Category: Daily News

Daniel Rikkels of Chula Vista was indicted by a federal grand jury on charges that he helped veterans fraudulently obtain disability benefits from the Department of Veterans Affairs (VA) while he was a department employee responsible for reviewing and approving disability claims.

In 2021, his annual VA salary was $106,963. This salary was 20 percent higher than the average and 45 percent higher than the median salary in the VA. He held two jobs from 2016 to 2024. From 2016 to 2023 Daniel Rikkels J held job of Veterans Claims Examining.

According to the 33-count indictment, since 2020, Rikkels knowingly and intentionally instructed veterans to provide false, exaggerated, and misleading claims of service-related injuries to support their disability claims. Rikkels also instructed veterans to alter documents submitted during the claims process.

Through these false claims, the indictment said, veterans fraudulently obtained millions of dollars in VA disability payments and backpay, and Rikkels received millions of dollars in payments from the veterans in return for his work on their behalf.

Until June of 2025 when he retired, Rikkels was employed by the Department of Veterans Affairs and was responsible for reviewing and approving VA disability claims from veterans. During this time-period he negotiated with veterans for assistance in their VA claims and demanded payment from them, all while he was taking official action on their claims in violation of government ethics laws.

The indictment also alleges that Rikkels frequently requested that veterans who lived in the local area meet him to make payments in cash to minimize what he would have to pay in taxes. According to court records, the investigation revealed that during just a three-month period between February and May of 2025, Rikkels met with at least four local veterans and received a total of $57,000 in cash payments from them. On November 13, 2025, agents searched Rikkels, his vehicle, and residence and seized a total of over $280,000 in cash.

Rikkels plead not guilty on November 14, and was released on $750,000 bond secured by Trust Deed.

“The Department of Veterans Affairs and the VA disability system serve a crucial role in providing support and care to those who have served and sacrificed in defense of our country,” said U.S. Attorney Adam Gordon. “We will zealously safeguard the integrity of the VA disability program and will investigate and prosecute those who attempt to undermine the system to their own financial advantage.”  

This case, 25-cr-4276-H, is being prosecuted by Assistant U.S. Attorneys Joseph S. Smith and Daniel F. Casillas.

A group of retired City of San Francisco employees challenged the City’s disability retirement benefit calculations under the San Francisco Employees’ Retirement System (SFERS). The lawsuit originated as a class action filed by Joyce Carroll in 2017. The parties agreed to a stipulated class certification order which included the requirement that members of the class retired because they were “incapacitated for performance of duty because of disability determined by the retirement board to be of extended and uncertain duration.”

The plaintiffs, all of whom met the disability requirement, and were at least 40 years old when hired and had between 10 and 22.222 years of credited service at retirement. The operative complaint asserted FEHA claims based on disparate treatment (intentional discrimination) and disparate impact (facially neutral policy with unequal effects), along with related claims for declaratory relief, breach of contract, and equal protection violations under the California Constitution.

They focused on “Formula 2,” a provision in the City’s Charter that imputes additional years of service up to age 60 for employees whose actual service yields less than 40% of their average final compensation under Formula 1 (which multiplies average final compensation by 1.8% times years of service). Plaintiffs claimed this formula disproportionately disadvantaged older hires by capping their benefits below the 40% maximum that younger entrants could more easily achieve.

At a four-day bench trial, plaintiffs’ expert, Jeffrey Petersen, Ph.D., presented hypothetical arithmetic calculations showing that employees entering SFERS at age 40 or older could never reach the 40% benefit cap under Formula 2, assuming continuous service, while those entering at 37 or younger could. He did not use actual employee data or perform statistical analysis.

The City’s expert, Dubravka Tosic, Ph.D., criticized this approach, emphasizing the need for real-world data on the entire SFERS population, including factors like service breaks, reciprocity, and purchased credits, which could alter outcomes. Tosic also noted that considering average final compensation (which rises with age) and extending analysis to Formula 1 scenarios showed no overall age-based disadvantage.

The trial court ruled for the City. On disparate treatment, it found no adverse employment action (as benefits were calculated per a fixed formula) and no discriminatory animus, concluding Formula 2 was motivated by pension eligibility (credited service years), not age, akin to the U.S. Supreme Court’s reasoning in Kentucky Retirement Systems v. EEOC, 554 U.S. 135 (2008). For disparate impact, the court deemed plaintiffs’ hypothetical evidence insufficient, as it lacked actual statistical disparities across the protected group. Other claims failed derivatively, with no breach of contract (benefits matched Charter promises) and no equal protection violation (rational basis satisfied).

