Last November, a putative class action was filed in Solano County Superior Court by Maria Johnson, on behalf of herself and other similarly situated current and former employees of Lowe's Home Centers, LLC, and as a proxy for the State of California.
She began working for Lowe's in 2015 and worked California, until her employment as a delivery coordinator ended in October of 2020.
This class and representative action challenges alleged systemic employment practices resulting in violations of the California Labor Code against individuals who worked for Defendants. The Complaint addresses Defendants' violations of Labor Code sections 201-202, 204,226,233, and 246, and seeks penalties, damages, and other relief pursuant to, among other provisions, Labor Code sections 203,210,218,218.5, 218.6, 248.5, and 2698 et seq., and the Unfair Competition Law, codified in the Business and Professions Code.
Maria Johnson alleges four causes of action; (1) Unpaid Sick Pay (including derivative penalties for such unpaid sick pay, including waiting time penalties); (2) Inaccurate Itemized Wage Statements; (3) Unfair or Unlawful Business Practices; and (4) Violations of the California Labor Code §§ 2698, et seq.
With respect to the first cause of action, plaintiffs allege that "As a matter of policy and practice, Defendants pay Plaintiff and the Sick Pay Class for sick time at the incorrect rate of pay. Defendants pay Plaintiff and the Sick Pay Class at the base hourly rate of pay, as opposed to the regular rate of pay, which would take into account all non-discretionary remuneration in addition to their base hourly wages, including for example incentives or bonuses, or the rate resulting from dividing the employees' total wages, not including overtime premium pay, by the employees' total hours worked in the full pay periods of the prior 90 days of employment, as required by Section 246. This results in underpayments of sick pay wages to Plaintiff and the Sick Pay Class."
They support this claim by saying "The California Supreme Court has explained that "[c]ourts have recognized that 'wages' also include those benefits to which an employee is entitled as a part of his or her compensation, including money, room, board, clothing, vacation pay, and sick pay." Murphy v. Kenneth Cole Prods., Inc., 40 Cal. 4th 109 4, 1103 (2007) ( emphasis added)."
According to Lowe’s data, there were approximately 18,799 full-time, non-exempt individuals employed by Lowe’s in California who were paid sick pay wages at any time during the period of November 23, 2017 to December 21, 2020.
On January 15, 2021 Lowe's provided Notice that it had filed documents to remove the case to the United States District Court for the Eastern District of California. In this regard they allege "Removal of a class action is proper if: (1) there are at least 100 members in the putative class; (2) there is minimal diversity between the parties, such that at least one class member is a citizen of a state different from any defendant; and (3) the aggregate amount in controversy exceeds $5 million, exclusive of interest and costs."
Lowe's maintains that this action was improperly filed in state court because "Plaintiff agreed to binding individual arbitration of the claims she has asserted in this action. Lowe’s also intends to oppose class certification on multiple grounds, including that (a) Plaintiff must arbitrate her claims against Lowe’s individually pursuant to the binding and enforceable arbitration agreement and class action waiver executed by Plaintiff, and (b) class treatment is inappropriate under these circumstances in part because there are many material differences between the named Plaintiff and the putative class members Plaintiff seeks to represent, as well as amongst the putative class members."
Lowe’s avers, for the purposes of meeting the jurisdictional requirements for removal only, that if Plaintiff were to prevail on every claim and allegation in her Complaint on behalf of the putative class, the requested monetary recovery would exceed $5 million ...
She began working for Lowe's in 2015 and worked California, until her employment as a delivery coordinator ended in October of 2020.
This class and representative action challenges alleged systemic employment practices resulting in violations of the California Labor Code against individuals who worked for Defendants. The Complaint addresses Defendants' violations of Labor Code sections 201-202, 204,226,233, and 246, and seeks penalties, damages, and other relief pursuant to, among other provisions, Labor Code sections 203,210,218,218.5, 218.6, 248.5, and 2698 et seq., and the Unfair Competition Law, codified in the Business and Professions Code.
Maria Johnson alleges four causes of action; (1) Unpaid Sick Pay (including derivative penalties for such unpaid sick pay, including waiting time penalties); (2) Inaccurate Itemized Wage Statements; (3) Unfair or Unlawful Business Practices; and (4) Violations of the California Labor Code §§ 2698, et seq.
With respect to the first cause of action, plaintiffs allege that "As a matter of policy and practice, Defendants pay Plaintiff and the Sick Pay Class for sick time at the incorrect rate of pay. Defendants pay Plaintiff and the Sick Pay Class at the base hourly rate of pay, as opposed to the regular rate of pay, which would take into account all non-discretionary remuneration in addition to their base hourly wages, including for example incentives or bonuses, or the rate resulting from dividing the employees' total wages, not including overtime premium pay, by the employees' total hours worked in the full pay periods of the prior 90 days of employment, as required by Section 246. This results in underpayments of sick pay wages to Plaintiff and the Sick Pay Class."
They support this claim by saying "The California Supreme Court has explained that "[c]ourts have recognized that 'wages' also include those benefits to which an employee is entitled as a part of his or her compensation, including money, room, board, clothing, vacation pay, and sick pay." Murphy v. Kenneth Cole Prods., Inc., 40 Cal. 4th 109 4, 1103 (2007) ( emphasis added)."
According to Lowe’s data, there were approximately 18,799 full-time, non-exempt individuals employed by Lowe’s in California who were paid sick pay wages at any time during the period of November 23, 2017 to December 21, 2020.
On January 15, 2021 Lowe's provided Notice that it had filed documents to remove the case to the United States District Court for the Eastern District of California. In this regard they allege "Removal of a class action is proper if: (1) there are at least 100 members in the putative class; (2) there is minimal diversity between the parties, such that at least one class member is a citizen of a state different from any defendant; and (3) the aggregate amount in controversy exceeds $5 million, exclusive of interest and costs."
Lowe's maintains that this action was improperly filed in state court because "Plaintiff agreed to binding individual arbitration of the claims she has asserted in this action. Lowe’s also intends to oppose class certification on multiple grounds, including that (a) Plaintiff must arbitrate her claims against Lowe’s individually pursuant to the binding and enforceable arbitration agreement and class action waiver executed by Plaintiff, and (b) class treatment is inappropriate under these circumstances in part because there are many material differences between the named Plaintiff and the putative class members Plaintiff seeks to represent, as well as amongst the putative class members."
Lowe’s avers, for the purposes of meeting the jurisdictional requirements for removal only, that if Plaintiff were to prevail on every claim and allegation in her Complaint on behalf of the putative class, the requested monetary recovery would exceed $5 million ...
In September 2012, Governor Brown signed into legislation Senate Bill (SB) 863. This reform of the workers’ compensation system in California included Independent Bill Review (IBR), which went into effect January 1, 2013. IBR is an efficient, non-judicial process for resolving medical treatment and medical-legal billing disputes in which the medical provider disagrees with the amount paid by a claims administrator on a properly documented bill after a second review.
The DWC just posted a progress report on the department’s Independent Bill Review program.
The 2020 Independent Bill Review (IBR) Report: Analysis of 2018-2019 Application Filings summarizes the activity of an essential component of Senate Bill 863, providing an evaluation of the program during the previous two calendar years. The report accounts for all applications filed to dispute payments not resolved through Second Bill Review during this time period.
Maximus Federal Services, the IBRO, provides the DWC with data extracted from its proprietary software. This data corresponds with information in the Final Determination Letters (FDLs) that are received by the filing parties. Anonymized copies of FDLs for cases decided in the current year are available on the DWC website within thirty days of their issuance
In 2018 and 2019, a similar number of IBR applications was received by the IBRO: 1,692 and 1,644, respectively. These are the first two years since the first year of the program in which application filings fell below 2,000. Each quarter in the two calendar years had a steady pace of IBR filings, ranging from 353 to 483 per quarter.
In 2018, one in three applicants was a provider based in the San Francisco Bay Area (34.9%), and one in four (26.6%) practiced in Los Angeles County. In 2019, nearly half the applications (48.7%) were from Bay Area providers, and applications from Los Angeles fell 25% from the previous year.
Approximately one in four IBR applications is determined to be ineligible for review. Ineligibility factors include untimely requests, requests made prior to completion of a second review, and requests made without payment of the required fee.
Among the filings that received a review and a case determination in 2018, 47% were overturned, meaning the IBRO determined that additional reimbursement is warranted. In 2019, 59.1% of the case determinations were overturned.
Overturned IBR case decisions for applications filed in 2018 and 2019 resulted in reimbursement to the providers totaling $3,823,402. This amount includes the repayment of the filing fees for these cases. The filing fee remains set at $195.
The report is posted on the DIR website ...
The DWC just posted a progress report on the department’s Independent Bill Review program.
The 2020 Independent Bill Review (IBR) Report: Analysis of 2018-2019 Application Filings summarizes the activity of an essential component of Senate Bill 863, providing an evaluation of the program during the previous two calendar years. The report accounts for all applications filed to dispute payments not resolved through Second Bill Review during this time period.
Maximus Federal Services, the IBRO, provides the DWC with data extracted from its proprietary software. This data corresponds with information in the Final Determination Letters (FDLs) that are received by the filing parties. Anonymized copies of FDLs for cases decided in the current year are available on the DWC website within thirty days of their issuance
In 2018 and 2019, a similar number of IBR applications was received by the IBRO: 1,692 and 1,644, respectively. These are the first two years since the first year of the program in which application filings fell below 2,000. Each quarter in the two calendar years had a steady pace of IBR filings, ranging from 353 to 483 per quarter.
