Gov. Jerry Brown has signed into law a bill that will prevent many professional athletes from filing workers’ compensation claims in California.
The bill, AB 1309, applies to athletes who played for teams outside of California or had limited experience playing on California teams. According to the story in the Los Angeles Times, they will no longer be allowed to make claims in the Golden State for cumulative trauma, a category of injury incurred over time that includes arthritis as well as certain brain injuries like chronic traumatic encepalopathy.
In recent years, thousands of athletes who played for teams elsewhere in the country have filed such claims in California because its workers’ compensation system - unlike many others - recognizes cumulative trauma. In addition, the state’s statute of limitations had a provision allowing some workers to file years or even decades after retirement. Some players made filings having played only a handful of games in California over the course of their careers.
Backers of the bill, including the National Football League, Major League Baseball and the other major sports leagues, argued that such filings were overly costly and that the athletes should be filing in their home states. "This new law sets reasonable standards to close an expensive loophole unique to California and to professional sports," Dennis Kuhl, chairman of the Los Angeles Angels of Anaheim baseball team, said in a statement.
Opponents, among them the players’ unions and organized labor, argued that it unfairly excludes one class of workers from the state’s system. Flight attendants and truck drivers - who also spend time in California, though they may not be employed in the state - will still be allowed to file such claims. In addition, they argued that the players were filing in California because they were prevented from making such claims in the states where they played, either due to a more restrictive statute of limitations or because the state doesn’t recognize cumulative trauma.
Although some high-profile athletes, including NFL Hall-of-Famer Deion Sanders and MLB most valuable player Juan Gonzalez, have made such claims, claims data show that most claims by athletes were filed by lesser-known professionals, including many who played only in the minor leagues.
The new law applies only to football, baseball, basketball, ice hockey and soccer players. Under a provision adopted shortly prior to its passage in the Senate in late August, it is effective as of Sept. 15, meaning any claims filed after that date by out-of-state athletes will not be valid.
AB 1309 passed overwhelmingly in both houses of the state legislature, garnering only five "no" votes in its final version.
The legislative victory follows news last month that the NFL had reached a tentative $765-million settlement with more than 4,500 former players who had sued the league over allegations that it did not properly warn them about the risks associated with concussions ...
The bill, AB 1309, applies to athletes who played for teams outside of California or had limited experience playing on California teams. According to the story in the Los Angeles Times, they will no longer be allowed to make claims in the Golden State for cumulative trauma, a category of injury incurred over time that includes arthritis as well as certain brain injuries like chronic traumatic encepalopathy.
In recent years, thousands of athletes who played for teams elsewhere in the country have filed such claims in California because its workers’ compensation system - unlike many others - recognizes cumulative trauma. In addition, the state’s statute of limitations had a provision allowing some workers to file years or even decades after retirement. Some players made filings having played only a handful of games in California over the course of their careers.
Backers of the bill, including the National Football League, Major League Baseball and the other major sports leagues, argued that such filings were overly costly and that the athletes should be filing in their home states. "This new law sets reasonable standards to close an expensive loophole unique to California and to professional sports," Dennis Kuhl, chairman of the Los Angeles Angels of Anaheim baseball team, said in a statement.
Opponents, among them the players’ unions and organized labor, argued that it unfairly excludes one class of workers from the state’s system. Flight attendants and truck drivers - who also spend time in California, though they may not be employed in the state - will still be allowed to file such claims. In addition, they argued that the players were filing in California because they were prevented from making such claims in the states where they played, either due to a more restrictive statute of limitations or because the state doesn’t recognize cumulative trauma.
Although some high-profile athletes, including NFL Hall-of-Famer Deion Sanders and MLB most valuable player Juan Gonzalez, have made such claims, claims data show that most claims by athletes were filed by lesser-known professionals, including many who played only in the minor leagues.
The new law applies only to football, baseball, basketball, ice hockey and soccer players. Under a provision adopted shortly prior to its passage in the Senate in late August, it is effective as of Sept. 15, meaning any claims filed after that date by out-of-state athletes will not be valid.
AB 1309 passed overwhelmingly in both houses of the state legislature, garnering only five "no" votes in its final version.
The legislative victory follows news last month that the NFL had reached a tentative $765-million settlement with more than 4,500 former players who had sued the league over allegations that it did not properly warn them about the risks associated with concussions ...
The former owner of a Los Angeles medical clinic management company has been indicted for his role in a $13 million scheme to defraud Medicare.
Mikran "Mike" Meguerian, 36, of Glendale, California, was indicted in the Central District of California on one count of conspiracy to commit health care fraud and five counts of health care fraud, each of which carries a maximum penalty of 10 years in prison upon conviction. Meguerian was arrested on September 26, 2013, and the indictment was unsealed following his initial appearance in federal court on September 27, 2013.
According to court documents, Meguerian owned Med Serve Management, a medical clinic management company located in Van Nuys, California. From approximately 2006 through February 2009, he allegedly engaged in a conspiracy to commit health care fraud, in part through the operation of Med Serve.
According to court documents, Meguerian oversaw several medical clinics that generated prescriptions and other medical documents for medically unnecessary power wheelchairs and other durable medical equipment (DME). Meguerian and his co-conspirators then sold the prescriptions to DME supply companies, knowing that the prescriptions were fraudulent. Court documents allege that, based on these fraudulent prescriptions, the DME supply companies then submitted false and fraudulent claims to Medicare.
Court documents allege that fraudulent prescriptions from Meguerian’s clinics were instrumental in generating approximately $13.6 million in fraudulent claims to Medicare, and Medicare paid approximately $7.6 on those claims.
The case was investigated by the FBI and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. This case is being prosecuted by Trial Attorneys Fred Medick and Blanca Quintero of the Criminal Division’s Fraud Section ...
Mikran "Mike" Meguerian, 36, of Glendale, California, was indicted in the Central District of California on one count of conspiracy to commit health care fraud and five counts of health care fraud, each of which carries a maximum penalty of 10 years in prison upon conviction. Meguerian was arrested on September 26, 2013, and the indictment was unsealed following his initial appearance in federal court on September 27, 2013.
According to court documents, Meguerian owned Med Serve Management, a medical clinic management company located in Van Nuys, California. From approximately 2006 through February 2009, he allegedly engaged in a conspiracy to commit health care fraud, in part through the operation of Med Serve.
According to court documents, Meguerian oversaw several medical clinics that generated prescriptions and other medical documents for medically unnecessary power wheelchairs and other durable medical equipment (DME). Meguerian and his co-conspirators then sold the prescriptions to DME supply companies, knowing that the prescriptions were fraudulent. Court documents allege that, based on these fraudulent prescriptions, the DME supply companies then submitted false and fraudulent claims to Medicare.
Court documents allege that fraudulent prescriptions from Meguerian’s clinics were instrumental in generating approximately $13.6 million in fraudulent claims to Medicare, and Medicare paid approximately $7.6 on those claims.
The case was investigated by the FBI and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. This case is being prosecuted by Trial Attorneys Fred Medick and Blanca Quintero of the Criminal Division’s Fraud Section ...
Jorge Mora was working as a carpenter for CLP Resources Inc. in 2009 when he was directed to use a table saw unsecured to a base and lacking a protective guard. He stepped on debris, lost his balance, and placed his hand on the unguarded table saw blade. Mora sustained serious cuts to his left hand. Mora filed an application for an award under Labor Code section 4553, which grants additional benefits to a worker who is injured by the "serious and willful misconduct" of his employer. Mora’s first theory alleged the injury was due to the willful failure of the employer to provide a safe place of work. His second theory alleged that the employer had knowingly violated a safety order in directing this work.
Mora testified he had 13 to 15 years’ work experience as a carpenter. He began work for CLP, a temporary placement agency, in April 2008, and had been assigned to several different jobsites prior to his accident. Mora was supervised by Lieb, who provided his tools and told him what to do. CLP had instructed Mora to contact Marlo Vasquez, a CLP employee, if "here was a problem, or if anything was not right," On direct examination, Mora testified he told Vasquez "here were a lot of things that were not right on the job site where he was working"and Vasquez "should check it out." As Mora was about to list the specific safety problems, however, Vasquez told him "there was no work, and he should just be careful." After that, Vasquez turned back to his computer and gave Mora no opportunity to provide more information. No one from CLP came to inspect the site. Mora acknowledged he had not told anyone at CLP specifically about the unsecured, unguarded table saw, although he said it was one of the safety problems he intended to discuss with Vasquez.
The only CLP employee to testify was a company safety official. He said CLP inspects the work sites of the contractors to whom its employees are assigned and had inspected the Lieb jobsite in October 2008, about two months prior to Mora’s injury. In the inspection, CLP had found no safety violations. If the unguarded table saw was present, it was not located by the inspector, although it had been "mentioned by the individuals who previously worked on the job site." The employee speculated the inspector might have missed the table saw because Lieb removed his tools from the site each day to prevent theft.
CLP was cited by Cal-OSHA for having an inadequate injury and illness prevention program and for the hazardous state of the table saw. Cal-OSHA ultimately reduced the proposed penalty against CLP, possibly after concluding that CLP was unaware of the hazardous nature of the saw.
The WCJ found that Mora’s injury was proximately caused by the willful and serious misconduct of CLP and awarded appropriate damages under Labor Code section 4553. In explaining her decision, the WCJ found the use of an unguarded table saw to be "an inherently dangerous proposition" likely to cause serious injury and noted Cal-OSHA had cited both CLP and Lieb for use of the unsafe saw. Although she found "no clear evidence that management representatives at CLP . . . knowingly violated the safety order" and "no[] evidence that a CLP managing representative ‘turned his mind’ to the dangerous situation here."
Reconsideration was denied. The Court of Appeal annulled the serious and willful award in the unpublished case of CLP Resources v. WCAB (Mora).
The mere failure to perform a statutory duty is not, alone, willful misconduct. It amounts only to simple negligence. To constitute ‘willful misconduct’ there must be actual knowledge, or that which in the law is esteemed to be the equivalent of actual knowledge, of the peril to be apprehended from the failure to act, coupled with a conscious failure to act to the end of averting injury. "The inadequate inspection cited by the WCJ and the Appeals Board as misconduct could not have constituted the type of intentional conduct required for liability under Labor Code section 4553." ...
Mora testified he had 13 to 15 years’ work experience as a carpenter. He began work for CLP, a temporary placement agency, in April 2008, and had been assigned to several different jobsites prior to his accident. Mora was supervised by Lieb, who provided his tools and told him what to do. CLP had instructed Mora to contact Marlo Vasquez, a CLP employee, if "here was a problem, or if anything was not right," On direct examination, Mora testified he told Vasquez "here were a lot of things that were not right on the job site where he was working"and Vasquez "should check it out." As Mora was about to list the specific safety problems, however, Vasquez told him "there was no work, and he should just be careful." After that, Vasquez turned back to his computer and gave Mora no opportunity to provide more information. No one from CLP came to inspect the site. Mora acknowledged he had not told anyone at CLP specifically about the unsecured, unguarded table saw, although he said it was one of the safety problems he intended to discuss with Vasquez.