The Court of Appeal affirmed the trial court in the published case of Carroll v. City & County of S.F. -A169408 (November 2025).

Reviewing factual findings for substantial evidence and legal conclusions de novo, it upheld the disparate treatment ruling, agreeing pension status – not age – drove Formula 2, supported by parallels to Kentucky Retirement Systems (e.g., tracking normal retirement rules like the 60/10 provision, uniform ex ante terms, non-stereotypical assumptions, and scenarios benefiting older workers).

Plaintiffs’ “inexorable zero” argument failed, as hypotheticals ignored real variables like service breaks. For disparate impact, the court confirmed the need for actual statistical proof of disproportionate effects, which plaintiffs lacked. The amendment denial was not reversible error, as the trial court’s decision was not solely based on the pleading variance but on broader evidentiary shortcomings.

The judgment was affirmed, with no costs awarded, reinforcing that retirement formulas tied to pension eligibility, even if correlated with age, do not inherently violate FEHA absent proof of discriminatory motive or actual adverse impact.

The Monterey County District Attorney announced that her Environmental Protection Unit resolved a case against The Growers Company, Inc. (“Growers”) for violations of pesticide-related laws, which exposed its employees to pesticides.

Specifically, on October 9, 2023, a supervisor for Growers ignored pesticide warning signs on a lettuce field and ordered his crew of 93 fieldworkers into a field that had been treated with various pesticides not 24 hours prior. One such pesticide, Sivanto Prime, had a 24-hour restricted entry interval during which no one was allowed to enter the field.

Sivanto Prime (also labeled as Sivanto 200 SL in some formulations) is a systemic insecticide manufactured by Bayer Crop Science, with the active ingredient flupyradifurone. While effective for integrated pest management (IPM), its risks stem from potential human exposure during application, handling, or re-entry into treated areas. Risks are primarily acute (short-term) from dermal, inhalation, or ocular contact, with low chronic (long-term) concerns at labeled use rates.

Sixty-six of the fieldworkers developed symptoms consistent with exposure to pesticides, including nausea, dizziness, headache, and irritation to the throat, nose, eyes, and skin. Moreover, despite legal requirements to take all exposed employees to a physician for medical care, Growers only took 34 of the exposed employees to a physician for evaluation.

The judgment requires Growers to pay a $125,194 in civil penalties and costs and includes injunctive terms prohibiting them from violating these requirements in the future.

A felony criminal charge was also filed against the Growers’ supervisor who ordered the employees into the field, but he has since passed away.

The Monterey County Agricultural Commissioner’s Office investigated this incident and referred the case to the District Attorney’s Office as a “priority investigation,” pursuant to 3 CCR section 6128, subdivision (e), because the incident caused over five persons to become ill.

This is not the first such enforcement under Pacioni’s tenure (elected in 2018 as the county’s first female DA). In 2021, three companies – Norcal Harvesting, Bay View Farms, and R&T Farms – paid $110,000 combined for failing to notify workers of a fumigant buffer zone (using Tri-Form 80 EC), leading to eye irritation in eight employees.

More recently, in an undated but recent case, Azcona Harvesting, LLC was fined $55,000 for not immediately seeking medical care after 27 workers suffered nausea and vomiting from pesticide drift at Reiter Berry Farms; the applicator paid $195,200 separately.

These cases, investigated similarly by the Ag Commissioner’s Office, show a pattern: drift/entry violations often stem from rushed operations, with penalties focusing on deterrence via fines and training mandates.

Nationally, the EPA tracks over 10,000 pesticide illness cases yearly, with California leading due to its ag scale -Monterey accounts for ~20% of the state’s incidents.

District Attorney Investigator George Costa assisted in the District Attorney’s investigation. The Growers Company cooperated with the Agricultural Commissioner’s Office and the District Attorney’s Office during its investigation.

In November 2016, Orlando Rodriguez suffered severe head and brain injuries while working as a mechanic for Managed Mobile, Inc. His employer’s insurer, Illinois Midwest Insurance Agency LLC, acknowledged the injuries as work-related and began providing compensation benefits.

