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DEA announced the release of the 2020 National Drug Threat Assessment, DEA’s annual publication outlining the threats posed to the United States by domestic and international drug trafficking and the abuse of illicit drugs.

Drugs trends in the United States continue to evolve. Although progress has been made in reducing the smuggling of fentanyl and fentanyl analogues from China following the DEA’s 2018 emergency scheduling action of fentanyl related substances and China’s enactment of fentanyl-class controls in May 2019, Mexican drug trafficking organizations have increased production causing more fentanyl to flow across our border. The opioid threat remains at epidemic levels, affecting large portions of the country. Meanwhile, the stimulant threat, including methamphetamine and cocaine, is worsening both in volume and reach, with traffickers selling increasing amounts outside of traditional markets.

According to the U.S. Centers for Disease Control and Prevention, more than 83,000 people lost their lives to drug-related overdoses in the twelve-month period ending in July of 2020, a significant increase from 2019, when more than 70,000 people died of overdoses.

Illicit fentanyl is one of the primary drugs fueling the epidemic of overdose deaths in the United States, while heroin and prescription opioids remain significant challenges to public health and law enforcement.

California highlights:

- - In 2019, California had more fentanyl seized than any other state.
- - In 2019, California, Ohio, and Texas reported the highest dollar amounts in bulk cash seizures for a combined total of $131,039,840 USC. In the first six months of 2020, California, New York, and Texas accounted for 39 percent of the bulk cash seized. Border restrictions between the United States and Mexico, brought on due to the pandemic, have increased the difficulty of transporting loads of bulk currency from the United States across the SWB into Mexico. As a result, large amounts of U.S. currency are being held along the U.S. side, awaiting transport to Mexico.
- - California had the second greatest amount of cocaine seized in 2019 due to the proximity of the Southwest Border (SWB) and high-traffic international airports and seaports.
- - DEA Field Divisions seized 6,951 kilograms of heroin in 2019, a 30 percent increase from 2018, with the largest amounts of heroin seized in Texas, California, Arizona, and New York. California, Texas and Arizona are all major entry points for heroin sourced from Mexico and also serve as transshipment points for the onward movement of heroin to domestic markets throughout the United States.
- - California leads the U.S. in methamphetamine conversion labs. Methamphetamine conversion laboratories are used to convert powder methamphetamine into crystal methamphetamine or to recrystallize methamphetamine in solution back into crystal methamphetamine.
- - In 2019, 26 percent of illicit fentanyl tablets contained a potential lethal dose of fentanyl which increased from 14 percent and 10 percent the two years prior.

Mexican cartels are increasingly responsible for producing and supplying fentanyl to the U.S. market. China remains a key source of supply for the precursor chemicals that Mexican cartels use to produce the large amounts of fentanyl they are smuggling into the United States ...
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/ 2021 News, Daily News
The National Association of Insurance Commissioners (NAIC) released data on life/fraternal and property/casualty insurers. The reports provide market share information and identify leading insurance writers in several key lines of business. The numbers in the reports will increase throughout the week and month as the report runs.

The 2020 market share data include countrywide direct written premiums for the top 25 groups and companies as reported on the state page of the annual financial statement for insurers that report to the NAIC.

The Property/Casualty Market Share report contains cumulative market share data for the following lines of business: personal auto, commercial auto, workers' compensation, medical professional liability, homeowners and other liability (excluding auto liability) insurance.

The top six carriers have more than a third of the market share (35.95%). Here are the top six.

1) Travelers Grp - Written Premium of $3,737,454,477 - - Market Share 8.91%.
2) Hartford Fire & Cas Grp - Written Premium of $2,992,053,652 - - Market Share 7.13%.
3) Zurich Ins Grp - Written Premium of $2,495,405,266 - - Market Share 5.95%.
4) Chubb Ltd Grp - Written Premium of $2,294,088,995 - - Market Share 5.47%.
5) Amtrust Financial Serv Grp - Written Premium of $1,895,538,139 - - Market Share 4.52%.
6) Berkshire Hathaway Grp - Written Premium of $1,673,865,206 - - Market Share 3.99%.

Other highlights from the report include:

- - With 69.47% of property/casualty insurance companies reporting to date, direct premiums written for all lines of business are $520,900,408,551.
- - The top 10 property/casualty companies reporting to date have a cumulative market share of 50.04%.
- - The two largest lines of business, private passenger auto and homeowners, have direct written premiums of $162,476,549,796 and $76,733,238,097, respectively, as of March 1.

The reports reflect data filed by insurers as of March 1 and will be refreshed daily through March 5 and then each Monday throughout March. The full 2020 Market Share Reports for Life/Fraternal Groups and Companies and the full 2020 Market Share Reports for Property/Casualty Groups and Companies will be available this summer and will contain more in-depth information ...
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/ 2021 News, Daily News
Following the implementation of the California Division of Occupational Safety and Health’s (Cal/OSHA) COVID-19 Emergency Temporary Standards (ETS) on November 30, 2020, several employers and trade associations filed a lawsuit in San Francisco Superior Court for declaratory and injunctive relief against Cal/OSHA.

