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Class Certification Denied in Carrier “Hidden Premium” Case

Two California policyholders, Brian Guthrie and Grady Lee Harris, Jr., sued Transamerica Life Insurance Company on behalf of themselves and a proposed class, alleging the company violated all three prongs of California’s Unfair Competition Law (Bus. & Prof. Code, § 17200 et seq.) – the unlawful, unfair, and fraudulent business practice prongs – in connection with a term life product called “Trendsetter LB.”

Transamerica markets two products in its Trendsetter line. The older, more basic Trendsetter Super offers term life coverage plus a single “accelerated death benefit” allowing an insured to draw down part of the death benefit early in the event of a qualifying terminal illness. Beginning in 2012, the company introduced Trendsetter LB, a bundled product that adds two more accelerated death benefits – for qualifying chronic and critical illness – delivered through one endorsement and two riders that are automatically included. The bundled LB policy is sold at a single premium rate.

The plaintiffs’ grievance centered on language in the policy’s “data pages.” A schedule listing “ADDITIONAL BENEFITS WHICH ARE PROVIDED BY RIDER” showed “NONE” and “NO CHARGE” in the plaintiffs’ policies, and the premium summary referred to the “INITIAL ANNUAL PREMIUM FOR POLICY EXCLUDING RIDERS.” Plaintiffs argued this language misleadingly portrayed the automatically included chronic and critical illness benefits as free, when (they claimed) Transamerica conceded in discovery that the total premium actually embedded charges for those benefits.

Notably, the plaintiffs did not claim they failed to receive the coverage they paid for. Their complaint was that the premium was never broken down into separate line items for each bundled component, which they said obscured the existence of the cheaper Trendsetter Super alternative.

For purposes of their class certification motion, the plaintiffs sharply narrowed their theory. They dropped any comparison to Trendsetter Super and rested certification solely on the proposition that the standard form policy language itself – read in isolation – was misleading and therefore amenable to common, classwide proof.

The Alameda County Superior Court granted certification in part and denied it in part in August 2024, and after two rounds of clarification ultimately denied certification entirely.The court found the proposed class numerous (Transamerica had issued more than 38,000 Trendsetter LB policies in California since May 2017) and ascertainable. The dispositive problem was predominance.

For the unlawful prong – premised on Insurance Code sections 330 through 332, which govern concealment and a party’s duty to communicate material facts – the court held common issues did not predominate. The claim “necessarily concern[ed]” not only the standard policy text but also marketing materials and oral representations by agents, which would differ from one purchaser to the next. The court reached the same conclusion on the unfair prong (applying the requirement that an unfair practice be “tethered” to a legislatively declared policy) and the fraudulent prong (which asks whether the language is “likely to deceive” a reasonable consumer), because each turned on the same individualized inquiry.

The court initially certified narrow unlawful/unfair claims tied to section 10127.9 – the “free look” statute requiring a cancellation-and-refund notice – reasoning that whether the standard policy contained the required notice was a common question. But after the plaintiffs sought clarification, the court confirmed that this certified claim was limited to whether Transamerica failed to provide the statutory notice. The plaintiffs then asked the court to deny certification outright, conceding they had never brought, and would not bring, a notice-failure claim. The court obliged, denying certification in full.

The Court of Appeal affirmed in the published case of Guthrie v. Transamerica Life Insurance Company, -Case No. A171526 (June 2026). It held the trial court did not abuse its discretion in denying class certification, and Transamerica was awarded its costs on appeal.

The plaintiffs’ appeal rested on a single premise: because their pared-down claims relied solely on “unambiguous” form language, common issues necessarily predominated. The appellate court rejected that premise on two independent grounds.

First, the language is not unambiguous. Reading the contract as a whole, as required by Civil Code section 1641, the court found the data-page language “ambiguous” on its face. Plaintiffs had ignored numerous other rider-related provisions – including a “Schedules of Premiums” paragraph stating that premiums “(excluding premiums for certain Riders)” remain level, the riders’ own recitals that they were issued “in consideration of … payment of the premiums for the policy,” and an application item identical to the disputed data-page language that lists only optional additional riders. At best, the court said, plaintiffs offered “an arguably plausible reading,” not the outright misstatement they claimed. Because the plaintiffs themselves had argued certification depended on the language being unambiguous, they effectively conceded that ambiguity would defeat certification. Under Brinker, the court found it proper to evaluate this merits-adjacent issue because it was germane to the certification question.

