Californians stricken with COVID-19 took the first step in filing more than 5,000 workers’ compensation claims from January through May, according to state data released to CalMatters.
More than 1,000 of those claims were denied, most of them before Gov. Gavin Newsom signed a May 6 executive order extending protections for essential workers infected on the job on or after March 19, the day California’s lockdown order went into effect. The order presumes that essential workers - including nurses, first responders, farmworkers and grocery workers who contracted COVID-19 - were infected on the job, and puts the burden on employers to prove otherwise.
At the same time, overall workers’ compensation claims plummeted during California’s lockdown as workplaces shut down and fewer employees were injured at work. Only 1,098 claims were filed in May, compared with more than 50,000 in January.
While a number of states have extended similar "presumptive eligibility" protections to varying groups of workers - mostly health care workers and first responders - California goes further than many in protecting all essential workers.
As of Tuesday, more than 10,000 health care workers have been diagnosed with COVID-19; 63 have died. More than half worked in nursing homes.
Analysts originally estimated that California employers and their insurers might face COVID claims of up to $33.6 billion annually but later downgraded that to about $2 billion.
COVID-related claims were denied at a rate of 10 to 60 percent depending on the month. In April, about 13 percent of claims were denied. Under Newsom’s executive order, essential workers, such as nurses or first responders, have to show that they were infected within a certain period after the statewide shutdown began; they also had to be diagnosed by a physician.
Alex Swedlow, president of the California Workers’ Compensation Institute said that even before Newsom’s order took effect, the majority of COVID claims were approved.
The shortage of diagnostic tests - a significant problem for workers in March and April, when most of the claims were filed - may have contributed to some of the denials, Swedlow said. Other workers may have been denied because they tested negative at a time when some COVID-19 tests have produced false negatives.
An Institute report released earlier this month found that about 41 percent of workers’ comp claims were made by health workers, with another 32 percent by first responders including police and firefighters. Some workers were denied because they worked at home; others because they declined to be tested, according to the report.
Swedlow anticipates that denials may decline as workers get more access to testing and California’s workers’ comp system adjusts to dealing with an entirely new disease.
...
More than 1,000 of those claims were denied, most of them before Gov. Gavin Newsom signed a May 6 executive order extending protections for essential workers infected on the job on or after March 19, the day California’s lockdown order went into effect. The order presumes that essential workers - including nurses, first responders, farmworkers and grocery workers who contracted COVID-19 - were infected on the job, and puts the burden on employers to prove otherwise.
At the same time, overall workers’ compensation claims plummeted during California’s lockdown as workplaces shut down and fewer employees were injured at work. Only 1,098 claims were filed in May, compared with more than 50,000 in January.
While a number of states have extended similar "presumptive eligibility" protections to varying groups of workers - mostly health care workers and first responders - California goes further than many in protecting all essential workers.
As of Tuesday, more than 10,000 health care workers have been diagnosed with COVID-19; 63 have died. More than half worked in nursing homes.
Analysts originally estimated that California employers and their insurers might face COVID claims of up to $33.6 billion annually but later downgraded that to about $2 billion.
COVID-related claims were denied at a rate of 10 to 60 percent depending on the month. In April, about 13 percent of claims were denied. Under Newsom’s executive order, essential workers, such as nurses or first responders, have to show that they were infected within a certain period after the statewide shutdown began; they also had to be diagnosed by a physician.
Alex Swedlow, president of the California Workers’ Compensation Institute said that even before Newsom’s order took effect, the majority of COVID claims were approved.
The shortage of diagnostic tests - a significant problem for workers in March and April, when most of the claims were filed - may have contributed to some of the denials, Swedlow said. Other workers may have been denied because they tested negative at a time when some COVID-19 tests have produced false negatives.
An Institute report released earlier this month found that about 41 percent of workers’ comp claims were made by health workers, with another 32 percent by first responders including police and firefighters. Some workers were denied because they worked at home; others because they declined to be tested, according to the report.
Swedlow anticipates that denials may decline as workers get more access to testing and California’s workers’ comp system adjusts to dealing with an entirely new disease.
...
The unemployment rate fell to 13.3 percent and payrolls unexpectedly rose by 2.5 million workers as the easing of restrictions on business activity and government aid led to new hiring in May.
The U.S. unemployment rate fell below last month’s record-high 14.7 percent, which was the highest on record in data going back to 1948. Economists estimate that the unemployment rate reached 25 percent during the Great Depression, although that predated the scientific economy-wide record keeping the government now deploys.
The job gains mark a sudden turnaround from a month earlier, when the economy shed a staggering 20.5 million jobs, by far the worst monthly decline on records back to 1939.
Economists had expected the unemployment rate to rise to nearly 20 percent and the economy to shed an additional 8 million jobs.
The mandatory closures of many businesses and stay-at-home orders slammed what had been a very healthy labor market hard. The economy added jobs for 113 straight weeks through February, a record streak of growth. The unemployment rate was 3.5 percent in February. And yet job creation was running very hot, with the economy adding an average of 211,000 new jobs each month.
The government has undertaken unprecedented efforts to support employment and provide aid to those who have lost their jobs. Around 150 million taxpayers received stimulus payments of up to $1200 for adults in their household plus additional amounts for children. The Treasury’s Paycheck Protection Program is backing $669 billion of loans to small businesses that can be forgiven if borrowers do not lay off workers. The federal government has been providing an additional $600 on top of state unemployment benefits, paying some Americans more than they earned on the job.
Recent data suggest the labor market has been stabilizing and is now improving. The number of people applying for unemployment benefits has declined every week since hitting a record high 6.8 million in March. Last week, this number fell to around 1.8 million. Over 40 million new claims have been made for unemployment since the wave but ongoing claims are just over 20 million, indicating many Americans have been rehired after losing jobs.
In May, employment in leisure and hospitality jumped by 1.2 million after falling by 7.5 million in April and 743,000 in March. Bars and restaurants hired an additional 1.4 million workers following a combined 6.1 million in job losses in April and March.
Construction employment jumped by 464,000 in May, gaining back almost half of April’s decline.
Dentist offices added 245,000 jobs. Health care employment overall rose by 312,000.
Retail shops added 368,000 jobs in May, after a loss of 2.3 million in April. Over-the-month job gains occurred in clothing and clothing accessories stores were 95,000. Auto dealers added 85,000. General merchandise stores added 84,000.
Manufacturers added 225,000 jobs, about evenly split between the durable and nondurable goods components. Twenty-eight thousand of those were in auto making plants ...
The U.S. unemployment rate fell below last month’s record-high 14.7 percent, which was the highest on record in data going back to 1948. Economists estimate that the unemployment rate reached 25 percent during the Great Depression, although that predated the scientific economy-wide record keeping the government now deploys.
The job gains mark a sudden turnaround from a month earlier, when the economy shed a staggering 20.5 million jobs, by far the worst monthly decline on records back to 1939.
Economists had expected the unemployment rate to rise to nearly 20 percent and the economy to shed an additional 8 million jobs.
The mandatory closures of many businesses and stay-at-home orders slammed what had been a very healthy labor market hard. The economy added jobs for 113 straight weeks through February, a record streak of growth. The unemployment rate was 3.5 percent in February. And yet job creation was running very hot, with the economy adding an average of 211,000 new jobs each month.
The government has undertaken unprecedented efforts to support employment and provide aid to those who have lost their jobs. Around 150 million taxpayers received stimulus payments of up to $1200 for adults in their household plus additional amounts for children. The Treasury’s Paycheck Protection Program is backing $669 billion of loans to small businesses that can be forgiven if borrowers do not lay off workers. The federal government has been providing an additional $600 on top of state unemployment benefits, paying some Americans more than they earned on the job.
Recent data suggest the labor market has been stabilizing and is now improving. The number of people applying for unemployment benefits has declined every week since hitting a record high 6.8 million in March. Last week, this number fell to around 1.8 million. Over 40 million new claims have been made for unemployment since the wave but ongoing claims are just over 20 million, indicating many Americans have been rehired after losing jobs.
In May, employment in leisure and hospitality jumped by 1.2 million after falling by 7.5 million in April and 743,000 in March. Bars and restaurants hired an additional 1.4 million workers following a combined 6.1 million in job losses in April and March.
Construction employment jumped by 464,000 in May, gaining back almost half of April’s decline.
Dentist offices added 245,000 jobs. Health care employment overall rose by 312,000.
Retail shops added 368,000 jobs in May, after a loss of 2.3 million in April. Over-the-month job gains occurred in clothing and clothing accessories stores were 95,000. Auto dealers added 85,000. General merchandise stores added 84,000.
Manufacturers added 225,000 jobs, about evenly split between the durable and nondurable goods components. Twenty-eight thousand of those were in auto making plants ...
Stuart Waldman is president of the Valley Industry & Commerce Association (VICA), which works to enhance the economic vitality of the greater San Fernando Valley region by advocating for a better business climate and quality of life.
He just published his views on the workers’ compensation presumptions that he says burdens the COVID-19 recovery in an opinion article published by the Los Angeles Daily News.
He says that the consequences of the governor’s COVID-19 "presumption" for workers is far-reaching and will potentially add billions in new costs to California’s already cost-laden system, especially as employers struggle to bring jobs and public services back online.
Now, he points out that state lawmakers stand ready with several legislative proposals which threaten to burden the relatively modest workers’ compensation system with an outsized responsibility for California’s response to COVID-19, even though the connection to the workplace may be tenuous or even nonexistent.
To be clear, he points out that employers have raised no objection to paying COVID-19 workers’ compensation claims that can be traced to the workplace. In fact, these claims are being paid in cases where there’s a positive test. The objection is that presumptions leave employers virtually defenseless against claims that originated outside the workplace but must be accepted as workers’ compensation claims.
Yet he makes four arguments against adding more presumptions to the current worker's compensation compensability architecture.
First, there’s no evidence that a COVID-19 presumption is needed. In addition to unprecedented safety measures and expansions of sick leave, all evidence points to employers accepting claims for COVID-19. Early reports suggest workers’ compensation claims are only being denied when COVID-19 tests come back negative.
Second, wholesale presumptions fail to consider whether a worker has any greater risk of COVID-19 sickness. Even if they leave their home, many workers are working with ample social distancing and do not interact with the public. Personal errands for these workers likely come with far greater risk than the workplace.