In 2018, one in three applicants was a provider based in the San Francisco Bay Area (34.9%), and one in four (26.6%) practiced in Los Angeles County. In 2019, nearly half the applications (48.7%) were from Bay Area providers, and applications from Los Angeles fell 25% from the previous year.
Approximately one in four IBR applications is determined to be ineligible for review. Ineligibility factors include untimely requests, requests made prior to completion of a second review, and requests made without payment of the required fee.
Among the filings that received a review and a case determination in 2018, 47% were overturned, meaning the IBRO determined that additional reimbursement is warranted. In 2019, 59.1% of the case determinations were overturned.
Overturned IBR case decisions for applications filed in 2018 and 2019 resulted in reimbursement to the providers totaling $3,823,402. This amount includes the repayment of the filing fees for these cases. The filing fee remains set at $195.
The report is posted on the DIR website ...
At the request of the United States Court of Appeals for the Ninth Circuit, the California Supreme Court agreed to decide the following question of California law: Does this court’s decision in Dynamex Operations West, Inc. v. Superior Court (2018) 4 Cal.5th 903 (Dynamex) apply retroactively?
In Dynamex, the Supreme Court was faced with a question of first impression: What standard applies under California law in determining whether workers should be classified as employees or independent contractors for purposes of the obligations imposed by California’s wage orders?
It held that such a worker can properly be found to be "an independent contractor to whom a wage order does not apply only if the hiring entity establishes: (A) that the worker is free from the control and direction of the hirer in connection with the performance of the work, both under the contract for the performance of such work and in fact; (B) that the worker performs work that is outside the usual course of the hiring entity’s business; and (C) that the worker is customarily engaged in an independently established trade, occupation, or business of the same nature as the work performed for the hiring entity."
This is now referred to as the A-B-C test.
Defendant argued that an exception to the general retroactivity principle should be applied here because, prior to Dynamex, businesses could not reasonably have anticipated that the ABC test would govern at the time when they classified workers as independent contractors rather than employees.
In answer to the question posed by the Ninth Circuit, the Supreme Court concluded in Gerardo Vazquez v Jan-Pro Franchising International, Inc.,that it's decision in Dynamex applies retroactively to all nonfinal cases that predate the effective date of the Dynamex decision.
Employers were clearly on notice well before the Dynamex decision that, for purposes of the obligations imposed by a wage order, a worker’s status as an employee or independent contractor might well depend on the suffer or permit to work prong of an applicable wage order - and that the law was not settled in this area ...
In Dynamex, the Supreme Court was faced with a question of first impression: What standard applies under California law in determining whether workers should be classified as employees or independent contractors for purposes of the obligations imposed by California’s wage orders?
It held that such a worker can properly be found to be "an independent contractor to whom a wage order does not apply only if the hiring entity establishes: (A) that the worker is free from the control and direction of the hirer in connection with the performance of the work, both under the contract for the performance of such work and in fact; (B) that the worker performs work that is outside the usual course of the hiring entity’s business; and (C) that the worker is customarily engaged in an independently established trade, occupation, or business of the same nature as the work performed for the hiring entity."
This is now referred to as the A-B-C test.
Defendant argued that an exception to the general retroactivity principle should be applied here because, prior to Dynamex, businesses could not reasonably have anticipated that the ABC test would govern at the time when they classified workers as independent contractors rather than employees.
In answer to the question posed by the Ninth Circuit, the Supreme Court concluded in Gerardo Vazquez v Jan-Pro Franchising International, Inc.,that it's decision in Dynamex applies retroactively to all nonfinal cases that predate the effective date of the Dynamex decision.
Employers were clearly on notice well before the Dynamex decision that, for purposes of the obligations imposed by a wage order, a worker’s status as an employee or independent contractor might well depend on the suffer or permit to work prong of an applicable wage order - and that the law was not settled in this area ...
The Ventura County District Attorney's office announced that former Ventura County firefighter, 34 year old Perry Adam Lieber, of Santa Barbara, was sentenced to 90 days in jail and 24 months of felony probation after pleading guilty to felony workers’ compensation fraud in violation of Insurance Code section 1871.4(a).
Lieber admitted as part of his guilty plea, that he made false material statements for the purpose of obtaining disability and other benefits to which he was not entitled during a prior workers’ compensation claim with the Ventura County Fire Department. Victim agencies York Risk Services and the County of Ventura sustained losses in excess of $186,082.
Chief Mark Lorenzen of the Ventura County Fire Department said Lieber resigned from the agency last March. According to a report in the Ventura County Star at the time of his arrest, the Chief said the department was not surprised by the charges the DA’s office has brought against Mr. Lieber. "We were aware of a number of irregularities during the last portion of his career. We brought those to the attention of the county risk management unit."
In addition to the jail sentence, Lieber was immediately ordered to pay $100,000 in victim restitution and $30,000 in fines.
The court also ordered multiple financial accounts controlled by Lieber that were previously frozen by the court be liquidated to satisfy its order.
A hearing relating to additional restitution still owed to the victim agencies is scheduled for March 4, 2021, at 9:00 a.m. in courtroom 26 of the Ventura County Superior Court ...
Lieber admitted as part of his guilty plea, that he made false material statements for the purpose of obtaining disability and other benefits to which he was not entitled during a prior workers’ compensation claim with the Ventura County Fire Department. Victim agencies York Risk Services and the County of Ventura sustained losses in excess of $186,082.
Chief Mark Lorenzen of the Ventura County Fire Department said Lieber resigned from the agency last March. According to a report in the Ventura County Star at the time of his arrest, the Chief said the department was not surprised by the charges the DA’s office has brought against Mr. Lieber. "We were aware of a number of irregularities during the last portion of his career. We brought those to the attention of the county risk management unit."
In addition to the jail sentence, Lieber was immediately ordered to pay $100,000 in victim restitution and $30,000 in fines.
The court also ordered multiple financial accounts controlled by Lieber that were previously frozen by the court be liquidated to satisfy its order.
A hearing relating to additional restitution still owed to the victim agencies is scheduled for March 4, 2021, at 9:00 a.m. in courtroom 26 of the Ventura County Superior Court ...
The Division of Workers’ Compensation (DWC) has issued a notice of conference call public hearing for a proposed evidence-based update to the Medical Treatment Utilization Schedule (MTUS), which can be found at California Code of Regulations, title 8, section 9792.24.7.
The conference call public hearing is scheduled for Thursday, February 18, at 10 a.m. and members of the public may attend by calling 866-390-1828 and using access code 5497535#. Members of the public may review and comment on the proposed updates. Written comments must be submitted no later than February 18. Please see the proposed regulation page for direction for submitting written comments.
The proposed evidence-based update to the MTUS incorporate by reference the latest published guideline from American College of Occupational and Environmental Medicine (ACOEM) for the following:
-- Coronavirus (COVID-19) Guideline (ACOEM December 14, 2020)
The 99 page guideline contains an analysis of the effectiveness of COVID-19 treatment using the following:
-- Hydroxychloroquine and Chloroquine.
-- Azithromycin.
-- Favipiravir.
-- lopinavir-ritonavir.
-- Remdesivir.
-- low-Molecular-Weight Heparin.
-- IL-6 Receptor Antagonists (Tocilizumab, Sarilumab, and Siltuximab).
-- Baricitinib.
-- Casirivimab plus lmdevimab.
-- Bamlanivimab.
-- Convalescent COVID-19 Antibodies.
-- Glucocorticosteroids.
-- Interferon Beta-lb.
-- Ribavirin.
-- Zinc.
-- Vitamin D.
The proposed evidence-based update to the MTUS regulations are exempt from Labor Code sections 5307.3 and 5307.4 and the rulemaking provisions of the Administrative Procedure Act. However, DWC is required under Labor Code section 5307.27 to have a 30-day public comment period, hold a public hearing, respond to all the comments received during the public comment period and publish the order adopting the update online ...
The conference call public hearing is scheduled for Thursday, February 18, at 10 a.m. and members of the public may attend by calling 866-390-1828 and using access code 5497535#. Members of the public may review and comment on the proposed updates. Written comments must be submitted no later than February 18. Please see the proposed regulation page for direction for submitting written comments.
The proposed evidence-based update to the MTUS incorporate by reference the latest published guideline from American College of Occupational and Environmental Medicine (ACOEM) for the following:
-- Coronavirus (COVID-19) Guideline (ACOEM December 14, 2020)
The 99 page guideline contains an analysis of the effectiveness of COVID-19 treatment using the following:
-- Hydroxychloroquine and Chloroquine.
-- Azithromycin.
-- Favipiravir.
-- lopinavir-ritonavir.
-- Remdesivir.
-- low-Molecular-Weight Heparin.
-- IL-6 Receptor Antagonists (Tocilizumab, Sarilumab, and Siltuximab).
-- Baricitinib.
-- Casirivimab plus lmdevimab.
-- Bamlanivimab.
-- Convalescent COVID-19 Antibodies.
-- Glucocorticosteroids.
-- Interferon Beta-lb.
-- Ribavirin.
-- Zinc.
-- Vitamin D.
The proposed evidence-based update to the MTUS regulations are exempt from Labor Code sections 5307.3 and 5307.4 and the rulemaking provisions of the Administrative Procedure Act. However, DWC is required under Labor Code section 5307.27 to have a 30-day public comment period, hold a public hearing, respond to all the comments received during the public comment period and publish the order adopting the update online ...