The only CLP employee to testify was a company safety official. He said CLP inspects the work sites of the contractors to whom its employees are assigned and had inspected the Lieb jobsite in October 2008, about two months prior to Mora’s injury. In the inspection, CLP had found no safety violations. If the unguarded table saw was present, it was not located by the inspector, although it had been "mentioned by the individuals who previously worked on the job site." The employee speculated the inspector might have missed the table saw because Lieb removed his tools from the site each day to prevent theft.
CLP was cited by Cal-OSHA for having an inadequate injury and illness prevention program and for the hazardous state of the table saw. Cal-OSHA ultimately reduced the proposed penalty against CLP, possibly after concluding that CLP was unaware of the hazardous nature of the saw.
The WCJ found that Mora’s injury was proximately caused by the willful and serious misconduct of CLP and awarded appropriate damages under Labor Code section 4553. In explaining her decision, the WCJ found the use of an unguarded table saw to be "an inherently dangerous proposition" likely to cause serious injury and noted Cal-OSHA had cited both CLP and Lieb for use of the unsafe saw. Although she found "no clear evidence that management representatives at CLP . . . knowingly violated the safety order" and "no[] evidence that a CLP managing representative ‘turned his mind’ to the dangerous situation here."
Reconsideration was denied. The Court of Appeal annulled the serious and willful award in the unpublished case of CLP Resources v. WCAB (Mora).
The mere failure to perform a statutory duty is not, alone, willful misconduct. It amounts only to simple negligence. To constitute ‘willful misconduct’ there must be actual knowledge, or that which in the law is esteemed to be the equivalent of actual knowledge, of the peril to be apprehended from the failure to act, coupled with a conscious failure to act to the end of averting injury. "The inadequate inspection cited by the WCJ and the Appeals Board as misconduct could not have constituted the type of intentional conduct required for liability under Labor Code section 4553." ...
Lloyd Ings was a retired telephone worker living in Simi Valley. He owns two triplexes in west Los Angeles to supplement his retirement income. Ings purchased one triplex in 1957 and the other in 1963. Matthias Bussard was Ings former neighbor. They became friends in 1999. Bussard lost his job as a mortgage broker at Wells Fargo Bank in March 2009.
In August, 2009, Ings agreed to pay Bussard $20 per hour to paint the eaves on one of the triplexes. On the first day of painting, Bussard walked backwards off the roof and sustained injuries. Bussard acknowledged there was nothing defective about the roof; he simply misjudged the size of it.
Ings paid Bussard’s medical bills for a period of time, but stopped when it became too expensive. Bussard then filed this lawsuit against Ings. Bussard’s complaint contained three causes of action: (1) premises liability; (2) general negligence; and (3) "uninsured employer liability (Labor Code[,] § 3706 et seq.)."
Ings filed a motion for summary judgment. The trial court ruled that Bussard was not an employee of Ings for purposes of Workers’ Compensation, and so Ings had no duty to purchase such insurance and no liability under Labor Code section 3706. The court also ruled Bussard was not an employee for purposes of Cal-OSHA and so Ings had no duty to comply with Cal-OSHA requirements. Because it was undisputed the fall was not due to any defect in the roof, the court ruled Ings had no liability for negligence. The court granted Ings’s motion for summary judgment.
The Court of Appeal reversed in the unpublished case of Bussard v. Ings.
Section 2750.5 establishes a "rebuttable presumption" that a worker performing services for which a license is required is an "employee rather than an independent contractor" for purposes of workers' compensation.
A person is an "employee" for purposes of Cal-OSHA if he is directed by an employer "to engage in any employment." (Lab. Code, § 6304.1, subd. (a).) "‘Employment’ includes the carrying on of any trade, enterprise, project, industry, business, occupation, work . . . except household domestic service." (Lab. Code, § 6303, subd. (b).) "OSHA does not define ‘household domestic service.’ Nor does the relevant legislative history offer any guidance on the meaning of the phrase."
"[O]wnership and rental of a house by an individual for the purpose of supplemental income, when such owner has no particular or principal business, is not a business within the contemplation of the [Workers’ Compensation] Act." (Stewart v. WCAB, supra, 172 Cal.App.3d at pp. 354, 355-356.)
The Workers’ Compensation Act has different language and a different history than Cal-OSHA. Both sets of laws trace their roots to legislation passed in 1913 and originally used the term "household domestic service" to refer to a class of excluded employees. There, the similarities end. Workers’ compensation contained an additional excluded class of employees consisting of any person whose duties were "both casual and not in the usual course of the trade, business, profession or occupation of his employer."
Bussard’s work may have qualified as maintenance work. However, Ings’s income-producing triplexes are not the equivalent of a private home. He does not live in either triplex and they are not located on the premises or grounds of his home. The above regulations suggest that Bussard’s maintenance work on Ings’s rental property is not "domestic household service." ...
In August, 2009, Ings agreed to pay Bussard $20 per hour to paint the eaves on one of the triplexes. On the first day of painting, Bussard walked backwards off the roof and sustained injuries. Bussard acknowledged there was nothing defective about the roof; he simply misjudged the size of it.
Ings paid Bussard’s medical bills for a period of time, but stopped when it became too expensive. Bussard then filed this lawsuit against Ings. Bussard’s complaint contained three causes of action: (1) premises liability; (2) general negligence; and (3) "uninsured employer liability (Labor Code[,] § 3706 et seq.)."
Ings filed a motion for summary judgment. The trial court ruled that Bussard was not an employee of Ings for purposes of Workers’ Compensation, and so Ings had no duty to purchase such insurance and no liability under Labor Code section 3706. The court also ruled Bussard was not an employee for purposes of Cal-OSHA and so Ings had no duty to comply with Cal-OSHA requirements. Because it was undisputed the fall was not due to any defect in the roof, the court ruled Ings had no liability for negligence. The court granted Ings’s motion for summary judgment.
The Court of Appeal reversed in the unpublished case of Bussard v. Ings.
Section 2750.5 establishes a "rebuttable presumption" that a worker performing services for which a license is required is an "employee rather than an independent contractor" for purposes of workers' compensation.
A person is an "employee" for purposes of Cal-OSHA if he is directed by an employer "to engage in any employment." (Lab. Code, § 6304.1, subd. (a).) "‘Employment’ includes the carrying on of any trade, enterprise, project, industry, business, occupation, work . . . except household domestic service." (Lab. Code, § 6303, subd. (b).) "OSHA does not define ‘household domestic service.’ Nor does the relevant legislative history offer any guidance on the meaning of the phrase."
"[O]wnership and rental of a house by an individual for the purpose of supplemental income, when such owner has no particular or principal business, is not a business within the contemplation of the [Workers’ Compensation] Act." (Stewart v. WCAB, supra, 172 Cal.App.3d at pp. 354, 355-356.)
The Workers’ Compensation Act has different language and a different history than Cal-OSHA. Both sets of laws trace their roots to legislation passed in 1913 and originally used the term "household domestic service" to refer to a class of excluded employees. There, the similarities end. Workers’ compensation contained an additional excluded class of employees consisting of any person whose duties were "both casual and not in the usual course of the trade, business, profession or occupation of his employer."
Bussard’s work may have qualified as maintenance work. However, Ings’s income-producing triplexes are not the equivalent of a private home. He does not live in either triplex and they are not located on the premises or grounds of his home. The above regulations suggest that Bussard’s maintenance work on Ings’s rental property is not "domestic household service." ...
The Commission on Health and Safety and Workers' Compensation (CHSWC) has released on its website for public comment and feedback the report, "Formulating a Copy Services Fee Schedule."
Senate Bill (SB) 863 requires the Administrative Director of the Division of Workers’ Compensation, in consultation with CHSWC, to adopt a copy services fee schedule. In 2013, CHSWC worked with Berkeley Research Group of Emeryville, CA to analyze copy services practices in the workers’ compensation system, review pricing options and prepare a report summarizing relevant fees in the marketplace and policy issues that may be addressed during the rulemaking process.
The Commission spoke to a number of different stakeholders involved in the procuring, preparation of and payment for copying and related services. It became clear almost immediately that the system was riven with distrust and that it had essentially broken down, with each side feeling justified in its approach to pricing. Applicant copy services accuse payers of unreasonable delay or refusal, and they build the cost of collections and bad debts into their fees. Payers accuse the applicant copy services of puffing the bills, and they reject the bills or offer only discounted payments.
The report says that it is essential to break this vicious cycle of inefficiency, which is why it is proposing a lump sum payment system. The report therefore recommends a flat fee schedule to cover all costs related to obtaining and reproducing a set of records up to 1,000 pages if the bill is paid timely and without dispute, and a higher fee to include the additional business expenses if the bill has to go into collection or dispute resolution. It also concluded that the major costs of providing documents copies were the costs of retrieving the documents, rather than the actual per page copy costs, which is one reason why a lump sum payment proposal disregards the number of pages in a copy set. The cost of each initial copy set should be $103.55. Additional copy sets should be made available at $.10 per page if paper and for a nominal lump sum fee of $5.00 if electronic.The advantage of a flat rate is to simplify the process, as well as to reduce the number of areas of potential disagreement between Applicant copy services and payers.
In order to prevent abuses of the new system, CHSWC recommend requiring that each subpoena be supported by the declaration of the attorney seeking documents that the subpoena was issued in good faith, is not duplicative and seeks documents necessary to pursue the applicant’s claim.
The report recommend requiring the use of a registered service to qualify for payment. Registered copiers cannot be convicted felons, must have a notary public involved in the management, must be bonded, must carry an identification card issued by the county clerk, and are statutorily responsible for maintaining the integrity and confidentiality of information obtained (Business & Professions Code section 22450 et seq.). This would be one way of trying to protect injured workers’ privacy as well as possibly reducing unprofessional practices.
CHSWC invites public comment and feedback by email at chswc@dir.ca.gov or in writing to: Commission on Health and Safety and Workers' Compensation (CHSWC).\1515 Clay Street, 17th Floor Oakland, CA 94612 or Fax at (510) 622-3265 through October 15, 2013 and by oral comments at the CHSWC meeting on October 17, 2013. Additional opportunities for public comment will be available when the Administrative Director begins the rulemaking process to establish a copy services fee schedule ...
Senate Bill (SB) 863 requires the Administrative Director of the Division of Workers’ Compensation, in consultation with CHSWC, to adopt a copy services fee schedule. In 2013, CHSWC worked with Berkeley Research Group of Emeryville, CA to analyze copy services practices in the workers’ compensation system, review pricing options and prepare a report summarizing relevant fees in the marketplace and policy issues that may be addressed during the rulemaking process.
