Governor Brown signed SB 623, a new workers' compensation law that will become effective this January.
According to the author, existing regulations were adopted upon the enactment by the voters of Proposition 187 in 1994, and initiative that restricted the rights of undocumented immigrants in a number of ways. Despite the courts' subsequent invalidation of that initiative, the regulations at issue in the bill have remained on the books. California regulations still prohibit an undocumented worker from receiving benefits from both the UEBTF and the SIBTF, as the regulations have not been updated since 1998. As such, these regulations have been out of compliance with state law since 2003. It is unknown, however, if this has resulted in the loss of any benefits for undocumented injured workers.This bill was intended to expressly overrule those regulations.
The California Applicants' Attorneys Association (CAAA) and the California Chamber of Commerce strongly supported SB 623, arguing that SB 623 would clarify current law so that no injured worker is refused benefits from the Uninsured Employers Benefit Trust Fund (UEBTF) and the Subsequent Injuries Benefit Trust Fund (SIBTF) based on their immigration status. CAAA argues that it is time for the out-of-date Division of Workers' Compensation regulations which allowed undocumented workers from being excluded from these benefits. There was no opposition to this bill shown in the legislative record.
The practical effect of this bill is to state unequivocally that the plain reading of the regulations is not the law. This bill declares the intent of the Legislature to override regulations which prevent undocumented workers from accessing benefits from the UEBTF and the SIBTF Thus the bill adds section 3733 to the Labor Code.
Existing federal law provides that a State may provide that an individual who is not lawfully present in the United States is eligible for any State or local public benefit for which such alien would otherwise be ineligible through the enactment of a State law which affirmatively provides for such eligibility. (8 U.S. Code § 1621(d)) ...
According to the author, existing regulations were adopted upon the enactment by the voters of Proposition 187 in 1994, and initiative that restricted the rights of undocumented immigrants in a number of ways. Despite the courts' subsequent invalidation of that initiative, the regulations at issue in the bill have remained on the books. California regulations still prohibit an undocumented worker from receiving benefits from both the UEBTF and the SIBTF, as the regulations have not been updated since 1998. As such, these regulations have been out of compliance with state law since 2003. It is unknown, however, if this has resulted in the loss of any benefits for undocumented injured workers.This bill was intended to expressly overrule those regulations.
The California Applicants' Attorneys Association (CAAA) and the California Chamber of Commerce strongly supported SB 623, arguing that SB 623 would clarify current law so that no injured worker is refused benefits from the Uninsured Employers Benefit Trust Fund (UEBTF) and the Subsequent Injuries Benefit Trust Fund (SIBTF) based on their immigration status. CAAA argues that it is time for the out-of-date Division of Workers' Compensation regulations which allowed undocumented workers from being excluded from these benefits. There was no opposition to this bill shown in the legislative record.
The practical effect of this bill is to state unequivocally that the plain reading of the regulations is not the law. This bill declares the intent of the Legislature to override regulations which prevent undocumented workers from accessing benefits from the UEBTF and the SIBTF Thus the bill adds section 3733 to the Labor Code.
Existing federal law provides that a State may provide that an individual who is not lawfully present in the United States is eligible for any State or local public benefit for which such alien would otherwise be ineligible through the enactment of a State law which affirmatively provides for such eligibility. (8 U.S. Code § 1621(d)) ...
One potentially important step towards the goal of creating safer opioid analgesics has been the development of opioids that are formulated to deter abuse. Abuse-deterrent properties are defined as those properties shown to meaningfully deter abuse, even if they do not fully prevent abuse. The term abuse is defined as the intentional, non-therapeutic use of a drug product or substance, even once, to achieve a desirable psychological or physiological effect. The FDA considers the development of these products a high public health priority.
An example of "abuse-deterrent properties" would be physical barriers that can prevent chewing, crushing, cutting, grating, or grinding of the dosage form. Chemical barriers, such as gelling agents, can resist extraction of the opioid using common solvents like water, simulated biological media, alcohol, or other organic solvents. Physical and chemical barriers can limit drug release following mechanical manipulation, or change the physical form of a drug, rendering it less amenable to abuse. An opioid antagonist can be added to interfere with, reduce, or defeat the euphoria associated with abuse. Substances can be added to the product to produce an unpleasant effect if the dosage form is manipulated or is used at a higher dosage than directed. Certain drug release designs or the method of drug delivery can offer resistance to abuse.
Collegium Pharmaceutical Inc's experimental opioid painkiller Xtampza moved one step closer to approval this month after a panel of outside advisers to the U.S. Food and Drug Administration unanimously voted in favor of the drug. The FDA panel's vote of approval for Xtampza is also a positive for other companies developing abuse-deterrent version of painkillers. Pernix Therapeutics Holdings Inc, Egalet Corp, KemPharm Inc, IntelliPharmaCeutics International Inc, Pain Therapeutics Inc and Acura Pharmaceuticals Inc are among the drugmakers developing abuse-deterrent painkillers.
The FDA has already approved Hysingla, made by Purdue Pharma, which also makes OxyContin. Hysingla is a "pure" hydrocodone drug, unlike Vicodin, which contains a combination of short-acting hydrocodone and acetaminophen.
Earlier this year, the FDA approved Targiniq ER, a painkiller that combines oxycodone and naloxone. The naloxone blocks the euphoric effects of oxycodone, making it less appealing to abuse. Targiniq ER, also made by Purdue Pharma, can be crushed and then snorted or injected. If the pills are crushed, the naloxone becomes active.
The FDA recently approved new labeling for the opioid painkiller Embeda that states the drug has abuse-deterrent features. The label will indicate Embeda has properties expected to reduce abuse of the drug when it is crushed and taken orally or snorted. The drug can still be misused if it is swallowed intact. Embeda contains morphine and naltrexone, and comes in extended-release capsules.
"The science of abuse-deterrent medication is rapidly evolving, and the FDA is eager to engage with manufacturers to help make these medications available to patients who need them," said FDA Commissioner Margaret A. Hamburg, M.D. "We feel this is a key part of combating opioid abuse. We have to work hard with industry to support the development of new formulations that are difficult to abuse but are effective and available when needed." ...
An example of "abuse-deterrent properties" would be physical barriers that can prevent chewing, crushing, cutting, grating, or grinding of the dosage form. Chemical barriers, such as gelling agents, can resist extraction of the opioid using common solvents like water, simulated biological media, alcohol, or other organic solvents. Physical and chemical barriers can limit drug release following mechanical manipulation, or change the physical form of a drug, rendering it less amenable to abuse. An opioid antagonist can be added to interfere with, reduce, or defeat the euphoria associated with abuse. Substances can be added to the product to produce an unpleasant effect if the dosage form is manipulated or is used at a higher dosage than directed. Certain drug release designs or the method of drug delivery can offer resistance to abuse.
Collegium Pharmaceutical Inc's experimental opioid painkiller Xtampza moved one step closer to approval this month after a panel of outside advisers to the U.S. Food and Drug Administration unanimously voted in favor of the drug. The FDA panel's vote of approval for Xtampza is also a positive for other companies developing abuse-deterrent version of painkillers. Pernix Therapeutics Holdings Inc, Egalet Corp, KemPharm Inc, IntelliPharmaCeutics International Inc, Pain Therapeutics Inc and Acura Pharmaceuticals Inc are among the drugmakers developing abuse-deterrent painkillers.
The FDA has already approved Hysingla, made by Purdue Pharma, which also makes OxyContin. Hysingla is a "pure" hydrocodone drug, unlike Vicodin, which contains a combination of short-acting hydrocodone and acetaminophen.
Earlier this year, the FDA approved Targiniq ER, a painkiller that combines oxycodone and naloxone. The naloxone blocks the euphoric effects of oxycodone, making it less appealing to abuse. Targiniq ER, also made by Purdue Pharma, can be crushed and then snorted or injected. If the pills are crushed, the naloxone becomes active.