Federal prosecutors for the Northern District of California filed an indictment charging defendant Rodney L. Stevenson II with wire fraud, mail fraud, and money laundering for his operation of an e-commerce site that claimed to have N95 masks for sale during the current COVID-19 epidemic.
Stevenson operated EM General, a company created in September 2019, which purported to sell N95 masks with N99 filters. At the onset of the COVID-19 pandemic in February 2020, EM General and its website, controlled by Stevenson, advertised that it had N95 masks "in stock" and available for shipping.
EM General sold many of these masks for as much as $24.95 each. Also according to the indictment, to bolster the legitimacy of EM General, Stevenson created a professional-looking website that included the names, backstories, and stock photographs of a group of fake EM General executives.
It also falsely described how long the company had been in business, its sales volume, and its reputation. Stevenson also used fictitious names in emails to customers.
The indictment alleges that, as the pandemic worsened and demand for N95 masks increased dramatically, EM General’s sales skyrocketed. EM General’s total sales from approximately on or about February 11, 2020, to approximately on or about March 8, 2020, were approximately $3,500,000 involving over 25,000 customers, the vast majority of which were sales of N95 masks that were never delivered to customers. This amount included over $900,000 in sales on February 28, 2020, alone.
Bay Area residents thought they were buying much needed N95 masks from EM General, but according to the criminal complaint Stevenson had no intention of delivering masks. "What's described in the complaint is a consumer nightmare of fake web pages and false promises," said US Attorney for the Northern District of California, David Anderson.
Stevenson and EM General delivered almost none of the masks. Instead, when customers complained and asked for refunds, Stevenson, at times communicating with Gmail accounts he created under the names of fake identities, generally refused to refund customers and instead offered a series of lies to fraudulently prolong his scheme while he continued selling masks.
These lies included that EM General could not offer refunds because it had already paid for the customer’s order from a manufacturer, that products would ship soon, and that customers would receive tracking orders soon. For a small number of customers, Stevenson eventually fraudulently substituted masks that did not meet the standards set by the National Institutes of Occupational Safety and Health for N95 or N99 masks, meaning that they did not filter out 95 or 99 percent of particulate matter from the air.
Stevenson is charged with nine counts of wire fraud, in violation of 21 U.S.C. § 1343; one count of mail fraud, in violation of 18 U.S.C. § 1341; five count of laundering of monetary instruments, in violation of 18 U.S.C. § 1956(a)(1)(A)(i); and one count of money laundering, in violation of 18 U.S.C. § 1957.
...
Stevenson operated EM General, a company created in September 2019, which purported to sell N95 masks with N99 filters. At the onset of the COVID-19 pandemic in February 2020, EM General and its website, controlled by Stevenson, advertised that it had N95 masks "in stock" and available for shipping.
EM General sold many of these masks for as much as $24.95 each. Also according to the indictment, to bolster the legitimacy of EM General, Stevenson created a professional-looking website that included the names, backstories, and stock photographs of a group of fake EM General executives.
It also falsely described how long the company had been in business, its sales volume, and its reputation. Stevenson also used fictitious names in emails to customers.
The indictment alleges that, as the pandemic worsened and demand for N95 masks increased dramatically, EM General’s sales skyrocketed. EM General’s total sales from approximately on or about February 11, 2020, to approximately on or about March 8, 2020, were approximately $3,500,000 involving over 25,000 customers, the vast majority of which were sales of N95 masks that were never delivered to customers. This amount included over $900,000 in sales on February 28, 2020, alone.
Bay Area residents thought they were buying much needed N95 masks from EM General, but according to the criminal complaint Stevenson had no intention of delivering masks. "What's described in the complaint is a consumer nightmare of fake web pages and false promises," said US Attorney for the Northern District of California, David Anderson.
Stevenson and EM General delivered almost none of the masks. Instead, when customers complained and asked for refunds, Stevenson, at times communicating with Gmail accounts he created under the names of fake identities, generally refused to refund customers and instead offered a series of lies to fraudulently prolong his scheme while he continued selling masks.
These lies included that EM General could not offer refunds because it had already paid for the customer’s order from a manufacturer, that products would ship soon, and that customers would receive tracking orders soon. For a small number of customers, Stevenson eventually fraudulently substituted masks that did not meet the standards set by the National Institutes of Occupational Safety and Health for N95 or N99 masks, meaning that they did not filter out 95 or 99 percent of particulate matter from the air.
Stevenson is charged with nine counts of wire fraud, in violation of 21 U.S.C. § 1343; one count of mail fraud, in violation of 18 U.S.C. § 1341; five count of laundering of monetary instruments, in violation of 18 U.S.C. § 1956(a)(1)(A)(i); and one count of money laundering, in violation of 18 U.S.C. § 1957.
...
A California Workers’ Compensation Institute analysis of claims reported to the state Division of Workers’ Compensation as of January 11 shows that the number of COVID-19 claims in the California workers’ compensation system more than tripled between October and November, then jumped another 64.2% to a record 23,483 claims in December. A new projection shows that the December total could climb to 37,573 cases once claims that are yet to be filed or still under investigation are added to the tally.
The latest figures show that after falling to a 6-month low in September, monthly COVID-19 claim counts began trending up in October as the fall wave of coronavirus cases hit the state.
Although not all November and December claims have been reported, the initial data from those months shows that as of the January 11, the DWC had recorded 14,298 COVID-19 claims with November injury dates, and a record 23,483 COVID-19 claims from December.
That year-end surge pushed the number of COVID-19 claims reported to the DWC for accident year (AY) 2020 to 93,470, which is 15.7% of all 2020 claims reported to the state, though with the recent spike, that proportion rose to 28.7% of all work injury claims reported for November and 47.4% of all claims reported for December.
The AY 2020 COVID-19 claim count includes 464 death claims -- up 21.7% from the 381 death claims reported as of December 28 -- which means COVID-19 death claims accounted for nearly half (48.0%) of the 966 work-related death claims recorded by the state for AY 2020.
Additional year-end claims continue to be filed, and CWCI’s projected COVID-19 claim count based on historical claim development that accounts for delays in COVID-19 claim reporting estimates that ultimately there will be 16,872 claims from November, and 37,573 claims from December, far surpassing the previous monthly record of 15,537 COVID-19 claims projected for July.
With hundreds of thousands of California jobs lost during the pandemic, and many workers in the state continuing to work remotely, DWC has recorded only 594,840 work injury claims for AY 2020, down 13.5% from 667,942 claims for AY 2019, despite the addition of the 93,470 COVID-19 claims.
However, the year-over-year decline in claim volume is only 6.5% if CWCI’s updated projection of the ultimate claim count for AY 2020 is used.
Other recent results show that health care workers’ share of the COVID-19 claims has declined from 44.7% in the first quarter of 2020 to 28.8% in the fourth quarter; males and younger workers continue to account for a growing share of the COVID-19 claims; and COVID-19 claim denial rates hit a 6-month high of 36.9% in October, though the denial data on claims from the last two months of 2020 is too green to be reliable.
Denial rates vary significantly by industry, with October claim denial rates ranging from 12.8% for utility workers to 66.8% for transportation workers. Many COVID-19 claims are denied because the claimants do not test positive for the virus.
The latest results on California workers’ comp COVID-19 claims are from the January 11 update to CWCI’s COVID-19/Non-COVID-19 Interactive Claim App, which integrates data from CWCI, DWC, and the Bureau of Labor and Statistics to provide information on California work injury claims from comparable periods of 2019 and 2020. The app is updated biweekly and is available to the public here ...
The latest figures show that after falling to a 6-month low in September, monthly COVID-19 claim counts began trending up in October as the fall wave of coronavirus cases hit the state.
Although not all November and December claims have been reported, the initial data from those months shows that as of the January 11, the DWC had recorded 14,298 COVID-19 claims with November injury dates, and a record 23,483 COVID-19 claims from December.
That year-end surge pushed the number of COVID-19 claims reported to the DWC for accident year (AY) 2020 to 93,470, which is 15.7% of all 2020 claims reported to the state, though with the recent spike, that proportion rose to 28.7% of all work injury claims reported for November and 47.4% of all claims reported for December.
The AY 2020 COVID-19 claim count includes 464 death claims -- up 21.7% from the 381 death claims reported as of December 28 -- which means COVID-19 death claims accounted for nearly half (48.0%) of the 966 work-related death claims recorded by the state for AY 2020.
Additional year-end claims continue to be filed, and CWCI’s projected COVID-19 claim count based on historical claim development that accounts for delays in COVID-19 claim reporting estimates that ultimately there will be 16,872 claims from November, and 37,573 claims from December, far surpassing the previous monthly record of 15,537 COVID-19 claims projected for July.
With hundreds of thousands of California jobs lost during the pandemic, and many workers in the state continuing to work remotely, DWC has recorded only 594,840 work injury claims for AY 2020, down 13.5% from 667,942 claims for AY 2019, despite the addition of the 93,470 COVID-19 claims.
However, the year-over-year decline in claim volume is only 6.5% if CWCI’s updated projection of the ultimate claim count for AY 2020 is used.
Other recent results show that health care workers’ share of the COVID-19 claims has declined from 44.7% in the first quarter of 2020 to 28.8% in the fourth quarter; males and younger workers continue to account for a growing share of the COVID-19 claims; and COVID-19 claim denial rates hit a 6-month high of 36.9% in October, though the denial data on claims from the last two months of 2020 is too green to be reliable.