Second, even assuming the language were misleading, that common question would not establish common liability. Drawing on two governing precedents, the court explained that the unlawful and unfair claims – grounded in sections 330 through 332 – require examining not just the policy text but what additional information was conveyed to each purchaser. The statutes themselves (§ 10295.12) contemplate that agents will discuss accelerated death benefit policies with applicants, so Transamerica could introduce marketing materials and other extrinsic evidence in its defense, generating individualized issues. As for the fraud prong, the court noted that the data pages are customized: an insured who buys optional riders sees different rider and premium entries than one who declines them, so even “within the four corners” the policies differ. Because the plaintiffs purchased through agents and alleged no way to buy the product on policy language alone, liability could not be resolved on a classwide basis.

UPS Mechanic Sentenced for Workers Compensation Fraud

A former UPS mechanic pleaded no contest in a Sacramento County insurance fraud case for claiming he was injured in a workplace incident that prosecutors said never happened.

The Sacramento County District Attorney’s office announced that Derrick Wayne Hodge pled no contest to felony insurance fraud and was sentenced to 90 days in jail, 2 years of formal probation and was ordered to pay $50,000 in restitution to Liberty Mutual Insurance Company.

Hodge was a mechanic at the United Parcel Service (UPS) facility in Grass Valley. On March 3, 2023, Hodge claimed he was injured while walking out of a door at the UPS facility when he said a “microwave-sized” chunk of ice fell from the roof and struck him on the back of his head and neck.

Hodge sought medical treatment from multiple physicians for injuries resulting from the incident. He was eventually placed off work due to his complaints.

In 2025, the Sacramento County District Attorney’s Insurance Fraud Unit began an investigation into the case after being informed that Hodge was suspected of filing a false injury claim.

Video surveillance from the date and time of the reported incident showed that nothing fell from the UPS facility roof and Hodge was not injured.

In addition, surveillance video after the claimed incident showed Hodge engaging in activities beyond what he told his doctors he could perform.

These false statements resulted in losses of $50,000 to UPS and Liberty Mutual Insurance for coverage of worker’s compensation injuries.

Charges were filed in Sacramento County Superior Court, case 25FE023089, on November 24, 2025, and Hodge was arraigned on December 5. A settlement conference took place on June 18, and the case was resolved by way of the defendants plea.

The case was prosecuted by Deputy District Attorney John MacKenzie, Insurance Fraud Unit.

Appellate Court Rules Cal/OSHA May Investigate Like a Grand Jury

When a state safety regulator wants records to figure out whether a dead gig-economy worker was an employee at all, does it have to win that question first – in a separate lawsuit – before it can even ask? In this new published decision, the Court of Appeal says no. California’s workplace-safety agency can subpoena the records it needs to establish its own jurisdiction. But the court also reined in a trial-court order that had handed the agency everything it asked for, sending the case back to trim overbroad requests.

In this case Dino Park fell down a flight of stairs after making a delivery for Uber Eats on May 26, 2023, and died several days later from his injuries. The Los Angeles County Coroner’s Office notified the Division of Occupational Safety and Health (Cal/OSHA) of the death on June 7, 2023. Park’s widow had limited information but provided tax returns showing he had been paid by Uber Technologies, Inc. Cal/OSHA tried to arrange a meeting with Uber to discuss Park’s employment status and the circumstances of his death; Uber declined.

On September 5, 2023, the agency served Uber with an administrative subpoena under Government Code section 11181, subdivision (e), and Labor Code section 6314, subdivision (c), seeking 20 categories of records bearing on whether Park was an employee or independent contractor, the circumstances of his death, and records about other similarly situated drivers. Uber produced nothing, raising only objections: that the agency lacked jurisdiction because Park was an independent contractor under Proposition 22 (Bus. & Prof. Code, § 7448 et seq.); that it had no consent or inspection warrant; that the requests sought confidential business information, invaded third-party privacy, and were overbroad and irrelevant.

Cal/OSHA petitioned to compel compliance (Gov. Code, § 11187). While that petition was pending, the agency issued a citation to Uber under Labor Code section 6317—$5,000 for failing to immediately report the death and $1,350 for failing to maintain an effective injury and illness prevention program—which Uber did not appeal. After a June 2024 hearing, the trial court granted the petition and ordered Uber to produce all 20 categories of documents within 30 days, without limiting or modifying any request. Uber appealed, and  the Court of Appeal granted a writ of supersedeas staying the order pending the appeal.

In the published case of Division of Occupational Safety and Health v. Uber Technologies, Inc., Case No. B340734 (June 2026), the Court of Appeal affirmed the order compelling production but reversed it to the extent it required production of all requested documents without limitation, and remanded for the trial court to reconsider the scope of the requests. In short: the agency’s power to subpoena was upheld at every turn, but the unbounded breadth of the order was not.