Third, California’s re-opening from the pandemic is not limited to workplaces. People are easing back into broader socializing and recreation. Presumptions assume that people are merely going to or from work. That is not the current reality. The "industrial causation" standard exists precisely because people have lives outside of work.
Fourth, presumptions lay billions of new costs on employers at the exact moment when they can least afford it. For many employers and most public agencies (cities, counties, schools, and others are also employers), workers’ compensation costs are not an indirect cost paid for through insurance. They are a direct, pay-as-you-go cost that redirects critical dollars away from other business needs or public services ...
He just published his views on the workers’ compensation presumptions that he says burdens the COVID-19 recovery in an opinion article published by the Los Angeles Daily News.
He says that the consequences of the governor’s COVID-19 "presumption" for workers is far-reaching and will potentially add billions in new costs to California’s already cost-laden system, especially as employers struggle to bring jobs and public services back online.
Now, he points out that state lawmakers stand ready with several legislative proposals which threaten to burden the relatively modest workers’ compensation system with an outsized responsibility for California’s response to COVID-19, even though the connection to the workplace may be tenuous or even nonexistent.
To be clear, he points out that employers have raised no objection to paying COVID-19 workers’ compensation claims that can be traced to the workplace. In fact, these claims are being paid in cases where there’s a positive test. The objection is that presumptions leave employers virtually defenseless against claims that originated outside the workplace but must be accepted as workers’ compensation claims.
Yet he makes four arguments against adding more presumptions to the current worker's compensation compensability architecture.
First, there’s no evidence that a COVID-19 presumption is needed. In addition to unprecedented safety measures and expansions of sick leave, all evidence points to employers accepting claims for COVID-19. Early reports suggest workers’ compensation claims are only being denied when COVID-19 tests come back negative.
Second, wholesale presumptions fail to consider whether a worker has any greater risk of COVID-19 sickness. Even if they leave their home, many workers are working with ample social distancing and do not interact with the public. Personal errands for these workers likely come with far greater risk than the workplace.
Third, California’s re-opening from the pandemic is not limited to workplaces. People are easing back into broader socializing and recreation. Presumptions assume that people are merely going to or from work. That is not the current reality. The "industrial causation" standard exists precisely because people have lives outside of work.
Fourth, presumptions lay billions of new costs on employers at the exact moment when they can least afford it. For many employers and most public agencies (cities, counties, schools, and others are also employers), workers’ compensation costs are not an indirect cost paid for through insurance. They are a direct, pay-as-you-go cost that redirects critical dollars away from other business needs or public services ...
The sudden loss of millions of jobs, restrictions on nonemergency health care and the potential workers compensation claims from pandemic-related illness have experts doubting whether claims will follow the conventional industry pattern of past downturns.
Experts say they are on the lookout for greater frequency, a longer chain on claims because of limited medical services and increased cumulative trauma claims.
According to the story in Business Insurance, Len Herk, executive director and senior economist at the National Council on Compensation Insurance said that "Not all recessions are the same," "We might see some of the same themes as in past recessions, but - the pandemic recession is really a different animal."
During recessions employment and payroll reductions typically lead to a drop in workers compensation premium, and injury frequency dips below trends, according to research from Boca Raton, Florida-based NCCI.
Workers compensation economists have a number of theories as to why claim frequency tends to dip during a recession, Mr. Herk said. One theory is that employers typically lay off their newest employees - who are more likely to be injured than longer-tenured workers - and when they are hired back they remain more susceptible to injury, he said.
Another theory is that employers who fear they may be laid off if they file a workers comp claim will be less likely to do so.
However, there is limited evidence on how much each factor contributes to these recession trends, and the data is too aggregated to "clearly distinguish one theory from another," Mr. Herk said. "There are a lot of good questions about employment fluctuations and workers comp that remain to be carefully addressed in research."
In the economic downturn spurred by shutdowns to limit the spread of COVID-19, "all bets are off," said David Bellusci, executive vice president and chief actuary of the Workers Compensation Insurance Ratings Bureau in Oakland, California.
"We almost instantly went from close to full employment to perhaps unemployment as high as 25% in a matter of four months," he said. "Even during the Great Depression, (unemployment) eventually went to 25% but that was over four years. It’s really unprecedented, and exactly how that’s going to impact (workers comp), who knows? We’ve never seen anything like this."
Nationally, the "relative magnitudes" of other factors will determine whether workers compensation acts differently during this economic downturn, NCCI noted in a quarterly briefing in April.
Some factors that could affect the comp system include whether injured employees who are temporarily laid off defer the reporting of workplace injuries for fear of losing their jobs when stay-at-home orders are lifted, or whether workers who anticipate a permanent job loss "accelerate" their reporting of injuries.
The enhanced unemployment insurance made available to laid-off workers by lawmakers early in the pandemic may also impact claims reporting, since the federal unemployment benefit for many lower-wage workers is higher than full indemnity benefits under workers comp - and generally workers cannot claim both unemployment and workers comp benefits at the same time, according to the NCCI ...
Experts say they are on the lookout for greater frequency, a longer chain on claims because of limited medical services and increased cumulative trauma claims.
According to the story in Business Insurance, Len Herk, executive director and senior economist at the National Council on Compensation Insurance said that "Not all recessions are the same," "We might see some of the same themes as in past recessions, but - the pandemic recession is really a different animal."
During recessions employment and payroll reductions typically lead to a drop in workers compensation premium, and injury frequency dips below trends, according to research from Boca Raton, Florida-based NCCI.
Workers compensation economists have a number of theories as to why claim frequency tends to dip during a recession, Mr. Herk said. One theory is that employers typically lay off their newest employees - who are more likely to be injured than longer-tenured workers - and when they are hired back they remain more susceptible to injury, he said.
Another theory is that employers who fear they may be laid off if they file a workers comp claim will be less likely to do so.
However, there is limited evidence on how much each factor contributes to these recession trends, and the data is too aggregated to "clearly distinguish one theory from another," Mr. Herk said. "There are a lot of good questions about employment fluctuations and workers comp that remain to be carefully addressed in research."
In the economic downturn spurred by shutdowns to limit the spread of COVID-19, "all bets are off," said David Bellusci, executive vice president and chief actuary of the Workers Compensation Insurance Ratings Bureau in Oakland, California.
"We almost instantly went from close to full employment to perhaps unemployment as high as 25% in a matter of four months," he said. "Even during the Great Depression, (unemployment) eventually went to 25% but that was over four years. It’s really unprecedented, and exactly how that’s going to impact (workers comp), who knows? We’ve never seen anything like this."
Nationally, the "relative magnitudes" of other factors will determine whether workers compensation acts differently during this economic downturn, NCCI noted in a quarterly briefing in April.
Some factors that could affect the comp system include whether injured employees who are temporarily laid off defer the reporting of workplace injuries for fear of losing their jobs when stay-at-home orders are lifted, or whether workers who anticipate a permanent job loss "accelerate" their reporting of injuries.
The enhanced unemployment insurance made available to laid-off workers by lawmakers early in the pandemic may also impact claims reporting, since the federal unemployment benefit for many lower-wage workers is higher than full indemnity benefits under workers comp - and generally workers cannot claim both unemployment and workers comp benefits at the same time, according to the NCCI ...
The architecture of the California workers' compensation system will be changing to favor compensability for health care workers' who contract COVID-19 from exposure to patients on the job. The number of cases that will follow is difficult to estimate. However, an estimate by an international organization of nurses paints a stunning picture of the size of potential claims.
The International Council of Nurses is part of a global voice that has been speaking for nurses around the world for 120 years. The ICN represents 130 national associations and more than 20 million registered nurses.
ICN claims that more than 600 nurses worldwide are known to have died from COVID-19, which has infected an estimated 450,000 healthcare workers.
The death toll among nurses more than doubled in the past month from 260 on May 6, according to its figures, which are based on data from more than 30 countries.
"In the last two months, we have seen the number of deaths of nurses as a result of coronavirus around the world rise from 100 to now in excess of 600 and we think worldwide the number of healthcare workers who could be infected by the virus is around 450,000," Howard Catton, chief executive officer of the Geneva-based ICN, told Reuters Television.
"These are numbers that keep going up," he said.
The pandemic’s true cost among health professionals was not known, the association said, renewing its appeal for greater protection for them and systematic collection of reliable data.
On average, 7 percent of all cases of COVID-19, the lung disease caused by the novel coronavirus, are among healthcare workers, which means that nurses and other staff are at great personal risk "and so are the patients they care for", it said.
Extrapolating from more than 6 million reported cases gave its estimate of some 450,000 infections among healthcare workers.
Infection rates among healthcare workers vary greatly between countries, with fewer than 1% in Singapore and more than 30% in Ireland, it said. Spain and Germany have recorded low numbers of fatalities among healthcare workers despite large outbreaks, it added.
"Why do the rates of deaths among nurses appear higher in some Latin American countries?" it asked, referring to the region that the World Health Organization (WHO) says has emerged as the new epicentre for the pandemic.
"Why are some countries reporting disproportionate deaths among black, Asian and minority ethnic HCWs (healthcare workers)? This is an issue raised directly by the Philippine Nurses Association to ICN, concerning Filipino HCWs in the UK," it said ...
The International Council of Nurses is part of a global voice that has been speaking for nurses around the world for 120 years. The ICN represents 130 national associations and more than 20 million registered nurses.
ICN claims that more than 600 nurses worldwide are known to have died from COVID-19, which has infected an estimated 450,000 healthcare workers.
The death toll among nurses more than doubled in the past month from 260 on May 6, according to its figures, which are based on data from more than 30 countries.
"In the last two months, we have seen the number of deaths of nurses as a result of coronavirus around the world rise from 100 to now in excess of 600 and we think worldwide the number of healthcare workers who could be infected by the virus is around 450,000," Howard Catton, chief executive officer of the Geneva-based ICN, told Reuters Television.
"These are numbers that keep going up," he said.
The pandemic’s true cost among health professionals was not known, the association said, renewing its appeal for greater protection for them and systematic collection of reliable data.
On average, 7 percent of all cases of COVID-19, the lung disease caused by the novel coronavirus, are among healthcare workers, which means that nurses and other staff are at great personal risk "and so are the patients they care for", it said.