Denial rates vary significantly by industry, with October claim denial rates ranging from 12.8% for utility workers to 66.8% for transportation workers. Many COVID-19 claims are denied because the claimants do not test positive for the virus.
The latest results on California workers’ comp COVID-19 claims are from the January 11 update to CWCI’s COVID-19/Non-COVID-19 Interactive Claim App, which integrates data from CWCI, DWC, and the Bureau of Labor and Statistics to provide information on California work injury claims from comparable periods of 2019 and 2020. The app is updated biweekly and is available to the public here ...
Licensed insurance agents Robert Farmer, 65, of Camarillo, and Marion Urcan, 67, of Agoura Hills, were arraigned in Los Angeles County Superior Court on multiple counts of grand theft after allegedly accepting over $687,000 in insurance premium payments from business owners and misappropriating the money for their personal use.
Farmer and Urcan, doing business as Centerpointe Insurance Services Limited in Camarillo, accepted insurance premium payments from two towing companies in the Los Angeles area.
On June 20, 2019, the California Department of Insurance received a complaint from the owner of one of the towing companies that alleged Centerpointe Insurance Services Limited accepted two checks totaling $391,000 for the company’s commercial auto insurance policy, but Farmer and Urcan did not forward these premium payments to the insurance company.
On December 20, 2019, the Department received a complaint from the other towing company that alleged Centerpointe embezzled a $50,000 down payment made toward the renewal of the towing company’s commercial auto insurance policy.
An investigation by the Department of Insurance revealed Farmer and Urcan accepted over $687,000 in total from the two towing companies but never sent the payments to an insurance company to secure liability insurance for either business owner, leaving them vulnerable to catastrophic loss.
The Department of Insurance is taking the appropriate administrative action against the licensees. Anyone who has been victimized or knows someone who has been victimized by either Farmer or Urcan, please call 661-253-7500.
They are scheduled to return to court on March 5, 2021. This case is being prosecuted by the Los Angeles County District Attorney’s Office ...
Farmer and Urcan, doing business as Centerpointe Insurance Services Limited in Camarillo, accepted insurance premium payments from two towing companies in the Los Angeles area.
On June 20, 2019, the California Department of Insurance received a complaint from the owner of one of the towing companies that alleged Centerpointe Insurance Services Limited accepted two checks totaling $391,000 for the company’s commercial auto insurance policy, but Farmer and Urcan did not forward these premium payments to the insurance company.
On December 20, 2019, the Department received a complaint from the other towing company that alleged Centerpointe embezzled a $50,000 down payment made toward the renewal of the towing company’s commercial auto insurance policy.
An investigation by the Department of Insurance revealed Farmer and Urcan accepted over $687,000 in total from the two towing companies but never sent the payments to an insurance company to secure liability insurance for either business owner, leaving them vulnerable to catastrophic loss.
The Department of Insurance is taking the appropriate administrative action against the licensees. Anyone who has been victimized or knows someone who has been victimized by either Farmer or Urcan, please call 661-253-7500.
They are scheduled to return to court on March 5, 2021. This case is being prosecuted by the Los Angeles County District Attorney’s Office ...
A major labor union and several ride-hailing drivers are suing to overturn a newly passed ballot measure classifying gig workers as independent contractors in California.
The Washington Post reports that the groups filed suit Tuesday in California’s Supreme Court, alleging Proposition 22 violates the state constitution and limits the power of state legislators to implement certain worker protections they are authorized to grant.
The suit, filed by Service Employees International Union and a group of ride-hailing drivers, asks the state Supreme Court to invalidate Prop 22, which cemented gig driver’s status as independent contractors after more than 58 percent of voters supported it in November.
They argue the measure limits state legislators’ ability to implement a system of workers' compensation in defiance of their constitutional authority to do so. It also argues that the proposition unconstitutionally defines what comprises an amendment to the measure, as well as violating a rule limiting ballot measures to a single subject to prevent voter confusion.
The Protect App-Based Drivers and Services coalition, which represents gig companies such as Uber, Lyft and Doordash, criticized the lawsuit in a statement attributed to Uber driver Jim Pyatt, an activist who has worked in favor of Prop 22.
The groups that filed the suit, which also include SEIU California State Council, took particular issue with the measure’s inclusion of a provision requiring a seven-eighths legislative supermajority to amend and even define what constitutes an amendment. That authority, they say, is vested with the courts.
The lawsuit blasts the measure’s drafters as having "impermissibly" usurped this Court’s authority to ‘say what the law is’ by determining what constitutes an ‘amendment.’"
Further, they argued, they violated the single-subject rule by "burying these cryptic amendment provisions on subjects not substantively addressed in the measure, and in language that most voters would not understand."
They said they were suing in the state Supreme Court rather than a lower court because the issues were of broad public importance and required a speedy resolution to minimize harm to gig workers ...
The Washington Post reports that the groups filed suit Tuesday in California’s Supreme Court, alleging Proposition 22 violates the state constitution and limits the power of state legislators to implement certain worker protections they are authorized to grant.
The suit, filed by Service Employees International Union and a group of ride-hailing drivers, asks the state Supreme Court to invalidate Prop 22, which cemented gig driver’s status as independent contractors after more than 58 percent of voters supported it in November.
They argue the measure limits state legislators’ ability to implement a system of workers' compensation in defiance of their constitutional authority to do so. It also argues that the proposition unconstitutionally defines what comprises an amendment to the measure, as well as violating a rule limiting ballot measures to a single subject to prevent voter confusion.
The Protect App-Based Drivers and Services coalition, which represents gig companies such as Uber, Lyft and Doordash, criticized the lawsuit in a statement attributed to Uber driver Jim Pyatt, an activist who has worked in favor of Prop 22.
The groups that filed the suit, which also include SEIU California State Council, took particular issue with the measure’s inclusion of a provision requiring a seven-eighths legislative supermajority to amend and even define what constitutes an amendment. That authority, they say, is vested with the courts.
The lawsuit blasts the measure’s drafters as having "impermissibly" usurped this Court’s authority to ‘say what the law is’ by determining what constitutes an ‘amendment.’"
Further, they argued, they violated the single-subject rule by "burying these cryptic amendment provisions on subjects not substantively addressed in the measure, and in language that most voters would not understand."
They said they were suing in the state Supreme Court rather than a lower court because the issues were of broad public importance and required a speedy resolution to minimize harm to gig workers ...
Simplified Labor Staffing Solutions, Inc. and Simplified Staffing Labor Solutions, LLC are sister entities that provide staffing services, that is, secure payroll services, insurance coverage, licenses, and corporate benefits.
Ashish Wahi owns Simplified. Michael Dougan is its chief financial officer. A major expense in their business operation is paying for workers' compensation insurance.
Simplified initiated litigation against Trinity Risk Management, LLC, affiliated entities Knight Management Group, Inc. and H.J. Knight International Insurance Agency, Inc., and other named defendants. Simplified alleged fraud-based claims related to workers’ compensation insurance it had purchased from defendants who sell workers’ compensation insurance to staffing companies.
Simplified filed a first amended complaint against defendants, and added Captive Resources, Inc. as another named defendant.
Simplified alleged defendants conspired to induce Simplified to purchase their worker’s compensation insurance through them by claiming that after one year of paying surcharges on the actual premiums for the coverage they required, Simplified would then earn "steep discounts on worker’s compensation coverage." Defendants "purported to offer underwriting of insurance risk without being a licensed insurance company, and/or offered for sale insurance coverage as a broker without being a licensed broker . . . or by means of misrepresenting the actual party they represented.
The defendants filed a cross-complaint against Simplified, alleging eight causes of action, including defamation. The cross-complainants alleged Simplified and/or Wahi were approximately $2 million dollars in arrears on Simplified’s workers’ compensation payments.
Simplified filed a special motion to strike the defamation cause of action from the cross-complaint as a strategic lawsuit against public participation under the anti-SLAPP statute. The trial court granted Simplified’s special motion to strike and the court of appeal affirmed in the unpublished case of Trinity Risk etc. v. Simplified Labor.
The purpose of the anti-SLAPP law is not to insulate defendants from any liability for claims arising from the protected rights of petition or speech. It only provides a procedure for weeding out, at an early stage, meritless claims arising from protected activity.
The wording of the statute protects the right of litigants to the utmost freedom of access to the courts without fear of being harassed subsequently by derivative tort actions. The law provides that it "shall be construed broadly." ...
Ashish Wahi owns Simplified. Michael Dougan is its chief financial officer. A major expense in their business operation is paying for workers' compensation insurance.
Simplified initiated litigation against Trinity Risk Management, LLC, affiliated entities Knight Management Group, Inc. and H.J. Knight International Insurance Agency, Inc., and other named defendants. Simplified alleged fraud-based claims related to workers’ compensation insurance it had purchased from defendants who sell workers’ compensation insurance to staffing companies.
Simplified filed a first amended complaint against defendants, and added Captive Resources, Inc. as another named defendant.
Simplified alleged defendants conspired to induce Simplified to purchase their worker’s compensation insurance through them by claiming that after one year of paying surcharges on the actual premiums for the coverage they required, Simplified would then earn "steep discounts on worker’s compensation coverage." Defendants "purported to offer underwriting of insurance risk without being a licensed insurance company, and/or offered for sale insurance coverage as a broker without being a licensed broker . . . or by means of misrepresenting the actual party they represented.
The defendants filed a cross-complaint against Simplified, alleging eight causes of action, including defamation. The cross-complainants alleged Simplified and/or Wahi were approximately $2 million dollars in arrears on Simplified’s workers’ compensation payments.