The Commission spoke to a number of different stakeholders involved in the procuring, preparation of and payment for copying and related services. It became clear almost immediately that the system was riven with distrust and that it had essentially broken down, with each side feeling justified in its approach to pricing. Applicant copy services accuse payers of unreasonable delay or refusal, and they build the cost of collections and bad debts into their fees. Payers accuse the applicant copy services of puffing the bills, and they reject the bills or offer only discounted payments.
The report says that it is essential to break this vicious cycle of inefficiency, which is why it is proposing a lump sum payment system. The report therefore recommends a flat fee schedule to cover all costs related to obtaining and reproducing a set of records up to 1,000 pages if the bill is paid timely and without dispute, and a higher fee to include the additional business expenses if the bill has to go into collection or dispute resolution. It also concluded that the major costs of providing documents copies were the costs of retrieving the documents, rather than the actual per page copy costs, which is one reason why a lump sum payment proposal disregards the number of pages in a copy set. The cost of each initial copy set should be $103.55. Additional copy sets should be made available at $.10 per page if paper and for a nominal lump sum fee of $5.00 if electronic.The advantage of a flat rate is to simplify the process, as well as to reduce the number of areas of potential disagreement between Applicant copy services and payers.
In order to prevent abuses of the new system, CHSWC recommend requiring that each subpoena be supported by the declaration of the attorney seeking documents that the subpoena was issued in good faith, is not duplicative and seeks documents necessary to pursue the applicant’s claim.
The report recommend requiring the use of a registered service to qualify for payment. Registered copiers cannot be convicted felons, must have a notary public involved in the management, must be bonded, must carry an identification card issued by the county clerk, and are statutorily responsible for maintaining the integrity and confidentiality of information obtained (Business & Professions Code section 22450 et seq.). This would be one way of trying to protect injured workers’ privacy as well as possibly reducing unprofessional practices.
CHSWC invites public comment and feedback by email at chswc@dir.ca.gov or in writing to: Commission on Health and Safety and Workers' Compensation (CHSWC).\1515 Clay Street, 17th Floor Oakland, CA 94612 or Fax at (510) 622-3265 through October 15, 2013 and by oral comments at the CHSWC meeting on October 17, 2013. Additional opportunities for public comment will be available when the Administrative Director begins the rulemaking process to establish a copy services fee schedule ...
In April 2004,Plaintiff Louise Pena was hired by Defendant Central Freight Lines, Inc. at its Hayward, California terminal. Pena’s job was a customer service representative.
In late February 2008, Central hired a new terminal manager, Aaron Holstein, at its Hayward Facility. On March 14, 2008, three weeks after hiring Holstein, Pena was injured in an automobile incident on her way to work. At approximately 5:30 am on highway 80 a large metal bar crashed through the windshield of her car barely missing her head, smashed the rear window and landed in the back seat. Later that day Pena called Holstein and notified him that she had hurt her back and neck and was in pain. Holstein asked her to keep Central informed as to her medical condition and when she would be returning to work. On several occasions Pena provided status information to her employer.
Based upon her regular status reports, the trial court concluded that the employer "knew or should have known and understood that Plaintiff had a serious health condition that entitled her to medical disability leave under the California Family Rights Act (CFRA) and Defendant knew or should have known that Pena was entitled to a reasonable accommodation under the Fair Employment and Housing Act (FEHA)."
Instead, on Tuesday, March 25, 2008, Holstein recommended in a memorandum to his supervisors, that Pena be terminated. This memorandum also states that Pena was experiencing migraine headaches and her doctor had taken her off work. Holstein’s memorandum indicates his dissatisfaction with her attendance, specifically mentioning March14, 17 and 25, 2008 which were protected leave dates. On March 28, 2008 Holstein and Central’s Human Resources Department executed Pena’s Notice of Separation. The form Separation Notice contained 21 possible categories for termination. The Defendant marked the category ‘absenteeism’ as the reason for Pena’s termination. No other category was marked.
On Monday, April 1, 2008, Pena returned to work without any limitations or restrictions and able to perform all the essential functions of her job. She brought with her written medical certifications confirming that she had been totally unable to work from March 14 to March 31, and that she had been under the doctor’s professional care. Holstein suspended her and sent her home and told her to call in every day to determine whether there was work for her, even though Holstein knew that he would not be offering Pena any work. The trial Court found that there was plenty of work to do in the customer service department at that time.
She sued Central under the Fair Housing and Employment Act (Gov. Code, § 12900 et seq. (FEHA)) and in a non-jury trial, prevailed on all of her causes of action. The court awarded Pena $470,000 in economic and noneconomic damages and $431,884.25 in attorneys’ fees. The award was affirmed by the Court of Appeal in the unpublished case of Pena vs Central Freight Lines. Inc.
On appeal Central claimed that emotional distress damages arising from job loss are barred by the exclusive remedy provisions of the workers’ compensation law. The court ruled that this argument was correct as a general matter, but wrong in this case. "Emotional distress caused by misconduct in employment relations involving, for example, promotions, demotions, criticism of work practices, negotiations as to grievances, is a normal part of the employment environment. A cause of action for such a claim is barred by the exclusive remedy provisions of the workers’ compensation law. [Citations.] The Legislature, however, did not intend that an employer be allowed to raise the exclusivity rule for the purpose of deflecting a claim of discriminatory practices. [Citations.] Thus, a claim for emotional and psychological damage, arising out of employment, is not barred where the distress is engendered by an employer’s illegal discriminatory practices." ...
In late February 2008, Central hired a new terminal manager, Aaron Holstein, at its Hayward Facility. On March 14, 2008, three weeks after hiring Holstein, Pena was injured in an automobile incident on her way to work. At approximately 5:30 am on highway 80 a large metal bar crashed through the windshield of her car barely missing her head, smashed the rear window and landed in the back seat. Later that day Pena called Holstein and notified him that she had hurt her back and neck and was in pain. Holstein asked her to keep Central informed as to her medical condition and when she would be returning to work. On several occasions Pena provided status information to her employer.
Based upon her regular status reports, the trial court concluded that the employer "knew or should have known and understood that Plaintiff had a serious health condition that entitled her to medical disability leave under the California Family Rights Act (CFRA) and Defendant knew or should have known that Pena was entitled to a reasonable accommodation under the Fair Employment and Housing Act (FEHA)."
Instead, on Tuesday, March 25, 2008, Holstein recommended in a memorandum to his supervisors, that Pena be terminated. This memorandum also states that Pena was experiencing migraine headaches and her doctor had taken her off work. Holstein’s memorandum indicates his dissatisfaction with her attendance, specifically mentioning March14, 17 and 25, 2008 which were protected leave dates. On March 28, 2008 Holstein and Central’s Human Resources Department executed Pena’s Notice of Separation. The form Separation Notice contained 21 possible categories for termination. The Defendant marked the category ‘absenteeism’ as the reason for Pena’s termination. No other category was marked.
On Monday, April 1, 2008, Pena returned to work without any limitations or restrictions and able to perform all the essential functions of her job. She brought with her written medical certifications confirming that she had been totally unable to work from March 14 to March 31, and that she had been under the doctor’s professional care. Holstein suspended her and sent her home and told her to call in every day to determine whether there was work for her, even though Holstein knew that he would not be offering Pena any work. The trial Court found that there was plenty of work to do in the customer service department at that time.
She sued Central under the Fair Housing and Employment Act (Gov. Code, § 12900 et seq. (FEHA)) and in a non-jury trial, prevailed on all of her causes of action. The court awarded Pena $470,000 in economic and noneconomic damages and $431,884.25 in attorneys’ fees. The award was affirmed by the Court of Appeal in the unpublished case of Pena vs Central Freight Lines. Inc.
On appeal Central claimed that emotional distress damages arising from job loss are barred by the exclusive remedy provisions of the workers’ compensation law. The court ruled that this argument was correct as a general matter, but wrong in this case. "Emotional distress caused by misconduct in employment relations involving, for example, promotions, demotions, criticism of work practices, negotiations as to grievances, is a normal part of the employment environment. A cause of action for such a claim is barred by the exclusive remedy provisions of the workers’ compensation law. [Citations.] The Legislature, however, did not intend that an employer be allowed to raise the exclusivity rule for the purpose of deflecting a claim of discriminatory practices. [Citations.] Thus, a claim for emotional and psychological damage, arising out of employment, is not barred where the distress is engendered by an employer’s illegal discriminatory practices." ...
Citing savings to the State, the DWC announced last month that the Goleta WCAB District Office will close and merge with the Oxnard office on November 30. The last day that hearings will be scheduled in Goleta will be Friday, November 29.
All cases currently in Goleta will be transferred to the Oxnard District Office, approximately 45 miles south. The seven DWC employees in Goleta will also transfer to the Oxnard office. The DWC claims that Goleta closure will consolidate resources and create savings for future DWC needs, including hiring. Oxnard has sufficient space to accommodate the Goleta staff, who will begin work there on Monday, December 2.
And the California Applicant Attorneys Association is not thrilled with the consolidation. It has called upon the DWC to either reverse its decision to close the Goleta WCAB at the end of November, or, at a minimum, continue to hold hearings in Goleta on injured workers’ insurance claims.
"The planned closure of the Goleta WCAB will impose considerable hardship on injured workers, particularly those without the ability to travel nearly one hour to Ventura or San Luis Obispo counties to pursue their insurance claims. For example, there is no public transportation that would get injured workers to Oxnard for an 8:30am hearing, which is customary," said Jill Singer, CAAA Central Coast Chapter president. "We call for the DWC to keep this board office open, or at a minimum, continue to hold hearings in Goleta, so that workers have access to the justice they deserve."
Singer said that area workers would now have no office in the area’s largest population center, the Santa Barbara area, and would have to travel up to 100 miles to pursue their workers’ compensation insurance claims for medical care and disability compensation for their work injuries, "There was no public notice of this decision. The area’s largest employer is UC Santa Barbara, so closing the Goleta board will affect employers who will also have to spend hours traveling to and from a faraway board for every case hearing. The closure would have great financial consequences for small businesses. Instead of taking an hour or two, or even being on call if their testimony is necessary, employers are now going to have to take up to a day or more off work to travel to Oxnard for hearings and trials."
Newly elected CAAA President Jim Butler said, "The DWC reduced employers’ assessments to pay for the system of reviewing injured workers’ claims, and is now closing this regional board. This reduces injured workers’ access to the State’s system to pursue medical care and disability compensation. We call upon the DWC to reverse this decision, or to follow its precedent in Palm Springs, Ukiah and Bishop, and continue to hold hearings on work injury cases in Goleta after closing its permanent office there."
CAAA said the closure will impact the poorest and most seriously injured workers the most, as there is no adequate or efficient transportation for those without cars. The closure would especially harm the large number of farmworkers - and farmers - in this agricultural area. "Injured workers would have to spend multiple hours on public transportation to travel to Oxnard or San Luis Obispo, which is most difficult for the most severely injured," said Singer ...