The lawsuit, National Retail Federation, et al. v. California Department of Industrial Relations, et al. (Case No. CGC20588367), was the first filed seeking to prevent the agency from enforcing the ETS.

Shortly thereafter, the Western Growers Association filed a related case in Los Angeles Superior Court. However, in an effort to avoid "duplicative and inconsistent rulings," the Western Growers Association lawsuit was transferred to San Francisco and the cases are being heard together.

The lawsuits alleged that the ETS were improper for several reasons, including that Cal/OSHA "exceeded the scope of its authority to promote occupational safety and health by attempting to regulate wages and paid leave" and "arbitrarily and capriciously deprive[d] Plaintiffs of property without just compensation or due process, particularly with respect to the COVID-19 testing and mandatory periods of paid exclusion from work."

On January 28, 2021, Superior Court Judge Ethan P. Schulman heard oral argument on the motions for a preliminary injunction in both cases. Both sides articulated a number of arguments.

Jason S. Mills of Morgan, Lewis & Bockius LLP argued on behalf of the NFR, and claimed that two new requirements - mandatory testing and paid leave for exposed employees - exceed the agency’s authority. Freeing employers from those two requirements won’t lead to increased Covid-19 cases in workplaces, he argued.

David A. Schwarz of Sheppard, Mullin, Richter & Hampton LLP represented the Western Growers Association asked the court to also block provisions regulating employee-provided housing and transportation. The regulations, which dictate things like the distance between beds and the number of people allowed on a bus, border on logistical absurdity when applied to the agricultural industry, Schwarz said. And he asserted that the labor shortage in that industry will be exacerbated by these rules.

Last Thursday, Judge Schulman denied the request for a preliminary injunction. His ruling said that the standards board "properly found that the COVID-19 pandemic constitutes an emergency" and that prior guidance was "not sufficient to address" the risk of occupational spread.

Judge Schulman also dismissed the argument that Cal/OSHA lacked the authority to enforce the ETS, and held that if he granted the injunction, "numerous workers in California would suffer severe and irreparable harm."
...
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Intravenous injection of bone marrow derived stem cells in patients with spinal cord injuries led to significant improvement in motor functions, researchers from Yale University and Japan report Feb. 18 in the Journal of Clinical Neurology and Neurosurgery.

Yale scientists Jeffery D. Kocsis, professor of neurology and neuroscience, and Stephen G. Waxman, professor of neurology, neuroscience and pharmacology, were senior authors of the study, which was carried out with investigators at Sapporo Medical University in Japan. Key investigators of the Sapporo team, Osamu Honmou and Masanori Sasaki, both hold adjunct professor positions in neurology at Yale.

For more than half of the patients, substantial improvements in key functions - such as ability to walk, or to use their hands - were observed within weeks of stem cell injection, the researchers report. No substantial side effects were reported.

The patients had sustained non-penetrating spinal cord injuries, in many cases from falls or minor trauma, several weeks prior to implantation of the stem cells. Their symptoms involved loss of motor function and coordination, sensory loss, as well as bowel and bladder dysfunction.

The stem cells were prepared from the patients’ own bone marrow, via a culture protocol that took a few weeks in a specialized cell processing center. The cells were injected intravenously in this series, with each patient serving as their own control. Results were not blinded and there were no placebo controls.

Kocsis and Waxman stress that additional studies will be needed to confirm the results of this preliminary, unblinded trial. They also stress that this could take years. Despite the challenges, they remain optimistic.

"Similar results with stem cells in patients with stroke increases our confidence that this approach may be clinically useful," noted Kocsis. "This clinical study is the culmination of extensive preclinical laboratory work using MSCs between Yale and Sapporo colleagues over many years."

"The idea that we may be able to restore function after injury to the brain and spinal cord using the patient’s own stem cells has intrigued us for years," Waxman said. "Now we have a hint, in humans, that it may be possible." ...
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/ 2021 News, Daily News
AMN Services, LLC is a healthcare services and staffing company that recruits nurses for temporary contract assignments.

Kennedy Donohue worked as a nurse recruiter at AMN’s San Diego offices. In that role, Donohue did not have predetermined shifts but was expected to work eight hours per day.

Under California law, employers must generally provide employees with one 30-minute meal period that begins no later than the end of the fifth hour of work and another 30-minute meal period that begins no later than the end of the tenth hour of work. If an employer does not provide an employee with a compliant meal period, then "the employer shall pay the employee one additional hour of pay at the employee’s regular rate of compensation for each workday that the meal . . . period is not provided."

Per AMN’s company policy, nurse recruiters were provided with 30 minute meal periods beginning no later than the end of the fifth hour of work.

AMN used an electronic timekeeping system called TeamTime to track its employees’ compensable time. Employees used their work desktop computers to punch in and out of Team Time, including at the beginning of the day, at the beginning of lunch, at the end of lunch, and at the end of the day.

Team Time rounded the time punches to the nearest 10-minute increment. For example, if an employee clocked out for lunch at 11:02 a.m. and clocked in after lunch at 11:25 a.m., Team Time would have recorded the time punches as 11:00 a.m. and 11:30 a.m. Although the actual meal period was 23 minutes, Team Time would have recorded the meal period as 30 minutes.