The FDA recently approved new labeling for the opioid painkiller Embeda that states the drug has abuse-deterrent features. The label will indicate Embeda has properties expected to reduce abuse of the drug when it is crushed and taken orally or snorted. The drug can still be misused if it is swallowed intact. Embeda contains morphine and naltrexone, and comes in extended-release capsules.
"The science of abuse-deterrent medication is rapidly evolving, and the FDA is eager to engage with manufacturers to help make these medications available to patients who need them," said FDA Commissioner Margaret A. Hamburg, M.D. "We feel this is a key part of combating opioid abuse. We have to work hard with industry to support the development of new formulations that are difficult to abuse but are effective and available when needed." ...
The Centers for Medicare and Medicaid Services' and the California DWC scheduled switch next month to a larger set of medical billing codes could ease Medicare secondary payer compliance for workers compensation claims, according to an article in Business Insurance. Starting Oct. 1, medical providers will switch from ICD-9, which includes about 17,000 diagnosis and procedure codes, to ICD-10, which includes more than 155,000 diagnosis and procedure codes. Many ICD-10 codes also specify the types, locations and severity of conditions and injuries.
Experts say the new codes will have the largest impact on workers comp payers who deal with Medicare secondary payer compliance. "The amount of detail it will provide the workers comp community will be amazing compared to what we've been using before," said Rafael Gonzalez, Tampa, Florida-based vice president of strategic solutions at Helios Settlement Solutions, a unit of pharmacy benefit manager Helios.
The Medicare Secondary Payer Act requires insurers and self-insured employers to notify CMS of any workers comp or liability claim settlement involving a Medicare-eligible individual. CMS can issue liens requiring that settlements be used to reimburse the agency for medical care it paid on a claimant's behalf, or that payers set aside money to pay for future medical care related to a compensable injury.
Medicare secondary payer experts say workers comp insurers and self-insured employers often are asked to reimburse Medicare for injuries or illnesses unrelated to a workers comp claim because those conditions are lumped in with the claimant's occupational injury in medical records.
Rita Wilson, CEO of Delray Beach, Fla.-based Medicare secondary payer compliance firm Tower MSA Partners L.L.C., said ICD-10 will be particularly helpful in allowing workers comp insurers and self-insured employers to specify for which injuries they accept responsibility and those that should be paid by Medicare.
"Better accuracy and greater granularity and detail in determining and describing the injury are going to be advantageous for us, the provider community and for the payers," Ms. Wilson said ...
Experts say the new codes will have the largest impact on workers comp payers who deal with Medicare secondary payer compliance. "The amount of detail it will provide the workers comp community will be amazing compared to what we've been using before," said Rafael Gonzalez, Tampa, Florida-based vice president of strategic solutions at Helios Settlement Solutions, a unit of pharmacy benefit manager Helios.
The Medicare Secondary Payer Act requires insurers and self-insured employers to notify CMS of any workers comp or liability claim settlement involving a Medicare-eligible individual. CMS can issue liens requiring that settlements be used to reimburse the agency for medical care it paid on a claimant's behalf, or that payers set aside money to pay for future medical care related to a compensable injury.
Medicare secondary payer experts say workers comp insurers and self-insured employers often are asked to reimburse Medicare for injuries or illnesses unrelated to a workers comp claim because those conditions are lumped in with the claimant's occupational injury in medical records.
Rita Wilson, CEO of Delray Beach, Fla.-based Medicare secondary payer compliance firm Tower MSA Partners L.L.C., said ICD-10 will be particularly helpful in allowing workers comp insurers and self-insured employers to specify for which injuries they accept responsibility and those that should be paid by Medicare.
"Better accuracy and greater granularity and detail in determining and describing the injury are going to be advantageous for us, the provider community and for the payers," Ms. Wilson said ...
A brother and sister have been sentenced after pleading no contest to charges involving workers’ compensation fraud and tax evasion.
The Sacramento County District Attorney’s Office announced that 37 year-old Michael George Mello Jr. pled no contest to felony workers’ compensation insurance fraud and felony tax evasion. His sister, 38-year-old Mary Catherine Rodriguez, pled no contest to misdemeanor tax evasion.
Between July 2010 and July 2013, the defendants made false statements in their worker’s compensation insurance applications and policies by significantly underreporting the number of employees and payroll in their business, Green Valley Landscaping Services. They also failed to take required deductions from their employees’ pay and did not make required contributions to the unemployment insurance fund. In so doing, they cheated their workers’ compensation insurance carriers by $144,672 in premiums and the Employment Development Department (EDD) by $110,462.
Mello was sentenced to 30 days county jail, 5 years formal probation, and ordered to pay $144,672 in restitution to the insurance companies and $110,462 to EDD. Rodriguez was sentenced to 3 years probation, ordered to serve 50 hours of community service, and ordered to pay EDD $110,462 in restitution jointly with her brother.
This case was investigated by the California Department of Insurance’s Fraud Division, the Employment Development Department, and the Department of Industrial Relations ...
The Sacramento County District Attorney’s Office announced that 37 year-old Michael George Mello Jr. pled no contest to felony workers’ compensation insurance fraud and felony tax evasion. His sister, 38-year-old Mary Catherine Rodriguez, pled no contest to misdemeanor tax evasion.
Between July 2010 and July 2013, the defendants made false statements in their worker’s compensation insurance applications and policies by significantly underreporting the number of employees and payroll in their business, Green Valley Landscaping Services. They also failed to take required deductions from their employees’ pay and did not make required contributions to the unemployment insurance fund. In so doing, they cheated their workers’ compensation insurance carriers by $144,672 in premiums and the Employment Development Department (EDD) by $110,462.
Mello was sentenced to 30 days county jail, 5 years formal probation, and ordered to pay $144,672 in restitution to the insurance companies and $110,462 to EDD. Rodriguez was sentenced to 3 years probation, ordered to serve 50 hours of community service, and ordered to pay EDD $110,462 in restitution jointly with her brother.
This case was investigated by the California Department of Insurance’s Fraud Division, the Employment Development Department, and the Department of Industrial Relations ...
The California Senate voted 24-15 to approve a bill (AB 305) that would prohibit medical problems primarily affecting women from being considered pre-existing conditions when calculating workers' compensation benefits. The bill now returns to the Assembly for a final vote.
This bill prohibits apportionment if pregnancy or menopause is contemporaneous with the injured worker's claimed injury. This bill also requires that breast cancer not be less than the comparable impairment rating for prostate cancer. It also prohibits apportionment in cases of psychiatric injury caused by sexual harassment or any of the conditions listed above if the conditions are contemporaneous with the psychiatric injury.
Senate Floor Amendments of 9/3/15 remove "osteoporosis casually related to menopause" from the list of conditions where apportionment is prohibited.
According to state Sen. Marty Block (D-San Diego), the bill is part of an effort to end gender bias in the workplace. Some proponents of the bill have argued that the AMA Guides are not objective, specifically in the area of gender-specific injuries. Specifically, proponents point to the fact that the AMA Guides rate the removal of female breasts at a WPI of 0%, while the removal of a prostate would rate a 16%-20% WPI, arguing that such a rating shows bias against women.
Opponents argue that AB 305 is an attempt to undermine an employer's use of apportionment when determining liability for permanent disability awards. Specifically, opponents note that apportionment is more than a decade old and ensures that employers do not need to pay for non-industrial injuries. Further, opponents point to case law and statute which protects injured workers from abusive apportionment, including apportionment on the basis of gender. Opponents further argue that AB 305 will increase litigation, raise indemnity costs on employers, and increase systemic instability and subjectivity ...
This bill prohibits apportionment if pregnancy or menopause is contemporaneous with the injured worker's claimed injury. This bill also requires that breast cancer not be less than the comparable impairment rating for prostate cancer. It also prohibits apportionment in cases of psychiatric injury caused by sexual harassment or any of the conditions listed above if the conditions are contemporaneous with the psychiatric injury.