Extrapolating from more than 6 million reported cases gave its estimate of some 450,000 infections among healthcare workers.
Infection rates among healthcare workers vary greatly between countries, with fewer than 1% in Singapore and more than 30% in Ireland, it said. Spain and Germany have recorded low numbers of fatalities among healthcare workers despite large outbreaks, it added.
"Why do the rates of deaths among nurses appear higher in some Latin American countries?" it asked, referring to the region that the World Health Organization (WHO) says has emerged as the new epicentre for the pandemic.
"Why are some countries reporting disproportionate deaths among black, Asian and minority ethnic HCWs (healthcare workers)? This is an issue raised directly by the Philippine Nurses Association to ICN, concerning Filipino HCWs in the UK," it said ...
Six Blue Cross Blue Shield companies filed a lawsuit against CVS Health in the United States District Court for the District of Rhode Island, claiming the retail pharmacy chain has "intentionally engaged" in a fraud scheme for more than a decade to overcharge for prescription drugs by submitting insurance claims for payment at artificially inflated prices.
The plaintiffs include BCBS companies in Alabama, Florida, Minnesota, North Carolina, North Dakota and Missouri. The lawsuit was filed May 27 in a Rhode Island District Court.
The lawsuit goes on to explain that CVS offered hundreds of generic drugs at low, discounted prices through cash discount programs. It then used the discount programs to hide the true prices of drugs from third-party payers, according to the lawsuit.
CVS allegedly intentionally told third-party payers that the prices charged to customers for the generic drugs were much higher, and the payers then reimbursed CVS based on the inflated prices instead of the lower prices CVS offered to the general public, the lawsuit claims.
The BCBS companies said CVS was required by governing contracts to submit the same low price offered to the general public.
The companies also claim CVS knew it was being overpaid for generic drugs and has pocketed billions from the scheme. They are seeking millions of dollars they say they were overcharged.
A CVS spokesperson told Becker's Hospital Review the discount programs were intended for customers who either didn't have insurance or chose not to use insurance. None of CVS Pharmacy's discount programs were "in any way concealed, nor fraudulent," the spokesperson said.
"We did not overcharge plans for prescription drugs, and we will vigorously defend against these baseless allegations, which are completely without merit," the CVS spokesperson told Becker's ...
The plaintiffs include BCBS companies in Alabama, Florida, Minnesota, North Carolina, North Dakota and Missouri. The lawsuit was filed May 27 in a Rhode Island District Court.
The lawsuit goes on to explain that CVS offered hundreds of generic drugs at low, discounted prices through cash discount programs. It then used the discount programs to hide the true prices of drugs from third-party payers, according to the lawsuit.
CVS allegedly intentionally told third-party payers that the prices charged to customers for the generic drugs were much higher, and the payers then reimbursed CVS based on the inflated prices instead of the lower prices CVS offered to the general public, the lawsuit claims.
The BCBS companies said CVS was required by governing contracts to submit the same low price offered to the general public.
The companies also claim CVS knew it was being overpaid for generic drugs and has pocketed billions from the scheme. They are seeking millions of dollars they say they were overcharged.
A CVS spokesperson told Becker's Hospital Review the discount programs were intended for customers who either didn't have insurance or chose not to use insurance. None of CVS Pharmacy's discount programs were "in any way concealed, nor fraudulent," the spokesperson said.
"We did not overcharge plans for prescription drugs, and we will vigorously defend against these baseless allegations, which are completely without merit," the CVS spokesperson told Becker's ...
California has experienced dramatic drops in employment as the COVID-19 pandemic continues to unfold. About 4.3 million first-time Unemployment Insurance claims were processed in the first ten weeks since the start of the pandemic. This comprises more than 20% of California’s total labor force prior to the pandemic.
The impact of this COVID-19 induced economic downturn on the workers’ compensation system is unclear given the magnitude and suddenness of the employment drop, uncertainty surrounding the economy reopening, trends in post-termination claims and potential future waves of COVID-19 infections.
Patterns of historical impacts of prior economic downturns on the workers’ compensation system may shed light on what we could anticipate in the California workers’ compensation system.
In this study, the WCIRB analyzed historical impacts of economic cycles between 1961 and 2017 on workers’ compensation claim frequency, provided forecasts of claim frequency changes in light of the current economic situation and summarized the potential impact of post-termination and COVID-19 claims on claim frequency. The WCIRB’s findings include:
-- While many factors influence claim frequency, between 1961 and 2017, overall claim frequency decreased modestly more during years of economic recession than during years of expansion. The modest decline during economic downturns was partly due to cumulative trauma (CT) claims, which, unlike other claims, often increased during downturns.
-- For industry sectors that were hit the hardest during the 2001 recession and the Great Recession, claim frequency tended to fall along with job losses or fall faster during economic downturns compared to economic expansions.
-- Based on the post-COVID-19 national unemployment rate for April 2020 of 14.7%,3 the WCIRB’s econometric model projects indemnity claim frequency to decline by 14% in 2020. This estimate accounts for several economic and claims related factors but does not fully reflect recent trends in post-termination claims or the impact of COVID-19 claims.
-- Since 2012, about 25 post-termination claims (most are CT claims) have been filed for every 1,000 jobs lost. If only 50% of the rate of post-termination claims is applied to the 4.3 million Californians who have lost jobs, about 54,000 post-termination claims could be filed over the next year, increasing statewide indemnity claim frequency by approximately 25%.
-- Many claims with a COVID-19 diagnosis are emerging in the workers’ compensation system. Based on two cost estimates of presumptions of compensability that the WCIRB recently published, the estimated frequency increase from COVID-19 claims ranges from 14% over a four-month period of a rebuttable presumption applied to all workers directed to work outside of home to 42% over an annual period of a conclusive presumption to all essential workers.
Historically in the California workers’ compensation system, indemnity claim frequency often declined during economic downturns at modestly greater rates than in periods of economic expansion. The rate of CT claims, on the other hand, often increased significantly during economic recessions. Non-economic factors also impact claim frequency.
The WCIRB’s econometric frequency model that accounts for both economic and non-economic factors suggests that with the dramatic post-COVID-19 economic slowdown and unprecedented job losses, indemnity claim frequency will drop significantly.
However, the model does not reflect any claims arising from COVID-19 diagnosis nor does it fully reflect recent trends in post-termination CT claims. It is possible and perhaps likely that growth in these types of claims will more than offset the impact of the economic slowdown on claim frequency ...
The impact of this COVID-19 induced economic downturn on the workers’ compensation system is unclear given the magnitude and suddenness of the employment drop, uncertainty surrounding the economy reopening, trends in post-termination claims and potential future waves of COVID-19 infections.
Patterns of historical impacts of prior economic downturns on the workers’ compensation system may shed light on what we could anticipate in the California workers’ compensation system.
In this study, the WCIRB analyzed historical impacts of economic cycles between 1961 and 2017 on workers’ compensation claim frequency, provided forecasts of claim frequency changes in light of the current economic situation and summarized the potential impact of post-termination and COVID-19 claims on claim frequency. The WCIRB’s findings include:
-- While many factors influence claim frequency, between 1961 and 2017, overall claim frequency decreased modestly more during years of economic recession than during years of expansion. The modest decline during economic downturns was partly due to cumulative trauma (CT) claims, which, unlike other claims, often increased during downturns.
-- For industry sectors that were hit the hardest during the 2001 recession and the Great Recession, claim frequency tended to fall along with job losses or fall faster during economic downturns compared to economic expansions.
-- Based on the post-COVID-19 national unemployment rate for April 2020 of 14.7%,3 the WCIRB’s econometric model projects indemnity claim frequency to decline by 14% in 2020. This estimate accounts for several economic and claims related factors but does not fully reflect recent trends in post-termination claims or the impact of COVID-19 claims.
-- Since 2012, about 25 post-termination claims (most are CT claims) have been filed for every 1,000 jobs lost. If only 50% of the rate of post-termination claims is applied to the 4.3 million Californians who have lost jobs, about 54,000 post-termination claims could be filed over the next year, increasing statewide indemnity claim frequency by approximately 25%.
-- Many claims with a COVID-19 diagnosis are emerging in the workers’ compensation system. Based on two cost estimates of presumptions of compensability that the WCIRB recently published, the estimated frequency increase from COVID-19 claims ranges from 14% over a four-month period of a rebuttable presumption applied to all workers directed to work outside of home to 42% over an annual period of a conclusive presumption to all essential workers.
Historically in the California workers’ compensation system, indemnity claim frequency often declined during economic downturns at modestly greater rates than in periods of economic expansion. The rate of CT claims, on the other hand, often increased significantly during economic recessions. Non-economic factors also impact claim frequency.
The WCIRB’s econometric frequency model that accounts for both economic and non-economic factors suggests that with the dramatic post-COVID-19 economic slowdown and unprecedented job losses, indemnity claim frequency will drop significantly.
However, the model does not reflect any claims arising from COVID-19 diagnosis nor does it fully reflect recent trends in post-termination CT claims. It is possible and perhaps likely that growth in these types of claims will more than offset the impact of the economic slowdown on claim frequency ...
A Georgia bankruptcy law firm sued its insurer last week seeking business interruption coverage for income it allegedly lost after courtrooms in the state were closed due to the COVID-19 pandemic. The case is Karmel Davis and Associates v. Hartford Financial Services Group, case number 1:20-mi-99999, in the U.S. District Court for the Northern District of Georgia.
In the proposed class-action suit the Douglasville, Georgia-based law firm argues that the coronavirus caused direct physical loss to its own office, triggering business interruption coverage under its policy.
Karmel Davis is seeking to represent a nationwide class of policyholders whose business insurance claims with Hartford were denied, whose insurance policies do not exclude viruses and who experienced business suspension due to civil authority orders during the pandemic.
In the suit, Karmel Davis claimed that Hartford is straining its credibility by stating that it is unaware of the statewide shelter order that implicates the civil authority coverage. The novel coronavirus can create physical damage because it can stay on a property's surface for days, the firm added.The firm contended that COVID-19 does not trigger the pollution exclusion in the policy because "a virus is not a solid, liquid, gaseous, or thermal irritant or contaminant."
In addition, the policy covers losses that result from damage to a "dependent property," which for Karmel Davis includes bankruptcy courts that have closed or reduced services since government-ordered lockdowns began in March, the suit states.