All cases currently in Goleta will be transferred to the Oxnard District Office, approximately 45 miles south. The seven DWC employees in Goleta will also transfer to the Oxnard office. The DWC claims that Goleta closure will consolidate resources and create savings for future DWC needs, including hiring. Oxnard has sufficient space to accommodate the Goleta staff, who will begin work there on Monday, December 2.
And the California Applicant Attorneys Association is not thrilled with the consolidation. It has called upon the DWC to either reverse its decision to close the Goleta WCAB at the end of November, or, at a minimum, continue to hold hearings in Goleta on injured workers’ insurance claims.
"The planned closure of the Goleta WCAB will impose considerable hardship on injured workers, particularly those without the ability to travel nearly one hour to Ventura or San Luis Obispo counties to pursue their insurance claims. For example, there is no public transportation that would get injured workers to Oxnard for an 8:30am hearing, which is customary," said Jill Singer, CAAA Central Coast Chapter president. "We call for the DWC to keep this board office open, or at a minimum, continue to hold hearings in Goleta, so that workers have access to the justice they deserve."
Singer said that area workers would now have no office in the area’s largest population center, the Santa Barbara area, and would have to travel up to 100 miles to pursue their workers’ compensation insurance claims for medical care and disability compensation for their work injuries, "There was no public notice of this decision. The area’s largest employer is UC Santa Barbara, so closing the Goleta board will affect employers who will also have to spend hours traveling to and from a faraway board for every case hearing. The closure would have great financial consequences for small businesses. Instead of taking an hour or two, or even being on call if their testimony is necessary, employers are now going to have to take up to a day or more off work to travel to Oxnard for hearings and trials."
Newly elected CAAA President Jim Butler said, "The DWC reduced employers’ assessments to pay for the system of reviewing injured workers’ claims, and is now closing this regional board. This reduces injured workers’ access to the State’s system to pursue medical care and disability compensation. We call upon the DWC to reverse this decision, or to follow its precedent in Palm Springs, Ukiah and Bishop, and continue to hold hearings on work injury cases in Goleta after closing its permanent office there."
CAAA said the closure will impact the poorest and most seriously injured workers the most, as there is no adequate or efficient transportation for those without cars. The closure would especially harm the large number of farmworkers - and farmers - in this agricultural area. "Injured workers would have to spend multiple hours on public transportation to travel to Oxnard or San Luis Obispo, which is most difficult for the most severely injured," said Singer ...
Ten months after "historic reforms" were made to California’s workers’ compensation system there is evidence that the changes are taking hold, however bad actors continue to find ways to game the system, said Department of Industrial Relations Director Christine Baker. Baker, who’s considered one of the state’s top labor officials and oversees the Department of Workers’ Compensation, offered an update on Senate Bill 863 during the California Workers’ Compensation and Risk Conference in Dana Point on Wednesday.
The Insurance Journal article says that the annual three-day conference was attended by a broad swath of professionals with interest in workers’ comp, including insurance agents, insurers, attorneys, interpreting services, investigative agencies, medical provider networks and billing services.
The theme of this year’s conference was "Surf’s Up! Navigating the ‘Waves of Change’ in Risk Management." The conference included an expo, several panels and guest speakers. Other keynote speakers included motivational speaker Bethany Hamilton, a professional surfer and shark attack survivor. The conference ends Friday.
Baker was one of a handful of people who hammered out the workers’ comp reform passed literally at the 12th hour as Legislative session was ending in 2012.She told the crowd it was too early to tell if some reforms were having an effect, although immediate results were seen in the form of a 30 percent increase in permanent disability indemnity rates for workers phased in over two years and lien reform.
Under SB 863, liens for reasonable medical expenses incurred by or on behalf of the injured employee are subject to a filing fee of $150. For liens filed before Jan. 1, there will be a $100 activation fee which must be paid prior to Jan. 1, 2014, or the lien will be subject to dismissal. The fees were intended to reduce the hundreds of thousands of liens filled each year costing the system hundreds-of-millions of dollars, according to SB 863 backers. However some of those reforms may have pushed people to file liens quicker to get them in on time, while other reforms may have prompted quicker resolution of ongoing workers’ comp disputes to get them out of the way before reforms kick in.
Some believe that activity may be the impetus for the Workers’ Compensation Insurance Rating Bureau decision to pursue a suggested hike in California’s advisory workers’ compensation rates of nearly 7 percent. The filing will propose advisory pure premium rates that average $2.70 per $100 of payroll, 6.9 percent higher than the industry average filed pure premium rate of $2.53 as of July 1. There were also significant front-end costs created by SB 863, which included the increased benefits for injured workers, and the newly created independent medical review and bill review processes. Baker said it’s not clear the reforms prompted WCIRB’s decision. "It may not have anything to do with SB 863," she said. However, she said it’s possible the increased loss experience in workers’ comp may be due to "things getting closed quicker."
Addressing the independent medical review and independent bill review processes - IMR and IBR - Baker said she believes there are already people attempting to find loopholes, or take advantage of any weaknesses in the system. "I’m going to assume there’s some gaming," she said. "There’s a little bit of evidence of that going on right now." However, she didn’t elaborate about what activities are cluing her and her staff into that activity, or just what those activities are. Despite the gaming, Baker said there is evidence the IMR process, which she noted uses "evidence-based" facts to resolve disputes, is working. According to her, 73 percent of IMR applications have been denied. "IMR represents a major paradigm shift for stakeholders in the workers’ comp community," she said ...
The Insurance Journal article says that the annual three-day conference was attended by a broad swath of professionals with interest in workers’ comp, including insurance agents, insurers, attorneys, interpreting services, investigative agencies, medical provider networks and billing services.
The theme of this year’s conference was "Surf’s Up! Navigating the ‘Waves of Change’ in Risk Management." The conference included an expo, several panels and guest speakers. Other keynote speakers included motivational speaker Bethany Hamilton, a professional surfer and shark attack survivor. The conference ends Friday.
Baker was one of a handful of people who hammered out the workers’ comp reform passed literally at the 12th hour as Legislative session was ending in 2012.She told the crowd it was too early to tell if some reforms were having an effect, although immediate results were seen in the form of a 30 percent increase in permanent disability indemnity rates for workers phased in over two years and lien reform.
Under SB 863, liens for reasonable medical expenses incurred by or on behalf of the injured employee are subject to a filing fee of $150. For liens filed before Jan. 1, there will be a $100 activation fee which must be paid prior to Jan. 1, 2014, or the lien will be subject to dismissal. The fees were intended to reduce the hundreds of thousands of liens filled each year costing the system hundreds-of-millions of dollars, according to SB 863 backers. However some of those reforms may have pushed people to file liens quicker to get them in on time, while other reforms may have prompted quicker resolution of ongoing workers’ comp disputes to get them out of the way before reforms kick in.
Some believe that activity may be the impetus for the Workers’ Compensation Insurance Rating Bureau decision to pursue a suggested hike in California’s advisory workers’ compensation rates of nearly 7 percent. The filing will propose advisory pure premium rates that average $2.70 per $100 of payroll, 6.9 percent higher than the industry average filed pure premium rate of $2.53 as of July 1. There were also significant front-end costs created by SB 863, which included the increased benefits for injured workers, and the newly created independent medical review and bill review processes. Baker said it’s not clear the reforms prompted WCIRB’s decision. "It may not have anything to do with SB 863," she said. However, she said it’s possible the increased loss experience in workers’ comp may be due to "things getting closed quicker."
Addressing the independent medical review and independent bill review processes - IMR and IBR - Baker said she believes there are already people attempting to find loopholes, or take advantage of any weaknesses in the system. "I’m going to assume there’s some gaming," she said. "There’s a little bit of evidence of that going on right now." However, she didn’t elaborate about what activities are cluing her and her staff into that activity, or just what those activities are. Despite the gaming, Baker said there is evidence the IMR process, which she noted uses "evidence-based" facts to resolve disputes, is working. According to her, 73 percent of IMR applications have been denied. "IMR represents a major paradigm shift for stakeholders in the workers’ comp community," she said ...
April Williams was employed by The Home Depot. In 2003, she was injured on the job. Williams claimed workers’ compensation benefits and in December 2005, the parties signed a "Stipulation and Award and/or Order" by which The Home Depot agreed to provide "benefits and treatment [to Williams] in accordance with the opinions of the AME, Dr. Abeliuk." Thereafter, Williams received medical treatment, including surgeries;
Williams disagrees that her condition is permanent and stationary, and claims she was "forced" to settle her claim; She made several appeals to the WCAB but the case has not resolved.
She then filed a pro-per request for removal of her case to the superior court,
Williams claimed in her civil action that the WCAB failed to require that she receive prompt and adequate medical treatment; She also claimed the WCAB allowed The Home Depot to hold her in involuntary servitude; Williams asserted that removal of her pending workers’ compensation matter to the superior court was necessary because she is mentally disabled, Her requests to the Department of Industrial Relations for reasonable accommodation under the Americans with Disabilities Act were not granted, and hence she claims her due process and civil rights have been violated;
Following a hearing, the trial court denied the request for removal, concluding that it has no jurisdiction over the matter. Williams appealed. The Court of Appeal sustained the dismissal in the unpublished case of Williams v. Home Depo.
The Court of Appeal concluded that the "trial court correctly ruled that it lacked jurisdiction to remove the workers’ compensation matter to the superior court."
Labor Code 5955 provides, "No court of this state, except the Supreme Court and the courts of appeal to the extent herein specified, has jurisdiction to review, reverse, correct, or annul any order, rule, decision, or award of the [WCAB], or to suspend or delay the operation or execution thereof, or to restrain, enjoin, or interfere with the appeals board in the performance of its duties," and gives the appellate courts the power to issue a writ of mandate "in all proper cases." ...
Williams disagrees that her condition is permanent and stationary, and claims she was "forced" to settle her claim; She made several appeals to the WCAB but the case has not resolved.
She then filed a pro-per request for removal of her case to the superior court,
Williams claimed in her civil action that the WCAB failed to require that she receive prompt and adequate medical treatment; She also claimed the WCAB allowed The Home Depot to hold her in involuntary servitude; Williams asserted that removal of her pending workers’ compensation matter to the superior court was necessary because she is mentally disabled, Her requests to the Department of Industrial Relations for reasonable accommodation under the Americans with Disabilities Act were not granted, and hence she claims her due process and civil rights have been violated;
Following a hearing, the trial court denied the request for removal, concluding that it has no jurisdiction over the matter. Williams appealed. The Court of Appeal sustained the dismissal in the unpublished case of Williams v. Home Depo.
The Court of Appeal concluded that the "trial court correctly ruled that it lacked jurisdiction to remove the workers’ compensation matter to the superior court."
Labor Code 5955 provides, "No court of this state, except the Supreme Court and the courts of appeal to the extent herein specified, has jurisdiction to review, reverse, correct, or annul any order, rule, decision, or award of the [WCAB], or to suspend or delay the operation or execution thereof, or to restrain, enjoin, or interfere with the appeals board in the performance of its duties," and gives the appellate courts the power to issue a writ of mandate "in all proper cases." ...
