For half a century, the medical world has classified traumatic brain injuries using essentially the same tool: the Glasgow Coma Scale, a bedside scoring system developed in 1974 that rates a patient's eye opening, verbal responses, and motor function on a 15-point scale. A score of 13 to 15 is "mild," 9 to 12 is "moderate," and 3 to 8 is "severe." That three-tier system has driven clinical decision-making, research design, insurance determinations, and — critically for this audience — workers' compensation claims adjudication for decades. That system is now being replaced. In May 2025, an international team of 94 experts from 14 countries, led by the National Institutes of Health and the National Institute of Neurological Disorders and Stroke, published a new classification framework in The Lancet Neurology. Called CBI-M, it represents the most significant change in how traumatic brain injuries are assessed and categorized since the Glasgow Coma Scale was introduced. Trauma centers nationwide are beginning to test it, and workers' compensation professionals handling head injury claims need to understand what is coming. The problem with the mild/moderate/severe classification is not that it is inaccurate — it is that it is incomplete. Within the "mild" TBI category alone, there is enormous variation. One patient might sustain a brief blow to the head with no loss of consciousness and a momentary gap in memory. Another patient in the same "mild" category might lose consciousness for 20 minutes and have a small brain bleed visible on imaging. Under the current system, both receive the same classification, the same label, and — too often — the same clinical follow-up, which for "mild" TBI frequently means discharge from the emergency department with minimal arrangements for ongoing care. The new framework does not discard the Glasgow Coma Scale — it expands on it. CBI-M stands for Clinical, Biomarker, Imaging, and Modifier, representing four pillars of assessment that together provide a multidimensional picture of the injury rather than a single number. The clinical pillar retains the Glasgow Coma Scale but uses each component score individually rather than collapsing them into a single sum. It also incorporates pupillary reactivity — whether the pupils respond normally to light — which is a significant predictor of outcomes that the traditional GCS sum score alone does not capture. The biomarker pillar is entirely new to TBI classification. It incorporates blood-based measures that can detect the presence and extent of brain injury. The FDA approved the first blood test for brain injury in 2018, and the technology has advanced rapidly since. Specific proteins released when brain tissue is damaged — including glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase L1 (UCH-L1), and S100 calcium-binding protein B (S100B) — can now be measured from a standard blood draw within hours of injury. Elevated levels indicate that brain injury has occurred, even when the patient's clinical presentation appears mild and CT imaging looks normal. The imaging pillar formalizes the role of brain imaging — CT and MRI — in characterizing the injury. Rather than simply asking whether a scan is "positive" or "negative," the framework categorizes the specific types of pathology present, such as contusions, hemorrhages, or diffuse axonal injury, each of which carries different implications for recovery. The modifier pillar accounts for individual factors that influence clinical presentation and outcome: the mechanism of injury, the patient's age, preexisting medical conditions, prior head injuries, and psychosocial factors. These modifiers have always been relevant to prognosis, but the current classification system ignores them entirely. Independent medical examinations will need to adapt. Medical evaluators who currently rely on the GCS classification to frame their opinions about injury severity and causation will need to engage with the new framework. The biomarker pillar deserves special attention because it introduces something the workers' comp system has never had for traumatic brain injury: an objective, measurable indicator of injury that does not depend on patient self-reporting or clinical judgment. Brain injury has historically been one of the most difficult conditions to evaluate in the claims context precisely because it lacks the kind of objective evidence — an X-ray showing a fracture, an MRI showing a disc herniation — that other orthopedic injuries produce. Blood-based biomarkers change that equation. This does not mean biomarker testing will resolve all disputes. Elevated protein levels indicate brain injury but do not, by themselves, predict the duration of symptoms or the degree of functional impairment. And the science is still maturing — reference ranges, timing windows for testing, and interpretation standards are all subjects of active research. But the direction is clear: TBI evaluation is moving from subjective to objective, and the workers' comp system will need to keep pace. The CBI-M framework is not yet in universal clinical use. The authors describe it as a framework that will require validation and refinement before full adoption. But it is being tested at trauma centers now, it was published in one of the world's leading neurology journals, and it carries the imprimatur of the NIH. The trajectory is unmistakable. For further reading, the CBI-M framework was published in The Lancet Neurology in May 2025: A New Characterisation of Acute Traumatic Brain Injury: The NIH-NINDS TBI Classification and Nomenclature Initiative. The NIH-NINDS also published an accessible summary: New Framework for Classifying Traumatic Brain Injury ...

The DOJ has called Southern California a "high-risk environment" for health care fraud. The FBI's Los Angeles Field Office has also pledged to crack down on health care fraud with the National Fraud Enforcement Division within the DOJ. This week a federal court has granted a request from the United States to seize more than $2 million from a Pasadena-based advanced wound care clinic accused of defrauding Medicare for reimbursements for skin graft substitutes and skin grafts that never were performed on patients. According to an affidavit filed with a federal seizure warrant, from September 2025 to April 2026, Expert Wound Care submitted more than $46.6 million in claims to Medicare for skin substitute products and wound care services purportedly provided to 78 beneficiaries. Medicare approved payments of approximately $34,031,382 on these claims, which included skin substitutes and skin grafts as well as skin application procedures. From January 2025 to June 2025, the national average for a billing provider’s allowed amount per claim for skin substitute grafts was $16,837. From July 2025 to March 2026, Expert Wound Care averaged approximately $37,449 in allowed amount per claim for substitute skin grafts, more than double the national average. The clinic increased its Medicare billing from $4,975 in July 2025 to approximately $33 million in December 2025, according to the affidavit. One beneficiary had a total payment amount to Medicare of approximately $6,232,645, and the average paid amount per beneficiary was approximately $299,639. One of the most alarming details involves a single patient. From October 2025 to February 2026, Expert Wound Care billed Medicare for approximately $2,611,105 and was paid approximately $2,039,792 for skin substitute grafts and 52 skin graft application services purportedly provided to one beneficiary. Law enforcement determined that the beneficiary did not receive any skin grafts as part of his treatment and did not receive any type of home service in December 2025 despite the fact Expert Wound Care filed 27 claims for services on this beneficiary’s behalf for that month. And there seems to have been some statistical red flags. Expert Wound Care’s percentage of total beneficiaries receiving substitute skin grafts of 38.5%, more than six times the national average of 6%. Its percentage of total claims for substitute skin grafts was 63%, approximately nine times the national average. Finally, Expert Wound Care’s percentage of total allowed amount for substitute skin grafts was 99.9%, more than double the national average. Homeland Security Investigations and the United States Department of Health and Human Services Office of Inspector General are investigating this matter. Assistant United States Attorney Jonathan S. Galatzan of the Asset Forfeiture and Recovery Section is handling this case. The Department of Justice has created the National Fraud Enforcement Division. The core mission of the Fraud Division is to zealously investigate and prosecute those who steal or fraudulently misuse taxpayer dollars. Department of Justice efforts to combat fraud support President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chair by Vice President J.D. Vance to eliminate fraud, waste, and abuse within federal benefit programs ...