The court grounded its analysis in the California Supreme Court case of  Brovelli v. Superior Court (1961) 56 Cal.2d 524, which holds that an administrative subpoena is valid so long as it (1) inquires into matters the agency is authorized to investigate, (2) is not too indefinite, and (3) seeks information reasonably relevant to the inquiry – agencies may investigate, like a grand jury, on mere suspicion the law is being violated “or even just because it wants assurance that it is not” (quoting United States v. Morton Salt Co. (1950) 338 U.S. 632).

But the order’s scope swept too far. The court found the record underdeveloped on the relevance of several requests, particularly Nos. 8 through 20, whose breadth was magnified by expansive definitions. The subpoena defined “DRIVER(S)” and “USER(S)” to include any “person” who uses Uber’s platform – language broad enough to reach customers – yet nothing explained how records about platform users or customers bore on Park’s employment status, the circumstances of his death, or Uber’s training and prevention practices.

On remand, the trial court must reconsider the scope of the requests under Brovelli and issue a new, appropriately tailored production order.

ACOEM Releases New Workplace Lifestyle Medicine Guide

The American College of Occupational and Environmental Medicine (ACOEM) and the American College of Lifestyle Medicine (ACLM) announced the release of the Guide to Bringing Lifestyle Medicine into Workplaces, a practical, evidence-based resource designed to help organizations build healthier workforces from the ground up.

Developed through a collaboration between the two organizations, the guide is intended for employers, benefits leaders, occupational health professionals, and lifestyle medicine clinicians who want to move beyond traditional wellness programs and create durable, systems-level approaches to workforce health.

Workplace health strategies have historically concentrated on downstream consequences: chronic disease, injury, absenteeism, burnout, and rising healthcare costs. The guide shifts the conversation upstream, integrating the six core pillars of lifestyle medicine – nutrition, physical activity, sleep, stress management, social connection, and avoidance of risky substances – into workplace culture, policies, and systems.

Because workers spend a substantial portion of their lives on the job, improving workforce health requires more than individual behavior change. It requires designing healthier workplaces that support healthy choices, psychological safety, recovery, resilience, and long-term well-being. The guide aligns lifestyle medicine, occupational and environmental medicine, Total Worker Health®, and population health strategies to help organizations improve worker health outcomes while advancing productivity, engagement, retention, and organizational performance.

“This collaboration reflects what occupational and environmental medicine has long understood: the workplace is one of the most powerful platforms we have for preventing chronic disease and supporting well-being,” said Jill Rosenthal President of the ACOEM Board of Directors. “By bringing lifestyle medicine and occupational health together, this guide gives employers and clinicians a practical roadmap to build environments where health can thrive, not just to treat disease after it appears, but to prevent it. That’s the future of workforce health, and ACOEM is proud to help lead the way.”

The American College of Occupational and Environmental Medicine (ACOEM) is the nation’s largest medical society dedicated to promoting the health of workers through preventive medicine, clinical care, research, and education. ACOEM’s members champion the health and safety of workers, workplaces, and environments. Learn more at acoem.org.

ACLM The American College of Lifestyle Medicine (ACLM) is the medical professional society for clinicians dedicated to the clinical and worksite practice of lifestyle medicine as the foundation of a transformed and sustainable healthcare system. Learn more at lifestylemedicine.org.  

Plaintiff Need Not Prove Anyone “Actually Viewed” Stolen Medical Data

A data breach at an education-technology company gave the California Supreme Court its first occasion to define how far two privacy statutes reach. The decision is a split outcome: the company escapes these particular claims because the plaintiff did not adequately plead that it was a covered entity, but in getting there the Court rejected a defense-friendly rule that had governed medical-privacy breach cases for over a decade – holding that a plaintiff need not prove anyone “actually viewed” the stolen data.

Illuminate Education, Inc. is an education-technology company that maintains a nationwide platform storing K–12 student data – including medical information such as diagnoses and treatment plans – to help educators evaluate students, monitor progress, and build educational plans. It contracts with the Ventura County Office of Education, which serves plaintiff J.M.’s school district. J.M. provided his medical information to the district, which in turn passed it to Illuminate.

In January 2022, Illuminate discovered suspicious activity and later confirmed that databases containing student information had been subject to unauthorized access. It notified families in June 2022, stating there was no evidence of actual or attempted misuse. J.M. alleged he subsequently received solicitations at an address he had given only to Illuminate, plus odd calls about “phantom Amazon accounts.” Through his guardian ad litem, he brought a putative class action under two statutes: the Confidentiality of Medical Information Act (CMIA; Civ. Code, § 56 et seq.) and the Customer Records Act (CRA; Civ. Code, § 1798.80 et seq.).