Simplified filed a special motion to strike the defamation cause of action from the cross-complaint as a strategic lawsuit against public participation under the anti-SLAPP statute. The trial court granted Simplified’s special motion to strike and the court of appeal affirmed in the unpublished case of Trinity Risk etc. v. Simplified Labor.
The purpose of the anti-SLAPP law is not to insulate defendants from any liability for claims arising from the protected rights of petition or speech. It only provides a procedure for weeding out, at an early stage, meritless claims arising from protected activity.
The wording of the statute protects the right of litigants to the utmost freedom of access to the courts without fear of being harassed subsequently by derivative tort actions. The law provides that it "shall be construed broadly." ...
Limin Gao filed an Application for Adjudication, alleging a psyche injury while employed by Chevron from May 2, 2014 to July 2, 2015.
The matter proceeded to trial on March 10, 2020. Gao provided in-person testimony, both direct and on cross-examination, flying in from her current residence in Ontario, Canada in order to do so.
Because the trial could not be completed in one session, the trial was continued to June 9, 2020, with in-person testimony contemplated from several defense witnesses.
In light of the Covid-19 pandemic, WCAB District Offices stopped conducting in-person trials as of March 16, 2020. Beginning May 4, 2020, WCAB District Offices began to hear trials on the case-in-chief remotely, via phone link.
On May 7, 2020, the State of California’s Governor, Gavin Newsom, issued Executive Order N-63-20 which essentially suspended the requirement that a witness testify in person under certain conditions and circumstances.
As the June 9, 20201 trial date approached, the parties made clear they had very different ideas about how the case should proceed. Applicant favored proceeding via remote testimony, while defendant objected, requesting a continuance until in-person testimony could be elicited from its three rebuttal witnesses.
The WCJ issued the Order Continuing September 1, 2020 Trial, stating that due process required continuing the trial to allow for in-person testimony from defendant’s witnesses, because applicant had previously given in-person testimony. Limin Gao Petitioned for Removal to have the WCAB rule on the legality of the WCJ order continuing the hearing. The panel reversed and remanded in the significant panel decision of Limin Gao v Chevron Corporation.
The WCAB ruled that "each case must be resolved according to its own particular circumstances, and it would therefore be inappropriate to institute a blanket rule that it is per se unreasonable to continue a case to allow for in-person testimony."
"However, in consideration of Executive Order N-63-20, the purposes of the workers’ compensation system, and current conditions, the default position should be that trials proceed remotely, in the absence of some clear reason why the facts of a specific case require a continuance. Moreover, as the party seeking the continuance, the burden should be on defendant in this case to demonstrate why a continuance is required." ...
The matter proceeded to trial on March 10, 2020. Gao provided in-person testimony, both direct and on cross-examination, flying in from her current residence in Ontario, Canada in order to do so.
Because the trial could not be completed in one session, the trial was continued to June 9, 2020, with in-person testimony contemplated from several defense witnesses.
In light of the Covid-19 pandemic, WCAB District Offices stopped conducting in-person trials as of March 16, 2020. Beginning May 4, 2020, WCAB District Offices began to hear trials on the case-in-chief remotely, via phone link.
On May 7, 2020, the State of California’s Governor, Gavin Newsom, issued Executive Order N-63-20 which essentially suspended the requirement that a witness testify in person under certain conditions and circumstances.
As the June 9, 20201 trial date approached, the parties made clear they had very different ideas about how the case should proceed. Applicant favored proceeding via remote testimony, while defendant objected, requesting a continuance until in-person testimony could be elicited from its three rebuttal witnesses.
The WCJ issued the Order Continuing September 1, 2020 Trial, stating that due process required continuing the trial to allow for in-person testimony from defendant’s witnesses, because applicant had previously given in-person testimony. Limin Gao Petitioned for Removal to have the WCAB rule on the legality of the WCJ order continuing the hearing. The panel reversed and remanded in the significant panel decision of Limin Gao v Chevron Corporation.
The WCAB ruled that "each case must be resolved according to its own particular circumstances, and it would therefore be inappropriate to institute a blanket rule that it is per se unreasonable to continue a case to allow for in-person testimony."
"However, in consideration of Executive Order N-63-20, the purposes of the workers’ compensation system, and current conditions, the default position should be that trials proceed remotely, in the absence of some clear reason why the facts of a specific case require a continuance. Moreover, as the party seeking the continuance, the burden should be on defendant in this case to demonstrate why a continuance is required." ...
The Division of Workers’ Compensation (DWC) is now accepting applications for the Qualified Medical Evaluator (QME) examination for April 17, 2021.
DWC will offer in-home computer-based testing (CBT) for the April 2021 QME examination using Proctor U.
Candidates who are interested in taking the CBT exam and have the minimum system requirements should indicate so on the application. CPS HR Consulting, the vendor managing the QME Exam, will notify interested candidates of the registration and scheduling process.
DWC will continue to offer an in-person examination in Northern and Southern California on April 17, 2021 following the guidelines and recommendations by the CDC and California Department of Public Health. The test sites will be announced on the Registration Notices.
Application and Registration packet for the QME exam may be downloaded from the DWC website.
Applicants may also contact the Medical Unit at 510-286-3700 to request an application via U.S. mail, email or fax. The deadline for filing the exam applications is March 4, 2021. No applications will be accepted after this postmarked date.
For more information, contact the Medical Unit at 510-286-3700 or by email at QMETest@dir.ca.gov ...
DWC will offer in-home computer-based testing (CBT) for the April 2021 QME examination using Proctor U.
Candidates who are interested in taking the CBT exam and have the minimum system requirements should indicate so on the application. CPS HR Consulting, the vendor managing the QME Exam, will notify interested candidates of the registration and scheduling process.
DWC will continue to offer an in-person examination in Northern and Southern California on April 17, 2021 following the guidelines and recommendations by the CDC and California Department of Public Health. The test sites will be announced on the Registration Notices.
Application and Registration packet for the QME exam may be downloaded from the DWC website.
Applicants may also contact the Medical Unit at 510-286-3700 to request an application via U.S. mail, email or fax. The deadline for filing the exam applications is March 4, 2021. No applications will be accepted after this postmarked date.
For more information, contact the Medical Unit at 510-286-3700 or by email at QMETest@dir.ca.gov ...
Distribution of the COVID vaccines, which in California is done in several phases and prioritizes first doses for health care workers and people at risk of becoming severely ill from the virus, has lagged other jurisdictions by a considerable margin.
Nationwide, about 6.7 million Americans have received a vaccine dose according to the Centers for Disease Control and Prevention. The CDC has projected that close to 90 million people will be vaccinated by March, still under one third of Americans and far less than the 70% officials say is needed to reach herd immunity.
In California, vaccine rollout has been beset by a number of issues that bring into focus challenges that come with such a gargantuan effort.California has received just over 2 million vaccine doses but only administered about 652,000 of them as of Jan. 8.
Vaccine doses are also lower than anticipated, with officials estimating they won’t have enough doses to immunize "most" residents of its 58 counties until the summer.
Lags are also tied to ultra-low temperature storage requirements for the Pfizer vaccine, a shortage of vaccination sites and staff to administer doses and a delay in setting up systems to track who is immunized and where they live.
The Golden State has the nation’s highest total of people infected with Covid-19, with more than 2.5 million cases. As of Jan. 7, health departments statewide have reported 73,862 positive cases among health care workers and 276 deaths.
California recently told local health departments and providers to expand vaccine eligibility by offering doses to community health and testing site workers, public health field staff and dental clinic and pharmacy personnel.
More than 586,000 health care workers in California have received the first dose of a Covid-19 vaccine, according to state data.
The new guidance also says once demand has subsided from the first priority group, doses should be allocated to people age 75 and older, childcare workers, staff in emergency response and food service and educators.
Los Angeles County, where about 1 in 5 people being tested for Covid-19 are currently testing positive, is the largest from a cluster of Southern California counties that has received about 256,000 doses from the state, the largest quantity of any region. The area includes Orange, San Luis Obispo, Santa Barbara and Ventura counties.
Still, there aren’t enough vaccine doses currently available to immunize even half of the county population by spring, Dr. Paul Simon, chief science officer at LA County’s Department of Public Health, said Friday.
The county said in a statement Friday it opened 19 vaccination sites this week and will open 75 more by next week ...
Nationwide, about 6.7 million Americans have received a vaccine dose according to the Centers for Disease Control and Prevention. The CDC has projected that close to 90 million people will be vaccinated by March, still under one third of Americans and far less than the 70% officials say is needed to reach herd immunity.
In California, vaccine rollout has been beset by a number of issues that bring into focus challenges that come with such a gargantuan effort.California has received just over 2 million vaccine doses but only administered about 652,000 of them as of Jan. 8.
Vaccine doses are also lower than anticipated, with officials estimating they won’t have enough doses to immunize "most" residents of its 58 counties until the summer.
Lags are also tied to ultra-low temperature storage requirements for the Pfizer vaccine, a shortage of vaccination sites and staff to administer doses and a delay in setting up systems to track who is immunized and where they live.
The Golden State has the nation’s highest total of people infected with Covid-19, with more than 2.5 million cases. As of Jan. 7, health departments statewide have reported 73,862 positive cases among health care workers and 276 deaths.
California recently told local health departments and providers to expand vaccine eligibility by offering doses to community health and testing site workers, public health field staff and dental clinic and pharmacy personnel.