AMN relied on the rounded time punches generated by Team Time to determine whether a meal period was short or delayed.

In April 2014, Donohue filed a class action lawsuit against AMN. Donohue alleged various wage and hour violations, including the meal period claim at issue here.

The trial court granted AMN’s motion for summary judgment, and the Court of Appeal affirmed the dismissal, reasoning that AMN’s rounding policy fairly compensated employees over time, and there was insufficient evidence that supervisors at AMN prevented employees from taking compliant meal periods. .

The California Supreme Court reversed in the case of Donohue v AMN Services, LLC.

The Supreme Court concluded that "employers cannot engage in the practice of rounding time punches - that is, adjusting the hours that an employee has actually worked to the nearest preset time increment - in the meal period context. The meal period provisions are designed to prevent even minor infringements on meal period requirements, and rounding is incompatible with that objective."

It also held that "that time records showing noncompliant meal periods raise a rebuttable presumption of meal period violations, including at the summary judgment stage." ...
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Two California residents were sentenced for defrauding Affordable Care Act programs in at least 12 states of more than $27 million.

63 year old Jeffrey White was sentenced to 36 months of imprisonment and three years of supervised release, and 35 year old Nicholas White was sentenced to 13 months of imprisonment and three years of supervised release. Both defendants reside in Twin Peaks, California.

Jeffrey White and his son, Nicholas White, conspired to defraud health care plans operating under the Affordable Care Act (commonly referred to as "Obamacare") by fraudulently enrolling individuals in ACA plans in states where the individuals did not live.

The Whites created phony residential leases using fictitious landlords in various states.The Whites also used an online application to obtain false cell phone numbers for the individuals with area codes that made it appear that the individuals lived at the fictitious addresses, and provided the false cell phone numbers to the ACA plans. If anyone at the ACA plan called the false local number, the call would ring through to a phone controlled by the Whites.

In order to enroll the individuals in an ACA plan, the Whites paid the insurance premiums for the individuals, and also paid to have the individuals transported to California where the individuals were placed in expensive residential substance abuse treatment programs. The treatment programs then billed the ACA plans for thousands of dollars of treatment each week, including claims for expensive laboratory tests such as blood or urine toxicology screenings.

The treatment programs paid the Whites thousands of dollars in kickbacks for each referral, and some programs arranged for the Whites to receive a percentage of the money the treatment programs received from the ACA health insurance plans.

In order to maximize their proceeds from the fraud scheme, the Whites enrolled the individuals in ACA plans in states that paid the highest amount for substance abuse treatment, even though the individuals did not live in those states.

The Whites have admitted that their scheme resulted in more than $27 million in losses to ACA plans across the country, including plans in Connecticut, Arizona, California, Delaware, Indiana, Kentucky, New Jersey, Ohio, Oregon, Pennsylvania, Tennessee, and Texas.
...
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/ 2021 News, Daily News
The Division of Workers’ Compensation (DWC) has posted on its website final rulemaking documents filed with the Office of Administrative Law (OAL) for approval of the new Medical-Legal Fee Schedule (MLFS). The documents include the final text of amendments to the Medical-Legal Fee Schedule (MLFS) regulations, as well as forum comments and the DWC response, and action to the comments.

OAL will review the filing and advise the Division as to whether the new fee schedule will be approved. DWC has requested an effective date of April 1, 2021.

There were non-substantial amendments made to the regulations as posted on October 28, 2020. The non-substantial changes include:

- - Clarification of the Physician’s obligation when records are received without an attestation.
- - Clarification on billing for records previously reviewed under ML202.
- - Deletion of the billing code ML206 related to the unreimbursed supplemental report.
- - Addition of the ability of physicians who are certified as Qualified Medical Evaluators in the specialty of Internal Medicine or who are board certified in Internal Medicine to use modifiers 97 & 98 for toxicology and oncology evaluations.
...
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/ 2021 News, Daily News
The DWC has posted the 2019 Ethics Advisory Committee's annual report on its website. The Committee is independent from the DWC, and is charged with reviewing and monitoring complaints of misconduct filed against workers' compensation administrative law judges.

The EAC is required to make a public report each year summarizing activities in the previous calendar year. Anyone may file a complaint with the EAC. Complaints may be submitted anonymously but must be in writing.

In 2019, the EAC considered and resolved 5 complaints from 2018. Of 27 new complaints received in 2019, it considered 24 and resolved 21. Of those considered, 9 resulted in investigations, 6 of which were concluded.

Two resulted in findings of judicial misconduct.

In one of those cases, a defense attorney, wrote that complainant was reluctant to file a complaint for fear of possible retaliation against the law firm and its clients. Complainant complained that, for some time now, the attorneys at the firm have been under the impression that the judge acts with bias, often prejudging claims, and has exhibited behavior that they would classify as "bullying" of defendants.