The Trial court sustained Illuminate’s demurrer without leave to amend, finding J.M. failed to adequately allege that Illuminate was a “provider of health care,” “contractor,” or “administrator” under the CMIA, failed to allege a qualifying “disclosure” or “release,” and could not sue under the CRA because Illuminate’s customer was the County Office of Education, not J.M.

The Court of Appeal reversed, holding that Illuminate fell within both statutes, that J.M. had stated causes of action, and that denying leave to amend was an abuse of discretion. It treated students like J.M. as the “ultimate ‘customers,’ consumers, and beneficiaries” of Illuminate’s services and found a five-month notice delay supported the CRA claim.

The California Supreme Court reversed the Court of Appeal and remanded in the case of J.M. v. Illuminate Education, Inc, No. S286699 (May 2026) reaching three holdings. J.M. did not sufficiently allege that Illuminate is a “provider of health care” under section 56.06, so his Confidentiality of Medical Information Act claims fail. A plaintiff need not allege that medical information was actually viewed by an unauthorized party. Confidentiality is breached when information is exposed to a significant risk of unauthorized access or use. J.M. did not sufficiently allege that he is Illuminate’s “customer,” so his Customer Records Act claim fails. The Supreme Court left it to the lower courts to decide whether J.M. may amend his complaint in light of these holdings.

Section 56.06 of the Confidentiality of Medical Information Act covers businesses that maintain medical information in order to make it available to an individual or health care provider upon request, for the purpose of letting the individual manage that information or for diagnosis and treatment. J.M.’s allegations described a tool for educators to assess and plan – not a service that lets individuals manage their own records or that supplies information to clinicians for diagnosis. The Court noted the Legislature has specified that school dyslexia screening is “a flag for potential risk,” not a diagnosis (Ed. Code, § 53008, subd. (l)). Legislative history confirmed the reading: the statute was built around services like MedicAlert and personal-health-record companies (e.g., WebMD-style tools that let consumers build and share their own records), which Illuminate is not. The Court stressed the statute is broad and technology-adaptive but still has limits – it does not sweep in any entity that stores medical information.

The Court took aim at a line of authority requiring proof that an unauthorized person actually viewed the data – Regents of the University of California v. Superior Court (2013) 220 Cal.App.4th 549, Sutter Health v. Superior Court (2014) 227 Cal.App.4th 1546, and Vigil v. Muir Medical Group IPA, Inc. (2022) 84 Cal.App.5th 197. Reading section 56.101 together with section 56.36, subdivision (b) – which allows $1,000 in nominal damages even when a plaintiff suffered no actual or threatened harm – the Court concluded liability turns on the entity’s negligent conduct, not on whether harm materialized.

An “actually viewed” rule would be nearly impossible to plead or prove (breach victims rarely know what a hacker did, and AI-driven cybercrime can misuse data without anyone reading it), and would gut a remedial statute that must be construed broadly (Pulliam v. HNL Automotive Inc. (2022) 13 Cal.5th 127). The proper test, the Court held, is whether information was exposed to a significant risk of unauthorized access or use – a flexible standard that distinguishes “smash-and-grab” hardware theft from data-targeted breaches and accounts for factors like the form, duration, and extent of the breach and any mitigation. Loss of possession is relevant but neither necessary nor automatically sufficient. The Court disapproved Regents, Sutter Health, and Vigil to the extent inconsistent.

The Customer Records Act (CRA) authorizes suit only by a “customer” – defined as someone who provides personal information to a business to purchase, lease, or obtain a service from that business (§ 1798.80, subd. (c)). The County Office of Education, not J.M., bought Illuminate’s services; J.M. sought educational services from his school district. The Court rejected the Court of Appeal’s “intended beneficiary” theory, noting the Legislature deliberately limited suit to an injured “customer” rather than any “consumer” or “individual” (Ferra v. Loews Hollywood Hotel, LLC (2021) 11 Cal.5th 858), and observed that other laws (e.g., the California Consumer Privacy Act) offer broader avenues for residents.

Courts Have Broad Discretion to Reduce PAGA Penalties and Fees

A new published decision gives trial courts broad latitude in two recurring PAGA fights: how to cut a sky-high maximum penalty down to a fair number, and how much to second-guess a judge who shrinks an attorney fee award. On both questions, the Court of Appeal sided with the trial court’s discretion.

Abraham Taduran sued his former employer, dental-products maker Glidewell, under the Labor Code Private Attorneys General Act (PAGA), Labor Code sections 2698 et seq. By the time of trial, liability had effectively been resolved—three issues by summary adjudication and a fourth by stipulation—leaving only the size of the civil penalties to be decided on briefs and stipulated facts.