Senate Floor Amendments of 9/3/15 remove "osteoporosis casually related to menopause" from the list of conditions where apportionment is prohibited.
According to state Sen. Marty Block (D-San Diego), the bill is part of an effort to end gender bias in the workplace. Some proponents of the bill have argued that the AMA Guides are not objective, specifically in the area of gender-specific injuries. Specifically, proponents point to the fact that the AMA Guides rate the removal of female breasts at a WPI of 0%, while the removal of a prostate would rate a 16%-20% WPI, arguing that such a rating shows bias against women.
Opponents argue that AB 305 is an attempt to undermine an employer's use of apportionment when determining liability for permanent disability awards. Specifically, opponents note that apportionment is more than a decade old and ensures that employers do not need to pay for non-industrial injuries. Further, opponents point to case law and statute which protects injured workers from abusive apportionment, including apportionment on the basis of gender. Opponents further argue that AB 305 will increase litigation, raise indemnity costs on employers, and increase systemic instability and subjectivity ...
The leading U.S. physicians' organization said on Tuesday that two proposed mergers of U.S. health insurers worth tens of billions of dollars could lead to higher prices in 17 states for companies that buy insurance for their workers or people who buy their own insurance. Aetna Inc announced plans to buy smaller rival Humana Inc in early July and Anthem Inc agreed to buy Cigna Corp later that month. Both mergers are being reviewed by the U.S. Department of Justice and state insurance officials.
The American Medical Association study focused on the impact on the commercial fully insured and self insured markets, largely made up of employer-based plans. The health insurers also manage plans for Medicare, Medicaid and other government programs not included in the study.
According to the report in Reuters Health, Anthem and Cigna combined would affect competition in 13 states where they sell individual insurance plans and in all 14 states where Anthem currently operates Blue Cross Blue Shield plans, the AMA's analysis found.
Anthem spokeswoman Kristin Binns said the two companies have limited overlap and the merger would help consumers by allowing the merged company to better manage costs.
An Aetna and Humana merger would raise anti-competitive issues in as many as 14 states overall including Humana's home state of Kentucky, Texas, Georgia, Utah and Florida, the study said. The majority of Humana's business is in Medicare Advantage, which is not part of the study.
An Aetna spokeswoman noted that Humana's focus is on Medicare. "The AMA report focuses on competition in the commercial marketplace, which would not meaningfully change following an Aetna/Humana combination given Humana’s very small commercial business," spokeswoman Cynthia Michener said.
The American Hospital Association has also made public its analysis of the two deals, saying they would diminish competition.
The Department of Justice will take a hard look at the study, said Mark Ryan, of the law firm Mayer Brown and formerly of the department's Antitrust Division ...
The American Medical Association study focused on the impact on the commercial fully insured and self insured markets, largely made up of employer-based plans. The health insurers also manage plans for Medicare, Medicaid and other government programs not included in the study.
According to the report in Reuters Health, Anthem and Cigna combined would affect competition in 13 states where they sell individual insurance plans and in all 14 states where Anthem currently operates Blue Cross Blue Shield plans, the AMA's analysis found.
Anthem spokeswoman Kristin Binns said the two companies have limited overlap and the merger would help consumers by allowing the merged company to better manage costs.
An Aetna and Humana merger would raise anti-competitive issues in as many as 14 states overall including Humana's home state of Kentucky, Texas, Georgia, Utah and Florida, the study said. The majority of Humana's business is in Medicare Advantage, which is not part of the study.
An Aetna spokeswoman noted that Humana's focus is on Medicare. "The AMA report focuses on competition in the commercial marketplace, which would not meaningfully change following an Aetna/Humana combination given Humana’s very small commercial business," spokeswoman Cynthia Michener said.
The American Hospital Association has also made public its analysis of the two deals, saying they would diminish competition.
The Department of Justice will take a hard look at the study, said Mark Ryan, of the law firm Mayer Brown and formerly of the department's Antitrust Division ...
Norman McAtee sustained industrial injury to his neck, back, psyche and other body parts while working for Briggs and Pearson Construction as a carpenter. On March 30, 2011 he received a stipulated award of I 00% disability and future medical treatment.
McAtee had unsuccessful back surgery, and he has chronic pain. A nerve stimulator was not effective. Thus he has used narcotic analgesics for several years and has tried various formulations, including Duragesic patches which are helpful and improve his functioning.
McAtee appealed a December 2, 2014 IMR determination that modified PTP requests for additional Duragesic. The IMR rationale states that "Guidelines go on to recommend discontinuing opioids if there is no documentation of improved function and pain." The rationale further states, "within the documentation available for review, there is no indication that the medication is improving the patient's function or pain (in terms of specific examples of functional improvement and percent reduction in pain or reduce NRS), no documentation regarding side effects, and no discussion regarding aberrant use." The WCJ denied the appeal, but a WCAB panel reversed in the case of McAtee v Briggs and Pearson Construction.
On appeal, McAtee argued it was shown at trial that the December 2, 2014 IMR determination resulted from plainly erroneous or implied findings of fact as described in Labor Code section 4610.6(h)(5). The WCAB agreed. The !MR findings are mistakes of fact as a matter of ordinary knowledge and not a matter that is subject to expert opinion. The PTP "specifically documents applicant's improved function and reduced pain with his use of the Duragesic patches." These indications of improved function,reduced pain with use of the medication, along with documentation concerning potential side effects and aberrant use, show that the contrary !MR findings were mistakes of fact as a matter of ordinary knowledge.
Reconsideration was granted, the decision was reversed, and hereby remanded to the Administrative Director pursuant to Labor Code section 4610.6(i) for Independent Medical Review by a different reviewer ...
McAtee had unsuccessful back surgery, and he has chronic pain. A nerve stimulator was not effective. Thus he has used narcotic analgesics for several years and has tried various formulations, including Duragesic patches which are helpful and improve his functioning.
McAtee appealed a December 2, 2014 IMR determination that modified PTP requests for additional Duragesic. The IMR rationale states that "Guidelines go on to recommend discontinuing opioids if there is no documentation of improved function and pain." The rationale further states, "within the documentation available for review, there is no indication that the medication is improving the patient's function or pain (in terms of specific examples of functional improvement and percent reduction in pain or reduce NRS), no documentation regarding side effects, and no discussion regarding aberrant use." The WCJ denied the appeal, but a WCAB panel reversed in the case of McAtee v Briggs and Pearson Construction.
On appeal, McAtee argued it was shown at trial that the December 2, 2014 IMR determination resulted from plainly erroneous or implied findings of fact as described in Labor Code section 4610.6(h)(5). The WCAB agreed. The !MR findings are mistakes of fact as a matter of ordinary knowledge and not a matter that is subject to expert opinion. The PTP "specifically documents applicant's improved function and reduced pain with his use of the Duragesic patches." These indications of improved function,reduced pain with use of the medication, along with documentation concerning potential side effects and aberrant use, show that the contrary !MR findings were mistakes of fact as a matter of ordinary knowledge.
Reconsideration was granted, the decision was reversed, and hereby remanded to the Administrative Director pursuant to Labor Code section 4610.6(i) for Independent Medical Review by a different reviewer ...
The Bureau of Health Workforce Health Resources and Services Administration (HRSA) - U.S. Department of Health and Human Services Data Warehouse (HDW) serves as the enterprise repository for HRSA’s data and makes that data available to the public. The data warehouse integrates this data with external sources, such as the U.S. Census Bureau, enabling users to gather relevant and meaningful information about health care programs and the populations they serve.
And the current data shows a growing shortage of psychiatrists. As of August 2015, an estimated 3,968 whole or partial counties in the United States, where roughly 44% of the population resides, are designated as Mental Health Professional Shortage Areas (MH-HPSAs) - defined broadly as an area with fewer than one psychiatrist per 30,000 population.