Starting in September 2018, Rodriguez’s primary treating physician, Dr. Yong Lee, repeatedly requested authorization for home health care services in six-week increments to support Rodriguez’s recovery. Illinois Midwest approved at least eight such requests between September 2018 and August 2019, sometimes directly by a claims adjuster and other times after subjecting them to utilization review.

However, when Dr. Lee submitted a new request for authorization on September 12, 2019, Illinois Midwest forwarded it to utilization review. On September 19, 2019, the reviewing physician denied the request, deeming the ongoing home health care no longer medically necessary. Rodriguez challenged this denial not through the statutorily required independent medical review (IMR) process, but by seeking an expedited hearing before a workers’ compensation administrative law judge (WCJ) at the Workers’ Compensation Appeals Board (WCAB).

In March 2020, the WCJ ruled in Rodriguez’s favor, awarding him ongoing home health care. The judge reasoned that since the treatment had been previously authorized and Rodriguez’s need was “ongoing and constant,” Illinois Midwest could not terminate it without demonstrating a substantive change in his medical condition – a showing the insurer had failed to make.

This decision relied heavily on a non-binding WCAB significant panel decision in Patterson v. The Oaks Farm (2014) 79 Cal.Comp.Cases 910 [2014 Cal. Wrk. Comp. P.D. LEXIS 98] (Patterson), that suggested employers must continue providing authorized ongoing treatments unless circumstances change, without restarting the review process.

A significant panel decision is a decision of the Appeals Board that has been designated by all members of the Appeals Board as of significant interest and importance to the workers’ compensation community. Although not binding precedent, significant panel decisions are intended to augment the body of binding appellate and en banc decisions by providing further guidance to the workers’ compensation community. (Cal. Code Regs., tit. 8, § 10305(r).)

The WCJ also noted that the facts presented were similar to those considered in Warner Brothers v. Workers’ Comp. Appeals Bd. (Ferrona) (2015) 80 Cal. Comp. Cases 831, 832-834 (writ denied), wherein the Appeals Board panel affirmed the trial judge’s finding that the reasoning in Patterson applies to assistive home care

Illinois Midwest petitioned the WCAB for reconsideration, arguing that the WCJ lacked jurisdiction because medical necessity disputes must be resolved exclusively through utilization review and IMR under reforms enacted in 2004 and 2013. These reforms aimed to shift such decisions from judges and courts to medical professionals, using evidence-based guidelines like the Medical Treatment Utilization Schedule (MTUS) to control costs and ensure quality care.

In January 2025 – after a nearly five-year delay – the WCAB affirmed the WCJ’s ruling, again invoking Patterson and concluding that Illinois Midwest bore the burden of proving changed circumstances to justify ending the treatment. It cited Patterson (supra)

Illinois Midwest then sought review in the California Court of Appeal. The Court of Appeal annulled the WCAB’s decision in the published case of Illinois Midwest Ins. Agency, LLC v. WCAB -B344044 (November 2025).

The Court of Appeal held that the WCAB exceeded its jurisdiction by bypassing the mandatory utilization review and IMR processes. It emphasized that the 2013 reforms (via Senate Bill No. 863) made IMR the sole avenue for appealing adverse utilization review decisions for injuries occurring after January 1, 2013, or denials communicated after July 1, 2013 – criteria met in Rodriguez’s case.

The Court of Appeal rejected any exception for “ongoing” or “continual” treatments, distinguishing and limiting Patterson to pre-2013 contexts where IMR was not yet exclusive. “We reject Patterson v. The Oaks Farm (2014) 79 Cal.Comp.Cases 910 (Patterson) to the extent it set forth a contrary rule for injuries or medical necessity determinations arising after the 2013 reforms.”

It clarified that even for extended treatments like home health care, each new request for authorization triggers the statutory review process, and the burden remains on the worker to prove ongoing medical necessity through medical evidence, not on the employer to prove changed circumstances.

The court underscored the legislative intent: to ensure medical professionals, not judges or courts, make medical necessity determinations, promoting efficiency and evidence-based care. By allowing the WCAB to intervene, the lower rulings had undermined this framework.

The case was remanded for proceedings consistent with the opinion, effectively requiring Rodriguez to pursue any further challenge through IMR if he sought to overturn the denial.