More than 586,000 health care workers in California have received the first dose of a Covid-19 vaccine, according to state data.
The new guidance also says once demand has subsided from the first priority group, doses should be allocated to people age 75 and older, childcare workers, staff in emergency response and food service and educators.
Los Angeles County, where about 1 in 5 people being tested for Covid-19 are currently testing positive, is the largest from a cluster of Southern California counties that has received about 256,000 doses from the state, the largest quantity of any region. The area includes Orange, San Luis Obispo, Santa Barbara and Ventura counties.
Still, there aren’t enough vaccine doses currently available to immunize even half of the county population by spring, Dr. Paul Simon, chief science officer at LA County’s Department of Public Health, said Friday.
The county said in a statement Friday it opened 19 vaccination sites this week and will open 75 more by next week ...
The California Commission on Health and Safety and Workers' Compensation (CHSWC) announce the unanimous election of Commissioner Martin Brady as the Chair of the Commission for 2021.
The election was held at the December 3, 2020 public CHSWC meeting held online due to the current Covid-19 pandemic.
Martin Brady is Executive Director at Schools Insurance Authority, where he has worked since 1988.
He is a member of the California Joint Powers Authority, California Coalition on Workers’ Compensation, Public Agency Risk Managers Association, Public School Risk Institute, Association of Governmental Risk Pools and the Public Risk Management Association.
Mr. Brady has been a member of the Commission since 2012.
CHSWC, created by the workers' compensation reform legislation of 1993, is charged with examining the health and safety and workers' compensation systems in California and recommending administrative or legislative modifications to improve their operation.
CHSWC was established to conduct a continuing examination of the workers' compensation system and of the state's activities to prevent industrial injuries and occupational diseases and to examine those programs in other states.
Information about CHSWC and its meetings is available online. Information may also be obtained by writing to the Commission on Health and Safety and Workers' Compensation, 1515 Clay Street, 17th Floor, Oakland, CA 94612; by calling (510) 622-3959; by faxing a request to (510) 286-0499; or by emailing chswc@dir.ca.gov.
Due to the current Covid-19 pandemic, CHSWC public meetings will be held online until further notice ...
The election was held at the December 3, 2020 public CHSWC meeting held online due to the current Covid-19 pandemic.
Martin Brady is Executive Director at Schools Insurance Authority, where he has worked since 1988.
He is a member of the California Joint Powers Authority, California Coalition on Workers’ Compensation, Public Agency Risk Managers Association, Public School Risk Institute, Association of Governmental Risk Pools and the Public Risk Management Association.
Mr. Brady has been a member of the Commission since 2012.
CHSWC, created by the workers' compensation reform legislation of 1993, is charged with examining the health and safety and workers' compensation systems in California and recommending administrative or legislative modifications to improve their operation.
CHSWC was established to conduct a continuing examination of the workers' compensation system and of the state's activities to prevent industrial injuries and occupational diseases and to examine those programs in other states.
Information about CHSWC and its meetings is available online. Information may also be obtained by writing to the Commission on Health and Safety and Workers' Compensation, 1515 Clay Street, 17th Floor, Oakland, CA 94612; by calling (510) 622-3959; by faxing a request to (510) 286-0499; or by emailing chswc@dir.ca.gov.
Due to the current Covid-19 pandemic, CHSWC public meetings will be held online until further notice ...
Since the onset of the COVID-19 crisis in March, the Division of Workers’ Compensation (DWC) has worked hard to ensure the continuity of its services to the workers’ compensation community. District offices continue to hear all cases either via teleconference or by video.
In an additional measure to keep DWC and the workers’ compensation community safe, DWC has not accepted any walk-in documents or walk-through documents since March. Documents have only been accepted via e-filing, JET filing or by mail during this time. Recently, DWC issued a Newsline further encouraging the workers’ compensation community to file documents by e-filing or JET filing due to the limited availability of staff in our district offices.
The Workers’ Compensation Appeals Board (WCAB) recently issued an en banc decision suspending Regulation Section 10789(c) on walk-throughs. This change allows DWC, effective January 11, to now offer a "walk-through alternative" in the Lifesize video conferencing platform. Instructions on using that platform may be found on the DWC website.
District offices will be available for walk-throughs Monday through Friday, from 2 to 4 p.m. only. Walk-throughs will be available only for a Compromise and Release, or Stipulation with Request for Award at this time. To be heard, the documents must be filed at least 24 hours ahead of the walk-through appearance, by either JET filing or e-filing. Documents filed by U.S. mail must be available to the judge in EAMS prior to the walk-through.
DWC has previously posted instructions on how to e-file settlement documents. The walk-through procedure will be handled via the Lifesize virtual courtroom which will be available for each office. A list of links for each office may be found here. The link for each virtual walk-through courtroom will not change. It should be noted that a judge will handle as many walk-throughs as are feasible for the day. The order in which a judge will hear the walk-throughs will be up to the judge handling that day’s matters. We encourage parties to file proposed orders to assist the judge with handling the matter more expeditiously.
DWC understands that parties may want to walk-through other documents. However, at this time walk-throughs are limited to only a Compromise and Release or Stipulation with Request for Award. Limits will be based on both availability and pursuant to the DWC/WCAB Policy and Procedural Manual section 1.25.
DWC will be monitoring the impact of this program and will look to expand hours and documents allowed in the future based on staffing availability ...
In an additional measure to keep DWC and the workers’ compensation community safe, DWC has not accepted any walk-in documents or walk-through documents since March. Documents have only been accepted via e-filing, JET filing or by mail during this time. Recently, DWC issued a Newsline further encouraging the workers’ compensation community to file documents by e-filing or JET filing due to the limited availability of staff in our district offices.
The Workers’ Compensation Appeals Board (WCAB) recently issued an en banc decision suspending Regulation Section 10789(c) on walk-throughs. This change allows DWC, effective January 11, to now offer a "walk-through alternative" in the Lifesize video conferencing platform. Instructions on using that platform may be found on the DWC website.
District offices will be available for walk-throughs Monday through Friday, from 2 to 4 p.m. only. Walk-throughs will be available only for a Compromise and Release, or Stipulation with Request for Award at this time. To be heard, the documents must be filed at least 24 hours ahead of the walk-through appearance, by either JET filing or e-filing. Documents filed by U.S. mail must be available to the judge in EAMS prior to the walk-through.
DWC has previously posted instructions on how to e-file settlement documents. The walk-through procedure will be handled via the Lifesize virtual courtroom which will be available for each office. A list of links for each office may be found here. The link for each virtual walk-through courtroom will not change. It should be noted that a judge will handle as many walk-throughs as are feasible for the day. The order in which a judge will hear the walk-throughs will be up to the judge handling that day’s matters. We encourage parties to file proposed orders to assist the judge with handling the matter more expeditiously.
DWC understands that parties may want to walk-through other documents. However, at this time walk-throughs are limited to only a Compromise and Release or Stipulation with Request for Award. Limits will be based on both availability and pursuant to the DWC/WCAB Policy and Procedural Manual section 1.25.
DWC will be monitoring the impact of this program and will look to expand hours and documents allowed in the future based on staffing availability ...
The number of U.S. workplace deaths rose 2% in 2019 to 5,333 from 5,250 fatal workplace injuries in 2018, according to the most recent Census of Fatal Occupational Injuries released by the Labor Department’s Bureau of Labor Statistics (BLS). The fatal work injury rate was 3.5 fatalities per 100,000 full-time equivalent (FTE) workers, the same rate reported in 2018.
It was the highest number of fatalities reported since 2007. Transportation incidents continued to account for the largest share of fatalities; transportation incidents increased 2% in 2019 to 2,122 cases. Falls, slips, and trips increased 11% in 2019 to 880 cases.
Other key findings in the BLS report included:
-- The 5,333 fatal occupational injuries in 2019 represents the largest annual number since 2007.
-- A worker died every 99 minutes from a work-related injury in 2019.
-- Fatalities among workers age 55 and over increased 8 percent from 1,863 in 2018 to 2,005 in 2019, which is the largest number ever recorded for this age group.
-- Hispanic or Latino worker fatalities were up 13 percent to 1,088 in 2019–a series high since 1992.
-- Workplace deaths due to suicides (307) and unintentional overdoses (313) increased slightly in 2019.
-- Fatalities in the private construction industry increased 5 percent to 1,06- the largest total since 2007.
-- Driver/sales workers and truck drivers incurred 1,005 fatal occupational injuries, the highest since this series began in 2003.
Both the NSC and American Society of Safety Professionals (ASSP) responded to the CFOI report, calling for employers to take consistent, systemic action to curtail the number of workplace deaths.
"Fatalities should never be the cost of doing business," NSC said in a statement. ASSP urged employers to adopt voluntary national consensus standards and implement safety and health management systems in response to numbers of workplace fatalities reported in 2019.
"With many safety advancements being readily available to employers nationwide, it’s troubling that we’re continuing to see higher numbers of worker fatalities," said ASSP President Deborah Roy said in a statement.
ASSP said that employer efforts to improve workplace safety should involve safety and health management systems like the one specified in the group’s Z10.0-2019 standard.
...
It was the highest number of fatalities reported since 2007. Transportation incidents continued to account for the largest share of fatalities; transportation incidents increased 2% in 2019 to 2,122 cases. Falls, slips, and trips increased 11% in 2019 to 880 cases.
Other key findings in the BLS report included:
-- The 5,333 fatal occupational injuries in 2019 represents the largest annual number since 2007.