The Los Angeles Times reports that California's health insurance exchange vastly overstated the number of online hits it received Tuesday during the rollout of Obamacare. State officials said the Covered California website got 645,000 hits during the first day of enrollment, far fewer than the 5 million it reported Tuesday. The state exchange had cited the 5 million figure as a sign of strong consumer interest and a major reason people had so much difficulty using its $313-million online enrollment system.
Dana Howard, a spokesman for Covered California, said the error was the result of internal miscommunication. "Someone misspoke and thought it was indeed 5 million hits. That was incorrect," he said. Howard said the revised Web traffic still represents a huge response. He said the number of unique online visitors Tuesday was 514,000 and the state received 19,000 calls.
Meantime, Californians were still running into computer problems and long hold times during the second day of enrollment under the federal healthcare law.
Those glitches have prompted Covered California to shut down its online enrollment system twice. First, the state took it down from 9 p.m. Tuesday until 7 a.m. Wednesday to make technical fixes. Then Covered California took enrollment offline for two hours Wednesday morning because information on health plans wasn't loading properly, according to the state. People calling for information continued to face wait times of 30 minutes or more. Some call-center representatives at the exchange told people they were having trouble accessing the state system themselves, further slowing down the enrollment process.
State officials say they are taking steps to remedy these service issues. California has about 300 people answering calls now, and it plans to add an additional 150 employees next month at a call center opening in Fresno.
Other states have similar woes. Louisiana’s top health-insurance provider said that not a single person enrolled in a new health-care plan offered through the Affordable Care Act on its first day. An executive with Blue Cross Blue Shield of Louisiana told the Times-Picayune that the agency was unable to sell the plan because customers were unable to access the HealthCare.gov website due to its website’s sluggishness. "It was not as intense as we had anticipated," the company’s vice president of communication said of the company’s sales.
WSMV, a Tennessee television station was unable to find a single person who had signed up. "We're hearing not a single person locally has been successful getting through to the new health insurance exchange," said a local reporter. "It seems to be a problem especially in states like Tennessee, where the state opted out and left it up to the federal government to run what is essentially an online shopping site." ...
Dana Howard, a spokesman for Covered California, said the error was the result of internal miscommunication. "Someone misspoke and thought it was indeed 5 million hits. That was incorrect," he said. Howard said the revised Web traffic still represents a huge response. He said the number of unique online visitors Tuesday was 514,000 and the state received 19,000 calls.
Meantime, Californians were still running into computer problems and long hold times during the second day of enrollment under the federal healthcare law.
Those glitches have prompted Covered California to shut down its online enrollment system twice. First, the state took it down from 9 p.m. Tuesday until 7 a.m. Wednesday to make technical fixes. Then Covered California took enrollment offline for two hours Wednesday morning because information on health plans wasn't loading properly, according to the state. People calling for information continued to face wait times of 30 minutes or more. Some call-center representatives at the exchange told people they were having trouble accessing the state system themselves, further slowing down the enrollment process.
State officials say they are taking steps to remedy these service issues. California has about 300 people answering calls now, and it plans to add an additional 150 employees next month at a call center opening in Fresno.
Other states have similar woes. Louisiana’s top health-insurance provider said that not a single person enrolled in a new health-care plan offered through the Affordable Care Act on its first day. An executive with Blue Cross Blue Shield of Louisiana told the Times-Picayune that the agency was unable to sell the plan because customers were unable to access the HealthCare.gov website due to its website’s sluggishness. "It was not as intense as we had anticipated," the company’s vice president of communication said of the company’s sales.
WSMV, a Tennessee television station was unable to find a single person who had signed up. "We're hearing not a single person locally has been successful getting through to the new health insurance exchange," said a local reporter. "It seems to be a problem especially in states like Tennessee, where the state opted out and left it up to the federal government to run what is essentially an online shopping site." ...
The Division of Workers’ Compensation will begin using a resource-based relative value scale (RBRVS) based physician fee schedule in 2014. On September 24, the OAL filed the Physician Fee Schedule with the Secretary of State which will be published in the California Code of Regulations. The adopted Physician Fee Schedule regulations are effective January 1, 2014, and will be applicable for services rendered on or after January 1.
"These regulations will provide a more responsive framework for appropriate medical care and returning injured employees to work," said Christine Baker, the director of the Department of Industrial Relations.
"Adopting a payment schedule based on the RBRVS will increase fairness in reimbursement across the spectrum of medical services, help to reduce disputes regarding the reasonable value of medical services, and improve injured workers’ access to the most needed medical services," said Dr. Rupali Das, Executive Medical Director of DWC.
In the RBRVS-based system, relative value units interact with payment ground rules and the conversion factor to determine the maximum fee in light of the resources to provide the service. Senate Bill 863 directs DWC’s administrative director to adopt a physician fee schedule based upon the federal RBRVS used in the Medicare payment system.
The Physician Fee Schedule will be updated before January 1, 2014, by Administrative Director Order, in accordance with Labor Code §5307.1(g)(2), to reflect 2014 changes in procedure codes, relative weights, and the adjustment factors in subdivision (g) (the Medicare Economic Index and any relative value scale adjustment factor), to be applicable for services rendered on or after January 1, 2014. The Administrative Director Order will be issued as soon as possible after CMS adopts the 2014 Medicare Physician Fee Schedule final rule. CMS usually publishes the Physician Fee Schedule final rule approximately the first of November.
This RBRVS based Physician Fee Schedule will be applicable for services rendered on or after January 1, 2014, instead of the earlier OMFS physician fee schedule. The earlier OMFS physician fee schedule has not been updated with new codes and relative value units since 1999. This newly adopted physician fee schedule uses current procedure codes and relative values, and provides a mechanism for annual updates to reflect changes in coding, practice patterns, and inflation ...
"These regulations will provide a more responsive framework for appropriate medical care and returning injured employees to work," said Christine Baker, the director of the Department of Industrial Relations.
"Adopting a payment schedule based on the RBRVS will increase fairness in reimbursement across the spectrum of medical services, help to reduce disputes regarding the reasonable value of medical services, and improve injured workers’ access to the most needed medical services," said Dr. Rupali Das, Executive Medical Director of DWC.
In the RBRVS-based system, relative value units interact with payment ground rules and the conversion factor to determine the maximum fee in light of the resources to provide the service. Senate Bill 863 directs DWC’s administrative director to adopt a physician fee schedule based upon the federal RBRVS used in the Medicare payment system.
The Physician Fee Schedule will be updated before January 1, 2014, by Administrative Director Order, in accordance with Labor Code §5307.1(g)(2), to reflect 2014 changes in procedure codes, relative weights, and the adjustment factors in subdivision (g) (the Medicare Economic Index and any relative value scale adjustment factor), to be applicable for services rendered on or after January 1, 2014. The Administrative Director Order will be issued as soon as possible after CMS adopts the 2014 Medicare Physician Fee Schedule final rule. CMS usually publishes the Physician Fee Schedule final rule approximately the first of November.
This RBRVS based Physician Fee Schedule will be applicable for services rendered on or after January 1, 2014, instead of the earlier OMFS physician fee schedule. The earlier OMFS physician fee schedule has not been updated with new codes and relative value units since 1999. This newly adopted physician fee schedule uses current procedure codes and relative values, and provides a mechanism for annual updates to reflect changes in coding, practice patterns, and inflation ...
As tech launches go, Obamacare has been pretty bumpy, if not a downright Fail Whale-style debacle according to a report in Bloomberg Businessweek. The federally run website was unresponsive for much of Tuesday morning, and only four of 15 exchange websites being run by states and the District of Columbia were working from 9:30 a.m. to 10:30 a.m. In the days before the launch, meanwhile, insurers complained about errors in the premiums that shoppers would see online and certain functions had to be delayed because the software that determined eligibility remained a work-in-progress.
"Like every new law, there will be glitches we'll fix," President Obama said during a Rose Garden speech. "This morning the [federal] site has been running more slowly than it normally will. The reason is more than one million people visited healthcare.gov before 7 this morning. There were five times more users this morning than had ever been on healthcare.gov at one time."
The San Jose Mercury News reported that the widely anticipated rollout of California's online health insurance exchange witnessed sluggish access and spotty problems Tuesday, but that didn't stop state officials from labeling it "a historic day'' that will begin to allow millions of Californians to access quality health care for the first time. For many, the array of plans and prices offered under Obamacare proved to be a welcome surprise, but others experienced sticker shock from significantly higher costs.
On the first day of a six-month open enrollment period, the California website received one million page views in the first hour, followed by 800,000 page views every hour after, according to Covered California staff. The computer system that was designed to accommodate 2,000 concurrent users was getting 3,000, officials said, while the exchange's two operative call centers in the state received nearly 9,000 calls by noon. But there were problems. Users reported "horrendously slow'' response times, with Web pages sometimes never loading. Some of the problems mimicked those around the country, where a combination of high demand and technical glitches seemed to overwhelm other online systems early in the day. But California's exchange didn't crash.
Covered California officials estimate that during the initial open-enrollment period, which ends March 31, they will enroll 500,000 to 700,000 Californians who are eligible for subsidies to make their care more affordable.
New York officials said roughly two million people had visited their state-run site by mid-afternoon.
However, Washington state residents going to their state-run exchange were greeted with the words "Connection Refused." Officials said the problems impacted only some visitors, but the site appeared down into Tuesday evening.
In Oregon, which has one of the country’s 16 state-based exchanges, ;glitches also materialized.Visitors were told: "Online enrollment is coming soon! Sign up to receive an email notification when it's available." Officials had warned earlier this week visitors would need an insurance agent or another third party to sign up in the first several weeks ...
"Like every new law, there will be glitches we'll fix," President Obama said during a Rose Garden speech. "This morning the [federal] site has been running more slowly than it normally will. The reason is more than one million people visited healthcare.gov before 7 this morning. There were five times more users this morning than had ever been on healthcare.gov at one time."
The San Jose Mercury News reported that the widely anticipated rollout of California's online health insurance exchange witnessed sluggish access and spotty problems Tuesday, but that didn't stop state officials from labeling it "a historic day'' that will begin to allow millions of Californians to access quality health care for the first time. For many, the array of plans and prices offered under Obamacare proved to be a welcome surprise, but others experienced sticker shock from significantly higher costs.
On the first day of a six-month open enrollment period, the California website received one million page views in the first hour, followed by 800,000 page views every hour after, according to Covered California staff. The computer system that was designed to accommodate 2,000 concurrent users was getting 3,000, officials said, while the exchange's two operative call centers in the state received nearly 9,000 calls by noon. But there were problems. Users reported "horrendously slow'' response times, with Web pages sometimes never loading. Some of the problems mimicked those around the country, where a combination of high demand and technical glitches seemed to overwhelm other online systems early in the day. But California's exchange didn't crash.
Covered California officials estimate that during the initial open-enrollment period, which ends March 31, they will enroll 500,000 to 700,000 Californians who are eligible for subsidies to make their care more affordable.