In the specific case reported by this attorney, the judge was unprofessional toward complainant. The judge was belligerent and threatening and would not allow complainant to speak, rebut, refute, or explain anything, in violation of Labor Code section 5311.

Based on its review of the investigation, the EAC found that the investigation supported a finding of ethical violations, including ex-parte communications, prejudging the case, and a violation of Canon 3B(4) for failing to be patient, dignified, and courteous. Based upon that conclusion, the EAC recommended further appropriate action by the CJ.

In another case, a lien representative, complained that over 43 lien hearings have been held without a final order on the doctor’s lien. Complainant claimed that since 2011, 30 hearings have been held before the judge, who has deliberately delayed final adjudication of the lien.

Among other claims, the lien claimant reported that rude and punitive approach to hearings is representative of the judge’s treatment of complainant in all hearings. The judge forced the parties to stay until the lunch hour or the end of the day to receive a disposition unless the disposition was settlement, an unopposed continuance, or an order taken off the calendar (OTOC).

The EAC found that the investigation supported a violation of Canon 3B(4) for failing to be patient, dignified, and courteous. Based on that conclusion, the EAC recommended further appropriate action by the CJ ...
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Felipe Saurez Barocio, 63, of Atwater, owner of Agriculture Services, Inc., and his daughter, Angelita Barocio-Negrete, 34, of Merced, were sentenced to 10 years after pleading no contest to six felony counts of insurance fraud each.

Pursuant to Penal Code 1170(h), they will both serve six years in custody and four years on mandatory supervision.

They have also been ordered to pay $2,582,142 in restitution - the amount of workers’ compensation insurance premium they avoided paying over five years.

Barocio and his daughter underreported employee payroll by $11 million in order to fraudulently reduce the business’s premium for workers’ compensation insurance. The fraud potentially left employed farm workers without insurance coverage and at financial risk.

On October 14, 2019, State Compensation Insurance Fund (SCIF) filed a suspected fraudulent claim with the California Department of Insurance alleging potential insurance fraud.

SCIF reported that Barocio, as owner of a farm labor contracting business, underreported employee payroll in order to reduce the proper rate of insurance premium owed to SCIF.

An investigation by the California Department of Insurance revealed that between 2015 and 2019, Barocio and his daughter, who worked as the office manager, provided SCIF with fabricated quarterly employee payroll reports.

The Department discovered $11 million in missing payroll when they compared the quarterly reports submitted to SCIF to the quarterly reports submitted to the Employment Development Department. This underreporting of employee payroll resulted in a total loss of $2,582,142 in insurance premium.

Barocio and his daughter, Barocio-Negrete, were sentenced on January 12, 2021, in the Merced Courthouse and ordered to pay restitution on February 22, 2021.

The Merced County District Attorney’s Office prosecuted this case ...
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Courthouse News reports that an attorney for the California Grocers Association told a federal judge Tuesday a city of Long Beach ordinance providing a $4 an hour boost in hazard pay for grocery workers interferes with ongoing labor negotiations and should be blocked.

The Southern California city’s "Premium Pay for Grocery Workers Ordinance" provides the $4 per hour in premium pay for essential grocery workers who face higher risk during the Covid-19 pandemic.

CGA, which represents 6,000 grocery stores across California, filed a federal lawsuit against Long Beach on Jan. 21, claiming companies operate on thin profit margins and that some have already given their workers hazard pay bonuses.

In court papers, attorneys for CGA said the ordinance would result in grocery stores being more crowded and food prices more expensive for customers.

Upon filing its lawsuit in the Central District of California, CGA moved on an ex parte basis for a temporary restraining order blocking enforcement of the ordinance.

The next day, U.S. District Judge Dolly M. Gee, who had been initially assigned to the case, denied CGA’s bid, ruling that the association failed to show how it would be irreparably harmed without emergency action by the court.

Gee also called the threat of city-sanctioned lawsuits against noncomplying grocery stores "speculative," which the ruling said cannot be the basis for granting a TRO.

The case had since been transferred to U.S. District Judge Otis D. Wright II.

In court papers opposing an injunction, attorneys for Long Beach cited reports of grocery store corporations such as Kroger earning "eye-popping" profits during the pandemic while their frontline workers continue to face potential daily exposure to the novel coronavirus.

In a virtual federal court hearing Tuesday, CGA attorney William F. Tarantino told Wright a preliminary injunction should be granted because the ordinance’s alleged effect on collective bargaining is preempted by the National Labor Relations Act.

To support CGA’s preemption claims, Tarantino cited the U.S. Supreme Court’s 1976 ruling in Machinists v. Wisconsin Employment Relations Comm, which held local governments should not interfere in business that would otherwise be determined by "the free play of economic forces."

Wright took the matter under submission and indicated a final ruling on the preliminary injunction would be issued soon.

Tuesday’s hearing came on the same day the Los Angeles County Board of Supervisors voted 4-1 to approve an urgency ordinance requiring national grocery and drug stores chains in unincorporated LA County to pay workers an extra $5 an hour in "hero pay."