On the morning of Monday, September 12, 2022, Kai-Lin Chang was riding his bicycle on Victory Boulevard in West Hills when Dr. Brittany Doremus, a palliative care physician employed by Southern California Permanente Medical Group (SCPMG), made a left turn across his path while pulling into a dry cleaner's parking lot to drop off her children's Halloween costumes. Chang collided with her vehicle and was hospitalized with injuries. He sued both Doremus and SCPMG, alleging Doremus was acting within the scope of her employment at the time of the accident and that SCPMG was therefore vicariously liable under the doctrine of respondeat superior. Doremus's work schedule was not a simple nine-to-five arrangement. On Mondays and Tuesdays she worked at her office at the Woodland Hills Medical Center. On Wednesday mornings she could work from home, on Thursday and Friday she worked with patients at the medical center's hospital, and when on call on nights or weekends she worked from home. SCPMG also provided its physicians with employer-issued cell phones equipped with special communication software. On the morning of the accident, Doremus testified she had left home around 8:30 a.m. to drive to the office and was on a purely personal errand — dropping off the costumes — when the collision occurred. She did not recall being on any call before the accident. Following the collision she called 911, then sent a group text to the nurse and social worker on her team to cancel her appointments for the day. SCPMG produced a text message log from Doremus's wireless carrier showing no texts between 8:30 and 8:44 a.m., with a cluster of messages beginning at 8:44 — the post-accident notifications to her coworkers. A call log showed no work calls before the accident. The trial court granted SCPMG's motion for summary judgment. The court found the going and coming rule plainly applied: Doremus was commuting to work on a Monday, as she did every week, and was in the middle of a personal errand — wholly unrelated to her employment — when the accident occurred. The court found no recognized exception to the rule applied: Doremus was driving her own personal vehicle that SCPMG neither provided nor required, she was on no special errand for her employer, and SCPMG derived no incidental benefit from her use of the vehicle. The court overruled Chang's evidentiary objections to the call and text records, noting that Chang himself had relied on those same records in his opposition. Chang appealed. The Second District affirmed summary judgment for SCPMG in full in the published case of Chang v. Southern California Permanente Medical Group Case No. B340770 (April 2026). The court awarded SCPMG its costs on appeal. The opinion was originally filed April 9, 2026 without publication, then certified for publication on April 28, 2026, with no change in judgment. SCPMG met its burden of proof; Chang did not meet his. The court emphasized that in respondeat superior cases involving driver testimony, an employer does not have to eliminate every conceivable possibility of work activity — sworn testimony that the driver was not working is sufficient to shift the burden. Doremus's deposition testimony that she was commuting on a personal errand, not on a call, and driving her own vehicle accomplished exactly that. Chang then had to offer admissible contradictory evidence, and he failed to do so. The "hybrid worker" argument failed on the facts. Chang's more novel contention was that because Doremus sometimes worked from home, her home had become a second worksite, and her Monday morning drive was therefore transit between worksites rather than an ordinary commute — placing her within the scope of employment. The court rejected this categorically. Doremus worked at the medical center on Mondays without exception. Even accepting the premise that a home can become a second worksite, it is only a worksite when the employee is actually working from home — not as a permanent all-day status. On Monday mornings Doremus was not working from home; she was driving to the office. The court found that none of the cases Chang cited — including Wilson v. Workers' Comp. Appeals Bd. (1976) 16 Cal.3d 181, 184, Bramall v. Workers' Comp. Appeals Bd. (1978) 78 Cal.App.3d 151, Zhu v. Workers' Comp. Appeals Bd. (2017) 12 Cal.App.5th 1031, and State Ins. Fund v. Industrial Commission (Utah 1964) 15 Utah 2d 363 — supported the proposition that a hybrid worker's home is a second worksite on days when she is not working from it. Workers' compensation cases are the wrong measuring stick. The court also noted — pointedly, since Chang had himself argued below that workers' compensation cases had "no applicability in tort cases" — that the going and coming rule as applied in tort is more restrictive than in workers' compensation. Citing Pierson v. Helmerich & Payne Internat. Drilling Co. (2016) 4 Cal.App.5th 608, 619, the court observed that workers' compensation law resolves any reasonable doubt in the employee's favor, a policy tilt that does not carry over to third-party tort liability against employers. Policy reinforced the holding. The court offered a final, practical observation: ruling for Chang would effectively abolish the going and coming rule for any employee who sometimes works from home, creating a perverse incentive for employers to curtail workplace flexibility to avoid expanded tort exposure. The court found no sound policy rationale for that result ...

On April 20, 2026, Rideshare Drivers United — which says it represents more than 20,000 drivers in California — filed a lawsuit in San Francisco Superior Court alleging that Uber is not providing the benefits to California drivers that Proposition 22 requires in order to treat them as independent contractors. The case is Rideshare Drivers United v Uber Technologies Inc., Case Number: CGC26636126. California has adopted the ABC test to determine if a worker is an independent contractor or an employee. The ABC test presumes a worker is an employee and places the burden on the hiring entity to establish three factors: “(a) that the worker is free from control and direction over performance of the work, both under the contract and in fact; (b) that the work provided is outside the usual course of the business for which the work is performed; and (c) that the worker is customarily engaged in an independently established trade, occupation or business (hence the ABC standard). In 2020, a coalition of companies, including Uber, initiated a ballot initiative to overturn the ABC test for drivers and instead declare all “app-based drivers” who met certain conditions to be independent contractors and not employees. Prop 22 was approved by voters in 2020 and established that drivers for app-based transportation services like Uber and Lyft are independent contractors — not employees — under state law. However, it only applies if drivers are provided with certain benefits, including a minimum wage, subsidies for health insurance, and the ability to appeal terminations Bus. & Prof. Code § 7452(c). The Plaintiff Rideshare Drivers United (“RDU”) is a California nonprofit corporation with a principal place of business in Pasadena, California. It was founded in 2018 and registered as a nonprofit corporation in 2020. RDU’s declared mission is to support “app-based drivers”, including Uber drivers, organizing to improve their working conditions and rights on the job. The RDU lawsuit alleges that "Uber has failed to comply with Proposition 22 since its enactment in various ways." And it claims that "Allowing Uber to wield Proposition 22 as a shield against driver misclassification claims, while simultaneously flouting its legal obligations under the law, is fundamentally unjust and unlawful." Plaintiffs allege Uber has failed to create an appeals system to give drivers due process when they're kicked off the app. The measure had included a promise that drivers would have an appeals process. Many deactivated drivers report that they struggle to appeal their cases — they say they are initially sent to sites where they appear to be talking with bots, then eventually reach agents working from a script who appear to be in another country, and rarely reach people who are empowered to truly help them. Plaintiffs thus allege Uber has not provided any bona fide appeals process for drivers to challenge their terminations (or “deactivations”, as Uber calls them), and "certainly no appeals process that comports with any standards of due process." The plaintiffs also allege that Uber deactivates drivers based on grounds not specified in its "Platform Access Agreement," and that the company does not provide drivers with enough information about their earnings to verify they are receiving 120% of minimum wage. The lawsuit seeks a declaration that Uber has violated Prop 22 and "is barred from asserting that its drivers are independent contractors," which would open the door for drivers to sue Uber for wage law violations. Rideshare Drivers United is seeking legal fees and costs but no monetary damages directly from this suit. However Attorney Shannon Liss-Riordan stated she is at some point seeking back pay and other damages for drivers who were unfairly deactivated, as well as their rights under the labor code. This lawsuit is the latest of many legal challenges against Prop. 22, which CalMatters has found has no state agency assigned to enforce it. The state Supreme Court upheld the gig-work law in 2024. Separately, Uber is also facing a lawsuit by the state Justice Department and the cities of San Francisco, Los Angeles, and San Diego over thousands of wage-theft claims that predate Prop. 22, with a trial-clock deadline set for December 2027 ...