And the problem is likely to get worse. A recent survey by the Association of American Medical Colleges found that 59 percent of psychiatrists are 55 or older, the fourth oldest of 41 medical specialties, signaling that many may soon be retiring or reducing their workload. Charles Ingoglia, a vice president of the National Council for Behavioral Health, helps coordinate a network of 2,300 not-for-profit clinics nationwide that provide mental health services. "I'm not aware of any part of the country where it is easy for our members to find psychiatrists," he said.
Statistics help tell the story. According to the American Medical Association, the total number of physicians in the U.S. increased by 45 percent from 1995 to 2013, while the number of adult and child psychiatrists rose by only 12 percent, from 43,640 to 49,079. During that span, the U.S. population increased by about 37 percent; meanwhile, millions more Americans have become eligible for mental health coverage under the Affordable Care Act.
Dr. Renee Binder, president of the American Psychiatric Association, says the perception of inadequate pay is a factor in discouraging some medical students from choosing psychiatry as a specialty. The latest federal data shows a mean annual wage of $182,700 for psychiatrists, slightly below the mean for general practitioners and 28 percent below that for surgeons.
Some psychiatrists are switching to a cash-only practice out of frustration with what they view as inadequate reimbursement from government and private insurance plans.
Geographically, the distribution of psychiatrists across the U.S. is uneven. California has 370 total designations in 53 geographical areas. 158 practitioners are needed to remove the designations ...
And the current data shows a growing shortage of psychiatrists. As of August 2015, an estimated 3,968 whole or partial counties in the United States, where roughly 44% of the population resides, are designated as Mental Health Professional Shortage Areas (MH-HPSAs) - defined broadly as an area with fewer than one psychiatrist per 30,000 population.
And the problem is likely to get worse. A recent survey by the Association of American Medical Colleges found that 59 percent of psychiatrists are 55 or older, the fourth oldest of 41 medical specialties, signaling that many may soon be retiring or reducing their workload. Charles Ingoglia, a vice president of the National Council for Behavioral Health, helps coordinate a network of 2,300 not-for-profit clinics nationwide that provide mental health services. "I'm not aware of any part of the country where it is easy for our members to find psychiatrists," he said.
Statistics help tell the story. According to the American Medical Association, the total number of physicians in the U.S. increased by 45 percent from 1995 to 2013, while the number of adult and child psychiatrists rose by only 12 percent, from 43,640 to 49,079. During that span, the U.S. population increased by about 37 percent; meanwhile, millions more Americans have become eligible for mental health coverage under the Affordable Care Act.
Dr. Renee Binder, president of the American Psychiatric Association, says the perception of inadequate pay is a factor in discouraging some medical students from choosing psychiatry as a specialty. The latest federal data shows a mean annual wage of $182,700 for psychiatrists, slightly below the mean for general practitioners and 28 percent below that for surgeons.
Some psychiatrists are switching to a cash-only practice out of frustration with what they view as inadequate reimbursement from government and private insurance plans.
Geographically, the distribution of psychiatrists across the U.S. is uneven. California has 370 total designations in 53 geographical areas. 158 practitioners are needed to remove the designations ...
Ride-sharing service Uber has agreed to pay a $77,925 fine to the state of Alaska over unpaid workers' compensation insurance for its drivers. Uber operated in Anchorage for about six months before pulling out of Alaska. In the Aug. 25 settlement, Uber admitted no wrongdoing. The company agreed not to return to Alaska until it is in compliance with state workers' compensation laws.
The state Department of Labor and Workforce Development said it began an investigation into Uber's business practices when the company began offering rides in Anchorage in October 2014. But the investigation never made it to a hearing because Uber pulled out of Alaska in March 2015, facing a judge's order that it operate for free and failed negotiations with the city of Anchorage.
Rhonda Gerharz, the chief investigator for the special investigations unit of the Department of Labor and Workforce Development, said that when Uber was offering rides in Anchorage, the company was operating under the assumption that its drivers were contractors and not employees. The Department of Labor disagreed, but Uber wasn't charged with violating state laws because the company stopped operating in Alaska while the investigation was ongoing -- the matter never got to a formal hearing. "It's just an allegation," Gerharz said. "It’s a settlement agreement because Uber left the state."
Other states, including California, have also ruled that Uber drivers are employees of the company and not contractors.
The workers' compensation insurance issue was just one of many roadblocks the company faced when it tried to start its service in Anchorage. The city went to court to stop Uber from operating because it didn't comply with the city's taxi ordinances -- rules requiring drivers to get city-sanctioned background checks, have video cameras in their cars and have a certain amount of collision and liability insurance.
In October 2014, an Anchorage Superior Court judge ruled Uber could only operate in Anchorage if it continued its initial free ride program. The judge prohibited Uber from charging for rides until it could come to an agreement with the city over the details of its operations. Uber paid its drivers but did not charge its customers in Anchorage for about six months before pulling out of Alaska entirely ...
The state Department of Labor and Workforce Development said it began an investigation into Uber's business practices when the company began offering rides in Anchorage in October 2014. But the investigation never made it to a hearing because Uber pulled out of Alaska in March 2015, facing a judge's order that it operate for free and failed negotiations with the city of Anchorage.
Rhonda Gerharz, the chief investigator for the special investigations unit of the Department of Labor and Workforce Development, said that when Uber was offering rides in Anchorage, the company was operating under the assumption that its drivers were contractors and not employees. The Department of Labor disagreed, but Uber wasn't charged with violating state laws because the company stopped operating in Alaska while the investigation was ongoing -- the matter never got to a formal hearing. "It's just an allegation," Gerharz said. "It’s a settlement agreement because Uber left the state."
Other states, including California, have also ruled that Uber drivers are employees of the company and not contractors.
The workers' compensation insurance issue was just one of many roadblocks the company faced when it tried to start its service in Anchorage. The city went to court to stop Uber from operating because it didn't comply with the city's taxi ordinances -- rules requiring drivers to get city-sanctioned background checks, have video cameras in their cars and have a certain amount of collision and liability insurance.
In October 2014, an Anchorage Superior Court judge ruled Uber could only operate in Anchorage if it continued its initial free ride program. The judge prohibited Uber from charging for rides until it could come to an agreement with the city over the details of its operations. Uber paid its drivers but did not charge its customers in Anchorage for about six months before pulling out of Alaska entirely ...
Former Miss Toyota Grand Prix beauty contestant busted for workers' compensation fraud in 2014 has been convicted and sentenced. Shawna Lynn Palmer, of Riverside, pleaded guilty to one misdemeanor count of workers' compensation fraud and was sentenced to 36 months' probation, perform 50 hours of community service and ordered to pay a $1,000 fine and more than $5,000 restitution.
Palmer worked as a clerk at Stater Brothers and on March 10, 2014 reported to her employer that she fractured a toe on her left foot at work. During multiple doctor visits Palmer claimed that she could not place any weight on her foot, could not move it in any direction, or wear a shoe for any length of time. Palmers' doctor provided an ortho shoe, crutches, and gave her orders to refrain from working and to elevate her foot whenever possible. Palmer stated that she was not able to work due to her foot injury and continued to collect workers' compensation benefits.
While collecting workers' comp benefits, Palmer participated in at least two beauty contests wearing high heels and walking without any signs of discomfort. Video was posted on YouTube of Palmer as a contestant in the 2014 Miss Toyota Long Beach Grand Prix beauty contest ...
Palmer worked as a clerk at Stater Brothers and on March 10, 2014 reported to her employer that she fractured a toe on her left foot at work. During multiple doctor visits Palmer claimed that she could not place any weight on her foot, could not move it in any direction, or wear a shoe for any length of time. Palmers' doctor provided an ortho shoe, crutches, and gave her orders to refrain from working and to elevate her foot whenever possible. Palmer stated that she was not able to work due to her foot injury and continued to collect workers' compensation benefits.