The ordinance - which takes effect immediately and is enforceable for the next 120 days - cited frontline workers’ higher risk of contracting Covid-19 and their ongoing labor contributions as justification for the wage increase ...
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Stephanie Medrano, 33, of West Covina, was arraigned on multiple counts of grand theft and insurance fraud after allegedly making misrepresentations following a COVID-19 diagnosis in an attempt to collect over $33,000 in undeserved workers’ compensation insurance benefits.

The California Department of Insurance launched an investigation after receiving a claim of suspected fraud from Medrano’s employer, the Baldwin Park Unified School District, on August 21, 2020.

The investigation revealed Medrano made multiple misrepresentations in order to extend a workers’ compensation insurance claim submitted to her employer after she was diagnosed with COVID-19.

Medrano was reportedly exposed to COVID-19 while in the workplace and subsequently filed a workers’ compensation claim. She told her employer that she self-quarantined from July 6, 2020 to August 3, 2020, and reported she only left her house twice to buy medicine for her mother and sister, who were also diagnosed with COVID-19. Medrano reported her symptoms related to the COVID-19 diagnosis were so severe she was unable to work.

The investigation found that during the time Medrano claimed she was self-quarantining, she was seen shopping at multiple stores for several hours a day and interacting with people from outside her immediate household without face masks.

Further, investigators uncovered that Medrano traveled to Lake Havasu with people who live outside her household just two days after she reported she was still experiencing symptoms to the doctor overseeing her claim.

The Department’s investigation into Medrano’s false statements regarding her symptoms and need for extended self-quarantine prevented a potential loss of $33,516 to the school district.

The Los Angeles County District Attorney’s Office is prosecuting this case ...
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A California woman, 65 year old Corby Kuciemba, sued her husband’s employer because she believes he caught the novel coronavirus at work and brought it home with him - ultimately infecting her also.

The couple then tested positive for the virus on July 16, 2020, and both were hospitalized as a result, with Corby Kuciemba being held for treatment until the beginning of August.

She and her husband, Robert Kuciemba, alleged in their Oct. 23, 2020 lawsuit that his employer, Nevada-based Victory Woodworks, violated local and federal virus-safety guidelines when it moved workers from one site to another in the San Francisco region.

The company’s failure to take basic precautions allegedly caused Robert Kuciemba to contract the virus and unknowingly bring it home and infect his wife, and both required extended hospital stays and suffer from after-effects.

The closely watched case was removed by the employer to the Federal District Court in Northern California on December 28. The removal was soon followed by a Motion to Dismiss filed on January 4, and then a hearing on that motion set for February 12.

On February 22, the federal judge ruled that the First, Second, Third, and Fifth Causes of Action, titled, respectively, "Negligence," "Negligence Per Se," "Negligence - Premises Liability," and "Loss of Consortium," are barred by the exclusive remedy provisions of California’s workers’ compensation statutes.

Judge Chesney also ruled that the couple’s Fourth Cause of Action doesn’t meet the required threshold, or standing, to hold Robert Kuciemba’s employer, Victory Woodworks Inc., liable for creating a public nuisance.

However, the plaintiffs were given leave to file, no later than March 19, 2021, a First Amended Complaint.

The case is Kuciemba v. Victory Woodworks, 20-cv-09355, U.S. District Court, Northern District of California (San Francisco) ...
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In approximately 2002, Ruben Martinez, and his son, Alex Martinez, opened a medical clinic in Calexico.

In 2009, a chiropractor, Dr. Steven Rigler, moved his practice into the clinic and examined patients who were referred to him by Ruben and Alex and were receiving workers’ compensation benefits.

Dr. Rigler did not pay rent or utilities or contribute to the salaries of clinic staff. In exchange, Rigler permitted Ruben and Alex to determine the providers to whom Dr. Rigler’s patients would be referred for ancillary medical services. These ancillary service providers compensated Ruben and Alex for the referrals, and Ruben and Alex split the referral fees evenly.

In 2010, Gonzalo Ernesto Paredes was the office administrator for an entity called Advanced Radiology, owned by Dr. Ronald Grusd. Ruben Martinez entered into an agreement with Paredes, on behalf of Dr. Grusd, through which Advanced Radiology would pay Ruben a referral fee for patients referred to Advanced Radiology for magnetic resonance imaging (MRI) scans.

Thereafter, Paredes implemented the agreement with Ruben by, among other activities, receiving invoices from Ruben for patient referral fees and arranging payment of those fees to Ruben.

Paredes and Grusd were tried in federal court in 2017. Grusd was found guilty on all 42 counts that went to the jury. The jury hung on the counts against Paredes. The federal case against Paredes was subsequently dismissed by the government, without prejudice, pending his trial on state charges.

A jury in the state court trial found Paredes guilty of 35 counts of offering or delivering compensation for workers’ compensation patient referrals and 16 counts of concealing an event affecting an insurance claim.

The trial court sentenced Paredes to an aggregate term of five years in prison.

On appeal, Paredes claims that the prosecutor committed misconduct during his examination of one of the witnesses and during closing argument by suggesting the existence of facts not in evidence. Paredes also maintains that the trial court erred in excluding, as hearsay, an unavailable witness’s testimony from a prior federal trial. Finally, Paredes contends that there is insufficient evidence to support the verdicts.