As we reported in our April 13, 2026 newsletter, Jeanette France worked as an occupational health nurse for the Los Angeles Department of Water and Power (DWP).On February 1, 2017 — less than a month after she had reported a work injury — the DWP terminated her employment. The DWP maintained that France was terminated for poor job performance that predated her injury. France filed a civil lawsuit under the Fair Employment and Housing Act alleging disability discrimination and retaliation. In December 2019, the Los Angeles County Superior Court granted summary judgment for the DWP, finding that France was terminated for legitimate, nondiscriminatory reasons — namely, poor performance predating her injury — and that France failed to raise a triable issue of pretext. France also filed a workers' compensation petition alleging the DWP violated Labor Code section 132a, which prohibits employers from discharging employees for filing or threatening to file a workers' compensation claim. After a multi-day hearing, the workers' compensation judge denied the claim, finding that France failed to prove the termination was retaliatory in light of the performance evidence, and that she produced no evidence that those involved in terminating her even knew about her statements in the workers' compensation meeting minutes earlier. France sought reconsideration. The Workers' Compensation Appeals Board (WCAB) granted the petition, reversed the judge, and found the DWP had violated section 132a. The WCAB concluded the DWP failed to carry its burden of establishing good cause for termination, emphasizing the absence of written disciplinary records, the lack of a stated reason on termination paperwork, and the fact that Dr. Israel could not recall exact dates for the performance issues she observed. On April 8, 2026 the Court of Appeal granted the DWP's petition for writ of review in the unpublished case of L.A. Department of Water & Power v. Workers' Compensation Appeals Board Case No. E086551 (April 2026) and annulled the WCAB's decision, directing the WCAB to reinstate the workers' compensation judge's original order denying France's section 132a claim. The Court of Appeal held on April 8th that the WCAB's findings were unreasonable because the Board systematically ignored relevant evidence rather than evaluating the record as a whole. Specifically, the court identified several ways the WCAB mischaracterized the record, such as ignoring the superior court's summary judgment order — part of the record — containing Israel's declaration placing those issues in October and November 2016, well before the injury. The court stressed that the WCAB was free to weigh evidence and make credibility determinations, but it was not free to simply ignore evidence that cut against its conclusions. The WCAB Petitioned the Court of Appeal for a Rehearing of the April 8 appellate decision against it. On April 27, 2026 the Court of Appeal issued and Order Denying Petition for Rehearing and Modifying Opinion [No Change in Judgment] Footnote 2 on page 12 of the April 8, 2026 Court of Appeal decision it was noted that "At oral argument, counsel for the WCAB contended that the reporter’s transcript of the February 2025 hearing, at which both Barnett and Israel testified, was not available to the WCAB when it issued its decision. The contention is based entirely on matters outside the certified record, so we cannot consider it. (§ 5951.) The reporter’s transcript of the February 2025 hearing is part of the record of proceedings that counsel for the WCAB certified is “a full, true and correct copy of the record of proceedings (consisting of 9 volumes) before the Appeals Board in the above-entitled matter involving a claim by Jeanette France. We also note that the reporter’s transcript of the February 2025 hearing was certified by the reporter in April 2025, and the WCAB issued its decision in June 2025." On its own motion, the Court Ordered that the opinion filed April 8, 2026, be modified as follows. "At the end of footnote 2 on page 12, add the following paragraph:" "The WCAB advances the same argument in its petition for rehearing, but the petition does not address or even mention the analysis in the first paragraph of this footnote. The WCAB argues that because it did not receive the reporter’s transcript before issuing its decision, we cannot rely on it." "But as we have explained, the WCAB’s assertion that it had not yet received the transcript when it issued its decision is based entirely on matters outside the certified record, so we are required by statute to reject it. (§ 5951 [“No new or additional evidence shall be introduced”].)" "Again, the record certified by the WCAB contains the transcript, and we are required by statute to base our decision on the certified record. (Ibid. [“the cause shall be heard on the record of the appeals board, as certified to by it”].) In addition, as we explain post, the reporter’s transcript of the hearing is not the only evidence that the WCAB unreasonably ignored." "For example, the certified record contains both the order granting summary judgment in the FEHA action and excerpts of Okhanes’s deposition testimony, both of which include evidence of the problems with France’s job performance. The WCAB ignored all of that evidence, and that dereliction is not explained by the WCAB’s alleged lack of access to the reporter’s transcript of the hearing." "The modification does not change the judgment." ...

California Senate Bill 553, signed into law on September 30, 2023, amended California Labor Code section 6401.7 and created section 6401.9, and required most California employers to develop and maintain a Workplace Violence Prevention Plan (WVPP) beginning July 1, 2024. The law also directed Cal/OSHA to propose a formal workplace violence prevention standard by December 31, 2025, with the Occupational Safety and Health Standards Board (OSHSB) required to adopt a final regulation no later than December 31, 2026. Since then, Cal/OSHA has issued several discussion drafts — including versions in July 2024, May 2025, and following a November 2025 advisory committee meeting — each incorporating stakeholder feedback from employer and employee advocacy groups. On April 24, 2026, the Cal/OSHA Standards Board released its latest revised discussion draft, which makes significant changes to the regulation's scope, definitions, and plan requirements. Key Provisions of the April 2026 Draft - - Expanded Scope. The revised draft broadens the regulation's coverage to include employer-provided transportation, stating that the rule applies to "all employers, employees, places of employment, employer-provided housing, and employer-provided transportation." - - Small Employer Exemption Clarified. A notable clarification addresses the small employer threshold. The regulation would not apply to employers whose places of employment are not accessible to the public and who have had fewer than ten total employees at that location at all times during the preceding 365 days, provided they are in compliance with California's existing Injury and Illness Prevention Program (IIPP) regulations. - - Definitions Updated. The definitions of "authorized employee representative" and "designated representative" were adjusted within the regulation. Importantly, the reference to the crime of stalking under California Penal Code section 646.9 was removed from the definition of workplace violence — a change employer advocates had pushed for, arguing that the broad statutory definition of stalking encompassed harassment and could involve conduct originating outside California. Stalking is, however, retained in the list of examples of workplace violence hazards. - - Workplace Violence Hazard Language Narrowed. The draft deleted several previously listed hazard factors, including references to hostile work environments, required and excessive overtime, working in high-crime areas, and providing security services. - - Training Requirements. The draft specifies that training not delivered in person must include interactive questions, with responses provided within one business day by someone knowledgeable about the employer's WVPP. - - Post-Incident Obligations. Employers would still be required to offer or make available post-incident trauma counseling for affected employees. Under the revised draft, a compliant WVPP must include: the name or title of the person responsible for the plan; procedures for active employee involvement; coordination with other employers at shared worksites; procedures for responding to reports of violence; compliance procedures; communication methods for reporting violence and sharing investigation results; emergency response procedures; training procedures; procedures for identifying and evaluating workplace violence hazards; methods for correcting identified hazards; post-incident response and investigation procedures; and procedures for periodic review and evaluation of the plan itself. The Standards Board is accepting public comments on the revised draft through June 1, 2026. Following the comment period, a final version of the regulation will be prepared for formal notice and a subsequent board vote. A vote approving the final standard is expected in late summer 2026, with an anticipated implementation date of January 1, 2027. Employers operating in California — particularly those in industries with elevated workplace violence risk, such as those involving public contact, nighttime work, isolated locations, or handling of cash, alcohol, or pharmaceuticals — should review the revised draft and consider submitting comments before the June 1 deadline. Cal/OSHA has directed interested parties to submit written comments to Principal Safety Engineer Kevin Graulich at KGraulich@dir.ca.gov. Employers may also reach out to Cal/OSHA directly at 833-579-0927 to confirm the correct email address or mailing address for this comment period ...

Karla Amezcua worked as a massage therapist at an Eastlake Chula Vista location operated under the Massage Envy brand from August 2011 until she was terminated in December 2019. She sued in January 2022, alleging wrongful termination and a series of Labor Code violations — including an illegal compensation scheme that penalized her for taking legally mandated meal and rest breaks by reducing her hourly rate during those periods. Her original and first amended complaints named only the franchisee, Securecare, Inc., and its sole principal, Robert Perez, along with DOE defendants. Discovery was protracted and contentious. Securecare initially represented it had no insurance and that documents related to the purchase of the franchise location had been "lost or misplaced." The real picture did not emerge until December 2024 — after the close of discovery — when Securecare finally produced both a Business Asset and Franchise Purchase Agreement and an employment practices liability insurance policy. The Purchase Agreement, significantly, showed that Massage Envy had approved the 2018 sale and transfer of the franchise, with terms that Amezcua alleged were structured to leave employees unable to recover for wage and hour violations. The insurance policy, meanwhile, revealed a separate Perez-controlled entity as the primary insured, with Securecare covered only as an additional insured. Armed with these late productions, Amezcua moved in December 2024 to substitute Massage Envy and three other parties for DOE defendants. The trial court granted the motion in January 2025, finding that while Amezcua had always known Massage Envy's identity as the franchisor, she had not known the facts giving rise to its potential liability. Trial was continued to August 2025. Amezcua filed an amended complaint naming Massage Envy, but the amendment contained no new substantive allegations against it — the body of the pleading was unchanged from the prior version. When Massage Envy sought to meet and confer about a demurrer in March 2025, Amezcua's counsel conceded the complaint was factually deficient as to Massage Envy, but declined to amend at that stage, proposing instead to let the demurrer proceed so the trial court could assess both Massage Envy's legal challenge and any proposed amendment in a single proceeding. Massage Envy filed its demurrer, asserting not only that the pleading lacked sufficient facts but also that Amezcua could not, as a matter of law, establish joint employer liability against a franchisor. Amezcua opposed the demurrer, attached a proposed second amended complaint alleging Massage Envy had developed the compensation matrix governing her pay and had structured the franchise sale to insulate itself from employee liability claims, and asked for leave to amend. The trial court sustained Massage Envy's demurrer and granted Amezcua leave to amend — but attached a condition: Amezcua had to pay Massage Envy's attorney fees and costs incurred in the meet-and-confer process and in preparing the demurrer papers before she could proceed with the amended complaint. The court relied on Code of Civil Procedure section 473, subdivision (a), reasoning that Amezcua had missed at least two earlier opportunities to include substantive allegations against Massage Envy and that her litigation approach was "antithetical" to the purpose of the statutory meet-and-confer requirement. Massage Envy sought $78,668.90; the court found $25,000 reasonable. Amezcua sought writ relief. The Court of Appeal granted the writ of mandate and directed the trial court to strike the attorney fee payment condition from its order in the published case of Amezcua v. Superior Court Case No. D087216 (April 2026). The court left undisturbed the portions of the order sustaining the demurrer and granting leave to amend; only the fee-shifting condition was invalidated. Section 473 does not authorize fee-shifting. The court opened with the foundational rule of California attorney fee law: courts may not order one party to pay another's attorney fees unless a statute specifically authorizes it or the parties have agreed to it. (Code Civ. Proc., § 1021.) Section 473, subdivision (a), the court held, contains no such authorization. Its language permits leave to amend on "terms as may be proper" and, when a trial postponement is required, on "payment to the adverse party of any costs as may be just" — but costs and attorney fees are not the same thing, and the Legislature chose the word "costs," not "fees." The leading treatises had it wrong. The court acknowledged candidly that several authoritative secondary sources — the Rutter Group's California Practice Guide: Civil Procedure Before Trial, California Jurisprudence, and Witkin's California Procedure — had interpreted case law to permit fee-shifting under section 473. The court declined to read the precedents so broadly, conducting a careful textual analysis of the two cases those treatises relied upon. Fuller v. Vista Del Arroyo Hotel (1941) 42 Cal.App.2d 400 never mentioned attorney fees at all and could not be read as endorsing them. Williams v. Myer (1907) 150 Cal. 714 referred to "expenses incurred in the employment of attorneys," but the court found this an oddly oblique way to say "attorney fees" — and concluded the Supreme Court would not have quietly overridden California's longstanding American Rule (each party pays its own fees) without saying so explicitly. In any event, the court held that whatever Williams may have permitted, it was superseded when the Legislature amended section 473 in 1933 to specifically address payment conditions when trial is postponed, limiting them to "costs," and simultaneously amended section 1021 to require express statutory authorization for any attorney fee award. The court confirmed the framework established in Bauguess v. Paine (1978) 22 Cal.3d 626, 639: trial courts have no inherent supervisory power to order payment of attorney fees as a sanction; such authority must come from statute. Statutes that do authorize fee sanctions — Code of Civil Procedure sections 128.5 and 128.7 — were neither invoked by either party nor by the trial court, and their procedural prerequisites (including a 21-day safe harbor and specific findings of bad faith or intent to harass) were never satisfied ...