Four violations remained. On the wage statement issue, Glidewell’s weekly statements omitted piece-rate pay information, though that information appeared on a separate “Production Sheet,” and no employee actually lost wages. On the rest period issue, Glidewell’s method of rounding fractional rest minutes into hours underpaid some piece-rate workers an average of $0.26 per pay period (about $63,464 total over five years). On the uptime issue, overtime pay was calculated without including non-productive “uptime” pay, costing employees roughly $7,310. On the bonus pay issue, non-discretionary bonuses were left out of the regular-rate calculation, costing about $13,433.

Taduran calculated the maximum statutory penalties at roughly $55.9 million and asked the court not to slash them drastically. Glidewell argued the violations were “hyper-technical” and proposed reductions of more than 99 percent.

The trial court reduced the maximum penalties dramatically, awarding a total of $516,965, allocated as: $100,165 (wage statement), $190,900 (rest period, calculated as 1,909 employees × $100), $167,400 (uptime, $150 × affected employees), and the full $58,500 (bonus pay – no reduction). The court reduced the first three penalties on a per-employee basis, reasoning that the larger violations caused little or no actual wage loss, that Glidewell had acted in good faith and corrected its systems before adjudication, and that the maximum penalties would be “unjust, arbitrary[, and] oppressive.”

Taduran sought about $1,571,658.75 in fees – a $1,047,772.50 lodestar enhanced by a 1.5 multiplier – plus $98,138.21 in costs. The court accepted the lodestar but applied a negative (0.70) multiplier, awarding $733,440 in fees plus the full costs. It found only contingency risk favored an increase (and only slightly), treated attorney skill as neutral, and identified several factors favoring a decrease: the records-based simplicity of the claims, the very limited success (the penalty award was under 1 percent of what was sought), and the fact that the lodestar already reflected current – rather than historical – billing rates for work done years earlier.

The Court of Appeal affirmed the judgment in full in the published case of Taduran v. James R. Glidewell, Dental Ceramics, Inc., No. G064718 (June 2026), rejecting both of Taduran’s arguments: that the penalty reduction had to be done per pay period, and that the negative fee multiplier could not survive “heightened scrutiny.”

Reviewing the scope of the trial court’s authority de novo and its exercise for abuse of discretion (see Amaral v. Cintas Corp. No. 2 (2008) 163 Cal.App.4th 1157; Thurman v. Bayshore Transit Management, Inc. (2012) 203 Cal.App.4th 1112), the court held that section 2699, subdivision (e)(2) lets a court award a “lesser amount” but supplies no formula for how to get there. While the maximum penalty is calculated per pay period under subdivision (f), nothing requires a reduction to follow that same path. A trial court may therefore reduce a penalty “on a percentage, per pay period or per employee basis.”

The court rejected Taduran’s deterrence argument, noting an employer cannot predict which reduction method (if any) a court will use – and here the court imposed the full penalty on the bonus pay claim, preserving deterrence. It distinguished Moniz v. Adecco USA, Inc. (2021) 72 Cal.App.5th 56, where a settlement unfairly split recovery between two employee classes; here, a single common fund compensated all aggrieved employees proportionately. The court also stressed that the same drastic result could have followed from a per-pay-period reduction, since the math can produce identical numbers.

The negative fee multiplier was within the court’s discretion. Applying the lodestar-multiplier framework of Laffitte v. Robert Half Internat. Inc. (2016) 1 Cal.5th 480 and the deferential review described in Karton v. Ari Design & Construction, Inc. (2021) 61 Cal.App.5th 734, the court sidestepped the unsettled debate over whether “heightened scrutiny” applies to across-the-board fee cuts – a split running between Warren v. Kia Motors America, Inc. (2018) 30 Cal.App.5th 24 and Kerkeles v. City of San Jose (2015) 243 Cal.App.4th 102 (applying heightened scrutiny) and Morris v. Hyundai Motor America (2019) 41 Cal.App.5th 24 (rejecting it), an issue now before the California Supreme Court in Cash v. County of Los Angeles (2025) 111 Cal.App.5th 741, review granted Aug. 20, 2025, No. S291827. Because the trial judge gave specific reasons, the panel found those reasons survived even the stricter standard.

The court approved each rationale. Under PLCM Group, Inc. v. Drexler (2000) 22 Cal.4th 1084, a judge may consider lower historical rates – not to double-count, but to ensure the lodestar reflects fair market value for older work. And in representative actions like PAGA, the degree of monetary success may properly support a negative multiplier (Lealao v. Beneficial California, Inc. (2000) 82 Cal.App.4th 19), a principle that does not apply to non-representative cases such as Graciano v. Robinson Ford Sales, Inc. (2006) 144 Cal.App.4th 140. Finding the trial court had weighed the proper factors, the panel held there was no abuse of discretion.