"Plaintiff suffered an actual loss of Business Income due to direct physical loss or physical damage to the Bankruptcy Court (a Dependent Property)," the suit states.
In a statement, Hartford said: "Unfortunately, viruses are generally outside the scope of business interruption coverage due to the absence of any physical damage. These policies do not cover this exposure and, accordingly, premiums were never collected for it."
Meanwhile, the policyholder in one of the first COVID-19 lawsuits to be ruled on has withdrawn its appeal. According to court papers, Social Life Magazine on Friday withdrew its appeal of a federal district court judge’s ruling that it was not owed coverage for coronavirus-related income losses ...
In the proposed class-action suit the Douglasville, Georgia-based law firm argues that the coronavirus caused direct physical loss to its own office, triggering business interruption coverage under its policy.
Karmel Davis is seeking to represent a nationwide class of policyholders whose business insurance claims with Hartford were denied, whose insurance policies do not exclude viruses and who experienced business suspension due to civil authority orders during the pandemic.
In the suit, Karmel Davis claimed that Hartford is straining its credibility by stating that it is unaware of the statewide shelter order that implicates the civil authority coverage. The novel coronavirus can create physical damage because it can stay on a property's surface for days, the firm added.The firm contended that COVID-19 does not trigger the pollution exclusion in the policy because "a virus is not a solid, liquid, gaseous, or thermal irritant or contaminant."
In addition, the policy covers losses that result from damage to a "dependent property," which for Karmel Davis includes bankruptcy courts that have closed or reduced services since government-ordered lockdowns began in March, the suit states.
"Plaintiff suffered an actual loss of Business Income due to direct physical loss or physical damage to the Bankruptcy Court (a Dependent Property)," the suit states.
In a statement, Hartford said: "Unfortunately, viruses are generally outside the scope of business interruption coverage due to the absence of any physical damage. These policies do not cover this exposure and, accordingly, premiums were never collected for it."
Meanwhile, the policyholder in one of the first COVID-19 lawsuits to be ruled on has withdrawn its appeal. According to court papers, Social Life Magazine on Friday withdrew its appeal of a federal district court judge’s ruling that it was not owed coverage for coronavirus-related income losses ...
The following WCAB offices are closed effective Monday, June 1 until further notice due to the impact of violent protests in the area: Fresno, Long Beach, Los Angeles, Oakland, Pomona, Redding, Riverside, San Bernardino, San Diego, San Francisco, San Jose, Santa Ana, Santa Barbara, Santa Rosa, Stockton, and Van Nuys
However, the Division of Workers’ Compensation and Workers’ Compensation Appeals Board continue to improve their operations during the COVID-19 pandemic. The following changes are effective June 8:
Updated Hearing Procedures Starting June 8:
DWC will continue to hear all mandatory settlement conferences, priority conferences, status conferences, case-in-chief trials and expedited hearings telephonically via the individually assigned judges’ conference lines as announced in DWC’s Newslines issued on April 3 and April 28.
Beginning June 8, DWC will hear up to 3 lien conferences per judge per calendar session via the individually assigned judges’ conference lines. Lien conferences in excess of that number will be continued.
All parties scheduled for a hearing should call the conference line for the judge in front of whom the case is set, at the designated time listed on the hearing notice. When prompted, the parties should enter the access code assigned to that line. DWC staff will instruct participants as to the procedure to follow during the call.
All lien trials will be continued during this time. District offices will not hold in-person hearings.
Continuing Filing Procedures:
DWC will not accept walk-in filings, walk-through documents, or in-person requests at this time. DWC will only accept electronic filing via EAMS and JET File, and paper filing by U.S. mail.
DWC will accept limited email filings pursuant to WCAB’s en banc dated April 6 and its Newsline issued on April 23. Email filings are limited to documents that are subject to a statute of limitations that cannot otherwise be efiled, JET filed, or filed by U.S. mail.
DWC has posted additional information to assist parties with filing settlement documents in EAMS. Refer to the district office page for email and other contact information.
DWC will continue to accept an electronic signature on any settlement documents, applications, pleadings, petitions or motions that are sent to the district offices or filed in EAMS. For all e-forms, parties should utilize “S signature” as shown in the E-forms Filing Reference Guide and the JET File Business Rules.
Injured workers who are unable to file utilizing the available options or need assistance may contact DWC’s call center at (909) 383-4522.
The WCAB Commissioners' office is closed to the public for in-person inquiries and requests until further notice. The Commissioners and staff are working remotely during the closure ...
However, the Division of Workers’ Compensation and Workers’ Compensation Appeals Board continue to improve their operations during the COVID-19 pandemic. The following changes are effective June 8:
Updated Hearing Procedures Starting June 8:
DWC will continue to hear all mandatory settlement conferences, priority conferences, status conferences, case-in-chief trials and expedited hearings telephonically via the individually assigned judges’ conference lines as announced in DWC’s Newslines issued on April 3 and April 28.
Beginning June 8, DWC will hear up to 3 lien conferences per judge per calendar session via the individually assigned judges’ conference lines. Lien conferences in excess of that number will be continued.
All parties scheduled for a hearing should call the conference line for the judge in front of whom the case is set, at the designated time listed on the hearing notice. When prompted, the parties should enter the access code assigned to that line. DWC staff will instruct participants as to the procedure to follow during the call.
All lien trials will be continued during this time. District offices will not hold in-person hearings.
Continuing Filing Procedures:
DWC will not accept walk-in filings, walk-through documents, or in-person requests at this time. DWC will only accept electronic filing via EAMS and JET File, and paper filing by U.S. mail.
DWC will accept limited email filings pursuant to WCAB’s en banc dated April 6 and its Newsline issued on April 23. Email filings are limited to documents that are subject to a statute of limitations that cannot otherwise be efiled, JET filed, or filed by U.S. mail.
DWC has posted additional information to assist parties with filing settlement documents in EAMS. Refer to the district office page for email and other contact information.
DWC will continue to accept an electronic signature on any settlement documents, applications, pleadings, petitions or motions that are sent to the district offices or filed in EAMS. For all e-forms, parties should utilize “S signature” as shown in the E-forms Filing Reference Guide and the JET File Business Rules.
Injured workers who are unable to file utilizing the available options or need assistance may contact DWC’s call center at (909) 383-4522.
The WCAB Commissioners' office is closed to the public for in-person inquiries and requests until further notice. The Commissioners and staff are working remotely during the closure ...
The recently ousted head of Aviron Pictures, William Sadleir, 66, of Beverly Hills, was arrested on federal fraud charges that allege he applied for $1.7 million in loans under the Paycheck Protection Program (PPP), falsely certified that the money would be used to finance the operations of other Aviron entities, and then used some of the relief funds for his personal expenses.
A criminal complaint that accuses him of fraudulently filing bank loan applications that sought more than $1.7 million dollars in forgivable PPP loans guaranteed by the Small Business Administration (SBA) under the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Sadleir allegedly obtained the forgivable loans by falsely representing that the funds would be used to support payroll expenses, when, in fact, Sadleir intended to use and did use a significant portion of the funds for personal and non-business-related expenses.
Sadleir has been charged with wire fraud, bank fraud, making false statements to a financial institution, and making false statements to the Small Business Administration.
Sadleir caused applications for PPP loans to be submitted to JPMorgan Chase on behalf of Aviron Group, LLC; Aviron Licensing, LLC; and Aviron Releasing, LLC dba Regatta. The bank approved the loans, and Sadleir received more than $1.7 million. "[I]mmediately upon receiving the funds a significant amount was diverted to Sadleir’s personal accounts and used for personal expenses," the complaint alleges.
Sadleir was terminated from Aviron Pictures in late 2019, and people associated with the film production company told investigators that Sadleir currently had no role in Aviron Pictures or the related entities, according to the affidavit, which notes that Aviron Group, Aviron Licensing and Aviron Releasing are not engaged in any ongoing operations.
Authorities have linked Sadleir to the three PPP loan applications made on behalf of the three Aviron entities. All three applications claimed each company had 33 employees and monthly payroll expenses of well over $200,000. On April 30, JPMorgan Chase approved the loan applications, and the next day money was wired to nearly empty JPMorgan Chase bank accounts associated with the three entities.
Within days, nearly $1 million of the PPP loan money was transferred into Sadleir’s personal account at JPMorgan Chase, the affidavit alleges. Investigators have determined that some of this money was used to pay personal expenses, including payments to Sadleir’s and his wife’s American Express cards. One payment allegedly made with PPP loan proceeds - a $40,000 payment on Sadleir’s car loan - was reversed and JPChase Morgan froze the accounts associated with the alleged scheme.
The four charges alleged in the criminal complaint collectively carry a maximum statutory penalty of 82 years in federal prison ...
A criminal complaint that accuses him of fraudulently filing bank loan applications that sought more than $1.7 million dollars in forgivable PPP loans guaranteed by the Small Business Administration (SBA) under the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Sadleir allegedly obtained the forgivable loans by falsely representing that the funds would be used to support payroll expenses, when, in fact, Sadleir intended to use and did use a significant portion of the funds for personal and non-business-related expenses.
Sadleir has been charged with wire fraud, bank fraud, making false statements to a financial institution, and making false statements to the Small Business Administration.
Sadleir caused applications for PPP loans to be submitted to JPMorgan Chase on behalf of Aviron Group, LLC; Aviron Licensing, LLC; and Aviron Releasing, LLC dba Regatta. The bank approved the loans, and Sadleir received more than $1.7 million. "[I]mmediately upon receiving the funds a significant amount was diverted to Sadleir’s personal accounts and used for personal expenses," the complaint alleges.
Sadleir was terminated from Aviron Pictures in late 2019, and people associated with the film production company told investigators that Sadleir currently had no role in Aviron Pictures or the related entities, according to the affidavit, which notes that Aviron Group, Aviron Licensing and Aviron Releasing are not engaged in any ongoing operations.
Authorities have linked Sadleir to the three PPP loan applications made on behalf of the three Aviron entities. All three applications claimed each company had 33 employees and monthly payroll expenses of well over $200,000. On April 30, JPMorgan Chase approved the loan applications, and the next day money was wired to nearly empty JPMorgan Chase bank accounts associated with the three entities.
