousands of times, cutting the overtime workers were paid.

Loloee pleaded guilty on April 23, 2026, to conspiracy to obstruct a Labor Department investigation, conspiracy to defraud the IRS, three counts of filing false tax returns, wire fraud, and money laundering. In his plea, he admitted that the company kept two sets of payroll books, one for the IRS and one labeled “Excess Payroll,” and paid workers partly in cash and in in-house “Green Checks” that could be cashed only at Viva stores, causing a tax loss of about $200,000. He also admitted giving Labor Department investigators an employee list with falsified, later hire dates in order to hide undocumented workers and reduce the back wages owed, and obtaining about $1.2 million in federal Restaurant Revitalization Fund money by understating his stores’ 2020 sales, then moving $949,900 of it to a trust account in a relative’s name. The Shams pleaded guilty on August 18, 2026, to filing false tax returns. Sentencing for all three is now set for November 19, 2026.

The case illustrates how a civil wage-and-hour audit can become a federal criminal prosecution. Under federal law (8 U.S.C. § 1324a), employers must verify each new hire’s identity and work authorization on Form I-9, and they meet that duty if the documents presented reasonably appear genuine on their face. An employer that accepts documents in good faith is generally protected. What the government says it proved here is different: a manager who knew the documents were fake and accepted them anyway, then worked to keep federal investigators from talking to the affected workers. The case also shows that individual managers, not just owners, can face personal criminal exposure.

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Minimally Invasive Knee Procedure Eases Arthritis Pain for a Year

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A minimally invasive procedure that temporarily blocks small blood vessels around the knee cut osteoarthritis pain roughly in half for most patients and kept it down for at least a year, according to a German study published in Radiology, the journal of the Radiological Society of North America (RSNA). The study, which tested a newer type of dissolving embolic particle, reported no moderate or severe complications across 239 procedures.

The procedure, called genicular artery embolization (GAE), is performed by interventional radiologists. Working through a small catheter inserted at the groin, the physician finds the abnormal, overgrown blood vessels that develop in the lining of an arthritic knee and injects tiny particles to shut them down. Researchers believe those new vessels travel alongside pain-sensing nerves and fuel low-grade inflammation, so cutting off the blood supply may calm both. GAE does not repair cartilage or replace the joint; it targets pain.

What the study tested is the embolic agent. The most commonly used material has been imipenem-cilastatin, an antibiotic that forms crystals when mixed with contrast dye. The authors note it is used off-label, is not always available, raises antibiotic-resistance concerns, and comes in uneven particle sizes. Permanent plastic microspheres are the main alternative, but because they never dissolve, they may raise the risk of particles lodging where they shouldn’t and of prolonged inflammation. The CharitÉ team instead used size-calibrated gelatin microspheres (Nexsphere-F, made by NextBiomedical) designed to dissolve within hours.

The researchers enrolled 194 patients treated between July and November 2024. Their median age was 69, and 114 were women. All had knee pain that had persisted at least three months despite conservative care such as anti-inflammatory drugs, injections, and physical therapy, and each case was reviewed by a board of orthopedic surgeons and interventional radiologists. Most treated knees had moderate to severe arthritis on X-ray, and 80% of patients had had symptoms for more than two years. Forty-five patients had both knees treated.

Every procedure was technically successful. Mild, self-limiting side effects occurred after 16 of the 239 procedures (6.7%). Fifteen involved temporary skin discoloration over the treated area that cleared within 24 hours, and one patient developed a superficial bruise-like collection of blood at the groin. The authors note that skin discoloration has been reported in about 16% of cases in a prior meta-analysis of GAE and in up to 65% of cases with permanent particles.

On a 0-to-10 pain scale, patients’ median score fell from 7 before treatment to 4 at six weeks and 3 at six and 12 months, a median drop of 4 points. At 12 months, 80% of patients who completed follow-up had improved by at least 2 points, the threshold the study used for a clinically meaningful change. Scores on the Knee Injury and Osteoarthritis Outcome Score (KOOS), a 0-to-100 measure, also rose across every domain. Median daily-activity scores climbed from 53 to 71.5, pain scores from 44 to 65, symptom scores from 51 to 68, sports and recreation from 15 to 36, and quality of life from 19 to 40. Depending on the domain, 55% to 69% of patients reached the meaningful-improvement threshold on KOOS at one year. (The paper’s abstract states the range as 55% to 80%, apparently folding in the pain-scale result; the full text reports 55% to 69% for KOOS alone.)

In the RSNA release, Fleckenstein said many knee-arthritis patients face a real treatment gap once injections stop working and surgery is not an option, and he described GAE as a new option between injections and joint replacement. Those are the lead author’s characterizations; the study itself did not compare GAE with injections, surgery, or any other treatment.

The authors flag several limitations. The study had no control or sham group, so it cannot separate the procedure’s effect from placebo response, regression to the mean, or natural ups and downs in symptoms. It was conducted at a single center, relied on patient-reported outcomes rather than imaging or objective function tests, and followed patients for only one year. Follow-up fell to 79% at 12 months, and patients who missed visits were excluded from that time point’s analysis rather than counted, which the authors say could overstate the benefit. They also caution that the meaningful-improvement thresholds have not been validated specifically for GAE and should be read as descriptive.

That caution matters because the broader evidence is mixed. According to the ScienceDaily article, a sham-controlled trial published in European Radiology this year found no significant difference between GAE and a sham procedure, a European Journal of Radiology review pooling three sham-controlled trials found no significant advantage, and a June 2026 analysis of 45 studies rated the overall evidence as low or very low certainty. On the other side, the Society of Interventional Radiology issued a position statement in May 2026 supporting GAE for adults with symptomatic knee osteoarthritis who have not responded to conservative care and are not candidates for knee replacement or want to delay it, while calling for larger randomized trials.

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