New York officials said roughly two million people had visited their state-run site by mid-afternoon.
However, Washington state residents going to their state-run exchange were greeted with the words "Connection Refused." Officials said the problems impacted only some visitors, but the site appeared down into Tuesday evening.
In Oregon, which has one of the country’s 16 state-based exchanges, ;glitches also materialized.Visitors were told: "Online enrollment is coming soon! Sign up to receive an email notification when it's available." Officials had warned earlier this week visitors would need an insurance agent or another third party to sign up in the first several weeks ...
The California Applicants’ Attorneys Association (CAAA) announced that it has installed a new president and team of officers for the coming year. Incoming CAAA President Jim Butler of ButlerViadro, a Bay Area firm specializing in fighting for the rights of California’s injured workers, said his priorities would include "bringing out-of-control Utilization Review (UR) to heel, building strategic alliances with like-minded organizations to address workplace injuries, improving CAAA’s communication with our members and the outside world, and strengthening the rules of professional conduct as applicable to workers’ compensation advocates. CAAA is urging stronger standards for all parties to the workers’ compensation system, and strengthening penalties for unreasonable delay and denial of recommended medical treatment and approved disability compensation."
Mr. Butler was born in Compton, California, the son of an attorney who represented plaintiffs in pharmaceutical malpractice and product liability cases. He lived in Central America for several years, and is fluent in Spanish.
Mr. Butler earned his law degree at the University of San Francisco. While in law school, he received awards for best brief and oral argument for the school’s Moot Court Competition. He has also received the American Jurisprudence Award in Professional Responsibility. He graduated with a Bachelor of Arts in rhetoric from the University of California at Berkeley. Butler is the author of the Injured Worker Survival Guide (1987 - 1995).
"CAAA has built a powerful digital platform over the past three years, and we will focus its power on improving our internal and external communications, and to distribute our education programs. As the premier workers’ compensation education provider, we want to make our expertise available to all interested parties to improve the treatment of injured workers," said Butler. "We invite visitors to caaa.org, and we will be making some of our programs available there for free; For example, right now the public will find a free podcast on Independent Medical Review."
CAAA’s leaders for 2013-2014 also include Larry Stern of Mallery and Stern as Legislative Chair, Bernardo De La Torre of the Law Office of Bernardo De La Torre, Bert Arnold of Boxer and Gerson as Treasurer and, Christel Schoenfelder of Rose, Klein and Marias as Secretary ...
Mr. Butler was born in Compton, California, the son of an attorney who represented plaintiffs in pharmaceutical malpractice and product liability cases. He lived in Central America for several years, and is fluent in Spanish.
Mr. Butler earned his law degree at the University of San Francisco. While in law school, he received awards for best brief and oral argument for the school’s Moot Court Competition. He has also received the American Jurisprudence Award in Professional Responsibility. He graduated with a Bachelor of Arts in rhetoric from the University of California at Berkeley. Butler is the author of the Injured Worker Survival Guide (1987 - 1995).
"CAAA has built a powerful digital platform over the past three years, and we will focus its power on improving our internal and external communications, and to distribute our education programs. As the premier workers’ compensation education provider, we want to make our expertise available to all interested parties to improve the treatment of injured workers," said Butler. "We invite visitors to caaa.org, and we will be making some of our programs available there for free; For example, right now the public will find a free podcast on Independent Medical Review."
CAAA’s leaders for 2013-2014 also include Larry Stern of Mallery and Stern as Legislative Chair, Bernardo De La Torre of the Law Office of Bernardo De La Torre, Bert Arnold of Boxer and Gerson as Treasurer and, Christel Schoenfelder of Rose, Klein and Marias as Secretary ...
The Division of Workers’ Compensation (DWC) has posted a 15-day notice of modification to the proposed utilization review (UR) and independent medical review (IMR) regulations to the DWC website. Members of the public are invited to present written comments regarding the proposed modifications to dwcrules@dir.ca.gov until 5 p.m. on October 11. The number of proposed changes are extensive. The following are some examples.
The new proposed rules set forth a revised Request for Authorization form (DWC Form RFA), emphasizing that it must be signed by the employee’s treating physician. There is a statement on the DWC Form RFA that it is not a separately reimbursable report under the Official Medical Fee Schedule.
One of the proposed changes that may be of concern to claim administrators is Section 9792.9.1(c)(2), Under this proposed language, a non-conforming request for authorization (i.e., an incomplete Form RFA or request that does not use the form) must be returned to the requesting physician within three business days or else be considered as complete and subject to all applicable timeframes and requirements. This provisions would seem to place a substantial burden on claim administrators. It would seem that a Request for Authorization buried in any document forwarded by a treating physician would have to be identified (by reading carefully every single word in the document) and then this obscure language would rise to the level of an official Request for Authorization unless the administrator objected in three days. It is difficult to see how a claim department could meet this burden.
Section 9792.10.4 of the proposed changes allow the independent review organization delegated the responsibility by the Administrative Director to conduct independent medical review pursuant to Labor Code section 139.5 (IMRO) may consolidate two or more eligible applications for independent medical review by a single employee for resolution in a single determination if the applications involve the same requesting physician and the same date of injury.
The new proposed regulations implement new procedures to impose sanctions. Section 9792.10.6(j) provides that upon receipt of credible information that the claims administrator has failed to has failed to comply with its obligations under the independent medical review requirements the Administrative Director shall, concurrent or subsequent to the issuance of the final determination issued by the independent review organization, issue an order to show cause for the assessment of administrative penalties against the claims administrator under new section 9792.12(c). Section Section 9792.10.7 provides that upon receipt of credible information that the claims administrator has failed to implement the final determination, the Administrative Director shall issue an order to show cause for the assessment of administrative penalties against the claims administrator under new section 9792.12(c).
Section 9792.12(c) is a new subdivision to provide for Independent Medical Review Administrative Penalties. The subdivision lists specific violations and the amount to be assessed as an administrative penalty for each.
The notice, text of the regulations, and forms can be found on the proposed regulations page ...
The new proposed rules set forth a revised Request for Authorization form (DWC Form RFA), emphasizing that it must be signed by the employee’s treating physician. There is a statement on the DWC Form RFA that it is not a separately reimbursable report under the Official Medical Fee Schedule.
One of the proposed changes that may be of concern to claim administrators is Section 9792.9.1(c)(2), Under this proposed language, a non-conforming request for authorization (i.e., an incomplete Form RFA or request that does not use the form) must be returned to the requesting physician within three business days or else be considered as complete and subject to all applicable timeframes and requirements. This provisions would seem to place a substantial burden on claim administrators. It would seem that a Request for Authorization buried in any document forwarded by a treating physician would have to be identified (by reading carefully every single word in the document) and then this obscure language would rise to the level of an official Request for Authorization unless the administrator objected in three days. It is difficult to see how a claim department could meet this burden.
Section 9792.10.4 of the proposed changes allow the independent review organization delegated the responsibility by the Administrative Director to conduct independent medical review pursuant to Labor Code section 139.5 (IMRO) may consolidate two or more eligible applications for independent medical review by a single employee for resolution in a single determination if the applications involve the same requesting physician and the same date of injury.
The new proposed regulations implement new procedures to impose sanctions. Section 9792.10.6(j) provides that upon receipt of credible information that the claims administrator has failed to has failed to comply with its obligations under the independent medical review requirements the Administrative Director shall, concurrent or subsequent to the issuance of the final determination issued by the independent review organization, issue an order to show cause for the assessment of administrative penalties against the claims administrator under new section 9792.12(c). Section Section 9792.10.7 provides that upon receipt of credible information that the claims administrator has failed to implement the final determination, the Administrative Director shall issue an order to show cause for the assessment of administrative penalties against the claims administrator under new section 9792.12(c).
Section 9792.12(c) is a new subdivision to provide for Independent Medical Review Administrative Penalties. The subdivision lists specific violations and the amount to be assessed as an administrative penalty for each.
The notice, text of the regulations, and forms can be found on the proposed regulations page ...
Private insurance companies across the U.S. pay doctors dramatically different amounts for the same routine office visits and services, according to a new study reported by Reuters Health. Physicians at the high end of the reimbursement spectrum get more than twice as much as those at the low end for the same service, with little apparent reason for the difference, researchers say.
"We figured that if we looked at fairly similar office services across clinics, the amount received by doctors might not vary much," said Laurence Baker, co-author of the study and chief of health services research at Stanford University in California. "But that was not true."
In the push to contain healthcare costs, focusing on how much care patients use won't solve the problem unless the market forces determining what doctors charge and what insurers pay are better understood, Baker and his colleagues write in the journal Health Affairs. Unlike other health care cost studies, theirs looks at actual reimbursement amounts to physicians, and not the amount billed.
The researchers analyzed more than 40 million claims filed in 2007 for nearly a dozen types of service ranging from five-minute check-ups to comprehensive exams. The most common claim filed was for a "problem-focused" exam lasting about 15 minutes with a patient the physician already knew. The lowest-paid 5 percent of doctors received $47 or less for the visit while the highest-paid 5 percent received $86 or more. The average reimbursement amount was $63. For more complex, yet identical, office visits lasting longer and involving a new patient, the reimbursements ranged from $103 or less to $257 or more.
The price differences couldn't be explained by the patients' age or sex, the physicians' specialty, the patients' insurance plan type - preferred provider organizations (PPO) or point of service (POS) - or whether the physician was in the plan's network. Geographic location accounted for some of the price variation, but only about one-third of it. Even with location taken into account, researchers could not pinpoint differences among specific cities because Truven Health Analytics, the company that provided the data, did not allow precise location information to be published in the study. "The point is that (there is) very little that can explain these price differences, no matter what information you put into the model," Dr. Renee Hsia, professor of emergency medicine at the University of California at San Francisco, told Reuters Health. "There is not much rhyme or reason as to why the prices are what they are," Hsia, who was not involved in the research, said.
Baker suggested that some variables, such as the quality of service provided by physicians, or the market power of insurance companies, could influence payments, but these were not analyzed in the study. "The take-away message is to get a quote before you go to the doctor's office and consider shopping around," said Chapin White, a senior health researcher at Center for Studying Health System Change in Washington, D.C.
Comparison shopping on cost isn't easy for consumers, however, because the information is not readily available. Companies trying to bring price information to the public include the San Francisco-based startup Castlight and FAIR Health in New York City. "We think it is important to push future analyses further to include information we were not able to look at here," Baker told Reuters Health. For example, the team did not know the size of the physicians' practices. Larger practices may be able to command higher reimbursements, he said ...
"We figured that if we looked at fairly similar office services across clinics, the amount received by doctors might not vary much," said Laurence Baker, co-author of the study and chief of health services research at Stanford University in California. "But that was not true."
In the push to contain healthcare costs, focusing on how much care patients use won't solve the problem unless the market forces determining what doctors charge and what insurers pay are better understood, Baker and his colleagues write in the journal Health Affairs. Unlike other health care cost studies, theirs looks at actual reimbursement amounts to physicians, and not the amount billed.