Joint employer status under the Fair Labor Standards Act (FLSA) determines when two or more entities are both considered employers of the same worker(s) and thus jointly and severally liable for FLSA obligations, such as minimum wage, overtime pay, recordkeeping, and child labor restrictions. If joint employment exists, each employer is responsible for the full amount of any unpaid wages or damages owed, even if the worker's hours or violations are split across the employers. This concept commonly arises in scenarios like: - - Vertical joint employment — A worker is employed by one entity (e.g., a staffing agency or subcontractor) but another entity (e.g., a client company or franchisor) also benefits from or influences the work. - - Horizontal joint employment — Separate but associated employers (e.g., two commonly owned businesses) share the same worker's services, with operations that are sufficiently integrated regarding that employee. When joint employment is found, all hours worked for the joint employers in a workweek are typically combined for overtime calculations (hours over 40 must be paid at 1.5 times the regular rate), and both entities can be held liable for violations. Joint employment is not explicitly defined in the statute but has been recognized in DOL regulations and case law for decades. The key question is whether the employers' relationships with the worker (and each other) mean the work for one is not "completely disassociated" from the work for the other. Since the Biden-era DOL rescinded the 2020 joint employer rule in 2021, there has been no formal DOL regulation providing specific guidance on joint employer status under the FLSA (or aligned statutes like the Family and Medical Leave Act (FMLA) and Migrant and Seasonal Agricultural Worker Protection Act (MSPA)). The DOL and courts have instead relied on pre-2020 case law, opinion letters, and a "totality of the circumstances" or economic realities approach, which can vary by jurisdiction. On April 22/23, 2026, the DOL (Wage and Hour Division) published a Notice of Proposed Rulemaking (NPRM) titled "Joint Employer Status Under the Fair Labor Standards Act, Family and Medical Leave Act, and Migrant and Seasonal Agricultural Worker Protection Act." This proposal aims to: - - Restore regulatory guidance in 29 CFR Part 791 for the FLSA. - - Align the joint employer analysis for FMLA and MSPA with the FLSA standard (since those statutes incorporate FLSA's employment definitions). - - Provide a single, nationwide standard to reduce uncertainty, litigation, and circuit splits. The NPRM proposes a four-factor balancing test (similar but not identical to the 2020 rule) to assess whether a potential joint employer (the entity that benefits from the work but is not the direct employer) is jointly liable. The factors examine whether the potential joint employer: 1) Hires or fires the employee. 2) Supervises and controls the employee's work schedule or conditions of employment to a substantial degree. 3) Determines the employee's rate and method of payment. 4) Maintains the employee's employment records. No single factor is dispositive; the analysis considers the totality of the facts. If all four factors point the same way (toward or against joint employment), there is a "substantial likelihood" that outcome is correct. Additional factors may be relevant but are unlikely to override a unanimous result on the core four. The test allows consideration of reserved or indirect control in some contexts and economic dependence, but it emphasizes actual substantial involvement. The proposal clarifies that certain business relationships alone (e.g., sharing a vendor or being franchisees of the same franchisor) do not establish joint employment without more direct ties to the specific employee's work. The 60-day public comment process for the Department of Labor's (DOL) Notice of Proposed Rulemaking (NPRM) on Joint Employer Status Under the Fair Labor Standards Act (FLSA), Family and Medical Leave Act (FMLA), and Migrant and Seasonal Agricultural Worker Protection Act (MSPA) began with the NPRM's publication and closes at 11:59 p.m. ET on June 22, 2026. The DOL encourages comments on all aspects of the proposal. Submit comments at https://www.regulations.gov/docket/WHD-2026-0067. (Click the “Comment” or “Submit a Formal Comment” button on this docket page. You can also go directly to the comment form via the Federal Register page.) ...