Comp Medical Inflation Driven by Growing Use of Unlisted Codes

California’s workers’ compensation fee schedules continue to hold the line on inflation for most scheduled medical services, but a new California Workers’ Compensation Institute (CWCI) study finds that a growing share of treatment rendered to injured workers in the state is billed under unlisted codes that fall outside fee schedule pricing controls, creating a new and increasingly important source of medical cost growth.

The new CWCI study, the second in a series on workers’ comp medical inflation, uses data from the Institute’s Industry Research Information System (IRIS) database to examine medical payments from 2017 through 2024. The results show that while professional services and facility fees consistently accounted for about 70% of all California workers’ comp medical spending, the strongest inflationary pressures came from professional services billed under codes that are not listed in the state’s Official Medical Fee Schedule (OMFS), where prices often grew far faster than applicable fee schedule benchmarks. Among the key findings:

– – The average payment per professional service transaction increased 33.2% between 2017 and 2024, exceeding the 25.9% growth in the Medicare Economic Index (MEI).
– – Total reimbursements for unlisted professional service codes more than doubled during the 8-year study period, as average payments rose 106.7%, while their share of professional service payments increased from 5.6% to 14.4%.
– – A single code, 97799 (unlisted physical medicine and rehabilitation), accounted for nearly half of all unlisted professional service payments in 2024, with an average payment of $1,663 per transaction.
– – Unlisted codes for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) increased from 41.9% of DMEPOS payments in 2017 to 50.1% in 2024, surpassing scheduled DMEPOS codes for the first time.
– – Medical-legal costs surged following the 2021 Medical-Legal Fee Schedule revision, with average payments increasing 35.1% above 2017 levels by the first full year of implementation.
– – Medical interpreter expenses were driven primarily by utilization rather than price, as the percentage of claims involving interpreter services nearly tripled between 2017 and 2024.
– – Pharmacy was the only major medical category to show sustained spending declines, largely due to reduced utilization following adoption of the MTUS Drug Formulary and opioid prescribing reforms.
– – Inpatient hospital utilization continued a long-term decline as inpatient discharges fell 33.8% from 2017 to 2024.

The analysis noted that the scheduled professional services generally behaved as intended under the OMFS, with price growth closely tracking established inflation benchmarks. In contrast, the unlisted professional service codes experienced substantially higher price growth and increased utilization, while in DMEPOS, the growing use of unlisted codes was the key cost driver. Thus, the report concludes that while the OMFS remains effective at controlling payments for scheduled services, its influence is diminishing as more treatment is billed under unlisted codes. Given the growing use of multidisciplinary pain programs, platelet-rich plasma injections, specialized medical equipment, and other unlisted medical services, policymakers and system stakeholders are likely to face growing pressure to address the widening gap between fee schedule-governed and market-rate pricing.

CWCI has issued its study, Medical Inflation and Cost Drivers in California Workers’ Compensation as a Report to the Industry, available free to CWCI members and subscribers. Others may purchase a copy for $23 by calling 510-251-9470.

Cal/OSHA National Trench Safety Stand Down Week

As employers across the country observe National Trench Safety Stand Down Week from June 15–19, Cal/OSHA is calling on employers statewide to review trench safety requirements and reinforce jobsite protections to eliminate preventable cave-in incidents.

Sponsored annually by the National Utility Contractors Association (NUCA), the nationwide NSSD campaign serves as a critical reminder that trenching and excavation work remains among the most hazardous construction operations. A single cubic yard of soil can weigh as much as a car, making proper shoring, sloping, and shielding essential safety practices.

June is recognized nationally as Trench Safety Month, an annual campaign dedicated to raising awareness of trenching and excavation hazards and promoting safe work practices across the construction industry.

As part of this effort, Trench Safety Stand Down Week, encourages employers and workers to pause work activities to discuss trench safety, review hazard prevention measures, and reinforce the importance of protecting workers from cave-ins and other excavation-related hazards.