-- A worker died every 99 minutes from a work-related injury in 2019.
-- Fatalities among workers age 55 and over increased 8 percent from 1,863 in 2018 to 2,005 in 2019, which is the largest number ever recorded for this age group.
-- Hispanic or Latino worker fatalities were up 13 percent to 1,088 in 2019–a series high since 1992.
-- Workplace deaths due to suicides (307) and unintentional overdoses (313) increased slightly in 2019.
-- Fatalities in the private construction industry increased 5 percent to 1,06- the largest total since 2007.
-- Driver/sales workers and truck drivers incurred 1,005 fatal occupational injuries, the highest since this series began in 2003.
Both the NSC and American Society of Safety Professionals (ASSP) responded to the CFOI report, calling for employers to take consistent, systemic action to curtail the number of workplace deaths.
"Fatalities should never be the cost of doing business," NSC said in a statement. ASSP urged employers to adopt voluntary national consensus standards and implement safety and health management systems in response to numbers of workplace fatalities reported in 2019.
"With many safety advancements being readily available to employers nationwide, it’s troubling that we’re continuing to see higher numbers of worker fatalities," said ASSP President Deborah Roy said in a statement.
ASSP said that employer efforts to improve workplace safety should involve safety and health management systems like the one specified in the group’s Z10.0-2019 standard.
...
Exceltox, a California diagnostic laboratory located in Irvine California, has agreed to pay $357,584 to resolve allegations that it violated the False Claims Act by submitting or causing to be submitted claims for genetic tests to Medicare without valid physician oversight..
Between September 2015 to November 2015, Exceltox used the services of contractor Seth Rehfuss, of Somerset, New Jersey, who persuaded groups of senior citizens in senior housing complexes to submit to genetic testing, despite applicable Medicare rules requiring proper orders from a treating physician for such tests.
Exceltox, in turn, submitted claims for payment to Medicare for Rehfuss’ genetic tests performed without valid physician oversight.
Rehfuss previously pleaded guilty in Trenton federal court to a superseding information charging him with conspiracy to commit health care fraud and was sentenced in May 2019 to 50 months in prison.
Exceltox was also connected with the prosecution of a Bakersfield physician in 2019, Jason Helliwell, who was at the time on probation by the state medical board for negligent patient care and sex with patients, faced criminal allegations of billing fraud.
Helliwell and two others were charged Sept. 4 2019, in a 31-count criminal complaint alleging a fraudulent medical billing scheme, according to the complaint filed by the Kern County District Attorney’s Office.
The complaint alleges that Helliwell, 47, conspired with Brandon Williams, 40, a sales representative for Irvine-based Exceltox toxicology lab, and Tamara Head, 53, owner of Rosedale Medical Billing Solution, to charge insurance companies for medically unnecessary treatment. The alleged fraud in the complaint dates back to 2010 and occurred as recently as 2016.
The schemes alleged in the DA’s complaint and investigative reports involve Helliwell ordering unnecessary blood and urine tests for patients for which Head is accused of fraudulently charging insurance companies. Helliwell received kickbacks from Williams, whose lab performed some of the testing, for the samples.
Reports state that Helliwell would collect urine samples from patients for lead and mercury testing and would "surreptitiously" order additional testing for illicit drugs without the patient’s knowledge.
Helliwell was given $20 to $25 per patient sample by the toxicology lab, former employees told an investigator, and the lab also paid for a personal medical assistant for Helliwell, according to reports.
Helliwell also ordered testing on an in-house blood allergy machine for patients who didn’t complain of allergy symptoms, the reports said.
Emails obtained between Helliwell and Head indicated the two worked together to bill insurance companies for services not provided to patients, to bill under other doctor’s names and to manipulate billing to receive higher reimbursements, the reports said.
The discovery was made as part of a joint investigation with the California Department of Insurance, according to Kern County Deputy District Attorney Joseph Kinzel.
...
Between September 2015 to November 2015, Exceltox used the services of contractor Seth Rehfuss, of Somerset, New Jersey, who persuaded groups of senior citizens in senior housing complexes to submit to genetic testing, despite applicable Medicare rules requiring proper orders from a treating physician for such tests.
Exceltox, in turn, submitted claims for payment to Medicare for Rehfuss’ genetic tests performed without valid physician oversight.
Rehfuss previously pleaded guilty in Trenton federal court to a superseding information charging him with conspiracy to commit health care fraud and was sentenced in May 2019 to 50 months in prison.
Exceltox was also connected with the prosecution of a Bakersfield physician in 2019, Jason Helliwell, who was at the time on probation by the state medical board for negligent patient care and sex with patients, faced criminal allegations of billing fraud.
Helliwell and two others were charged Sept. 4 2019, in a 31-count criminal complaint alleging a fraudulent medical billing scheme, according to the complaint filed by the Kern County District Attorney’s Office.
The complaint alleges that Helliwell, 47, conspired with Brandon Williams, 40, a sales representative for Irvine-based Exceltox toxicology lab, and Tamara Head, 53, owner of Rosedale Medical Billing Solution, to charge insurance companies for medically unnecessary treatment. The alleged fraud in the complaint dates back to 2010 and occurred as recently as 2016.
The schemes alleged in the DA’s complaint and investigative reports involve Helliwell ordering unnecessary blood and urine tests for patients for which Head is accused of fraudulently charging insurance companies. Helliwell received kickbacks from Williams, whose lab performed some of the testing, for the samples.
Reports state that Helliwell would collect urine samples from patients for lead and mercury testing and would "surreptitiously" order additional testing for illicit drugs without the patient’s knowledge.
Helliwell was given $20 to $25 per patient sample by the toxicology lab, former employees told an investigator, and the lab also paid for a personal medical assistant for Helliwell, according to reports.
Helliwell also ordered testing on an in-house blood allergy machine for patients who didn’t complain of allergy symptoms, the reports said.
Emails obtained between Helliwell and Head indicated the two worked together to bill insurance companies for services not provided to patients, to bill under other doctor’s names and to manipulate billing to receive higher reimbursements, the reports said.
The discovery was made as part of a joint investigation with the California Department of Insurance, according to Kern County Deputy District Attorney Joseph Kinzel.
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Los Angeles County on Tuesday approved a proposal to require national grocery and drug retailers operating in unincorporated areas of Los Angeles County to pay frontline workers an additional $5 per hour in "hero pay."
Supervisors Hilda Solis and Holly Mitchell co-authored the motion calling for a temporary "urgency" ordinance that would apply to store chains that are publicly traded or have at least 300 employees nationwide and more than 10 employees per store. Supervisor Kathryn Barger abstained from the vote, which was 4-0.
"There's no question that these people deserve hero pay," Barger said, but told her colleagues that she wanted to make sure there would not be unintended consequences before offering her support.
The motion pointed to a rising number of outbreaks of the virus in grocery stores and the additional stress that workers suffer when they cannot consistently maintain distance from crowds of customers at work. Workers also bear increased child care costs incurred while kids are at home distance learning.
Solis and Mitchell noted that several grocery corporations offered $2 to $4 hourly raises at the outset of the pandemic, but that additional support lapsed in May.
The California Grocers Association pushed back hard, agreeing that their employees are heroes, but that the ordinance would result in higher food costs, hurting low-income families and seniors already struggling to cover those costs.
"Grocery store workers are frontline heroes, and that's why grocers have undertaken a massive effort to institute store policies to make both workers and customers safer," California Grocers Association President and CEO Ron Fong said. "Many grocers have already provided workers with extra pay, bonuses and generous health benefits during the pandemic as a supplement to the fair, competitive wages and benefits collectively bargained by grocery workers' unions."
San Francisco supervisors have also passed a resolution Tuesday to give them hazard pay, after urging large chain grocery stores to raise hourly wages for employees by $5.
The $5 in hazard pay would last while the city remains in the purple, red or orange tier on the state’s tiered system.
The extra compensation would not be required of small mom-and-pop groceries ...
Supervisors Hilda Solis and Holly Mitchell co-authored the motion calling for a temporary "urgency" ordinance that would apply to store chains that are publicly traded or have at least 300 employees nationwide and more than 10 employees per store. Supervisor Kathryn Barger abstained from the vote, which was 4-0.
"There's no question that these people deserve hero pay," Barger said, but told her colleagues that she wanted to make sure there would not be unintended consequences before offering her support.
The motion pointed to a rising number of outbreaks of the virus in grocery stores and the additional stress that workers suffer when they cannot consistently maintain distance from crowds of customers at work. Workers also bear increased child care costs incurred while kids are at home distance learning.
Solis and Mitchell noted that several grocery corporations offered $2 to $4 hourly raises at the outset of the pandemic, but that additional support lapsed in May.
The California Grocers Association pushed back hard, agreeing that their employees are heroes, but that the ordinance would result in higher food costs, hurting low-income families and seniors already struggling to cover those costs.
"Grocery store workers are frontline heroes, and that's why grocers have undertaken a massive effort to institute store policies to make both workers and customers safer," California Grocers Association President and CEO Ron Fong said. "Many grocers have already provided workers with extra pay, bonuses and generous health benefits during the pandemic as a supplement to the fair, competitive wages and benefits collectively bargained by grocery workers' unions."
San Francisco supervisors have also passed a resolution Tuesday to give them hazard pay, after urging large chain grocery stores to raise hourly wages for employees by $5.
The $5 in hazard pay would last while the city remains in the purple, red or orange tier on the state’s tiered system.