The Court of Appeal affirmed the conviction in the unpublished case of People v. Gonzalo Ernesto Paredes.

The appellate court rejected his arguments one by one, and concluded that there was substantial evidence supporting his conviction ...
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While it obviously presented challenges, 2020 is looking like it may not have been such a bad year for workers’ compensation insurers and insureds after all.

Insurers took in less premium but paid fewer claims. They managed to achieve one of the lowest combined ratios in history. An increasing number of workers were able to be treated via telemedicine, meaning they did not have to travel. Injured workers, including COVID-claimants, appear to have received their medical care without much delay. And the vast majority of COVID-19 claimants needed only limited treatment.

On the down side, 2020 may have seen a return of opioid over-prescribing.

Experts from the industry’s data and rating organization, the National Council on Compensation Insurance (NCCI), recently shared their preliminary analysis of 2020 claims data. In a virtual roundtable, COVID-19 and Workers Compensation, summarized by the Insurance Journal.

NCCI looked at results through the third quarter of 2020 and extended those through the end of the year. NCCI uses data from private carriers and state funds in 41 jurisdictions but its data does not include many public entities such as first responders or health care entities including hospitals and nursing homes that are largely self-insured.

Some highlights of the year include:

- - The pandemic has "put gas on a fire that was already burning," that is, workers’ compensation loss costs have been on a downward trend for years and expense ratios have been climbing.
- - The percentage of COVID-19 claims among all workers’ compensation paid claims has varied greatly among states and occupations, as has the decrease in non-COVID claims, according to research from the Workers Compensation Research Institute (WCRI).
- - While at least 17 states have passed laws or issued orders that expanded access to workers’ compensation benefits for employees who contract COVID-19, many of those directives are creating new exposure for only a sliver of the workforce, new research by the WCRI shows.
- - Although the nation’s focus may have shifted to the coronavirus pandemic, the opioid crisis not only remains a challenge, but also may have worsened due to COVID-19, according to speakers at a forum sponsored by the American Property Casualty Insurance Association and the U.S. Chamber of Commerce.
- - Written premium for the full calendar year of 2020 is expected to be the lowest since 2012.

The NCCI figures are calendar year and do not reflect the full costs of treating COVID-19 or other health conditions with long-term effects.

Overall for 2020, NCCI projects an 8% decline in premium to $38.6 billion, the lowest since 2014. That is accompanied by a 7.6% decline in losses and a favorable 86% calendar year combined ratio.

Worker claims due to COVID-19 have ranged from no symptoms to critical care, hospitalizations and, unfortunately, fatalities in some cases.

The overall COVID-19 claims picture is by no means dire. The larger majority of the cases are small and have only required the injured worker to miss work and quarantine or recover at home ...
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A proposed class action just filed in a federal court in California, alleges Sun-Maid Growers of California has failed to pay proper wages and provide adequate meal and rest breaks to workers at its raisin and dried fruit processing plant.

The plaintiff, who worked for Sun-Maid from September 2016 to March 2020, alleges in the 55-page complaint that the company has unilaterally and unlawfully failed to accurately calculate overtime wages to avoid paying such.

Further, Sun-Maid has allegedly failed to accurately record the amount of time employees worked despite being required by law to do so, and permitted work to be done off the clock without pay, the case says.

More specifically, the lawsuit alleges Sun-Maid required the plaintiff and similarly situated employees to work while clocked out during what was supposed to be off-duty meal breaks. The plaintiff, the suit claims, was from time to time interrupted by work assignments, and there were many days where the man did not even receive a partial lunch, according to the lawsuit. Per the case, Sun-Maid workers were deprived of an off-duty meal period for every five hours worked during a shift, as well as a second off-duty meal period when they were required to work 10 hours.

Further, the lawsuit claims Sun-Maid, from time to time, failed to pay wages, including overtime, for every hour worked, such that employees were in aggregate underpaid wages due to the defendant’s "pattern and practice of unevenly rounding" their hours worked. Instead of receiving overtime at one-and-one-half times their regular rate of pay,

The case alleges Sun-Maid failed to include non-discretionary incentive pay in employees’ regular rates of pay for the purpose of calculating overtime wages. Per the suit, workers were also underpaid when it came to sick pay, as Sun-Maid allegedly failed to pay such at their regular pay rate and instead remitted the wages based on their base rates of pay sans non-discretionary incentives.

The case also alleges Sun-Maid failed to reimburse workers for business expenses, in particular for the required use of their personal cell phones for work purposes.

Sun-Maid has not yet entered an appearance in the federal case, and has not filed any responsive document ...
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For many years the life expectancy for the average American increased, and as a result, so did the reserve estimate for lifetime awards in workers' compensation claims. Maybe it is time to re-think that assumption in the mathematical calculation.

American life expectancy decreased by a full year in the first half of 2020, hitting its lowest point since 2006, as the Covid-19 pandemic burned through the country.

The Centers for Disease Control and Prevention announced the findings Thursday in a first-of-its-kind report based on provisional vital statistics data, joining the annual and decennial national life tables that the agency typically publishes.