Within days, nearly $1 million of the PPP loan money was transferred into Sadleir’s personal account at JPMorgan Chase, the affidavit alleges. Investigators have determined that some of this money was used to pay personal expenses, including payments to Sadleir’s and his wife’s American Express cards. One payment allegedly made with PPP loan proceeds - a $40,000 payment on Sadleir’s car loan - was reversed and JPChase Morgan froze the accounts associated with the alleged scheme.
The four charges alleged in the criminal complaint collectively carry a maximum statutory penalty of 82 years in federal prison ...
Barbara Justice was a workers’ compensation claims adjuster for the County of Santa Clara. She fell at work in 2011 and injured her left knee. She later developed problems in her right knee, which was found to be a compensable consequence of the injury to her left knee. In 2012, Justice had total knee replacement surgery on the right knee. In 2013, she had total knee replacement surgery on her left knee.
The AME testified that a 2012 X-ray of her knees showed "marked osteoarthritis" of the knees. An MRI conducted in 2012, showed that she had suffered a medial and lateral meniscal tear as a result of the fall at work and also revealed significant preexisting degeneration, all of which predated the fall at work: an "old" tear of the anterior cruciate ligament, "marked loss of articular cartilage in the medial compartment," "moderate loss of articular cartilage in the lateral compartment," and "moderate loss in the patellofemoral joint." There was also scar tissue on both knees indicating that Justice had undergone a "significant open procedure" at some point in the past.
The agreed medical examiner thought the permanent disability should be apportioned 50/50,
The workers’ compensation judge then stated that prior to the decision in Hikida v. Workers’ Comp. Appeals Bd. (2017) 12 Cal.App.5th 1249 (Hikida), he would have issued a decision awarding permanent disability with 50% apportionment based upon the AME's opinion. However, Hikida precluded apportionment in this case because the ratings were based upon having total knee replacements. Since both were the result of medical care, he awarded permanent disability of 48 percent without apportionment.
The WCAB denied reconsideration (except to correct a clerical error). However the Court of Appeal reversed in the Published opinion of County of Santa Clara v WCAB and Barbara Justice.
The Court of Appeal found the case of City of Petaluma v. Workers’ Comp. Appeals Bd. (2018) 29 Cal.App.5th 1175, 1181-1182 to be instructive. In that case, police officer Aaron Lindh was engaged in a canine training exercise when he took blows to the left side of his head . He first suffered severe headaches, and weeks later "suddenly lost most of the vision in his left eye." The QME said that Lindh had a congenital abnormality that caused poor blood circulation in his left eye. Without the injury, he most likely would have retained a lot of his vision in that eye. But that it was unlikely Lindh would have suffered a vision loss if he had not had the ‘underlying condition.Thus, the examiner apportioned 85 percent of the permanent disability to the preexisting condition, and 15 percent to the industrial injury.
As in Petaluma, the injured worker in the instant case had an extensive preexisting pathology that when combined with an industrial injury, led to permanent disability. The preexisting pathology was well documented. "The workers’ compensation judge and the Board believed that Hikida dictated a different result. Not so." ... ", the Hikida court’s conclusion that there should be no apportionment makes sense only because the medical treatment in Hikida resulted in a new compensable consequential injury, namely CRPS, which was entirely the result of the industrial medical treatment." ...
The AME testified that a 2012 X-ray of her knees showed "marked osteoarthritis" of the knees. An MRI conducted in 2012, showed that she had suffered a medial and lateral meniscal tear as a result of the fall at work and also revealed significant preexisting degeneration, all of which predated the fall at work: an "old" tear of the anterior cruciate ligament, "marked loss of articular cartilage in the medial compartment," "moderate loss of articular cartilage in the lateral compartment," and "moderate loss in the patellofemoral joint." There was also scar tissue on both knees indicating that Justice had undergone a "significant open procedure" at some point in the past.
The agreed medical examiner thought the permanent disability should be apportioned 50/50,
The workers’ compensation judge then stated that prior to the decision in Hikida v. Workers’ Comp. Appeals Bd. (2017) 12 Cal.App.5th 1249 (Hikida), he would have issued a decision awarding permanent disability with 50% apportionment based upon the AME's opinion. However, Hikida precluded apportionment in this case because the ratings were based upon having total knee replacements. Since both were the result of medical care, he awarded permanent disability of 48 percent without apportionment.
The WCAB denied reconsideration (except to correct a clerical error). However the Court of Appeal reversed in the Published opinion of County of Santa Clara v WCAB and Barbara Justice.
The Court of Appeal found the case of City of Petaluma v. Workers’ Comp. Appeals Bd. (2018) 29 Cal.App.5th 1175, 1181-1182 to be instructive. In that case, police officer Aaron Lindh was engaged in a canine training exercise when he took blows to the left side of his head . He first suffered severe headaches, and weeks later "suddenly lost most of the vision in his left eye." The QME said that Lindh had a congenital abnormality that caused poor blood circulation in his left eye. Without the injury, he most likely would have retained a lot of his vision in that eye. But that it was unlikely Lindh would have suffered a vision loss if he had not had the ‘underlying condition.Thus, the examiner apportioned 85 percent of the permanent disability to the preexisting condition, and 15 percent to the industrial injury.
As in Petaluma, the injured worker in the instant case had an extensive preexisting pathology that when combined with an industrial injury, led to permanent disability. The preexisting pathology was well documented. "The workers’ compensation judge and the Board believed that Hikida dictated a different result. Not so." ... ", the Hikida court’s conclusion that there should be no apportionment makes sense only because the medical treatment in Hikida resulted in a new compensable consequential injury, namely CRPS, which was entirely the result of the industrial medical treatment." ...
Unlicensed insurance agent Ai Ling Lee, also known as Linda Lee, 60, of Hacienda Heights, was arrested on nine felony counts of grand theft after allegedly stealing approximately half a million dollars in clients’ insurance premium payments and failing to place adequate coverage for her clients’ small businesses.
An investigation by the Department of Insurance found Lee, as owner/operator of Jubilee Insurance Services, allegedly acted as an insurance agent to steal half a million dollars in premium payments even though she was not properly licensed by the department.
Lee accepted premium payments from her clients to place liability, property or workers’ compensation insurance coverage for their small businesses. Lee failed to place insurance coverage or allowed the coverage to lapse for nonpayment leaving her clients’ small businesses, including restaurants, construction companies and biochemical companies at risk.
In order to inflate premium payments and hide her alleged embezzlement, Lee altered declaration pages for several clients. The premium payments collected by Lee were either not remitted to insurance carriers or only partially paid. Lee also allegedly forged clients’ signatures on finance agreements in order to finance some of the insurance premiums without her clients’ knowledge or consent.
Lee was arrested on Friday, May 22, 2020, and is scheduled to appear in court on September 30, 2020. This case is being prosecuted by the White Collar Crime Division of the Los Angeles County District Attorney’s Office.
The Department of Insurance issued a Cease and Desist Order against Lee on August 7, 2018, and revoked her business’, Jubilee Insurance Services, license on December 1, 2018.
People can check the license status of their agent or contact the Department of Insurance at 800-927-4357 if they suspect they are victims of insurance fraud ...
An investigation by the Department of Insurance found Lee, as owner/operator of Jubilee Insurance Services, allegedly acted as an insurance agent to steal half a million dollars in premium payments even though she was not properly licensed by the department.
Lee accepted premium payments from her clients to place liability, property or workers’ compensation insurance coverage for their small businesses. Lee failed to place insurance coverage or allowed the coverage to lapse for nonpayment leaving her clients’ small businesses, including restaurants, construction companies and biochemical companies at risk.
In order to inflate premium payments and hide her alleged embezzlement, Lee altered declaration pages for several clients. The premium payments collected by Lee were either not remitted to insurance carriers or only partially paid. Lee also allegedly forged clients’ signatures on finance agreements in order to finance some of the insurance premiums without her clients’ knowledge or consent.
Lee was arrested on Friday, May 22, 2020, and is scheduled to appear in court on September 30, 2020. This case is being prosecuted by the White Collar Crime Division of the Los Angeles County District Attorney’s Office.
The Department of Insurance issued a Cease and Desist Order against Lee on August 7, 2018, and revoked her business’, Jubilee Insurance Services, license on December 1, 2018.
People can check the license status of their agent or contact the Department of Insurance at 800-927-4357 if they suspect they are victims of insurance fraud ...
Please join Bernadette M. O’Brien, Esq., SPHR, of Floyd Skeren Manukian Langevin, along with Senior Partners John B. Floyd, Esq. and Amanda A. Manukian, Esq., this Friday for an updated COVID-19 Webinar. The presentation will featuring special guest speakers, Dr. Nachman Brautbar, M.D., medical expert, practicing physician and Managing Partner of Ford & Wallach, Scott Ford Esq., for important updated information on workers’ compensation and COVID-19.
Topics Include:
-- An employment law update on issues pertained of COVID-19 provided by Ms. O’Brien;
-- Update on the work comp presumption and the impact on California COVID-19 claims;
-- Workers’ compensation case scenarios;
-- DOL’s enforcement of paid sick leave laws;
-- Reopening guidance and requirements;
-- Pros and Cons of "Immunity Certificates"; and
-- Common questions
Friday, May 29, 2020 from 10:00 am until 12:00 pm (PST). Webinar is free. Please register online
Contact: Rebecca.zandovskis@floydskerenlaw.com for assistance.
Bernadette M. O’Brien is a Partner at Floyd Skeren Manukian Langevin, LLP, and an SPHR/SHRM-SCP certified Human Resources Consultant.
Ms. O’Brien is author of the LexisNexis publication Labor and Employment in California: A Guide to Employment Laws, Regulations and Practices, co-author of California Leave Law: A Practical Guide for Employers, and co-author of California Unemployment Insurance and Disability Compensation Programs ...
Topics Include:
-- An employment law update on issues pertained of COVID-19 provided by Ms. O’Brien;
-- Update on the work comp presumption and the impact on California COVID-19 claims;
-- Workers’ compensation case scenarios;
-- DOL’s enforcement of paid sick leave laws;
-- Reopening guidance and requirements;
-- Pros and Cons of "Immunity Certificates"; and
-- Common questions
Friday, May 29, 2020 from 10:00 am until 12:00 pm (PST). Webinar is free. Please register online
Contact: Rebecca.zandovskis@floydskerenlaw.com for assistance.