The researchers analyzed more than 40 million claims filed in 2007 for nearly a dozen types of service ranging from five-minute check-ups to comprehensive exams. The most common claim filed was for a "problem-focused" exam lasting about 15 minutes with a patient the physician already knew. The lowest-paid 5 percent of doctors received $47 or less for the visit while the highest-paid 5 percent received $86 or more. The average reimbursement amount was $63. For more complex, yet identical, office visits lasting longer and involving a new patient, the reimbursements ranged from $103 or less to $257 or more.
The price differences couldn't be explained by the patients' age or sex, the physicians' specialty, the patients' insurance plan type - preferred provider organizations (PPO) or point of service (POS) - or whether the physician was in the plan's network. Geographic location accounted for some of the price variation, but only about one-third of it. Even with location taken into account, researchers could not pinpoint differences among specific cities because Truven Health Analytics, the company that provided the data, did not allow precise location information to be published in the study. "The point is that (there is) very little that can explain these price differences, no matter what information you put into the model," Dr. Renee Hsia, professor of emergency medicine at the University of California at San Francisco, told Reuters Health. "There is not much rhyme or reason as to why the prices are what they are," Hsia, who was not involved in the research, said.
Baker suggested that some variables, such as the quality of service provided by physicians, or the market power of insurance companies, could influence payments, but these were not analyzed in the study. "The take-away message is to get a quote before you go to the doctor's office and consider shopping around," said Chapin White, a senior health researcher at Center for Studying Health System Change in Washington, D.C.
Comparison shopping on cost isn't easy for consumers, however, because the information is not readily available. Companies trying to bring price information to the public include the San Francisco-based startup Castlight and FAIR Health in New York City. "We think it is important to push future analyses further to include information we were not able to look at here," Baker told Reuters Health. For example, the team did not know the size of the physicians' practices. Larger practices may be able to command higher reimbursements, he said ...
A new study reported in SC Magazine says that as the number of individuals impacted by medical identity theft continues to climb, so does the number of victims fooled by spurious emails and websites designed to purloin their sensitive information.
According to the "2013 Survey on Medical Identity Theft," the number of people who've fallen victim to this type of fraud has increased by 19 percent since last year, accounting for more than 1.8 million victims in 2013. More than 300,000 new medical identity theft cases cropped up during the one-year period, the study found. The survey was conducted by the Ponemon Institute and sponsored by the Medical Identity Fraud Alliance (MIFA) and data breach prevention firm ID Experts.
The study, in its fourth year, surveyed nearly 800 adults in the U.S. who self-reported that they, or their close family members, were victims of medical identity theft. Along with the rise in medical identity fraud, experts also saw a significant uptick in dubious websites being erected by saboteurs and spam emails being sent - all with the intent of tricking individuals into giving up their medical information.
Between 2012 and 2013, the percentage of medical identity theft victims reporting spoofed websites and phishing emails as the likely cause of their troubles doubled. This year, eight percent of respondents cited the cyber schemes as the cause of their issues, while only four percent of victims reported the same in 2012.
In the report, medical identity theft was defined as a person using an individual's name or personal identity "to fraudulently receive medical service, prescription drugs and goods, including attempts to commit fraudulent billing."
Larry Ponemon, chairman and founder of the Ponemon Institute, told SCMagazine.com earlier this week that in this study, and in other Ponemon studies, the frequency of spear phishing targeting medical identity theft victims has gone up. Furthermore, spear phishing, attempts to infiltrate an individual's network or steal their data by crafting a targeted ruse they are likely to open via email, is likely under-reported among medical identity theft victims, Ponemon added.
"A lot of people aren't even aware that they have fallen for a phishing scam because they were so sophisticated," he said. "The ability to record it is difficult because people aren't even aware that it's happened to them."
In the study, the groups also found that seven percent of medical identity theft victims believed a data breach suffered by their health care provider, insurer or related organizations, was the cause of fraud. Last year, six percent of respondents cited those reasons as the cause ...
According to the "2013 Survey on Medical Identity Theft," the number of people who've fallen victim to this type of fraud has increased by 19 percent since last year, accounting for more than 1.8 million victims in 2013. More than 300,000 new medical identity theft cases cropped up during the one-year period, the study found. The survey was conducted by the Ponemon Institute and sponsored by the Medical Identity Fraud Alliance (MIFA) and data breach prevention firm ID Experts.
The study, in its fourth year, surveyed nearly 800 adults in the U.S. who self-reported that they, or their close family members, were victims of medical identity theft. Along with the rise in medical identity fraud, experts also saw a significant uptick in dubious websites being erected by saboteurs and spam emails being sent - all with the intent of tricking individuals into giving up their medical information.
Between 2012 and 2013, the percentage of medical identity theft victims reporting spoofed websites and phishing emails as the likely cause of their troubles doubled. This year, eight percent of respondents cited the cyber schemes as the cause of their issues, while only four percent of victims reported the same in 2012.
In the report, medical identity theft was defined as a person using an individual's name or personal identity "to fraudulently receive medical service, prescription drugs and goods, including attempts to commit fraudulent billing."
Larry Ponemon, chairman and founder of the Ponemon Institute, told SCMagazine.com earlier this week that in this study, and in other Ponemon studies, the frequency of spear phishing targeting medical identity theft victims has gone up. Furthermore, spear phishing, attempts to infiltrate an individual's network or steal their data by crafting a targeted ruse they are likely to open via email, is likely under-reported among medical identity theft victims, Ponemon added.
"A lot of people aren't even aware that they have fallen for a phishing scam because they were so sophisticated," he said. "The ability to record it is difficult because people aren't even aware that it's happened to them."
In the study, the groups also found that seven percent of medical identity theft victims believed a data breach suffered by their health care provider, insurer or related organizations, was the cause of fraud. Last year, six percent of respondents cited those reasons as the cause ...
House of Representatives and Senate committees have agreed on legislation that would give the Food and Drug Administration greater authority to regulate companies that compound sterile drugs and ship them across state lines. The legislation would also create a national set of standards to track pharmaceuticals through the distribution chain to help thwart the introduction of fake medication into the drug supply.
Reuters Health reports that the bill, called the Drug Quality and Security Act, comes in response to a deadly outbreak last year of fungal meningitis that killed more than 50 people and was traced to a tainted steroid sold by the New England Compounding Center in Framingham, Massachusetts.
The legislation is expect to pass smoothly and quickly through the full House and Senate.
Traditionally, pharmacists who compound medication mix tailored doses for individual patients in response to specific prescriptions. Over the last decade the practice has mushroomed, with some pharmacies selling thousands of doses of regularly used mixtures without prescriptions for physicians to keep for future use. The legislation would draw a distinction between traditional compounding pharmacies and those such as NECC which ship sterile products across state lines. These larger organizations, to be known as "outsourcing facilities," would be regulated by the FDA but be exempt from the full spectrum of regulations that apply to traditional pharmaceutical companies. Traditional compounding pharmacies would continue to be regulated by state boards of pharmacy.
Previous attempts to create national standards to track and trace drugs have foundered amid complaints from companies that they would be too costly to implement. But concerns over counterfeit drugs have been growing. Last year, fake vials of Roche Holding AG's cancer drug Avastin appeared in the United States from Britain where it was purchased from a Turkish wholesaler.
The World Health Organization estimates that less than 1 percent of medicines available in the developed world are likely to be counterfeit. Globally, that number is around 10 percent.
In the United States, dozens of states have some type of regulation designed to track a drug's pedigree, but the rules are inconsistent. The bill is designed to resolve the current patchwork of federal regulation by applying a uniform standard nationwide ...
Reuters Health reports that the bill, called the Drug Quality and Security Act, comes in response to a deadly outbreak last year of fungal meningitis that killed more than 50 people and was traced to a tainted steroid sold by the New England Compounding Center in Framingham, Massachusetts.
The legislation is expect to pass smoothly and quickly through the full House and Senate.
Traditionally, pharmacists who compound medication mix tailored doses for individual patients in response to specific prescriptions. Over the last decade the practice has mushroomed, with some pharmacies selling thousands of doses of regularly used mixtures without prescriptions for physicians to keep for future use. The legislation would draw a distinction between traditional compounding pharmacies and those such as NECC which ship sterile products across state lines. These larger organizations, to be known as "outsourcing facilities," would be regulated by the FDA but be exempt from the full spectrum of regulations that apply to traditional pharmaceutical companies. Traditional compounding pharmacies would continue to be regulated by state boards of pharmacy.
Previous attempts to create national standards to track and trace drugs have foundered amid complaints from companies that they would be too costly to implement. But concerns over counterfeit drugs have been growing. Last year, fake vials of Roche Holding AG's cancer drug Avastin appeared in the United States from Britain where it was purchased from a Turkish wholesaler.
The World Health Organization estimates that less than 1 percent of medicines available in the developed world are likely to be counterfeit. Globally, that number is around 10 percent.
In the United States, dozens of states have some type of regulation designed to track a drug's pedigree, but the rules are inconsistent. The bill is designed to resolve the current patchwork of federal regulation by applying a uniform standard nationwide ...
Fred F. Hafezi, M.D. is currently listed on the DWC QME database as a spine specialist with offices in Azusa and Ontario California. The Medical Board of California reflects that he holds Physicians and Surgeons certificate G19337 originally issued in October 1970. The Board records reflect that he is certified in Orthopedic Surgery.
Medical Board records also reflect that on June 25, 2013 the office of the Attorney General of California filed an Accusation against Dr. Hafezi asking that the Board revoke or suspend his Physician and Surgeon's Certificate,
In support of this request, the Accusation alleged that "on April 25, 2013, in the case of The People of the State of California v. Farhad Fred Hafezi, Los Angeles County Superior Court case number KA090841, Respondent (Hafezi) was ordered, as part of his sentence, to register as a sex offender pursuant to the provisions of Penal Code section 290. As a result of his being ordered to register as a sex offender, Respondent's Physician's and Surgeons' Certificate No. 019337 is subject to mandatory revocation pursuant to the provisions of Business and Professions Code Section 2232."
The Accusation continues to allege the circumstances of the criminal prosecution. "Respondent was charged with several counts of oral copulation, contact with a minor with intent to commit a sexual offense, unlawful sexual intercourse with a person under the age of 18, all violations of the Penal Code. On April 1, 2011, Respondent did an "open plea" and pled nolo contendere to all 4 counts. Then on May 26, 2011, Respondent withdrew his plea of guilty. On April 5, 2013, the court denied Respondent's motion to withdraw his guilty plea. As a result of his plea, he now stands convicted of several counts of oral copulation and a count of unlawful sexual intercourse with a person under 18. Respondent was sentenced on May 23, 2013. Imposition of sentence was suspended, and Respondent was placed on formal probation for 36 months, ordered to serve 180 days in the Los Angeles County Jail and required to register as a sex offender pursuant to Penal Code section 290. Respondent is currently out of jail as he was given credit for time served for his county jail sentence."