While collecting workers' comp benefits, Palmer participated in at least two beauty contests wearing high heels and walking without any signs of discomfort. Video was posted on YouTube of Palmer as a contestant in the 2014 Miss Toyota Long Beach Grand Prix beauty contest ...
Uber drivers scored a victory Tuesday when a federal judge ruled that they could move forward with a class-action lawsuit that seeks to designate them as employees, not independent contractors.
The LA Times reports that U.S. District Judge Edward Chen in San Francisco ruled for the plaintiffs, denying the on-demand transportation company's motion for a quick judgment and allowing the lawsuit to proceed as a class action.
The decision could have deep implications for Uber and other companies in the fast-growing on-demand economy, in which customers use smartphone apps to order services such as car rides and home delivery of groceries and restaurant food.
Uber now stands to lose far more than if the case had proceeded as a suit involving only three plaintiffs. In addition to potentially being on the hook for back wages, sick leave, expenses and benefits such as workers' compensation coverage, the company could be ordered to pay gratuities owed to thousands of former drivers. And that doesn't even touch on what a loss would mean for Uber's independent contractor-reliant business model, which has earned the company a $50-billion valuation.
Plaintiff lawyer Shannon Liss-Riordan, who is also representing Lyft drivers in a separate class-action lawsuit against Lyft, Uber's top competitor, said in a prepared statement that Chen's decision Tuesday was a "major victory" for Uber drivers. The class however is not as big as Liss-Riordan had hoped the judge would certify. The certified class excludes current and recent Uber drivers bound by Uber's 2014 arbitration clause. And one of the three plaintiffs, Thomas Colopy, was also found to not qualify. An Uber spokesperson said this leaves them with only a "tiny fraction of the class [of 160,000] the plaintiffs were seeking."
A trial date has not yet been set. Uber's spokesperson said the company plans to appeal ...
The LA Times reports that U.S. District Judge Edward Chen in San Francisco ruled for the plaintiffs, denying the on-demand transportation company's motion for a quick judgment and allowing the lawsuit to proceed as a class action.
The decision could have deep implications for Uber and other companies in the fast-growing on-demand economy, in which customers use smartphone apps to order services such as car rides and home delivery of groceries and restaurant food.
Uber now stands to lose far more than if the case had proceeded as a suit involving only three plaintiffs. In addition to potentially being on the hook for back wages, sick leave, expenses and benefits such as workers' compensation coverage, the company could be ordered to pay gratuities owed to thousands of former drivers. And that doesn't even touch on what a loss would mean for Uber's independent contractor-reliant business model, which has earned the company a $50-billion valuation.
Plaintiff lawyer Shannon Liss-Riordan, who is also representing Lyft drivers in a separate class-action lawsuit against Lyft, Uber's top competitor, said in a prepared statement that Chen's decision Tuesday was a "major victory" for Uber drivers. The class however is not as big as Liss-Riordan had hoped the judge would certify. The certified class excludes current and recent Uber drivers bound by Uber's 2014 arbitration clause. And one of the three plaintiffs, Thomas Colopy, was also found to not qualify. An Uber spokesperson said this leaves them with only a "tiny fraction of the class [of 160,000] the plaintiffs were seeking."
A trial date has not yet been set. Uber's spokesperson said the company plans to appeal ...
Eleven individuals were caught and may be charged with contracting without a license after a two-day sting operation conducted in Sacramento by the Contractors State License Board (CSLB). Among the suspects were two who didn’t let past contracting violations stop them from continuing to violate state contracting laws.
The undercover sting conducted by CSLB’s Statewide Investigative Fraud Team (SWIFT) took place at a single-family home in the Natomas area of Sacramento, with the assistance of the Sacramento County District Attorney’s Office. Four misdemeanor illegal contracting citations were issued on August 27, and seven on August 28, 2015.
CSLB stages sting operations year-round to crack down on unlicensed contracting, which feeds a multi-billion-dollar underground economy in California, and creates unfair business competition for licensed, law-abiding contractors.
Using a list of suspected unlicensed contractors developed mostly from online ads, local pamphlets, and a newspaper, SWIFT investigators posed as homeowners seeking bids for various home improvement projects that included fencing, painting, a concrete driveway, and tankless water heater installation.
Two men cited at the Sacramento sting were no strangers to CSLB. One had been caught in a 2012 sting operation in El Dorado County, was given a probation term and a fine, and had been previously denied a contractor license. He also is a registered sex offender. The other man, on probation for a 2014 unlicensed contracting conviction, tried to pass off a contractor license that did not belong to him.
"Time after time, the stings we conduct show that property owners need to be very careful about who they’re allowing in and around their home and family," said CSLB Registrar Cindi Christenson. "It’s very easy to use CSLB’s website to see if a bidder is a legitimate contractor who has undergone a background check, and has the necessary experience."
All suspects were issued a Notice to Appear in superior court for contracting without a license. Ten of the 11 were cited for illegal advertising (BPC 7027.1). Contracting law requires unlicensed operators to state in all advertising that they are not licensed; the penalty is a fine of $700 to $1,000 ...
The undercover sting conducted by CSLB’s Statewide Investigative Fraud Team (SWIFT) took place at a single-family home in the Natomas area of Sacramento, with the assistance of the Sacramento County District Attorney’s Office. Four misdemeanor illegal contracting citations were issued on August 27, and seven on August 28, 2015.
CSLB stages sting operations year-round to crack down on unlicensed contracting, which feeds a multi-billion-dollar underground economy in California, and creates unfair business competition for licensed, law-abiding contractors.
Using a list of suspected unlicensed contractors developed mostly from online ads, local pamphlets, and a newspaper, SWIFT investigators posed as homeowners seeking bids for various home improvement projects that included fencing, painting, a concrete driveway, and tankless water heater installation.
Two men cited at the Sacramento sting were no strangers to CSLB. One had been caught in a 2012 sting operation in El Dorado County, was given a probation term and a fine, and had been previously denied a contractor license. He also is a registered sex offender. The other man, on probation for a 2014 unlicensed contracting conviction, tried to pass off a contractor license that did not belong to him.
"Time after time, the stings we conduct show that property owners need to be very careful about who they’re allowing in and around their home and family," said CSLB Registrar Cindi Christenson. "It’s very easy to use CSLB’s website to see if a bidder is a legitimate contractor who has undergone a background check, and has the necessary experience."
All suspects were issued a Notice to Appear in superior court for contracting without a license. Ten of the 11 were cited for illegal advertising (BPC 7027.1). Contracting law requires unlicensed operators to state in all advertising that they are not licensed; the penalty is a fine of $700 to $1,000 ...
A new study published in the Journal of Bone and Joint Surgery may help establish reserve estimates for future medical care following meniscus transplant surgeries. While most patients younger than age 50 experienced reduced pain and improved knee function following transplant surgery, many patients required additional surgery within 10 years
The meniscus is a wedge-shaped piece of fibrocartilage in the knee that acts as a shock absorber between the thighbone and shinbone. For younger patients with knee pain after loss of the meniscus, a meniscus transplant is performed to maintain a cushion between the two bones. An orthopedic surgeon executes the knee surgery by using an arthroscope to accurately place and stitch new, transplanted meniscal tissue.
In the new study, researchers followed 38 meniscal transplant patients under age 50, who did not have arthritis, for an average of 11 years following surgery. The estimated probabilities of transplant survival were 88% at five years, 63% at ten years, and 40% at fifteen years. Worst-case survival rate estimates were 73% at five years, 68% at seven years, 48% at ten years, and 15% at fifteen years. The mean time to failure was 8.2 years for medial transplants and 7.6 years for lateral transplants.
"This data provides surgeons with reasonable percentages that encourage delaying additional major knee surgeries related to a damaged meniscus," said Frank R. Noyes, MD, lead study author and founder of the Noyes Knee Institute at the Cincinnati Sports Medicine and Orthopaedic Center.