According to the analysis in the report by Courthouse News, life expectancy summarizes the mortality conditions in a given year, providing a baseline for health officials to track changes across populations and over time.

According to the latest data, pandemic-related deaths have deepened life-expectancy disparities along racial and ethnic lines that were already striking.

The CDC put the latest life-expectancy gap between Black and white Americans at six years - the largest since 1998. In addition to reporting on the three-year fall in the expected life spans of Black Americans, the CDC observed a nearly two-year drop in the lives of Hispanic Americans, another group whom white Americans statistically tend to outlive.

"This is a huge decline," Robert Anderson, who oversees the numbers for the CDC, announced on Thursday. "You have to go back to World War II, the 1940s, to find a decline like this."

The study from the CDC’s National Center for Health Statistics backs up what other researchers have been finding.

In an email, University of Southern California postdoctoral scholar Theresa Andrasfay called it "another important piece of evidence of the enormous mortality toll - and the large racial and ethnic disparities - of Covid-19."

Andrasfay was the co-author of a similar study on the subject that appeared last month in the Proceedings of the National Academy of Sciences ...
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/ 2021 News, Daily News
A San Dimas man pleaded guilty to a criminal charge that he fraudulently obtained more than $500,000 in COVID-19-related unemployment benefits in the names of foreign nationals he falsely claimed were local real estate agents hit hard financially by the pandemic.

50 year old Bonifacio Jastilana Marinas, pleaded guilty to a single-count criminal information charging him with mail fraud.

According to his plea agreement, from April 2020 to August 2020, Marinas took advantage of provisions in the CARES Act to file approximately 85 unemployment insurance claims with the California Employment Development Department (EDD) that falsely asserted that the named claimants were self-employed real estate agents in Los Angeles County whose jobs had been adversely impacted by the COVID-19 pandemic.

Marinas often listed his own real estate business - Vintage Realty & Finance Inc., located in West Covina - as the purported workplace of the named claimants.

In actuality, the named claimants resided in Saipan or the Philippines, were not registered as real estate agents in Los Angeles County, had no employment history in California, and were not eligible for the benefits Marinas claimed.

Marinas listed his own residence as the mailing address for each of the named claimants, the plea agreement states. As a result, the debit cards used to distribute the unemployment benefits were mailed to Marinas, who then used them to withdraw the fraudulently obtained funds.

In his plea agreement, Marinas admitted that his scheme caused losses to EDD and the United States Treasury of at least $516,244.

The Coronavirus Aid, Relief, and Economic Security (CARES) Act passed by Congress and signed into law in March 2020, helped provide unemployment insurance benefits during the COVID-19 pandemic to people who did not otherwise qualify, including business owners, self-employed workers, independent contractors, and those with a limited work history.

A June 24 sentencing hearing has been scheduled, at which time Marinas will face a statutory maximum sentence of 20 years in federal prison.

This matter was investigated by the Department of Labor Office of Inspector General, IRS Criminal Investigation; the United States Postal Inspection Service, and the United States Secret Service. EDD Investigations provided substantial assistance.
...
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/ 2021 News, Daily News
The California Labor Commissioner has cited a Los Angeles McDonald’s franchisee $125,913 for workplace retaliation and labor law violations, after the Labor Commissioner found that the employer illegally fired four workers for reporting unsafe working conditions during the COVID-19 pandemic.

The four employees of the Marengo Street McDonald’s, operated by R&B Sanchez, Inc., filed retaliation complaints with the Labor Commissioner’s Office last September.

The workers had advised their employer, Cal/OSHA and the Los Angeles County Health Department about unsafe work conditions that they were concerned exposed them to COVID-19 infections. They had also participated in strikes over safety conditions at the Marengo Street McDonald’s, and subsequently received termination letters from their employer.

The Labor Commissioner’s Office on February 12th issued citations totaling $125,913 in wages and penalties against McDonald’s franchisee R&B Sanchez, Inc. Also named in the citations as jointly and severally liable are owners Robert Sanchez and Beverly Sanchez, as well as Brian Sanchez, who served as the franchisee human resources officer.

The citations include $45,193 in lost wages, $720 in interest due, $40,000 in Section 98.6 retaliation penalties, and $40,000 in Section 1102.5 retaliation penalties. R&B Sanchez must reinstate the four workers to their jobs, remove any negative references from their personnel files, and post information on the citations and violations in the workplace.

"Too many workers fear retaliation if they report a problem or stand up for their rights," said Labor Commissioner Lilia García-Brower. "California law has anti-retaliation protections in place that make it illegal for employers to punish workers for exercising their labor rights, such as reporting a workplace safety hazard. My office is committed to ensuring those laws are enforced."

The Labor Commissioner’s Office enforces more than 45 labor laws that specifically prohibit discrimination and retaliation, including Equal Pay Act violations. The Labor Commissioner’s Office investigates workplace retaliation complaints including instances of termination, suspension, transfer or demotion, reduction in pay or hours, disciplinary actions or threats, or unfair immigration-related practices.