Brianna Davis worked as an EMT at Tri-City Medical Center. On May 15, 2018, she injured her back, neck, and legs on the job and filed a workers' compensation claim. After a period of modified duty, Dr. Patrick O'Meara evaluated her in February 2019 and concluded she was not disabled, leading to her return to full duty in March 2019. Davis alleged she continued to suffer pain throughout, and on May 25, 2019, performing chest compressions for more than two hours caused a second industrial injury, for which she filed a new workers' compensation claim. Davis alleged that Corvel Corporation — the workers' compensation claims administrator hired by Tri-City — and Corvel claims adjuster Rob Maag pressured Dr. O'Meara to falsify his medical findings so that Corvel could deny her benefits. Critically, Davis alleged that in a July 2019 medical report, Dr. O'Meara stated he had physically examined her when he had not, then falsely concluded she had reached maximum medical improvement and needed no work restrictions. She also alleged that Maag pressured a second physician, identified only as "Dr. M.," to produce similar findings, and that when Dr. M. refused, Maag and others stopped referring patients to him. A third physician, Dr. Clarence Lee, allegedly refused to complete Davis's disability paperwork for the California Employment Development Department due to pressure from the defendants. Based on these allegations, Davis sued Corvel, Maag, and Dr. O'Meara for fraud and deceit under Civil Code sections 1709 and 1710, violations of the Unfair Competition Law (Bus. & Prof. Code § 17200 et seq.), and conduct she characterized as a RICO violation under 18 U.S.C. section 1962(c). The case reached the trial court on Davis's third amended complaint — her fourth attempt at pleading viable claims. The trial court sustained demurrers filed by Corvel, Maag, and Dr. O'Meara without leave to amend and dismissed the claims against them. The court found that all of Davis's alleged injuries arose from the workers' compensation claims process — specifically, disputes over the extent of her injury and the appropriate level of treatment — and were therefore barred by the exclusivity provisions of the California Workers' Compensation Act (WCA; Lab. Code § 3200 et seq.). The court rejected Davis's argument that fraud-based conduct places claims outside the WCA's reach, finding that allegations of improper denial or limitation of benefits, even if framed as a conspiracy or tortious scheme, remain squarely within the compensation bargain. The court also found that the RICO allegations failed because the TAC did not allege facts showing conduct affecting interstate commerce or a pattern of continuing racketeering activity. Dr. Lee, who did not demur, was not part of the dismissal. The Fourth District Court of Appeal affirmed the dismissal in full in the unpublished case of Davis v. Corvel Corporation et al., Case No. D085457 (April 2026). The court conducted a de novo review — the standard applicable when a demurrer has been sustained — and independently concluded that Davis's claims fell within the WCA's exclusivity bar. The appellate court also declined to grant further leave to amend, noting that Davis had already been allowed three rounds of amendments and offered no new facts or theories on appeal that could cure the deficiencies. The opinion was not certified for publication. The workers' compensation exclusivity doctrine is broad. The court traced the two-step analytical framework established by the California Supreme Court. First, courts ask whether the alleged injury falls within the scope of the WCA's exclusive remedy provisions — meaning whether it is "collateral to or derivative of" a compensable workplace injury. Second, if it does, courts ask whether the acts or motives behind the claim fall outside the risks encompassed by the compensation bargain, such as by violating a fundamental policy of the state. Citing Vacanti v. State Comp. Ins. Fund (2001) 24 Cal.4th 800, 811–812, and King v. CompPartners, Inc. (2018) 5 Cal.5th 1039, 1051–1052, the court emphasized that the WCA covers not just the original workplace injury but all injuries stemming from the claims process itself, including wrongful delays or denials of benefits. Fraud in the claims process is not enough to escape exclusivity. Davis argued that Dr. O'Meara's false medical reports constituted "outright fraud" placing her claims outside the WCA — analogizing to cases where an insurer fraudulently denied the very existence of an insurance policy, or where an employer concealed a workplace hazard. The court rejected both analogies. Citing Jablonski v. Royal Globe Ins. Co. (1988) 204 Cal.App.3d 379, it distinguished cases involving denial of a policy's existence from cases involving disputed benefit levels, finding the latter to be a normal part of the WCA process. It similarly distinguished Johns-Manville Products Corp. v. Superior Court (1980) 27 Cal.3d 465, which involved concealment of a known occupational hazard from employees who were unaware of both the danger and their rights. Davis, by contrast, was aware of her injuries and her WCA rights throughout. What she alleged, at bottom, was that her benefits were improperly limited — a dispute the WCA process is designed to resolve. Individual capacity and treating-physician status did not help. Davis argued that Maag was personally liable because he was sued individually rather than in his corporate role. The court rejected this, finding that Maag's conduct — pressuring physicians to alter reports on Corvel's behalf — was unambiguously part of the claims administration process. Citing Mitchell v. Scott Wetzel Services, Inc. (1991) 227 Cal.App.3d 1474, 1479, the court noted that even intentional refusal to pay benefits, with full knowledge of the hardship caused, does not avoid WCA exclusivity. As to Dr. O'Meara, Davis invoked the dual capacity doctrine from Duprey v. Shane (1952) 39 Cal.2d 781, which allows a physician to be sued in tort for negligently aggravating a patient's injury through treatment. The court found Duprey inapplicable: Davis was not alleging a new physical injury caused by negligent medical care, but rather that falsified reports caused her to lose benefits. That is a claims-process injury, not a treatment injury — and the WCA provided a remedy she could have pursued before the Workers' Compensation Appeals Board ...

After more than a decade and a half without a new treatment option, the FDA approved Tonmya (cyclobenzaprine HCl sublingual tablets) last August for the treatment of fibromyalgia in adults. The drug is now commercially available in U.S. pharmacies, and workers' compensation professionals should expect to see it appearing in treatment plans — bringing with it a fresh set of questions about medical necessity, cost, and the ever-contentious issue of fibromyalgia in the workers' comp system. Fibromyalgia is one of the most divisive diagnoses in workers' compensation. It affects an estimated 10 million adults in the United States — roughly 80 percent of them women — and is characterized by chronic widespread pain, nonrestorative sleep, fatigue, morning stiffness, and cognitive difficulties often described as "fibro fog." There is no objective diagnostic test. No blood marker. No imaging finding. Diagnosis relies on clinical criteria established by the American College of Rheumatology, centering on patient-reported symptoms. That diagnostic profile has made fibromyalgia claims a persistent source of friction between claimants, employers, insurers, and medical evaluators. Until now, treating physicians have had only three FDA-approved medications to work with: pregabalin (Lyrica), approved in 2007; duloxetine (Cymbalta), approved in 2008; and milnacipran (Savella), approved in 2009. All three have significant limitations. Many patients do not respond adequately, and side-effect profiles often lead to discontinuation. Some treating physicians have resorted to off-label prescribing — including opioids — to manage symptoms, adding another layer of complexity and risk to these claims. Tonmya is the fourth FDA-approved treatment and the first new approval since 2009. Tonmya is a sublingual (under-the-tongue) formulation of cyclobenzaprine hydrochloride. Workers' comp professionals will recognize cyclobenzaprine immediately — it is one of the most commonly prescribed muscle relaxants in the system, marketed for decades under the brand name Flexeril for short-term treatment of acute muscle spasms. But Tonmya is not simply a repackaged Flexeril. The sublingual delivery method is a deliberate design choice. By dissolving under the tongue, the drug is absorbed directly through the oral mucosa into the bloodstream, bypassing the liver's first-pass metabolism. This reduces production of norcyclobenzaprine, a long-acting metabolite associated with next-day grogginess — a common complaint with oral cyclobenzaprine. Tonmya is taken once daily at bedtime. Its mechanism of action in fibromyalgia is not fully understood, but it acts on multiple receptor systems involved in pain modulation and sleep regulation, including serotonin, adrenergic, histamine, and muscarinic receptors. Critically, it is a non-opioid therapy. In an era where workers' comp systems across the country are actively working to reduce opioid utilization in chronic pain management, a new non-opioid option for a condition that frequently drives opioid prescribing is noteworthy. The FDA approval was supported by three randomized, double-blind, placebo-controlled trials involving a total of 1,474 patients who met current ACR diagnostic criteria for fibromyalgia. The Phase III RELIEF and RESILIENT trials demonstrated that Tonmya significantly reduced daily pain scores compared to placebo over 14 weeks, with a clinically meaningful proportion of patients achieving at least 30 percent pain improvement. The trials also showed improvements in sleep quality, fatigue, and daily function — symptoms that directly affect an injured worker's ability to perform job duties and participate in rehabilitation. The arrival of Tonmya raises several practical issues for the claims industry. Expect to see it on bills. Now that Tonmya is commercially available, treating physicians who diagnose fibromyalgia in injured workers — whether as a primary condition or a complication of a workplace injury — will have a new prescribing option. Claims adjusters, utilization review professionals, and bill review teams should familiarize themselves with the drug, its approved indication, and its clinical profile. As a brand-name medication with patent exclusivity extending to at least 2034, Tonmya will carry a higher price point than generic cyclobenzaprine or the older approved alternatives, and cost inquiries from payers are inevitable ...

Sean Vice worked as an IT Analyst for the Shasta County Office of Education. On June 4, 2025, he claimed he was injured on the job while setting up equipment for a graduation ceremony. According to Vice, a speaker stacked on top of another speaker began to fall, and as he reached behind his back to catch it, he felt a pop in his shoulder followed by sharp pain. He testified that he told two co-workers — Ashley Talladino and Cole Rumford — about the incident, then drove to seek medical treatment and called his supervisor, James Alspaugh, to report the injury en route. The account unraveled, however, through the testimony of co-worker Talladino. She testified that on the morning of the alleged workplace incident, Vice had told her he had actually hurt his shoulder playing hockey the night before. According to Talladino, Vice said he had no sick time left, needed to see a doctor, and was considering filing a workers' compensation claim by attributing the injury to the graduation setup — specifically, that "he was going to say he lifted a speaker up and fell possibly backwards and that his shoulder had popped." A text message Vice sent to Talladino was admitted into evidence, in which he wrote: "Hey keep my shoulder between you and I. I'm saying I pulled it on a speaker." Vice attempted to explain the text at trial by saying he simply did not want people to know he was hurt, and attributed the phrase "I'm saying I pulled it on a speaker" to a "fat thumb" or autocorrect error. Workers' compensation administrative law judge (WCJ) issued Findings and Order on January 5, 2026, finding that Vice did not sustain any injury arising out of and in the course of his employment. The WCJ found Talladino's testimony credible and found Vice's testimony "not completely forthcoming." She rejected his explanations for the text message — particularly the autocorrect defense — as not credible, especially given that he had already reported the injury to his supervisor and to Rumford by the time he claimed he wanted to keep the matter quiet. Vice petitioned the Workers' Compensation Appeals Board for reconsideration. The Workers' Compensation Appeals Board denied the Petition for Reconsideration in the case of Vice v. Shasta County Office of Education -ADJ21105749 (April 2026), leaving the WCJ's findings intact. The Board's reasoning was brief and rested entirely on the deference owed to a trial-level credibility determination. Credibility findings are nearly unreviewable. The Board cited the well-settled principle that in bench proceedings, the finder of fact is the sole judge of witness credibility and may believe or disbelieve any witness if there is a rational basis for doing so. It quoted Schmidt v. Superior Court (2020) 44 Cal.App.5th 570, 582, which in turn drew on Davis v. Kahn (1970) 7 Cal.App.3d 868, 874; and other published cases. The Board reinforced this principle in the workers' compensation context by citing Garza v. Workmen's Comp. App. Bd. (1970) 3 Cal.3d 312, 318–319 [35 Cal.Comp.Cases 500], which holds that a WCJ's credibility determinations are entitled to great weight because of the judge's direct opportunity to observe witness demeanor. The WCJ's call was well within her discretion. The text message corroborated Talladino's testimony directly. Vice's innocent explanations for the message — that he merely wanted privacy and that autocorrect was responsible for the incriminating phrase — were undermined by the fact that he had already openly reported the injury to his supervisor and a second co-worker. The Board found no basis to disturb the WCJ's weighing of the competing accounts and denied the petition accordingly ...