Bernadette M. O’Brien is a Partner at Floyd Skeren Manukian Langevin, LLP, and an SPHR/SHRM-SCP certified Human Resources Consultant.
Ms. O’Brien is author of the LexisNexis publication Labor and Employment in California: A Guide to Employment Laws, Regulations and Practices, co-author of California Leave Law: A Practical Guide for Employers, and co-author of California Unemployment Insurance and Disability Compensation Programs ...
Mihran Stepanyan, Artur Stepanyan, Yan German, and Khachig Geuydjian pleaded guilty to crimes stemming from their respective roles in a wide-ranging racketeering conspiracy involving diversion of prescription drugs, money laundering, bank fraud, identity theft, and additional crimes, This leaves one remaining defendant to stand trial for allegations made in a Second Superseding Indictment filed in February of 2016 against 38 defendants.
The crimes committed by these defendants ranged from picking up drugs at a pizza shop to a half-million-dollar tax check fraud scheme. In total, more than $199 million in diverted prescription drug proceeds were laundered through bank accounts established with false identities and shell companies.
The four acknowledged that they were members of a nationwide conspiracy referred to in court documents as the Karapedyan-Stepanyan Enterprise. One key aspect of the criminal activity was a multi-million dollar prescription drug diversion scheme.
Members and associates of the Enterprise procured prescription drugs from unlicensed sources, usually street dealers, and resold the drugs to unknowing customers. The Stepanyans also admitted that they are not licensed to sell drugs, that they procured millions of dollars of drugs through street suppliers and other unlicensed sources, and that the drugs they procured eventually were resold as legitimate products.
Members of the Enterprise conducted the affairs of the organization through a pattern of racketeering and committed crimes throughout California as well as in Minnesota, Ohio, and Puerto Rico. Members and associates of the Enterprise procured and distributed a wide variety of drugs from unlicensed sources for distribution throughout the country.
The drugs included medications used to treat HIV infection, Type-2 diabetes, dementia, and high blood pressure, among other conditions.
Members and associates of the Enterprise also created false and fraudulent paperwork, referred to as pedigrees, to make it appear that those drugs had been purchased from legitimate sources. In addition, they created sham companies and used multiple bank accounts to receive and distribute the proceeds from their fraudulent transactions.
The plea agreements also describe how the Stepanyans, along with other members and associates of the Enterprise, intentionally used the identities of real people to carry out their unlawful objectives.
Geuydjian’s plea agreement describes how he negotiated fraudulent personal and tax checks for the benefit of the Enterprise, and German’s plea agreement describes how he supplied drugs for distribution by the Enterprise and managed aspects of the Enterprise’s money laundering operations.
Stepanyan became a member of the Enterprise as early as January 2010. He admitted that he agreed with his co-conspirators to commit multiple criminal acts involving money laundering, mail fraud, wire fraud, bank fraud, identity theft, and multiple acts involving the distribution of drugs from unlicensed sources to conduct the affairs of the Enterprise. Stepanyan admitted that he controlled several entities through which approximately $199 million of pharmaceutical money flowed between 2010 and 2014.
All four defendants pleading guilty have released on bond pending sentencing. A majority of the defendants in this case have pleaded guilty to various charges ...
The crimes committed by these defendants ranged from picking up drugs at a pizza shop to a half-million-dollar tax check fraud scheme. In total, more than $199 million in diverted prescription drug proceeds were laundered through bank accounts established with false identities and shell companies.
The four acknowledged that they were members of a nationwide conspiracy referred to in court documents as the Karapedyan-Stepanyan Enterprise. One key aspect of the criminal activity was a multi-million dollar prescription drug diversion scheme.
Members and associates of the Enterprise procured prescription drugs from unlicensed sources, usually street dealers, and resold the drugs to unknowing customers. The Stepanyans also admitted that they are not licensed to sell drugs, that they procured millions of dollars of drugs through street suppliers and other unlicensed sources, and that the drugs they procured eventually were resold as legitimate products.
Members of the Enterprise conducted the affairs of the organization through a pattern of racketeering and committed crimes throughout California as well as in Minnesota, Ohio, and Puerto Rico. Members and associates of the Enterprise procured and distributed a wide variety of drugs from unlicensed sources for distribution throughout the country.
The drugs included medications used to treat HIV infection, Type-2 diabetes, dementia, and high blood pressure, among other conditions.
Members and associates of the Enterprise also created false and fraudulent paperwork, referred to as pedigrees, to make it appear that those drugs had been purchased from legitimate sources. In addition, they created sham companies and used multiple bank accounts to receive and distribute the proceeds from their fraudulent transactions.
The plea agreements also describe how the Stepanyans, along with other members and associates of the Enterprise, intentionally used the identities of real people to carry out their unlawful objectives.
Geuydjian’s plea agreement describes how he negotiated fraudulent personal and tax checks for the benefit of the Enterprise, and German’s plea agreement describes how he supplied drugs for distribution by the Enterprise and managed aspects of the Enterprise’s money laundering operations.
Stepanyan became a member of the Enterprise as early as January 2010. He admitted that he agreed with his co-conspirators to commit multiple criminal acts involving money laundering, mail fraud, wire fraud, bank fraud, identity theft, and multiple acts involving the distribution of drugs from unlicensed sources to conduct the affairs of the Enterprise. Stepanyan admitted that he controlled several entities through which approximately $199 million of pharmaceutical money flowed between 2010 and 2014.
All four defendants pleading guilty have released on bond pending sentencing. A majority of the defendants in this case have pleaded guilty to various charges ...
An initiative that would overturn provisions of AB 5 applying to app-based transportation and delivery drivers has qualified for the November ballot in California. The "Protect App-Based Drivers and Services Act" was written in response to last year's passage of AB 5. If passed by the voters, the initiative would add Chapter 10.5 (commencing with Section 7448) to Division 3 of the Business and Professions Code with approximately 18 pages of new law.
On August 30, 2019, three companies - DoorDash, Lyft, and Uber - each placed $30 million into campaign accounts to fund the ballot initiative campaign. Subsequently Instacart (Maplebear, Inc.) and Postmates Inc. contributed $10 million each to the effort.
Backers of the initiative say it would allow app-based drivers to gain additional income by working a few hours a week on schedules they determine as independent contractors. The official ballot title will be "Changes Employment Classification Rules for App-based Transportation and Delivery Drivers. Initiative Statute."
The ballot measure would enact labor and wage policies specific to app-based drivers and companies, including a net earnings floor based on 120 percent of the state's or municipality's minimum wage and 30 cents per mile; a limit to the hours permitted to work during a 24-hour period; healthcare subsidies; occupational accident insurance; and accidental death insurance. The ballot measure would also require the companies to develop anti-discrimination and sexual harassment policies.
Opponents, led by the California Labor Federation, say passage of the initiative would remove protections for app-based drivers, such as paid sick and family leave, health insurance and workers' compensation. The Coalition to Protect Riders and Drivers, Sponsored by the California Labor Federation, AFL-CIO contributed $690 thousand to defeat the initiative.
If approved by voters, the initiative would require companies with independent contractor drivers to provide specified alternative benefits, including minimum compensation and health care subsidies based on engaged driving time, vehicle insurance, safety training and sexual harassment policies.
The initiative would also restrict local regulation of app-based drivers, criminalize impersonation of such drivers and require background checks. Interestingly, the last sentence of the proposed law provides that "this Act shall be liberally construed in order to effectuate its purposes."
The initiative needed at least 685,534 projected valid signatures to become eligible by random sampling. It exceeded that threshold Friday, Secretary of State Alex Padilla announced ...
On August 30, 2019, three companies - DoorDash, Lyft, and Uber - each placed $30 million into campaign accounts to fund the ballot initiative campaign. Subsequently Instacart (Maplebear, Inc.) and Postmates Inc. contributed $10 million each to the effort.
Backers of the initiative say it would allow app-based drivers to gain additional income by working a few hours a week on schedules they determine as independent contractors. The official ballot title will be "Changes Employment Classification Rules for App-based Transportation and Delivery Drivers. Initiative Statute."
The ballot measure would enact labor and wage policies specific to app-based drivers and companies, including a net earnings floor based on 120 percent of the state's or municipality's minimum wage and 30 cents per mile; a limit to the hours permitted to work during a 24-hour period; healthcare subsidies; occupational accident insurance; and accidental death insurance. The ballot measure would also require the companies to develop anti-discrimination and sexual harassment policies.
Opponents, led by the California Labor Federation, say passage of the initiative would remove protections for app-based drivers, such as paid sick and family leave, health insurance and workers' compensation. The Coalition to Protect Riders and Drivers, Sponsored by the California Labor Federation, AFL-CIO contributed $690 thousand to defeat the initiative.
If approved by voters, the initiative would require companies with independent contractor drivers to provide specified alternative benefits, including minimum compensation and health care subsidies based on engaged driving time, vehicle insurance, safety training and sexual harassment policies.
The initiative would also restrict local regulation of app-based drivers, criminalize impersonation of such drivers and require background checks. Interestingly, the last sentence of the proposed law provides that "this Act shall be liberally construed in order to effectuate its purposes."
The initiative needed at least 685,534 projected valid signatures to become eligible by random sampling. It exceeded that threshold Friday, Secretary of State Alex Padilla announced ...
Along with hair stylists, camera operators and the hundreds of others who make magic happen for TV and film, Hollywood is counting on a new supporting member for future productions: COVID-19 consultants.
According to the report in Reuters, the coronavirus pandemic has prompted producers, movie studios and workers’ unions to seek expert advice on how to safely reopen film and TV sets, which shut down worldwide in mid-March.
In demand are epidemiologists and other public health specialists to provide detailed strategies for dealing with large crews who work in cramped spaces, makeup artists who get face-to-face with stars, and actors who kiss, hug and fight on set.
The shutdown has taken a severe financial toll across the industry, as well as on cities such as Los Angeles that benefit economically from production. Restarting is important to companies, including Netflix Inc, Walt Disney Co and others, which need fresh programming to engage audiences.
While sets remain empty in the United States, productions are ramping back up in South Korea, Australia, Sweden, as well as New Zealand, where James Cameron’s "Avatar 2" is restarting this week.
People who work in the industry expect to see smaller crews, regular testing, hand sanitizer everywhere and the use of computer-generated imagery to create big crowds on screen when work resumes.