"However, the longer-term function of meniscus transplants remains questionable because the survivorship rate of the transplants decreases to between 40 and 15 percent at 15 years," said Dr. Noyes. "Patients should be advised that this procedure is not curative in the long-term and additional surgery will most likely be necessary." ...
The meniscus is a wedge-shaped piece of fibrocartilage in the knee that acts as a shock absorber between the thighbone and shinbone. For younger patients with knee pain after loss of the meniscus, a meniscus transplant is performed to maintain a cushion between the two bones. An orthopedic surgeon executes the knee surgery by using an arthroscope to accurately place and stitch new, transplanted meniscal tissue.
In the new study, researchers followed 38 meniscal transplant patients under age 50, who did not have arthritis, for an average of 11 years following surgery. The estimated probabilities of transplant survival were 88% at five years, 63% at ten years, and 40% at fifteen years. Worst-case survival rate estimates were 73% at five years, 68% at seven years, 48% at ten years, and 15% at fifteen years. The mean time to failure was 8.2 years for medial transplants and 7.6 years for lateral transplants.
"This data provides surgeons with reasonable percentages that encourage delaying additional major knee surgeries related to a damaged meniscus," said Frank R. Noyes, MD, lead study author and founder of the Noyes Knee Institute at the Cincinnati Sports Medicine and Orthopaedic Center.
"However, the longer-term function of meniscus transplants remains questionable because the survivorship rate of the transplants decreases to between 40 and 15 percent at 15 years," said Dr. Noyes. "Patients should be advised that this procedure is not curative in the long-term and additional surgery will most likely be necessary." ...
A new study published in Spine and summarized in an article published by Beckers' Spine Review examines the postoperative narcotic consumption among workers' compensation patients after minimally invasive transforaminal lumbar interbody fusion.
The researchers examined a cohort of patients undergoing single-level minimally invasive TLIF procedures for degenerative spine pathology from 2007 to 2013. There were 136 single-level, primary minimally invasive transforaminal lumbar interbody fusion procedures included in the analysis. Forty-six of the patients were workers' compensation patients - 33.8 percent. The workers compensation patients were younger on average - 47.8 years old compared with 57.9 years old among non-workers' compensation patients. They also had a lower comorbidity burden, at 1.85 compared with 3.42 among the non-workers compensation patients. Here are five things to know about the procedures:
1. The workers' compensation patients had longer procedure times. Their procedures were clocked at 135.2 minutes, compared with 118.9 minutes.
2. The hospital length of stay, estimated blood loss and day of discharge were similar between both groups of patients.
3. The average oral morphine equivalent consumption was similar between the two groups after adjusting for age, ethnicity, procedure times and Charleston Comorbidity Index.
4. Even though there are concerns that workers' compensation patients use more opioids, this study demonstrated the total narcotics consumption between workers' compensation and non-workers compensation are similar during the immediate postoperative period.
5. The amount of narcotics used could still vary from after the immediate postoperative period ...
The researchers examined a cohort of patients undergoing single-level minimally invasive TLIF procedures for degenerative spine pathology from 2007 to 2013. There were 136 single-level, primary minimally invasive transforaminal lumbar interbody fusion procedures included in the analysis. Forty-six of the patients were workers' compensation patients - 33.8 percent. The workers compensation patients were younger on average - 47.8 years old compared with 57.9 years old among non-workers' compensation patients. They also had a lower comorbidity burden, at 1.85 compared with 3.42 among the non-workers compensation patients. Here are five things to know about the procedures:
1. The workers' compensation patients had longer procedure times. Their procedures were clocked at 135.2 minutes, compared with 118.9 minutes.
2. The hospital length of stay, estimated blood loss and day of discharge were similar between both groups of patients.
3. The average oral morphine equivalent consumption was similar between the two groups after adjusting for age, ethnicity, procedure times and Charleston Comorbidity Index.
4. Even though there are concerns that workers' compensation patients use more opioids, this study demonstrated the total narcotics consumption between workers' compensation and non-workers compensation are similar during the immediate postoperative period.
5. The amount of narcotics used could still vary from after the immediate postoperative period ...
A Santa Barbara-area physician who wrote numerous prescriptions for powerful painkillers, such as OxyContin, for "patients" - many of whom were drug addicts, and some of whom died from drug overdoses - was convicted after a jury trial on 79 drug trafficking charges. Julio Gabriel Diaz, 67, a Goleta resident who operated the Family Medical Clinic in Santa Barbara, was found guilty following a 2½-week trial in United States District Court. As a result of these verdicts, Diaz will face a maximum possible sentence of 1,360 years in federal prison. Diaz is scheduled to be sentenced on December 14.
Diaz, who was known to some "patients" as the "Candyman," was a prolific writer of prescriptions for highly addictive and dangerous drugs. In 2011, for example, Diaz wrote prescriptions for more than 1.7 million doses of painkillers. His "patients" typically paid cash, waited hours for a 10-minute visit with Diaz, and received prescriptions for powerful drugs that included opioids, anti-anxiety medications and muscle relaxants. Several doctors and pharmacists who testified during the trial said that they had never seen any doctor prescribe the combination and quantity of drugs prescribed by Diaz.
Diaz was found guilty of 79 counts of distribution of a controlled substance. Twenty-six of the charges relate to oxycodone (a drug often sold under the brand name OxyContin), 10 of the charges relate to methadone, seven of the counts relate to hydromorphone (a drug commonly sold under the brand name Dilaudid), 10 of the charges relate to fentanyl, 11 of the charges relate to hydrocodone (a drug often sold under the brand names Vicodin and Norco), 10 of the charges relate to alprazolam (a drug often sold under brand name Xanax), and five of the charges related to the distribution of various controlled substances to a minor. In relation to all 79 counts, the jury found that Diaz distributed the drugs outside of the usual course of professional practice and without a legitimate medical purpose.
According to the evidence presented at trial, doctors, nurses and other personnel with Santa Barbara Cottage Hospital wrote to the Medical Board of California and gave statements to investigators to complain about Diaz. Cottage Hospital doctors believed that Diaz posed such a threat that they prepared a spreadsheet documenting emergency room visits by patients who had been prescribed narcotics by Diaz.
Diaz was arrested in this case in January 2012. After his arrest, the state of California revoked his license after finding that he provided incompetent and grossly negligent care ...
Diaz, who was known to some "patients" as the "Candyman," was a prolific writer of prescriptions for highly addictive and dangerous drugs. In 2011, for example, Diaz wrote prescriptions for more than 1.7 million doses of painkillers. His "patients" typically paid cash, waited hours for a 10-minute visit with Diaz, and received prescriptions for powerful drugs that included opioids, anti-anxiety medications and muscle relaxants. Several doctors and pharmacists who testified during the trial said that they had never seen any doctor prescribe the combination and quantity of drugs prescribed by Diaz.
Diaz was found guilty of 79 counts of distribution of a controlled substance. Twenty-six of the charges relate to oxycodone (a drug often sold under the brand name OxyContin), 10 of the charges relate to methadone, seven of the counts relate to hydromorphone (a drug commonly sold under the brand name Dilaudid), 10 of the charges relate to fentanyl, 11 of the charges relate to hydrocodone (a drug often sold under the brand names Vicodin and Norco), 10 of the charges relate to alprazolam (a drug often sold under brand name Xanax), and five of the charges related to the distribution of various controlled substances to a minor. In relation to all 79 counts, the jury found that Diaz distributed the drugs outside of the usual course of professional practice and without a legitimate medical purpose.
According to the evidence presented at trial, doctors, nurses and other personnel with Santa Barbara Cottage Hospital wrote to the Medical Board of California and gave statements to investigators to complain about Diaz. Cottage Hospital doctors believed that Diaz posed such a threat that they prepared a spreadsheet documenting emergency room visits by patients who had been prescribed narcotics by Diaz.