Adam Martinez worked as an emergency medical technician (EMT) for Sierra Lifestar, Inc. — an ambulance company serving Tulare County — for roughly ten months, from September 2019 to July 2020. During that tenure he received a single bonus: a $109.47 "EMS Bonus" paid in May 2020 in recognition of National Emergency Medical Services Week, netting him $100 after withholdings. Lifestar paid that bonus to all of its employees that week. Martinez filed a class action in July 2023 on behalf of himself and approximately 135 current and former Lifestar employees. His theory was straightforward: California law requires that nondiscretionary bonuses be folded into an employee's "regular rate of pay" when calculating overtime, double time, and meal and rest period premium pay. (Lab. Code, §§ 510, 226.7.) Lifestar, he alleged, paid ten categories of bonuses — including EMS Bonuses, Sign-On Bonuses, Paramedic Bonuses, Preceptor Bonuses, and others — but systematically excluded every one of them when computing those elevated rates, causing class-wide underpayment. An expert who reviewed Lifestar's payroll data estimated the potential overtime and double-time shortfall at roughly $462,000, with an additional $32,000 in unpaid meal premiums. In March 2025, the trial court denied Martinez's motion for class certification on a single ground: Martinez had failed to show his claim was typical of the proposed class. The court reasoned that Lifestar paid ten different types of bonuses, each with its own criteria, and that various exclusions listed in the Division of Labor Standards Enforcement (DLSE) Policies and Interpretations Manual could apply differently to each bonus type. Specifically, the court found a "significant possibility" that Martinez faced defenses unique to him — namely, that his EMS Bonus was either a gift or a purely discretionary payment — which could distract from the broader class litigation and swamp the common issues. The court declined to reach the separate question of whether common questions of law or fact actually predominated across the ten bonus categories. The Fifth District Court of Appeal reversed the denial of class certification in the published case of Martinez v. Sierra Lifestar, Inc. Case No. F089576 (April 2026) and remanded for further proceedings. The court did not direct the trial court to certify the class outright, instead acknowledging that several certification criteria beyond typicality had never been addressed below and warranted fresh consideration on remand. The appellate panel noted that the trial court retains discretion on remand to consider whether to narrow the proposed class or to create subclasses organized around particular bonus types. The court's analysis turned on a single legal error: the trial court misunderstood what "unique" means in the class-action typicality context. Typicality is not a demanding standard. Citing Seastrom v. Neways, Inc. (2007) 149 Cal.App.4th 1496, 1502, the court restated the familiar three-part test: typicality is satisfied when (1) other members suffered the same or similar injury, (2) the action rests on conduct not unique to the named plaintiff, and (3) other class members were harmed by the same course of conduct. Quoting Mullen v. Treasure Chest Casino, LLC (5th Cir. 1999) 186 F.3d 620, 625, the panel emphasized that federal courts consistently describe typicality as "not demanding," and that California has never required a class representative to have interests identical to those of every class member. Classen v. Weller (1983) 145 Cal.App.3d 27, 46. The "unique defense" doctrine was misapplied. A proposed representative's claim may fail typicality if it is subject to a defense peculiar to that plaintiff alone — one that would distract from the claims of the rest of the class. CE Design Ltd. v. King Architectural Metals, Inc. (7th Cir. 2011) 637 F.3d 721, 726. But where a defense applies broadly across the class, it cannot defeat typicality for the representative. Here, Lifestar's argument — that EMS Bonuses paid during National Emergency Medical Services Week were gift-like or discretionary — applied with equal force to all 51 other employees who received the same EMS Bonus under the same circumstances. Lifestar's own vice-president testified that no bonuses of any kind were ever included in overtime calculations. The defense was class-wide, not individual. The evidence compelled the opposite conclusion. Even construing the trial court's ruling as a factual finding, the appellate court held it was unsupported by substantial evidence. Payroll data, pay stubs, and the analyses of both parties' own witnesses uniformly showed that Martinez's situation mirrored that of his fellow EMS Bonus recipients. There was nothing about his claim that set it apart from theirs. Under Brinker Restaurant Corp. v. Superior Court (2012) 53 Cal.4th 1004, 1022, a certification ruling based on erroneous legal assumptions cannot stand, and under Ayala v. Antelope Valley Newspapers, Inc. (2014) 59 Cal.4th 522, 530, reversal is required whenever the stated reasons for a ruling are legally infirm — even if other reasons might theoretically have supported the same outcome ...

In November 1988, California voters approved Proposition 103, which made changes in the regulation of automobile insurance, as well as the approval of premium rates for property and casualty lines of insurance in California. Proposition 103 also allows for public participation through consumer intervention. Any person who "represents the interests of consumers" and intends to raise any issue relevant to a rate proceeding is permitted to intervene. Recognizing the importance of public participation, the Legislature also authorized the award of certain costs, expenses, and reasonable attorneys' fees to an intervenor who makes a "substantial contribution" to a rate decision. Proposition 103 has allowed, from the time it was implemented in 1988, for any person to initiate or intervene in any proceeding before the Department and to challenge any action of the Insurance Commissioner. However, citing abuses of this process primarily by an organization known as Consumer Watchdog, the California Insurance Commissioner has proposed and submitted for approval, the first overhaul of intervenor process in 35 years. A broad coalition of insurance consumers, including home builders, farmers, affordable housing advocates, local governments, bankers, independent insurance agents and others, wrote that they were "in strong support of the California Department of Insurance’s proposed intervenor reforms." They claimed that "the intervenor process has been abused for financial gain - at the direct expense of consumers - while contributing to the growing insurance availability and affordability crisis." They claim that "at the heart of this crisis is a broken rate approval process - made worse by a flawed intervenor process that Consumer Watchdog wrote into Proposition 103 for its own benefit." And as an example they say "Despite contributing no measurable benefit, Consumer Watchdog - an organization with ZERO members and no accountability - has pocketed more than $22.5 million in intervenor fees by exploiting the intervenor program - the very program they wrote into law. These fees are ultimately paid for by consumers through higher premiums.' A coalition of consumer, labor, senior, immigrant, low-income, and public advocates and concerned civic organizations on proposed regulations authored a letter in opposition to the proposed reforms. It claimed the reforms would result in "stifling consumer voices in the setting of insurance rates and regulations." However, it was the Insurance Commissioner who concluded in legal documents that "Significantly, Consumer Watchdog is the primary financial beneficiary of a process it created over thirty years ago, and a process that constitutes the largest source of funding for its organization." The Commissioner went on to say "Consumer Watchdog, who has no members and is accountable to no one but itself, fails to acknowledge the role of the Department's rate regulation branch in the rate application process, and wrongly contends to have saved consumers $6 billion in insurance premiums since 2002. The Department's rate regulation branch analyzes all rate change requests to ensure that what is being requested by insurers is compliant under Proposition 103. If proposed rates are excessive, the Department then requires insurers to reduce the proposed rates to no greater than the maximum permitted rate under Proposition 103. The goal of inviting additional public participation is to bring in a unique perspective or additional value, and not to simply participate for participation's sake." Following the rulemaking procedures that aired these points of view, the California Department of Insurance has submitted its Intervenor and Administrative Hearing Bureau Fairness and Accountability rulemaking package to the Office of Administrative Law (OAL) for final review - what is claims is "marking the most significant modernization of the intervenor system since Proposition 103 was enacted in 1988. The reforms strengthen transparency, improve efficiency, and protect consumer dollars in the insurance rate review process. Once approved by OAL, the regulations will establish clear standards for intervenor compensation, expand public reporting, and reinforce the Department’s authority to ensure that every dollar in the rate review process serves the public interest. “These reforms strengthen Proposition 103 by bringing long overdue transparency and accountability to every part of the rate review process,” said Commissioner Lara. “Californians deserve to know that every dollar in this system is protected, and I will not allow any organization — insurer or intervenor — to operate without clear guardrails.” Key provisions of the regulations include: - - Clarifying “substantial contribution” and reasonableness standards for an intervenor’s request for compensation - - Defining the role of the Department’s Administrative Hearing Bureau (AHB) in settlement agreements and requests for compensation - - Requiring regular status updates from AHB Administrative Law Judges every 30 days to all parties - - Expanding public reporting by posting intervenor activity and statistics on the Department’s website - - Improving public access to proceedings through required posting of AHB calendars, dockets, and documents The Insurance Commissioner also addressed mischaracterizations raised by opponents during the rulemaking process. “Some groups have misrepresented these reforms as limiting consumer voices. That is simply false,” he said. “The right to intervene remains untouched. What changes is the expectation that compensation must be earned, documented, and aligned with the issues in the proceeding.” The Office of Administrative Law has up to 30 working days to complete its review. Once approved, the regulations will be filed with the Secretary of State and take effect shortly thereafter ...