Unions representing actors and set employees, including SAG-AFTRA, IATSE and the Directors Guild of America, have hired experts from Harvard and the University of California to help develop guidelines.
All are looking to California Gov. Gavin Newsom, who is taking input from labor and industry representatives and said he is aiming to release protocols for film and TV shoots as early as this week.
Handling the coronavirus is complicated in television because many workers are freelancers, said Dr. Paul Litchfield, an occupational physician, who helped develop guidelines for TV networks in Britain.
"People are moving in and out of your bubble to other productions with other companies," he said. "So it’s making sure that the guidance is consistent across (TV) companies." ...
According to the report in Reuters, the coronavirus pandemic has prompted producers, movie studios and workers’ unions to seek expert advice on how to safely reopen film and TV sets, which shut down worldwide in mid-March.
In demand are epidemiologists and other public health specialists to provide detailed strategies for dealing with large crews who work in cramped spaces, makeup artists who get face-to-face with stars, and actors who kiss, hug and fight on set.
The shutdown has taken a severe financial toll across the industry, as well as on cities such as Los Angeles that benefit economically from production. Restarting is important to companies, including Netflix Inc, Walt Disney Co and others, which need fresh programming to engage audiences.
While sets remain empty in the United States, productions are ramping back up in South Korea, Australia, Sweden, as well as New Zealand, where James Cameron’s "Avatar 2" is restarting this week.
People who work in the industry expect to see smaller crews, regular testing, hand sanitizer everywhere and the use of computer-generated imagery to create big crowds on screen when work resumes.
Unions representing actors and set employees, including SAG-AFTRA, IATSE and the Directors Guild of America, have hired experts from Harvard and the University of California to help develop guidelines.
All are looking to California Gov. Gavin Newsom, who is taking input from labor and industry representatives and said he is aiming to release protocols for film and TV shoots as early as this week.
Handling the coronavirus is complicated in television because many workers are freelancers, said Dr. Paul Litchfield, an occupational physician, who helped develop guidelines for TV networks in Britain.
"People are moving in and out of your bubble to other productions with other companies," he said. "So it’s making sure that the guidance is consistent across (TV) companies." ...
The COVID-19 pandemic and resultant stay-at-home orders are significantly impacting California’s economic, health care and workers’ compensation systems. Many COVID-19 workers’ compensation claims have already been filed. However, at this time, it is unclear what proportion of the illnesses and deaths resulting from the virus will ultimately be determined to be work-related.
On May 6, 2020, the Governor issued Executive Order N-62-20 (Order) providing for a rebuttable presumption of compensability for all workers directed by their employer to work outside the home. Key provisions of the Order include:
-- Rebuttable presumption of compensability applied to workers contracting COVID-19 who worked outside of their home or residence at the employer’s direction within 14 days prior to diagnosis
-- Presumption limited to dates of injury from March 19, 2020 to July 5, 2020
-- Requires a positive test for COVID-19 or a diagnosis of COVID-19 by a licensed physician that is confirmed by a positive test within 30 days
-- Temporary disability must be certified by a physician and can be offset by COVID-19 related sick leave
-- Elimination of death benefits for workers with no dependents that are usually paid to the state
The WCIRB has evaluated the potential workers’ compensation claims cost arising from COVID-19 claims under the Order. While some of the workers who are directed to work outside their home during this period have filed or would file a compensable workers’ compensation claim in the absence of a rebuttable presumption, we had no basis to estimate this proportion and, as a result, made no estimate of the incremental impact of the Order. Also, since an actual positive test or diagnosis of COVID-19 is required for the Order to apply, our cost estimates exclude any potential costs for workers who are quarantined, but have not been diagnosed with COVID-19. Finally, our estimates reflect the potential cost impact arising from COVID-19 diagnoses during the time the Order applies and do not reflect costs for potential extensions of the Order or future legislation.
The cost estimates in this Research Brief are based on WCIRB data including unit statistical reports, aggregate financial data calls and medical transaction data. The WCIRB estimates that the cost of COVID-19 claims filed by workers subject to the Order ranges from $0.6 billion to $2.0 billion with a mid-range estimate of $1.2 billion. This mid-range estimate comprises 7% of the $18.3 billion estimated annual cost of workers’ compensation claims in the system prior to the pandemic ...
On May 6, 2020, the Governor issued Executive Order N-62-20 (Order) providing for a rebuttable presumption of compensability for all workers directed by their employer to work outside the home. Key provisions of the Order include:
-- Rebuttable presumption of compensability applied to workers contracting COVID-19 who worked outside of their home or residence at the employer’s direction within 14 days prior to diagnosis
-- Presumption limited to dates of injury from March 19, 2020 to July 5, 2020
-- Requires a positive test for COVID-19 or a diagnosis of COVID-19 by a licensed physician that is confirmed by a positive test within 30 days
-- Temporary disability must be certified by a physician and can be offset by COVID-19 related sick leave
-- Elimination of death benefits for workers with no dependents that are usually paid to the state
The WCIRB has evaluated the potential workers’ compensation claims cost arising from COVID-19 claims under the Order. While some of the workers who are directed to work outside their home during this period have filed or would file a compensable workers’ compensation claim in the absence of a rebuttable presumption, we had no basis to estimate this proportion and, as a result, made no estimate of the incremental impact of the Order. Also, since an actual positive test or diagnosis of COVID-19 is required for the Order to apply, our cost estimates exclude any potential costs for workers who are quarantined, but have not been diagnosed with COVID-19. Finally, our estimates reflect the potential cost impact arising from COVID-19 diagnoses during the time the Order applies and do not reflect costs for potential extensions of the Order or future legislation.
The cost estimates in this Research Brief are based on WCIRB data including unit statistical reports, aggregate financial data calls and medical transaction data. The WCIRB estimates that the cost of COVID-19 claims filed by workers subject to the Order ranges from $0.6 billion to $2.0 billion with a mid-range estimate of $1.2 billion. This mid-range estimate comprises 7% of the $18.3 billion estimated annual cost of workers’ compensation claims in the system prior to the pandemic ...
The California Workers’ Compensation Institute (CWCI) has issued a white paper that looks at the historic role of workers’ compensation presumptions, the current and proposed COVID-19 presumptions and results of a survey detailing characteristics and outcomes of initial COVID-19 claims.
On May 6, Governor Newsom issued Executive Order N-62-20 creating a disputable presumption of compensability for COVID-19 as it relates to California workers directed by their employers to work outside the home. The order applies to work performed on or after March 19, 2020 and unless extended, will remain in place until July 5, 2020.
Beyond that, a legislative approach has been proposed in SB 1159 (Hill, Daly) which would create a disputable COVID-19 presumption with an extended timeframe for first responders and "critical" workers, a group that has yet to be specifically defined, but that would include public or private sector employees working to combat the spread of the virus.
The CWCI analysis compares the differences between the current and proposed presumptions, but notes that both shift the traditional burden of proof found in workers’ compensation by no longer requiring employees to prove the illness is work-related, instead requiring employers to accept compensability for a COVID-19 claim unless they can overwhelmingly prove it is not work-related.
Although COVID-19 is new to workers’ compensation, the analysis also reviews existing precedents and policies regarding presumptions that policymakers should consider in evaluating the potential impacts of modifying the existing workers’ compensation legal architecture in regard to compensability and coverage.
The white paper also adds real-world perspective to advance the presumption debate by providing results of a survey of 28 insurer and self-insured CWCI members that encompassed 1,077 California workers’ compensation COVID-19 claims filed before April 30, a week before the governor’s Order granted the disputable presumption.
Among key results, the survey found that 35% of the COVID-19 claims in the study sample were denied, but 7 out of 10 workers whose claims were denied tested negative for the virus, with the balance of the denials made after it was found that the employee had not been exposed at work, or for other reasons including the lack of a diagnosis, lack of symptoms, or that the employee had been working at home or refused to take a COVID-19 test.
CWCI has released the white paper as a Report to the Industry, "Integrating COVID-19 Presumptions into the California Workers’ Compensation System." The free report is available on the CWCI website ...
On May 6, Governor Newsom issued Executive Order N-62-20 creating a disputable presumption of compensability for COVID-19 as it relates to California workers directed by their employers to work outside the home. The order applies to work performed on or after March 19, 2020 and unless extended, will remain in place until July 5, 2020.
Beyond that, a legislative approach has been proposed in SB 1159 (Hill, Daly) which would create a disputable COVID-19 presumption with an extended timeframe for first responders and "critical" workers, a group that has yet to be specifically defined, but that would include public or private sector employees working to combat the spread of the virus.
The CWCI analysis compares the differences between the current and proposed presumptions, but notes that both shift the traditional burden of proof found in workers’ compensation by no longer requiring employees to prove the illness is work-related, instead requiring employers to accept compensability for a COVID-19 claim unless they can overwhelmingly prove it is not work-related.
Although COVID-19 is new to workers’ compensation, the analysis also reviews existing precedents and policies regarding presumptions that policymakers should consider in evaluating the potential impacts of modifying the existing workers’ compensation legal architecture in regard to compensability and coverage.
The white paper also adds real-world perspective to advance the presumption debate by providing results of a survey of 28 insurer and self-insured CWCI members that encompassed 1,077 California workers’ compensation COVID-19 claims filed before April 30, a week before the governor’s Order granted the disputable presumption.
Among key results, the survey found that 35% of the COVID-19 claims in the study sample were denied, but 7 out of 10 workers whose claims were denied tested negative for the virus, with the balance of the denials made after it was found that the employee had not been exposed at work, or for other reasons including the lack of a diagnosis, lack of symptoms, or that the employee had been working at home or refused to take a COVID-19 test.
CWCI has released the white paper as a Report to the Industry, "Integrating COVID-19 Presumptions into the California Workers’ Compensation System." The free report is available on the CWCI website ...
An outsized battle looms in Washington, as trade associations for trial lawyers push their own vision of open-ended lawsuits while groups like the U.S. Chamber of Commerce come down on the side of restricting litigation over coronavirus. The brewing fight in Congress, too, could become a hinge-point on whether there is a fourth major coronavirus relief package that could pass and be signed into law in the coming weeks and if there is one what it looks like.
The issue that confronts lawmakers is how to limit the scope of litigation over coronavirus while also not giving away too much to the business community.