The Labor Commissioner’s Office has launched an interdisciplinary outreach campaign, "Reaching Every Californian." The campaign amplifies basic protections and builds pathways to impacted populations so that workers and employers understand legal protections, obligations and how to defend them. Californians can follow the Labor Commissioner’s Office on Facebook and on Twitter ...
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/ 2021 News, Daily News
The New York Attorney General filed a lawsuit against Amazon over its failures to provide adequate health and safety measures for employees at the company’s New York facilities and Amazon’s retaliatory actions against multiple employees amidst the COVID-19 pandemic.

An investigation into Amazon started in March 2020 following numerous complaints about the lack of precautions taken to protect employees in Amazon facilities as New York was ravaged by COVID-19.

The investigation was later broadened to examine whether Amazon unlawfully fired or disciplined employees who reported these safety concerns. In particular, the investigation focused on two facilities with a combined workforce of more than 5,000 individuals.

The investigation uncovered evidence showing that Amazon’s health and safety response violated state law with respect to cleaning and disinfection protocols, contact tracing, and generally permitting employees to take necessary precautions to protect themselves from the risk of COVID-19 infection, among other things.

For example, Amazon was notified of at least 250 employees at the Staten Island facility who had positive COVID-19 tests or diagnoses, with more than 90 of those individuals present in the facility within seven days of notification to Amazon. However, in all but seven of these instances, Amazon failed to close any portion of the facility after learning of the positive cases.

Additionally, Amazon implemented an inadequate COVID-19 tracing program that failed to consistently identify workers who came into close contact with employees who tested positive for COVID-19. On occasions when a worker reported having close contact with a coworker with a positive COVID-19 test, Amazon dismissed the worker’s concerns and did not investigate or follow up on the reports.

The evidence also demonstrates that Amazon unlawfully fired and disciplined workers who reported their concerns about Amazon’s compliance with these health and safety mandates.

The lawsuit, filed in the Supreme Court of New York County, argues that Amazon’s actions are in violation of New York labor, whistleblower protection, and anti-retaliation laws. The suit seeks broad injunctive relief and damages, including:

- - Requiring Amazon to take all affirmative steps, including changing policies, conducting training, and undergoing monitoring, among others, to ensure that Amazon reasonably and adequately protects the lives, health, and safety of its employees.
- - Awarding backpay, liquidated damages, emotional distress damages, and reinstatement for former employee Christian Smalls.
- - Awarding liquidated damages and emotional distress damages for employee Derrick Palmer.
- - Requiring Amazon to give up the profits it made as a result of its illegal acts ...
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/ 2021 News, Daily News
The coronavirus variant first seen in Los Angeles in July now accounts for about 44% of new infections in Southern California and more than a third of new infections throughout the state, researchers reported Thursday.

In addition, the variant has spread across the United States and to six countries around the globe, according to the study in the Journal of the American Medical Assn.

It "remains uncertain" whether the genetic changes that characterize the fast-moving variant have improved its ability to transmit from person to person, or to make people infected with it sicker, a team from Cedars-Sinai Medical Center in Los Angeles acknowledged in the JAMA report. But the virus’ rapid propagation in California is a cause for some concern, they wrote.

The Los Angeles Times reports that the homegrown variant is distinct from other versions of the virus present in the U.S., including the B.1.1.7 strain from the United Kingdom and the B.1.351 strain from South Africa. But like those new strains, this variant is defined by several mutations in the virus’ spike protein, the "docking mechanism" the virus uses to latch on to human cells.

One of the California variant’s five mutations, known to scientists as L452R, could alter a particularly critical part of the spike protein called the receptor-binding domain.

A study conducted last year by Howard University researchers found that the mutation helps the virus attach more firmly to human cells. It therefore has the potential to enhance the virus’ transmission.

At both Cedars-Sinai and the UC San Francisco Medical Center, samples of the new variant are being tested in an effort to detect whether its altered genetic makeup has given the virus new powers to spread or sicken.

Its rapidly increasing share of California cases is also ominous, the study authors said.

Although the variant was barely detectable in early October, it accounted for 24% of roughly 4,500 viral samples gathered throughout Southern California in the last weeks of 2020, and 18% of statewide samples. Less than a month later, its share of new infections had climbed.

From Jan. 1 to Jan. 22, the variant accounted for 44% of coronavirus samples collected in Southern California and 35% of samples from throughout the state.

Shaolei Teng, a Howard University biologist who led a team exploring the effect of the virus’ genetic changes, said the variant’s L452R mutation clearly improved its ability to bind to human cells. In all likelihood, he said, the change also makes it easier for the virus to get inside cells - a crucial step in the replication process.

What’s more, the variant has begun to travel widely. It has been detected in Alaska, Arizona, Connecticut, Georgia, Hawaii, Maryland, Michigan, New Mexico, Nevada, New York, Oregon, Rhode Island, South Carolina, Texas, Utah, Washington, Wisconsin, Wyoming and Washington, D.C.

It has also made its way to Australia, Denmark, Israel, New Zealand, Singapore and the United Kingdom ...
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/ 2021 News, Daily News
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