Zurich American Insurance Company has filed suit in the U.S. District Court for the Central District of California against two Ontario-based staffing companies — Managing Personnel Services, Inc. and Employee Force Provider, Inc. — alleging breach of contract for failure to pay over $1.1 million in workers' compensation insurance premiums following post-policy audits. The defendants, described in the complaint as a captive insurance provider and program, were issued two consecutive workers' compensation policies by Zurich. The first policy (WC Agreement I) covered the period July 1, 2023 through July 1, 2024. The second (WC Agreement II) covered July 1, 2024 through July 1, 2025, but was canceled by Zurich effective June 9, 2025 for nonpayment of premium. Managing Personnel Services, Inc. (MPS) was incorporated in California on February 11, 2015, and as of late 2024 maintained an active filing status with the California Secretary of State. The company describes its core mission as empowering employers by building workforces and assisting job seekers, specializing in outsourced employment and human resource services. It serves machine operators, clerical, general labor, and light industrial sectors. Employee Force Provider, Inc. (EFP) was also founded in 2015 and is headquartered at 3400 Inland Empire Blvd., Suite 210, Ontario, California — the same street address listed in the complaint for both defendants. EFP describes itself as supporting companies ranging from small to Fortune 500 firms throughout the United States, offering on-site, direct hire, temp-to-hire, and temp services, with specialties in distribution/logistics, manufacturing/industrial, clerical, and IT/technical staffing. The BBB profile for Employee Force Provider lists two CEOs: Walter Ladislao Ramirez and Jairo Mendoza Jr. Both companies operate in the same Inland Empire labor market, were founded in the same year, share the same street address, and appear to offer nearly identical services. The complaint itself specifically alleges that the two defendants are alter egos of one another and essentially extensions of each other. Under both policies, initial premiums were based on estimated payroll exposure, subject to a "true-up" audit at the end of the policy period — a standard feature of workers' comp policies for staffing and labor-intensive businesses. When actual payroll exposure exceeds the estimate, additional premium is owed; if lower, a refund is issued. The audits here produced substantial additional premium obligations. In December 2024, the audit for WC Agreement I revealed an additional premium owed of $179,753. The defendants made a partial payment of $100,000 in May 2025, leaving a balance of $79,752. The post-cancellation audit for WC Agreement II, issued in August 2025, produced a demand of $1,059,255 — which the defendants did not pay at all. In February 2026, Zurich issued a consolidated Statement of Account demanding $1,139,007, plus interest. When the defendants failed to respond, Zurich filed this single-count breach of contract action in federal court, invoking diversity jurisdiction based on the parties' differing states of incorporation and the amount in controversy exceeding $75,000. Zurich seeks a judgment for the full $1,139,007, pre-judgment interest at the applicable statutory rate, and costs of suit. A bench trial has been requested. This lawsuit is a reminder of the significant premium audit exposure that can arise in workers' compensation programs serving staffing companies, particularly those operating under captive or loss-sensitive structures. The gap between estimated and audited payroll — particularly for WC Agreement II, where the audit produced a figure nearly six times the outstanding balance from WC Agreement I — underscores the importance of diligent mid-term payroll monitoring and timely premium collections. Carriers and program administrators would do well to review their audit enforcement procedures and premium security mechanisms before exposure of this magnitude accumulates. Case filings are publicly available through PACER. The case docket does not contain any responsive pleading from any named defendants ...

Jessie Walton enrolled as a postsecondary nursing student at Victor Valley Community College District in 2017. Her coursework required her to complete clinical rotations at two local hospitals under the supervision of District faculty. Her supervisor during the spring 2018 rotations was Diego Garcia, the District's nursing program director. Walton alleged that Garcia subjected her to extensive verbal and physical sexual harassment, attempting to coerce her into a sexual relationship in exchange for better grades. When she rejected his advances, Garcia allegedly retaliated by giving her a failing grade and refusing to discuss it with her. In June 2018, Walton sent a formal complaint letter to the District. The District placed Garcia on administrative leave and hired a third-party firm to investigate. In August 2018, the District denied Walton's request for a grade correction. She withdrew from the program in September 2018 and eventually completed her nursing degree out of state. By November 2018, the third-party investigator issued a 79-page report confirming Garcia had engaged in "highly inappropriate behavior" and harassed at least one other female student. District HR recommended his removal from his tenured position, and Garcia never returned. In December 2018, Walton's attorney sent the District a detailed 13-page letter outlining Garcia's misconduct and Walton's estimated damages, warning of potential litigation. After failed mediation, Walton filed suit asserting five claims under the Fair Employment and Housing Act (FEHA) for sex discrimination, sexual harassment, failure to prevent, retaliation, and injunctive relief; Civil Code violations; Education Code violations; and negligence. The District moved for summary judgment, arguing Walton lacked FEHA standing, failed to comply with the Government Claims Act, and could not show deliberate indifference under Education Code section 66270. At the hearing, the trial court excluded Walton's attorney's declaration because it lacked a penalty-of-perjury subscription and omitted the place of execution — a technical deficiency counsel acknowledged on the spot as an oversight. Less than an hour after the hearing, counsel filed a corrected declaration curing both defects. The court ignored the corrected filing and sustained the objection. Without the declaration, key opposition evidence — including deposition excerpts showing the District had prior knowledge of Garcia's harassment of other students — was stripped from the record. The trial court then granted summary judgment for the District on all claims, finding: (1) Walton lacked FEHA standing because she was a student, not an unpaid intern; (2) the December 2018 attorney letter did not satisfy Government Claims Act notice requirements; and (3) the District's investigation demonstrated it was not deliberately indifferent to Walton's complaints. The Court of Appeal reversed summary judgment on all claims except Walton's Civil Code cause of action, which she did not contest on appeal in the published case of Walton v. Victor Valley Community College District Case No. G064668 (April 2026). The District was granted summary adjudication on that single claim only. On the excluded declaration, the court held the trial court abused its discretion by refusing to allow a cure of a plainly technical defect. The court emphasized that granting summary judgment based on a curable procedural default deprives a party of a decision on the merits. Here, counsel was present in the courtroom, offered to fix the error immediately, and in fact filed a corrected declaration within the hour. The District identified no prejudice from allowing the cure. On FEHA standing, the court rejected the notion that "student" and "unpaid intern" are mutually exclusive categories. The Legislature's 2015 amendment to FEHA explicitly extended protections to unpaid interns, and the legislative history of Assembly Bill No. 1443 (2013–2014 Regular Session) specifically identified nursing clinical rotations as the type of internship the amendment was designed to cover. California Code of Regulations, title 2, section 11008(m) further defines an unpaid intern as "any individual (often a student or trainee)" working without pay in a limited-duration program. Walton therefore had standing. On Government Claims Act notice, the court found Walton's attorney's detailed December 2018 letter substantially satisfied the statutory requirements. The court reiterated that a claim is sufficient if it discloses enough information for the public entity to investigate and potentially settle. The District could not even identify which required element the letter allegedly omitted. A claimant's subjective intent in labeling a letter a confidential settlement communication is irrelevant — what matters is whether the letter disclosed a claim that, if unresolved, would result in litigation. It did. On deliberate indifference, the court found triable issues of material fact precluding summary judgment. While the District pointed to its investigation as proof of responsiveness, the court noted the investigation concluded only after Walton had already been forced out of the program — it conferred no benefit on her. A reasonable jury could find deliberate indifference from the District's refusal to address her grade while she was still enrolled. The excluded deposition evidence — showing the District had prior complaints about Garcia harassing other students — reinforced that a genuine factual dispute existed. On negligence, the court rejected the District's reliance on Thomas v. Regents of University of California (2023) 97 Cal.App.5th 587, which held that colleges have no duty to protect students from purely nonphysical harassment. Because Walton alleged unwanted physical touching, Thomas was inapplicable, and her negligence claim survived ...