A trial lawyer representing part of a group of celebrity chefs suing insurance giants over the pandemic, described the forthcoming fight in a quote to the Washington Post as what he said is "going to be the most expensive legal battle in history." He then predicted: The insurance companies are going to win some of those, and they’re going to lose some of those. But in the meantime, the businesses are going to fail. People are going to be out of work.
Houghtaling is a managing partner at Gauthier Murphy & Houghtaling LLC, a firm in the New Orleans suburb Metairie, Louisiana. Houghtaling is testifying before the Democrat-led House Small Business Committee on Thursday afternoon, where lawmakers will discuss the liability issues as Congress considers potentially granting a liability shield to companies nationwide upon reopening - something many Republicans consider imperative to successfully return to normal as a society.
Houghtaling is representing Thomas Keller, the celebrity chef who the Washington Post’s Tim Carman described as "the mastermind behind the three-star Michelin restaurants Per Se in New York and the French Laundry in California." Keller is one of many restauranteurs nationwide suing their insurance companies because the insurance companies are not paying them for the shutdowns caused by COVID-19.
"The owners are pressing carriers to honor business-interruption policies during an outbreak that has wreaked so much financial havoc that it could bankrupt insurance companies and put at risk claims not related to covid-19," Carman wrote in the Post.
In these particular kinds of cases, what these trial lawyers like Houghtaling and the others representing these various restaurants are looking for is for insurance companies to honor business interruption policies or to cover their clients like they would in a natural disaster even if the policies do not explicitly cover pandemics.
But this is just the tip of the iceberg for trial lawyers as the reopening battle moves forward coast to coast - cases that could be forthcoming include against states for various policies they implemented like New York Gov.
According to Politico, the American Association for Justice - a national collective of trial lawyers - released polling on the issue that forecast many potential lines of litigation that the attorneys may see coming.
"The trial lawyers hired Hart Research Associates, a Democratic polling firm, which surveyed more than 1,200 voters online last week," Politico’s Theodoric Meyer wrote earlier in May. "The pollsters told voters that companies want to prevent workers and consumers who contract coronavirus from suing them ‘even if they could demonstrate that the company engaged in unsafe practices.’ Sixty-four percent of respondents said they opposed giving companies such immunity, while 36 percent supported it."
The Chamber of Commerce, which is squarely on the other side of the fight, released its own polling according to Politico showing the exact opposite.
"A poll conducted days earlier by the Republican firm Public Opinion Strategies for the Chamber’s Institute for Legal Reform found the opposite among 800 voters surveyed by phone," Politico’s Meyer wrote. "Asked whether ‘Congress should protect many businesses and types of companies from lawsuits related to the coronavirus,’ 61 percent of voters agreed and 27 percent said no."
But no matter who is paying out and who is receiving payments as a result of litigation, and no matter who wins and who loses lawsuits, the one group that always comes out on top is the trial lawyers. That "most expensive legal battle in history" that Houghtaling describes has but one absolute winner: the trial lawyers who bring the cases ...
The issue that confronts lawmakers is how to limit the scope of litigation over coronavirus while also not giving away too much to the business community.
A trial lawyer representing part of a group of celebrity chefs suing insurance giants over the pandemic, described the forthcoming fight in a quote to the Washington Post as what he said is "going to be the most expensive legal battle in history." He then predicted: The insurance companies are going to win some of those, and they’re going to lose some of those. But in the meantime, the businesses are going to fail. People are going to be out of work.
Houghtaling is a managing partner at Gauthier Murphy & Houghtaling LLC, a firm in the New Orleans suburb Metairie, Louisiana. Houghtaling is testifying before the Democrat-led House Small Business Committee on Thursday afternoon, where lawmakers will discuss the liability issues as Congress considers potentially granting a liability shield to companies nationwide upon reopening - something many Republicans consider imperative to successfully return to normal as a society.
Houghtaling is representing Thomas Keller, the celebrity chef who the Washington Post’s Tim Carman described as "the mastermind behind the three-star Michelin restaurants Per Se in New York and the French Laundry in California." Keller is one of many restauranteurs nationwide suing their insurance companies because the insurance companies are not paying them for the shutdowns caused by COVID-19.
"The owners are pressing carriers to honor business-interruption policies during an outbreak that has wreaked so much financial havoc that it could bankrupt insurance companies and put at risk claims not related to covid-19," Carman wrote in the Post.
In these particular kinds of cases, what these trial lawyers like Houghtaling and the others representing these various restaurants are looking for is for insurance companies to honor business interruption policies or to cover their clients like they would in a natural disaster even if the policies do not explicitly cover pandemics.
But this is just the tip of the iceberg for trial lawyers as the reopening battle moves forward coast to coast - cases that could be forthcoming include against states for various policies they implemented like New York Gov.
According to Politico, the American Association for Justice - a national collective of trial lawyers - released polling on the issue that forecast many potential lines of litigation that the attorneys may see coming.
"The trial lawyers hired Hart Research Associates, a Democratic polling firm, which surveyed more than 1,200 voters online last week," Politico’s Theodoric Meyer wrote earlier in May. "The pollsters told voters that companies want to prevent workers and consumers who contract coronavirus from suing them ‘even if they could demonstrate that the company engaged in unsafe practices.’ Sixty-four percent of respondents said they opposed giving companies such immunity, while 36 percent supported it."
The Chamber of Commerce, which is squarely on the other side of the fight, released its own polling according to Politico showing the exact opposite.
"A poll conducted days earlier by the Republican firm Public Opinion Strategies for the Chamber’s Institute for Legal Reform found the opposite among 800 voters surveyed by phone," Politico’s Meyer wrote. "Asked whether ‘Congress should protect many businesses and types of companies from lawsuits related to the coronavirus,’ 61 percent of voters agreed and 27 percent said no."
But no matter who is paying out and who is receiving payments as a result of litigation, and no matter who wins and who loses lawsuits, the one group that always comes out on top is the trial lawyers. That "most expensive legal battle in history" that Houghtaling describes has but one absolute winner: the trial lawyers who bring the cases ...
A San Fernando Valley man was sentenced to 108 months in federal prison for leading a conspiracy to distribute powerful prescription opioids via sham medical clinics that hired corrupt doctors who wrote fraudulent prescriptions to black market customers.
Minas Matosyan, a.k.a. "Maserati Mike," 40, of Encino, was sentenced by United States District Judge Philip S. Gutierrez. Matosyan pleaded guilty in April 2019 to one count of conspiracy to distribute a controlled substance.
Matosyan was arrested in August 2017 pursuant to a federal grand jury indictment charging him and 12 other defendants with scheming to divert at least 2 million controlled prescription pills for sale on the black market.
According to his plea agreement, Matosyan and his co-conspirators controlled the sham clinics and hired corrupt doctors who allowed their names to be used on fraudulent prescriptions in exchange for kickbacks. Matosyan also admitted that he and his co-conspirators stole the identities of other doctors and then issued prescriptions in those doctors’ names, either by personally acquiring prescription pads in the doctors’ names or by arranging for other co-conspirators to do so.
As part of the scheme, Matosyan staffed receptionists at the clinics who would falsely verify the phony prescriptions to pharmacists who called to check on their veracity. He also sold narcotic prescriptions to black market customers – either directly or through couriers – and bulk quantities of hydrocodone and oxycodone he had acquired from phony prescriptions filled at pharmacies by other customers.
In May 2016, Matosyan offered a doctor a "very lucrative position" where the doctor would "sit home making $20,000 a month doing nothing," according to Matosyan’s plea agreement. After the doctor declined the offer, Matosyan stole the doctor’s identity, sending a co-conspirator a text message containing the doctor’s full name, medical license number and national provider identifier number that the co-conspirator used to order prescription pads in the doctor’s name. Over the next two months, Matosyan and his co-conspirators sold fraudulent prescriptions, purportedly issued by the victim doctor, for at least 9,450 pills of oxycodone and 990 pills of hydrocodone.
Matosyan also admitted in the plea agreement that he conspired with others, including a lawyer, Fred Minassian, 53, of Glendale, to obstruct justice, by providing falsifying medical records to police to thwart an investigation into the seizure of a load of Vicodin from one of the conspiracy’s major customers.
This case so far has resulted in 11 convictions. Minassian is scheduled to go on trial on July 7.
...
Minas Matosyan, a.k.a. "Maserati Mike," 40, of Encino, was sentenced by United States District Judge Philip S. Gutierrez. Matosyan pleaded guilty in April 2019 to one count of conspiracy to distribute a controlled substance.
Matosyan was arrested in August 2017 pursuant to a federal grand jury indictment charging him and 12 other defendants with scheming to divert at least 2 million controlled prescription pills for sale on the black market.
According to his plea agreement, Matosyan and his co-conspirators controlled the sham clinics and hired corrupt doctors who allowed their names to be used on fraudulent prescriptions in exchange for kickbacks. Matosyan also admitted that he and his co-conspirators stole the identities of other doctors and then issued prescriptions in those doctors’ names, either by personally acquiring prescription pads in the doctors’ names or by arranging for other co-conspirators to do so.
As part of the scheme, Matosyan staffed receptionists at the clinics who would falsely verify the phony prescriptions to pharmacists who called to check on their veracity. He also sold narcotic prescriptions to black market customers – either directly or through couriers – and bulk quantities of hydrocodone and oxycodone he had acquired from phony prescriptions filled at pharmacies by other customers.
In May 2016, Matosyan offered a doctor a "very lucrative position" where the doctor would "sit home making $20,000 a month doing nothing," according to Matosyan’s plea agreement. After the doctor declined the offer, Matosyan stole the doctor’s identity, sending a co-conspirator a text message containing the doctor’s full name, medical license number and national provider identifier number that the co-conspirator used to order prescription pads in the doctor’s name. Over the next two months, Matosyan and his co-conspirators sold fraudulent prescriptions, purportedly issued by the victim doctor, for at least 9,450 pills of oxycodone and 990 pills of hydrocodone.
Matosyan also admitted in the plea agreement that he conspired with others, including a lawyer, Fred Minassian, 53, of Glendale, to obstruct justice, by providing falsifying medical records to police to thwart an investigation into the seizure of a load of Vicodin from one of the conspiracy’s major customers.
This case so far has resulted in 11 convictions. Minassian is scheduled to go on trial on July 7.
...