Survivors of the Eaton and Palisades fires on Thursday urged Gov. Gavin Newsom to call for the resignation of California Insurance Commissioner Ricardo Lara, following a front-page New York Times report revealing that Lara privately struck a deal with insurers allowing them to drop tens of thousands of policyholders ahead of the Los Angeles fires.

The New York Times investigation, based on internal state documents and communications, found that in 2023 Lara struck a secret deal with insurance companies that incentivized them to dump tens of thousands of policyholders in exchange for future rate hikes. The deal was sold to the public as a way to keep people out of the state’s high-cost, low-benefit FAIR Plan, but just the opposite happened. FAIR Plan nearly doubled, and many families lost coverage just months before the Los Angeles fires.

At a press conference in Altadena, survivors point to this and their own experience to say that California now faces two crises: families who can no longer buy or renew insurance, and those who still have coverage but cannot access the benefits they’ve already paid for. Both failures, survivors said, fall under Lara’s leadership – and now sit on the governor’s desk.

Joy Chen, executive director of the Eaton Fire Survivors Network and a former deputy mayor of Los Angeles, said:

“Families can no longer buy or renew coverage, and those who still have it can’t access the benefits they’ve already paid for. Californians can’t afford another year of failed oversight. This crisis now sits on the governor’s desk. Governor Newsom should call for Commissioner Lara to resign and install leadership that enforces the law and restores public trust.”

A Department of Angels report found that 70 percent of insured Eaton and Palisades survivors face systemic underinsurance and delays and denials blocking their recovery. A second Department of Angels report, released in October 2025, found that more than eight in ten Los Angeles fire survivors remain displaced, with most expected to lose their temporary housing coverage within months. With coverage expiring in real time, families are being forced out of rentals now – a slow-motion disaster unfolding as state leaders fail to act. Survivors described widespread, needless suffering among tens of thousands of Los Angeles fire survivors – families still displaced, underinsured, or denied the benefits they’ve paid for.

Branislav Kecman, an Eaton Fire survivor, said his family paid premiums to State Farm for 12 years before being dropped just months before the fire. The cancellation forced them onto the state’s FAIR Plan, which costs more and covers less.

“That was painful enough,” he said. “But what’s truly devastating is learning that our own Insurance Commissioner secretly cut a deal that encouraged insurers to drop families like ours. We thought we could trust the system. We never imagined we’d be betrayed by the very person elected to protect us.”

Jill Spivack, a longtime Pacific Palisades resident and State Farm policyholder whose home burned in the Palisades Fire, said what began as heartbreak has turned into outrage.

“After the fire, I thought we were protected – we’d paid State Farm for 25 years. But the real disaster was the endless maze of delays and denials. I had to put my business on hold just to fight for what we’d already paid for. Governor Newsom, your words gave us hope. Now we need your actions to make that hope real. Californians deserve an Insurance Commissioner who protects families, not the insurers doing the most harm.”

Consumer Watchdog Executive Director Carmen Balber said Lara’s secret deal exposed a crisis of leadership that can only be resolved by the Governor.

Survivors warned that Los Angeles stands on the edge of a second catastrophe – one of permanent displacement. Lara has approved billion-dollar rate hikes for the state’s largest insurer, State Farm, while 82 percent of its policyholders report negative claims experiences.

A Los Angeles Times analysis found that five major California wildfires between 2017 and 2020 destroyed 22,500 homes – and by 2025, only 38 percent had been rebuilt. The Times identified insurance as the single biggest factor determining recovery: when insurance paid promptly, families rebuilt; when it didn’t, most never recovered.

The Eaton Fire Survivors Network, representing more than 8,500 Californians, has documented nearly 500 firsthand accounts of insurer misconduct and delivered a five-step enforcement plan to Commissioner Lara.. Every elected official representing the Eaton and Palisades fire zones – including Senators Sasha Renée Pérez and Ben Allen, Assembly members John Harabedian and Jacqui Irwin, Supervisor Kathryn Barger, Mayor Karen Bass, and Altadena Town Council President Victoria Knapp – has joined survivors’ call for accountability.

In closing, Chen added: “Let our Los Angeles experience be a warning to every Californian. Our entire housing market will collapse if families can’t buy or renew insurance, and if those who have it can’t get the benefits they’ve paid for. California cannot afford another year of Ricardo Lara. We call on Governor Newsom to act now: urge Commissioner Lara to resign, and install new leadership that enforces the law and rebuilds a functioning insurance market.”