The extra compensation would not be required of small mom-and-pop groceries ...
Courthouse News reports that the pharmaceutical industry’s effort to block California’s requirement that drug companies publicly notify and explain major price increases has stalled, with a federal judge ruling the landmark transparency law does not violate the First Amendment.
Siding with the state, a U.S. District Judge rejected an industry group’s arguments that the 2017 bill infringes drugmakers’ free speech and regulates interstate commerce. Noting the Pharmaceutical Research and Manufacturers of America (PhRMA) willingly bypassed discovery and pushed for summary judgment, the court found the group’s case plainly underdeveloped and unfit for market.
"There are genuine disputes of material fact as to whether providing advance notice of certain increases in a prescription drug’s wholesale acquisition cost results in either direct or extraterritorial regulation," the judge explained while denying the group’s facial challenge. "Ultimately, PhRMA has not met its burden in showing that Senate Bill 17 violates the dormant Commerce Clause on its face."
Hoping to force the industry to explain sudden increases to Californians, a bipartisan group of lawmakers approved the transparency bill in 2017. Then-Governor Jerry Brown quickly signed the bill, saying the public deserved more information on medication costs with "pharmaceutical profits soaring."
Supported by an influential coalition of California unions and health care groups, SB 17 requires drug companies to give the state and insurers at least 60 days’ notice before planned price increases of more than 16% over a two-year period. It also forces insurance companies to file yearly reports with state regulators outlining the impact of medicine costs on health care premiums.
Additional reporting requirements include annual reports to regulators by health plans and insurers with specified information related to the proportion of the premium dollar spent on prescription drugs, the year-over-year increase in net costs and member costs, the 25 most frequently prescribed medications, most costly drugs by total plan spending, and drugs with the highest year over year increase in net cost.
The law also tasks regulators with compiling the information into a consumer-friendly report showing the overall impact of drug costs on health care premiums.
Shortly after its passage, the industry responded with its lawsuit in the Eastern District of California, arguing the state was picking on drug manufacturers and ignoring the underlying reasons for spiking costs.
In court, the group contended the advance-notice requirement effectively triggers a "60-day nationwide price freeze" by preventing manufacturers from increase a drug’s wholesale acquisition cost or list price. It also claimed SB 17 interferes with Medicaid reimbursement schemes enacted in other states.
"That is unconstitutional," the group claimed in court papers. "The Commerce Clause does not permit a single state to ‘project its legislation into other states by regulating the price to be paid for drugs in those states.’"
Following the defeat, the group’s public affairs director hinted an appeal was likely.
"Our position remains that SB 17 is unconstitutional. We will continue to make that case," said Nick McGee in an email ...
Siding with the state, a U.S. District Judge rejected an industry group’s arguments that the 2017 bill infringes drugmakers’ free speech and regulates interstate commerce. Noting the Pharmaceutical Research and Manufacturers of America (PhRMA) willingly bypassed discovery and pushed for summary judgment, the court found the group’s case plainly underdeveloped and unfit for market.
"There are genuine disputes of material fact as to whether providing advance notice of certain increases in a prescription drug’s wholesale acquisition cost results in either direct or extraterritorial regulation," the judge explained while denying the group’s facial challenge. "Ultimately, PhRMA has not met its burden in showing that Senate Bill 17 violates the dormant Commerce Clause on its face."
Hoping to force the industry to explain sudden increases to Californians, a bipartisan group of lawmakers approved the transparency bill in 2017. Then-Governor Jerry Brown quickly signed the bill, saying the public deserved more information on medication costs with "pharmaceutical profits soaring."
Supported by an influential coalition of California unions and health care groups, SB 17 requires drug companies to give the state and insurers at least 60 days’ notice before planned price increases of more than 16% over a two-year period. It also forces insurance companies to file yearly reports with state regulators outlining the impact of medicine costs on health care premiums.
Additional reporting requirements include annual reports to regulators by health plans and insurers with specified information related to the proportion of the premium dollar spent on prescription drugs, the year-over-year increase in net costs and member costs, the 25 most frequently prescribed medications, most costly drugs by total plan spending, and drugs with the highest year over year increase in net cost.
The law also tasks regulators with compiling the information into a consumer-friendly report showing the overall impact of drug costs on health care premiums.
Shortly after its passage, the industry responded with its lawsuit in the Eastern District of California, arguing the state was picking on drug manufacturers and ignoring the underlying reasons for spiking costs.
In court, the group contended the advance-notice requirement effectively triggers a "60-day nationwide price freeze" by preventing manufacturers from increase a drug’s wholesale acquisition cost or list price. It also claimed SB 17 interferes with Medicaid reimbursement schemes enacted in other states.
"That is unconstitutional," the group claimed in court papers. "The Commerce Clause does not permit a single state to ‘project its legislation into other states by regulating the price to be paid for drugs in those states.’"
Following the defeat, the group’s public affairs director hinted an appeal was likely.
"Our position remains that SB 17 is unconstitutional. We will continue to make that case," said Nick McGee in an email ...
John S. Romero, 74, of Loma Linda, the former president of a Colton-based labor union was sentenced to 144 months in prison for stealing nearly $800,000 from the union’s health plan trust fund, which he used to pay for personal expenses including legal bills and a car loan for his son’s sports car.
At the conclusion of a five-day trial, a jury found Romero guilty of one count of conspiracy, 12 counts of theft in connection with health care, and one count of making a false statement to a government agency.
Romero appointed himself president of United Industrial Services Workers of America (UISWA) and trustee of the UISWA health plan trust fund. Money paid into the fund was supposed to be used exclusively for health care benefits of its participants. Instead, Romero stole the union’s health funds for the benefit of himself and his immediate family.
In furtherance of his scheme, Romero appointed a sham trustee who had no prior experience with unions. He also actively misled the third-party administrators of the health plan into making improper payments from the trust fund.
From 2008 to 2014, Romero embezzled health plan funds to pay a $110,000 personal civil judgment against himself and his son, John J. Romero, 55, also of Loma Linda. He also embezzled $40,000 to pay criminal defense lawyers who represented Romero in a separate case. Romero funneled more than $310,000 to himself by disguising the funds as rent payments on two properties he owned and held under a shell company.
In addition, he stole more than $300,000 in union health plan money to make "salary" payments to his family, even though none of his family members ever worked for the plan. He also used plan funds to pay off a $25,000 loan on his son’s Ford Mustang Shelby GT500 sports car.
Romero also filed a false financial report with the U.S. Department of Labor in which he concealed the existence of more than $100,000 in union receipts and disbursements that Romero held in a secret bank account and from which he made regular payments to his mistress.
Romero advanced his scheme by appointing his son as the secretary and treasurer of the union. He later appointed his ex-wife, Evelyn Romero, 71, as the UISWA president and trustee in 2010, shortly before Romero began serving a two-year federal prison sentence for making false statements to federal officials while he was president of a different labor union. Romero’s son, ex-wife, and daughter, Danae Romero, 42, of Loma Linda, pleaded guilty to criminal charges in this case. Evelyn and Danae Romero each were sentenced to two years’ probation in this case. John J. Romero was sentenced to time served in prison, plus three years of supervised release.
At a September 9 hearing, Judge Phillips ordered this case’s other defendants to pay restitution in the following amounts: Evelyn Romero - $316,502; John J. Romero - $273,350; and Danae Romero - $200,552.
...
At the conclusion of a five-day trial, a jury found Romero guilty of one count of conspiracy, 12 counts of theft in connection with health care, and one count of making a false statement to a government agency.
Romero appointed himself president of United Industrial Services Workers of America (UISWA) and trustee of the UISWA health plan trust fund. Money paid into the fund was supposed to be used exclusively for health care benefits of its participants. Instead, Romero stole the union’s health funds for the benefit of himself and his immediate family.
In furtherance of his scheme, Romero appointed a sham trustee who had no prior experience with unions. He also actively misled the third-party administrators of the health plan into making improper payments from the trust fund.
From 2008 to 2014, Romero embezzled health plan funds to pay a $110,000 personal civil judgment against himself and his son, John J. Romero, 55, also of Loma Linda. He also embezzled $40,000 to pay criminal defense lawyers who represented Romero in a separate case. Romero funneled more than $310,000 to himself by disguising the funds as rent payments on two properties he owned and held under a shell company.
In addition, he stole more than $300,000 in union health plan money to make "salary" payments to his family, even though none of his family members ever worked for the plan. He also used plan funds to pay off a $25,000 loan on his son’s Ford Mustang Shelby GT500 sports car.
Romero also filed a false financial report with the U.S. Department of Labor in which he concealed the existence of more than $100,000 in union receipts and disbursements that Romero held in a secret bank account and from which he made regular payments to his mistress.
Romero advanced his scheme by appointing his son as the secretary and treasurer of the union. He later appointed his ex-wife, Evelyn Romero, 71, as the UISWA president and trustee in 2010, shortly before Romero began serving a two-year federal prison sentence for making false statements to federal officials while he was president of a different labor union. Romero’s son, ex-wife, and daughter, Danae Romero, 42, of Loma Linda, pleaded guilty to criminal charges in this case. Evelyn and Danae Romero each were sentenced to two years’ probation in this case. John J. Romero was sentenced to time served in prison, plus three years of supervised release.
At a September 9 hearing, Judge Phillips ordered this case’s other defendants to pay restitution in the following amounts: Evelyn Romero - $316,502; John J. Romero - $273,350; and Danae Romero - $200,552.
...