Diaz was arrested in this case in January 2012. After his arrest, the state of California revoked his license after finding that he provided incompetent and grossly negligent care ...
An Orange County employee was convicted and sentenced for committing insurance fraud by making false statements and concealing information related to his Workers’ Compensation claim. William Parker, 43, Corona, pleaded guilty to one felony count of making a fraudulent statement, five felony counts of insurance fraud. Parker was sentenced to six months in jail and paid over $41,000 in restitution.
On June 4, 2005, Parker was hired by the Orange County Probation Department (OCPD) as a Deputy Juvenile Corrections Officer. On Oct. 5, 2007, Parker was involved in a non-work related motor vehicle accident which caused injuries to his back and resulted in loss of time from work. Parker filed an insurance claim as a result of that automobile accident and received a settlement. Parker failed to disclose his back injury to the OCPD.
On Sept. 28, 2010, Parker suffered a back injury while working for the OCPD. Parker filed a Workers’ Compensation claim and was taken off work by his treating doctors after the county accepted the claim. The county was not aware of the previous back injury that Parker suffered in 2007.
On Jan. 31, 2012, Parker saw a medical examiner and told the doctor he still has daily pain. The doctor determined Parker had reached maximum medical improvement but would have to have permanent work restrictions. The defendant settled his Workers’ Compensation case and continued to see his primary doctor in the Worker’s Compensation claim from 2012 to 2014.
On Feb. 14, 2012, Parker was involved in a car accident where he was rear ended by another driver. The California Highway Patrol was called to the scene and reported minor property damage only.
On Feb. 23, 2012, Parker visited his primary doctor in the Workers’ Compensation case where he completed an updated medical questionnaire and intentionally omitted to tell the doctor about the motor vehicle accident he was involved in nine days earlier. Parker did not return to work until late February 2013, when he returned to a different position as an office specialist due to his claimed injuries.
On March 27, 2013, Parker filed a civil lawsuit for his personal injuries sustained in the car accident in 2012. The defendant was interrogated under oath and his deposition was taken. In the civil lawsuit, he made misrepresentations stating that he had completely recovered from the injuries in the Workers’ Compensation case and that he had returned to work as a correctional officer in order to collect a financial settlement from injuries the defendant claimed he sustained in the car accident. He stated that he was released in March 2012 but did not return to work until March 2013 because the county did not have a position for him ...
On June 4, 2005, Parker was hired by the Orange County Probation Department (OCPD) as a Deputy Juvenile Corrections Officer. On Oct. 5, 2007, Parker was involved in a non-work related motor vehicle accident which caused injuries to his back and resulted in loss of time from work. Parker filed an insurance claim as a result of that automobile accident and received a settlement. Parker failed to disclose his back injury to the OCPD.
On Sept. 28, 2010, Parker suffered a back injury while working for the OCPD. Parker filed a Workers’ Compensation claim and was taken off work by his treating doctors after the county accepted the claim. The county was not aware of the previous back injury that Parker suffered in 2007.
On Jan. 31, 2012, Parker saw a medical examiner and told the doctor he still has daily pain. The doctor determined Parker had reached maximum medical improvement but would have to have permanent work restrictions. The defendant settled his Workers’ Compensation case and continued to see his primary doctor in the Worker’s Compensation claim from 2012 to 2014.
On Feb. 14, 2012, Parker was involved in a car accident where he was rear ended by another driver. The California Highway Patrol was called to the scene and reported minor property damage only.
On Feb. 23, 2012, Parker visited his primary doctor in the Workers’ Compensation case where he completed an updated medical questionnaire and intentionally omitted to tell the doctor about the motor vehicle accident he was involved in nine days earlier. Parker did not return to work until late February 2013, when he returned to a different position as an office specialist due to his claimed injuries.
On March 27, 2013, Parker filed a civil lawsuit for his personal injuries sustained in the car accident in 2012. The defendant was interrogated under oath and his deposition was taken. In the civil lawsuit, he made misrepresentations stating that he had completely recovered from the injuries in the Workers’ Compensation case and that he had returned to work as a correctional officer in order to collect a financial settlement from injuries the defendant claimed he sustained in the car accident. He stated that he was released in March 2012 but did not return to work until March 2013 because the county did not have a position for him ...
A former Los Angeles County probation officer, Robyn Palmer, 29, of Long Beach, was arrested on six felony counts of insurance fraud for allegedly forging documents to illegally collect disability insurance benefits while serving probation for another insurance fraud conviction.
Palmer was arrested while serving five years' probation following her conviction on 14 felony counts of insurance fraud, forgery, wire fraud, and grand theft in May 2014 for illegally collecting disability benefits from Allstate Insurance. Palmer was sentenced to five years' probation and ordered to pay restitution in the amount of $31,122.
"Palmer's nerve in allegedly collecting disability benefits fraudulently while serving probation for doing the same thing to another insurer is egregious," said Insurance Commissioner Dave Jones. "Crimes like these are costly to business, consumers and California's economy."
Department of Insurance detectives were contacted by American Family Life Insurance Company (AFLAC) after the insurer identified suspected fraud by Palmer. The investigation revealed that Palmer was allegedly collecting disability benefits totaling $24,000 from AFLAC while being prosecuted for the first crime against Allstate and continued to do so after her conviction and while on probation.
Palmer is being held at the Century Regional Detention Center in Lynwood, CA in lieu of $150,000 bail. This case is being prosecuted by the Los Angeles District Attorney's Office. If convicted, Palmer could be sentenced to five years in state prison ...
Palmer was arrested while serving five years' probation following her conviction on 14 felony counts of insurance fraud, forgery, wire fraud, and grand theft in May 2014 for illegally collecting disability benefits from Allstate Insurance. Palmer was sentenced to five years' probation and ordered to pay restitution in the amount of $31,122.
"Palmer's nerve in allegedly collecting disability benefits fraudulently while serving probation for doing the same thing to another insurer is egregious," said Insurance Commissioner Dave Jones. "Crimes like these are costly to business, consumers and California's economy."
Department of Insurance detectives were contacted by American Family Life Insurance Company (AFLAC) after the insurer identified suspected fraud by Palmer. The investigation revealed that Palmer was allegedly collecting disability benefits totaling $24,000 from AFLAC while being prosecuted for the first crime against Allstate and continued to do so after her conviction and while on probation.
Palmer is being held at the Century Regional Detention Center in Lynwood, CA in lieu of $150,000 bail. This case is being prosecuted by the Los Angeles District Attorney's Office. If convicted, Palmer could be sentenced to five years in state prison ...
The state Public Utilities Commission unanimously approved a $2 million utility-financed wide-ranging investigation to gauge Pacific Gas and Electric Co.’s emphasis on safety in the aftermath of the San Bruno gas explosion. The panel previously imposed a historic $1.6 billion penalty for the Sept. 9, 2010, blast that killed eight people. Now the company’s string of post-San Bruno regulatory troubles suggested that utility was simply too big to regulate and might need to be broken up.
The investigation will amount to a deeper review of the companies organizational culture, governance, and operations, and the systemic issues identified by the National Transportation Safety Board. The safety board blames the 2010 explosion largely on PG & E’s "organizational failure" and lax safety leading up to the event. The safety arm of the commission will now work with an outside consultant to draft a report that will be reviewed by an administrative law judge in charge of the proceeding.
Meanwhile, the Los Angeles Times reports that the Public Utilities Commission itself -- beset by criticism that its officials have a too-cozy relationship with the utilities they regulate -- failed to respond to a search warrant for records related the California attorney general’s investigation of agency operations. A court document filed Aug. 7 states that "after multiple requests, and two months after the search warrant was served on CPUC, no records have been produced." Special Agent Reye Diaz of the attorney general’s office added: "No extension has been requested and no indication has been given as to when the records will be produced."