From 2021 through 2025, Cal/OSHA issued approximately 90 trench safety violations tied to worker injuries and fatalities. Currently, Cal/OSHA is investigating two Los Angeles County trench collapses that resulted in fatalities this year. Cal/OSHA enforces trench safety through penalties and criminal referrals while actively guiding employers to prevent future tragedies. Recent enforcement actions include:

– –  Blackhawk Electric Company, San Diego; willful-serious and serious violations; $160,000 in proposed penalties. On December 3, 2025, the employer knowingly allowed their employees to work in a trench more than five feet high without protection from cave-ins.
– –  W.E. O’Neill Construction Company of California, San Diego; willful-serious and serious violations; $160,000 in proposed penalties. On December 3, 2025, the employer knowingly allowed their employees to work in a trench more than five feet high without protection from cave-ins.
– –  City of San Diego Public Utilities Department; willful-serious violations; $297,850 in proposed penalties. On December 1, 2025, two employees were working in a trench when the sides collapsed, causing injuries that required hospitalization.
– –  Smelly Mel’s Plumbing and Sewer Rat Plumbing, South San Francisco; willful-serious, serious accident-related violations; $529,640 in fines combined. On August 1, 2024, a crew was handling a sewer-line project at a private residence; the walls of the trench collapsed, burying a worker and causing injuries that required hospitalization. Cal/OSHA’s Bureau of Investigations referred the case to the San Mateo District Attorney’s office, which has pressed felony charges.

What Cal/OSHA Chief Debra Lee said: “Trenching is one of the most dangerous jobs in construction, and employers are legally required to protect their workers. These recent citations highlight a troubling lack of compliance in the industry.”

A trench collapse is an avoidable tragedy. Fatalities and serious injuries continue to occur because employers fail to follow established trench safety requirements. Under Cal/OSHA regulations, employers are responsible for evaluating excavation hazards, including the potential for cave-ins, regardless of trench depth, and must implement appropriate protective measures to ensure worker safety.

For detailed trenching safety guidelines, review the “Excavation, Trenches, and Earthwork” chapter in Cal/OSHA’s Pocket Guide for the Construction Industry. Additional resources are available on NUCA’s Trench Safety Stand Down webpage.

Harvard Poll Shows Dramatic Decline in Trust in Federal Health Agencies

One Year In: Public Views of a Changing Public Health Landscape is a national poll by Harvard T.H. Chan School of Public Health and the de Beaumont Foundation’s Public Health Listening Lab. The poll was conducted March 19 – April 1, 2026, among a probability-based, nationally representative sample of 2205 U.S. adults ages 18 and older, to better understand people’s views about the changing public health landscape one year into the new federal administration.

It was fielded online and via telephone (cell phone and landline) by SSRS, an independent research company. This survey is nationally representative of U.S. adults. Interviews were conducted in English and Spanish, March 19 – April 1, 2026, among a sample of 2205 adults ages 18 or older in the United States. Republicans include adults who lean Republican, Democrats include adults who lean Democrat, and Independents includes adults who identify as “other” or are unaffiliated. The margin of error at the 95% confidence interval is +/- 2.0 percentage points.

For decades, the Centers for Disease Control and Prevention was one of the most trusted institutions in American life. Trust in the CDC remained relatively stable in the wake of the COVID-19 pandemic, hovering around 75% from 2022 to 2025. These new national poll findings show concerning declines in the American public’s trust in federal health agencies one year into the new federal administration. One year into new leadership of the U.S. public health system, trust in the Centers for Disease Control and Prevention (CDC) and other federal health institutions has dropped dramatically. Only 50% of the public says they now trust health recommendations from the CDC, compared to 77% in spring 2025.

This decline in trust is driven by deep partisan divides. From 2025 to 2026, trust in CDC health recommendations has fallen from 92% to 34% among Democrats and from 77% to 47% among Independents, (92% to 34%) and 30 percentage points among Independents (77% to 47%), while trust among Republicans has increased very slightly from 63% to 67%.

The steep drop in public trust also translates to losses in trust across many demographic groups. Trust in the CDC has fallen more than 30 percentage points among women (80% to 48%); Black and Hispanic adults (77% to 43% and 81% to 50% respectively); those living in urban areas (80% to 48%); and those with a college degree (80% to 46%).

When examining public trust across prominent leaders and groups, the top trusted sources for health recommendations in 2026 are clinicians – nurses (89%), doctors (88%), and pharmacists (85%) – followed by friends and family (81%), nonprofit health and healthcare groups (79% – 80%), and researchers (78%).

State and local public health agencies are now substantially more trusted than the CDC. Trust in state and local public health agencies has also fallen in the last year, but not by as much. A majority of the public still trusts health recommendations from their local (70%) and state (66%) public health agencies.

A slim majority disapproves of federal public health agency actions in the past year, with a high level of concern about the influence of leaders’ personal beliefs, misplaced priorities, and budget cuts. With 55% public disapproval of federal health agencies’ actions in the past year, top concerns about their actions under new leadership include wide agreement that their recommendations have been influenced too much by leaders’ personal beliefs (68%), leaders are focused on the wrong priorities (66%), and programs have been cut or scaled back too much (61%).