On August 6, 2013, while being represented in the Matter of the Accusation by the Law Offices of Richard A. Moss, Hafezi and his attorney signed a Stipulation for Restricted Practice. The purpose of the Stipulation was to restrict his Physicians and Surgeons certificate pursuant to Government Code section 11529.
Pursuant to the Stipulation, on August 16, Hafezi was ordered to "cease performing any activity for which a license as a physician is required in the State o! California with the sole and singular exception he may complete reports on patients seen as workers compensation referrals who were referred to him prior to the date of endorsement of this Stipulation by the administrative law judge."
It is further stipulated and agreed that the Stipulation would be posted on the Boards website as a public document. The Stipulation is to remain in effect until completion of the administrative proceedings against him, and the issuance of a final decision of the Medical Board thereon.
A Medical Board "Action Report" dated July 1997 reflects prior discipline for Dr. Hafezi based upon Business and Professions Code §2234(b)(c)(d) "Negligent and incompetent treatment of a patient with a back injury." ...
Medical Board records also reflect that on June 25, 2013 the office of the Attorney General of California filed an Accusation against Dr. Hafezi asking that the Board revoke or suspend his Physician and Surgeon's Certificate,
In support of this request, the Accusation alleged that "on April 25, 2013, in the case of The People of the State of California v. Farhad Fred Hafezi, Los Angeles County Superior Court case number KA090841, Respondent (Hafezi) was ordered, as part of his sentence, to register as a sex offender pursuant to the provisions of Penal Code section 290. As a result of his being ordered to register as a sex offender, Respondent's Physician's and Surgeons' Certificate No. 019337 is subject to mandatory revocation pursuant to the provisions of Business and Professions Code Section 2232."
The Accusation continues to allege the circumstances of the criminal prosecution. "Respondent was charged with several counts of oral copulation, contact with a minor with intent to commit a sexual offense, unlawful sexual intercourse with a person under the age of 18, all violations of the Penal Code. On April 1, 2011, Respondent did an "open plea" and pled nolo contendere to all 4 counts. Then on May 26, 2011, Respondent withdrew his plea of guilty. On April 5, 2013, the court denied Respondent's motion to withdraw his guilty plea. As a result of his plea, he now stands convicted of several counts of oral copulation and a count of unlawful sexual intercourse with a person under 18. Respondent was sentenced on May 23, 2013. Imposition of sentence was suspended, and Respondent was placed on formal probation for 36 months, ordered to serve 180 days in the Los Angeles County Jail and required to register as a sex offender pursuant to Penal Code section 290. Respondent is currently out of jail as he was given credit for time served for his county jail sentence."
On August 6, 2013, while being represented in the Matter of the Accusation by the Law Offices of Richard A. Moss, Hafezi and his attorney signed a Stipulation for Restricted Practice. The purpose of the Stipulation was to restrict his Physicians and Surgeons certificate pursuant to Government Code section 11529.
Pursuant to the Stipulation, on August 16, Hafezi was ordered to "cease performing any activity for which a license as a physician is required in the State o! California with the sole and singular exception he may complete reports on patients seen as workers compensation referrals who were referred to him prior to the date of endorsement of this Stipulation by the administrative law judge."
It is further stipulated and agreed that the Stipulation would be posted on the Boards website as a public document. The Stipulation is to remain in effect until completion of the administrative proceedings against him, and the issuance of a final decision of the Medical Board thereon.
A Medical Board "Action Report" dated July 1997 reflects prior discipline for Dr. Hafezi based upon Business and Professions Code §2234(b)(c)(d) "Negligent and incompetent treatment of a patient with a back injury." ...
Floyd, Skeren and Kelly LLP is pleased to announce its Northern California Annual Employment Law Conference, which will feature keynote speakers Christine Baker, Director of the Department of Industrial Relations and Phyllis W. Cheng, Director of the California Department of Fair Employment and Housing (DFEH).
The conference will be held on November 7, at the South San Francisco Conference Center.
This is an all-day event, designed for employers, managers, claims adjusters, risk managers, attorneys, and any other professionals associated with human resources and employment law. The conference will provide helpful guidance related to numerous workplace topics, including: the new California disability regulations (which impact an employer’s policies on reasonable accommodation, the interactive process and leaves of absence); the new comprehensive pregnancy disability regulations; a workers’ compensation update, focusing in on the latest developments related to SB 863; an overview of important OSHA workplace requirements and procedures; a review of 6 critical steps an employer can take to avoid costly employment related lawsuits; and, an update on the evolving role of social media in the workplace.
Ms. Cheng will discuss the important new disability and pregnancy regulations in effect as of January 2013. The new disability regulations significantly expand the protections for disabled workers and set forth new employer obligations and requirements related to disability discrimination, reasonable accommodation, the interactive process, job descriptions, and medical certifications. The new pregnancy disability regulations greatly expand the protections afforded to employees disabled by pregnancy including new notice requirements and an expanded list of conditions that constitute a pregnancy disability. Ms. Cheng will review key provisions of the new regulations, what is new for employers, the DFEH's enforcement perspective, and employer best practices for ensuring compliance.
Ms. Baker will co-present with David W. O'Brien, Esq., Retired Workers' Compensation Administrative Law Judge. They will provide a workers' compensation update focusing in on the latest developments pertaining to SB 863 and new case law.
Visit www.fskhrtraining.com for more information and online registration ...
The conference will be held on November 7, at the South San Francisco Conference Center.
This is an all-day event, designed for employers, managers, claims adjusters, risk managers, attorneys, and any other professionals associated with human resources and employment law. The conference will provide helpful guidance related to numerous workplace topics, including: the new California disability regulations (which impact an employer’s policies on reasonable accommodation, the interactive process and leaves of absence); the new comprehensive pregnancy disability regulations; a workers’ compensation update, focusing in on the latest developments related to SB 863; an overview of important OSHA workplace requirements and procedures; a review of 6 critical steps an employer can take to avoid costly employment related lawsuits; and, an update on the evolving role of social media in the workplace.
Ms. Cheng will discuss the important new disability and pregnancy regulations in effect as of January 2013. The new disability regulations significantly expand the protections for disabled workers and set forth new employer obligations and requirements related to disability discrimination, reasonable accommodation, the interactive process, job descriptions, and medical certifications. The new pregnancy disability regulations greatly expand the protections afforded to employees disabled by pregnancy including new notice requirements and an expanded list of conditions that constitute a pregnancy disability. Ms. Cheng will review key provisions of the new regulations, what is new for employers, the DFEH's enforcement perspective, and employer best practices for ensuring compliance.
Ms. Baker will co-present with David W. O'Brien, Esq., Retired Workers' Compensation Administrative Law Judge. They will provide a workers' compensation update focusing in on the latest developments pertaining to SB 863 and new case law.
Visit www.fskhrtraining.com for more information and online registration ...
An identity theft service that sells Social Security numbers, birth records, credit and background reports on millions of Americans has infiltrated computers at some of America’s largest consumer and business data aggregators, according to a seven-month investigation by KrebsOnSecurity.
Two of the hacked servers were inside the networks of Atlanta, Ga.-based LexisNexis Inc., a company that maintains the world’s largest electronic database for legal and public-records related information. LexisNexis is also widely used by members of the workers' compensation community for legal research.
Contacted about the findings, LexisNexis confirmed that the two systems listed in the botnet interface were public-facing LexisNexis Web servers that had been compromised.
A tiny unauthorized program called "nbc.exe" was placed on the servers as far back as April 10, 2013, suggesting the intruders have had access to the company’s internal networks for at least the past five months. The program was designed to open an encrypted channel of communications from within LexisNexis’s internal systems to the botnet controller on the public Internet.
An initial analysis of the malicious bot program installed on the hacked servers reveals that it was carefully engineered to avoid detection by antivirus tools. A review of the bot malware in early September using Virustotal.com - which scrutinizes submitted files for signs of malicious behavior by scanning them with antivirus software from nearly four dozen security firms simultaneously - gave it a clean bill of health: none of the 46 top anti-malware tools on the market today detected it as malicious.
All three victim companies said they are working with federal authorities and third-party forensics firms in the early stages of determining how far the breaches extend, and whether indeed any sensitive information was accessed and exfiltrated from their networks.
For its part, LexisNexis confirmed that the compromises appear to have begun in April of this year, but said it found "no evidence that customer or consumer data were reached or retrieved," via the hacked systems. The company indicated that it was still in the process of investigating whether other systems on its network may have been compromised by the intrusion.
"Immediately upon becoming aware of this matter, we contacted the FBI and initiated a comprehensive investigation working with a leading third party forensic investigation firm," said Aurobindo Sundaram, vice president of information assurance and data protection at Reed Elsevier, the parent company of LexisNexis. "In that investigation, we have identified an intrusion targeting our data but to date have found no evidence that customer or consumer data were reached or retrieved. Because this matter is actively being investigated by law enforcement, I can’t provide further information at this time." ...
Two of the hacked servers were inside the networks of Atlanta, Ga.-based LexisNexis Inc., a company that maintains the world’s largest electronic database for legal and public-records related information. LexisNexis is also widely used by members of the workers' compensation community for legal research.
Contacted about the findings, LexisNexis confirmed that the two systems listed in the botnet interface were public-facing LexisNexis Web servers that had been compromised.
A tiny unauthorized program called "nbc.exe" was placed on the servers as far back as April 10, 2013, suggesting the intruders have had access to the company’s internal networks for at least the past five months. The program was designed to open an encrypted channel of communications from within LexisNexis’s internal systems to the botnet controller on the public Internet.
An initial analysis of the malicious bot program installed on the hacked servers reveals that it was carefully engineered to avoid detection by antivirus tools. A review of the bot malware in early September using Virustotal.com - which scrutinizes submitted files for signs of malicious behavior by scanning them with antivirus software from nearly four dozen security firms simultaneously - gave it a clean bill of health: none of the 46 top anti-malware tools on the market today detected it as malicious.
All three victim companies said they are working with federal authorities and third-party forensics firms in the early stages of determining how far the breaches extend, and whether indeed any sensitive information was accessed and exfiltrated from their networks.
For its part, LexisNexis confirmed that the compromises appear to have begun in April of this year, but said it found "no evidence that customer or consumer data were reached or retrieved," via the hacked systems. The company indicated that it was still in the process of investigating whether other systems on its network may have been compromised by the intrusion.
"Immediately upon becoming aware of this matter, we contacted the FBI and initiated a comprehensive investigation working with a leading third party forensic investigation firm," said Aurobindo Sundaram, vice president of information assurance and data protection at Reed Elsevier, the parent company of LexisNexis. "In that investigation, we have identified an intrusion targeting our data but to date have found no evidence that customer or consumer data were reached or retrieved. Because this matter is actively being investigated by law enforcement, I can’t provide further information at this time." ...