The attorney general is investigating secret talks between the commission and Southern California Edison, the state’s second largest investor-owned utility, that led to decisions that are costing utility customers billions of dollars ...
The investigation will amount to a deeper review of the companies organizational culture, governance, and operations, and the systemic issues identified by the National Transportation Safety Board. The safety board blames the 2010 explosion largely on PG & E’s "organizational failure" and lax safety leading up to the event. The safety arm of the commission will now work with an outside consultant to draft a report that will be reviewed by an administrative law judge in charge of the proceeding.
Meanwhile, the Los Angeles Times reports that the Public Utilities Commission itself -- beset by criticism that its officials have a too-cozy relationship with the utilities they regulate -- failed to respond to a search warrant for records related the California attorney general’s investigation of agency operations. A court document filed Aug. 7 states that "after multiple requests, and two months after the search warrant was served on CPUC, no records have been produced." Special Agent Reye Diaz of the attorney general’s office added: "No extension has been requested and no indication has been given as to when the records will be produced."
The attorney general is investigating secret talks between the commission and Southern California Edison, the state’s second largest investor-owned utility, that led to decisions that are costing utility customers billions of dollars ...
On August 14, 2013, the WCJ in the case of Trinh v Tzeng Long USA Inc. issued an Order For Costs And Sanctions against Professional Lien Services, Inc., (PLS), ordering it to pay defendant’s costs and attorney’s fees in the amount of $2,355 along with a separate court sanction of $1,000. The sanctions were imposed for PLS’s bad faith and frivolous conduct in pursuing a trial on the issues of penalty and interest when it did not offer evidence at the trial adequate to meet its initial burden of proof.
Neither PLS nor its representative, Mike Traw petitioned for reconsideration or otherwise appealed the August 14, 2013 Sanction Order and it is now final and binding for all purposes.
Deputy Commissioner Rick Dietrich, Secretary of the Appeals Board, notified PLS in October 2013 that payment of the $1,000 court sanction was expected within ten days and further advised that failure to pay the sanction was grounds for suspending the privilege of appearing before the WCAB pursuant to section 4907. PLS replied that it was petitioning for reconsideration, but that was not the case.
Defendant also made unsuccessful efforts to recover the costs and attorney’s fees that PLS is obligated to pay as part of the Sanction Order. Thus the En Banc panel concluded "None of the efforts by the Appeals Board and the defendant have resulted in voluntary compliance with the August 14, 2013 Sanction Order by PLS and Mr. Traw, and it appears they are willfully disobeying the August 14, 2013 Sanction Order."
Section 4907(a)(2) provides for suspension of the privilege of appearing before the WCAB for, "failure to pay final order of sanctions, attorney’s fees, or costs, issued under Section 5813." The failure to comply with an order or regulation of the WCAB, including an order to pay a sanction, is an interference with the judicial process that provides good cause for suspending or removing the privilege of appearing before the WCAB.
For this reason it was ordered that "that the Appeals Board intends to suspend the privilege of Professional Lien Services, Inc., and Mike Traw of appearing before the Workers’ Compensation Appeals Board pursuant to Labor Code section 4907 for ninety (90) days unless good cause is shown why the suspensions should not be imposed." ...
Neither PLS nor its representative, Mike Traw petitioned for reconsideration or otherwise appealed the August 14, 2013 Sanction Order and it is now final and binding for all purposes.
Deputy Commissioner Rick Dietrich, Secretary of the Appeals Board, notified PLS in October 2013 that payment of the $1,000 court sanction was expected within ten days and further advised that failure to pay the sanction was grounds for suspending the privilege of appearing before the WCAB pursuant to section 4907. PLS replied that it was petitioning for reconsideration, but that was not the case.
Defendant also made unsuccessful efforts to recover the costs and attorney’s fees that PLS is obligated to pay as part of the Sanction Order. Thus the En Banc panel concluded "None of the efforts by the Appeals Board and the defendant have resulted in voluntary compliance with the August 14, 2013 Sanction Order by PLS and Mr. Traw, and it appears they are willfully disobeying the August 14, 2013 Sanction Order."
Section 4907(a)(2) provides for suspension of the privilege of appearing before the WCAB for, "failure to pay final order of sanctions, attorney’s fees, or costs, issued under Section 5813." The failure to comply with an order or regulation of the WCAB, including an order to pay a sanction, is an interference with the judicial process that provides good cause for suspending or removing the privilege of appearing before the WCAB.
For this reason it was ordered that "that the Appeals Board intends to suspend the privilege of Professional Lien Services, Inc., and Mike Traw of appearing before the Workers’ Compensation Appeals Board pursuant to Labor Code section 4907 for ninety (90) days unless good cause is shown why the suspensions should not be imposed." ...
On October 5 or 6, 2011 Richard Gurrola, a Police Officer II with the City of Los Angeles, suffered a back spasm, which was a flare-up of a prior work-related injury. He scheduled an appointment with Dr. Simon Lavi, who had treated the initial injury, but could not get an appointment earlier than October 11, 2011. Dr. Lavi’s office, which had previously backdated medical notes for Gurrola, assured him he would receive injured on duty (IOD) pay notwithstanding the delay in seeing the doctor.
What followed was numerous communications between Gurrola and the LAPD about his status, and the documentation that was needed from his doctors. Finally Gurrola was served with a personnel complaint and notice of relief from duty and proposed removal, suspension or demotion issued by Chief of Police Charlie Beck, charging him with one count of being absent from work without leave and one count of providing false statements during the investigation into his absence.
There was conflicting testimony from seven witnesses on the board of rights hearing on several points. The board of rights found Gurrola guilty of count 1 and not guilty of count 2 and he was terminated. He appealed his termination and the Court of Appeal affirmed in the unpublished case of Gurrola v City of Los Angeles.
In a mandamus proceeding to review an administrative order, the determination of the penalty by the administrative body will not be disturbed unless there has been an abuse of its discretion. In considering whether an agency abused its discretion, "the overriding consideration in these cases is the extent to which the employee’s conduct resulted in, or if repeated is likely to result in, ‘[harm] to the public service.’ [Citations.] Other relevant factors include the circumstances surrounding the misconduct and the likelihood of its recurrence."
Using this standard the Court of Appeal concluded "Although the penalty of termination is harsh, these facts do not present the exceptional case in which reasonable minds cannot differ: The board properly found that public service was compromised by Gurrola’s two-month absence from work without leave, requiring other personnel to cover his shifts. In addition, the evidence supports a finding Gurrola’s actions were consistent with a pattern of improperly taking extended absences from work." ...
What followed was numerous communications between Gurrola and the LAPD about his status, and the documentation that was needed from his doctors. Finally Gurrola was served with a personnel complaint and notice of relief from duty and proposed removal, suspension or demotion issued by Chief of Police Charlie Beck, charging him with one count of being absent from work without leave and one count of providing false statements during the investigation into his absence.
There was conflicting testimony from seven witnesses on the board of rights hearing on several points. The board of rights found Gurrola guilty of count 1 and not guilty of count 2 and he was terminated. He appealed his termination and the Court of Appeal affirmed in the unpublished case of Gurrola v City of Los Angeles.
In a mandamus proceeding to review an administrative order, the determination of the penalty by the administrative body will not be disturbed unless there has been an abuse of its discretion. In considering whether an agency abused its discretion, "the overriding consideration in these cases is the extent to which the employee’s conduct resulted in, or if repeated is likely to result in, ‘[harm] to the public service.’ [Citations.] Other relevant factors include the circumstances surrounding the misconduct and the likelihood of its recurrence."
Using this standard the Court of Appeal concluded "Although the penalty of termination is harsh, these facts do not present the exceptional case in which reasonable minds cannot differ: The board properly found that public service was compromised by Gurrola’s two-month absence from work without leave, requiring other personnel to cover his shifts. In addition, the evidence supports a finding Gurrola’s actions were consistent with a pattern of improperly taking extended absences from work." ...