Public support for routine childhood vaccination policies remains strong, though a substantial minority supports reductions to the routine vaccine schedule. More than three-quarters (77%) of the public – including majorities across party lines – say that parents should be required to vaccinate their children in order to attend school. A majority (58%) also oppose reducing the childhood vaccine schedule, which forms the basis of childhood vaccine requirements, but there is substantial minority support (42%) for this change.

Views of vaccine safety have dropped closer to pre-COVID-19 levels. As another indication that support for vaccines may be softening, the fraction of the public saying childhood vaccines are “very safe” has dipped from 63% in 2025 to 57% in 2026, trending back to pre-pandemic levels (54% in 2019) from a high of 70% during COVID-19 (2022).

A majority of the public supports federal changes to the Dietary Guidelines for Americans, with higher support for individual recommendations on less sugar and more protein. Six in ten (60%) support the recent changes to the food pyramid and dietary guidelines, and even stronger majorities support specific measures, like recommendations to avoid or sharply limit sugar and highly-processed food (90%) and to increase protein intake (85%). A much smaller majority (62%) supports recommendations to increase beef and whole milk consumption.

Support is bipartisan for limiting sugar and highly-processed food (Republicans: 94%, Democrats: 89%) and for increasing protein intake (Republicans: 92%, Democrats: 79%).

However, there is more division when considering overall support for changes, with 83% of Republicans saying they support the overall changes, compared to only 37% of Democrats. Support for recommendations to increase beef and whole milk consumption is also divided, with 80% support among Republicans and 44% support among Democrats.

Rising SoCal CT Claims Are Shifting Costs and Claim Patterns

The Workers’ Compensation Insurance Rating Bureau of California (WCIRB) has released Emerging Patterns of Cumulative Trauma Claims. The new report finds that cumulative trauma (CT) claims have increased sharply in recent years and are contributing to notable changes in claim characteristics, costs and claim outcomes.

CT claims have long been a part of the California workers’ compensation system. Recently, while claim frequency for non-CT claims has been relatively flat, the proportion of claims involving CT has increased sharply. This contrasts with the rest of the country, where rates of CT claims have remained stable since 2013. This report explores the key drivers of the recent CT claim increases and their impact on system costs.

The report shows CT claims are playing a growing role in system-wide trends, with higher levels of litigation and earlier involvement of medical-legal and interpreter services than non-CT claims. These differences are influencing both medical and allocated loss adjustment expense (ALAE) costs and shaping overall claim severity trends.

While the frequency of non-CT claims has remained relatively stable, the rising share of CT claims has shifted the composition of claims in California’s workers’ compensation system, with implications for pricing, reserving and trend analysis.

The report examines:

– – Key drivers of the recent increase in CT claims
– – The extent to which CT claim growth is affecting medical and ALAE cost trends
– – How changes in CT claim filings are influencing claim severity trends

Summary of Key Findings:

– – The share of CT claims filed post-termination has risen sharply, and these claims are highly likely to be litigated, driving significant increases in allocated loss adjustment expenses (ALAE) costs across the system
– – Whether claims are valued at 18 months or at a projected ultimate level, the share of indemnity claims involving CT was relatively stable prior to the pandemic and has increased since.
– – The shares in 2023 and 2024 are almost double the share in 2012 and the highest levels observed in this period.
– – CT claims are consistently more common in Southern California, with the highest rates in Los Angeles (LA) and surrounding areas followed by San Diego, likely reflecting higher litigation activity and larger workforce concentrations in industries with high rates of CT filings
– – Regardless of where in the state the injured worker is located, the vast majority of litigated CT claims are represented by firms based in the LA area.
– – CT claims are more likely to involve medical-legal and interpreter services early on, contributing significantly to increases in these medical costs for the system.
– – The share of CT claims without medical payments at 18 months past policy inception is consistently much higher than for non-CT claims and has increased since accident year (AY) 2019.
– – Since 2021, changes in average indemnity and medical costs have been lower for CT claims than for non-CT claims, suggesting the increase in CT claims is dampening overall claim severity trends. Changes in average ALAE costs have been lower for CT claims than for non-CT claims.
– – Since 2020, total costs (pure premium) for CT claims have more than doubled, while costs for non-CT claims have increased by more than 30%. CT claims now account for roughly a quarter of total pure premium costs.

This study relies on WCIRB unit statistical report (USR), medical transaction and CT survey data. Access the report on the Research Studies and Reports page, where you can also explore related WCIRB research.