Former teacher Jeanett Valenzuela Ayub pleaded guilty in federal court admitting that she conspired with others to launder millions of dollars of health care fraud proceeds. In total, Valenzuela admitted that she and her co-conspirators billed Medicare nearly $51 million for bogus prescriptions and were paid approximately $20 million, ultimately laundering at least $14 million dollars of Medicare proceeds and paying $3.7 million in unlawful kickbacks. On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division. The core mission of the Fraud Division is to zealously investigate and prosecute those who steal or fraudulently misuse taxpayer dollars. Department of Justice efforts to combat fraud support President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs According to her plea agreement, Valenzuela and co-conspirators owned and operated multiple durable medical equipment (DME) companies, which sold orthotics – including back, wrist, and knee braces – to Medicare beneficiaries. Valenzuela admitted that in operating the DME companies, she and co-conspirators paid unlawful kickback payments to sham marketing companies who provided bogus prescriptions for DME. The prescriptions were signed by physicians who had no legitimate doctor-patient relationship with the beneficiary; had not conducted a legitimate medical evaluation of the beneficiary; and had not impartially determined that the beneficiary actually needed the DME. When agents interviewed Medicare beneficiaries during its investigation, the Medicare beneficiaries confirmed that they never spoke with a doctor, were never examined by a doctor related to the prescribed DME, and were not familiar with the prescribing doctor; never used nor even opened the packages containing the DME; and many of the Medicare beneficiaries still had the DME in their original unopened packages. Valenzuela further admitted that she used DME companies to submit fraudulent claims to Medicare. Once Valenzuela’s or her co-conspirator’s DME companies were suspended from billing Medicare, Valenzuela conspired to put DME companies in the names of nominee owners while she and her co-conspirators maintained control of the companies and the monies received from Medicare. Among Valenzuela’s co-conspirators was her brother, Fernando Valenzuela Ayub, who previously pleaded guilty to the same offense and is pending sentencing. When her brother was arrested on December 9, 2024, for his involvement in this conspiracy, Valenzuela absconded to Tijuana. Ultimately, Valenzuela was detained in August 2025 in the Dominican Republic after she left Mexico and traveled with family for a vacation. After being detained in the Dominican Republic, Valenzuela was removed to the United States through Miami, Florida, where she was then arrested by U.S. Marshals and ultimately transported to San Diego to face the pending charges against her. Valenzuela is scheduled to be sentenced on July 24, 2026, at 9 a.m. The case is being prosecuted by Assistant U.S. Attorney Blanca Quintero of the Southern District of California. Former Assistant U.S. Attorney Valerie Chu contributed significantly to the case ...

A technology that has been gaining significant traction in orthopedic practice offers a faster and more accurate alternative. In-office needle arthroscopy — sometimes called in-office diagnostic arthroscopy, or IONA — allows orthopedic surgeons to directly visualize the interior of a joint during a routine office visit, using nothing more than local anesthesia and a needle-sized camera. The leading device in this space is the mi-eye system, now in its third generation, manufactured by Trice Medical. The mi-eye 3 is an FDA-cleared, single-use needlescope measuring just 2.3 millimeters in diameter — roughly the width of a standard blood-draw needle. It integrates a high-resolution image sensor, LED illumination, and a camera into a single handheld instrument, paired with a portable tablet for real-time visualization. The most recent iteration introduced a 25-degree angled lens, a feature long standard in traditional operating-room arthroscopes, which significantly expands the surgeon's field of view. According to Trice Medical, early data suggests the angled camera can capture over sixteen times more visual information than a zero-degree scope. The clinical workflow is straightforward. The physician numbs the tissue around the joint with a local anesthetic, inserts the needlescope through a standard portal site, and injects a small amount of saline to distend the joint for visibility. Within seconds, the surgeon can visualize cartilage surfaces, meniscal tissue, ligaments, and other structures directly, capturing both still images and video for the medical record. The entire procedure typically takes only minutes, and patients generally resume normal activity within 24 hours. No general anesthesia is required, no operating room is needed, and no hospital facility fee is generated. Physicians who have integrated the procedure into their practices report that it can be performed the same day as the presenting office visit, often while the patient is still in the exam room. The clinical evidence supporting needle arthroscopy's diagnostic performance is compelling. In a prospective, multicenter study comparing the mi-eye device to both MRI and traditional surgical arthroscopy as a reference standard, the needle arthroscope correctly identified all pathologies in over 91% of patients, compared to roughly 61% for MRI. The device proved more sensitive than MRI in detecting meniscal tears — 92.6% versus 77.8% — and substantially more specific, at 100% versus 41.7%. Those specificity numbers are particularly significant in a workers' compensation context, where a false-positive MRI finding can drive unnecessary surgical authorizations and inflated claim costs. Published case reports have illustrated the technology's value in precisely the kind of scenario that frustrates claims professionals. In one well-documented case, a patient with persistent knee pain following an injury had undergone MRI imaging that came back negative. Despite the normal scan, symptoms continued. An in-office needle arthroscopy was performed and immediately identified a tear of the medial meniscus that was subsequently confirmed and repaired during follow-up surgery. The diagnosis was reached in approximately twenty seconds of visualization. A 2025 review published in the Journal of Arthroscopic Surgery and Sports Medicine examined the expanding clinical applications of IONA across multiple joints — knee, shoulder, ankle, wrist, elbow, and hip — and concluded that it is more accurate than MRI for identifying intra-articular pathologies in many of these settings. Notably, the technology has also extended beyond pure diagnostics: surgeons are now performing minor therapeutic procedures through the same needle-sized portals, including partial meniscectomies using miniaturized instruments, which could further reduce operating-room utilization and associated costs. The economic case for in-office needle arthroscopy is particularly relevant to the workers' compensation system. A cost-minimization analysis published in the Journal of Bone and Joint Surgery Open Access evaluated societal costs of using in-office diagnostic arthroscopy compared to MRI for employed patients receiving workers' compensation or disability benefits. The study, which examined data from four U.S. metropolitan regions, found that in-office arthroscopy produced potential savings of approximately $7,852 to $11,227 per operative patient compared to the MRI pathway. Those savings reflected not only lower direct procedure costs — average commercial reimbursement for in-office knee arthroscopy was approximately $629, compared to over $1,000 for outpatient MRI — but also the substantial indirect costs of delayed diagnosis: lost wages, extended disability payments, additional office visits, and interim treatments that might prove unnecessary once a definitive diagnosis is reached ...

Air ambulances can be lifesaving for workers with severe job related injuries, and their costs vary widely across states. A new FlashReport from the Workers Compensation Research Institute (WCRI) examines air ambulance use and payments in workers’ compensation claims across 32 states. “Air ambulances play a critical role in workers’ compensation by providing rapid emergency transport for workers with severe or life‑threatening injuries,” said Sebastian Negrusa, vice president of research at WCRI. “This study helps clarify key questions about costs and access to services, particularly in remote areas.” The study finds wide variation in average payments for air ambulance services across states. It also highlights ongoing legal uncertainty over who has authority to regulate air ambulance pricing, as providers and states differ on whether federal law preempts state workers’ compensation fee schedules. This uncertainty has contributed to wide variation in air ambulance payments across states. The study addresses: - - How frequently air ambulance services are used in workers’ compensation claims and how use differs between rural and non rural areas. - - Differences in air ambulance use and payment levels across states. - - Changes in payments for air ambulance services over time and how trends in payment growth vary by state. The analysis for Use and Cost of Air Ambulance Transport Services in Workers’ Compensation—A WCRI FlashReport is based on workers’ compensation claims from 32 states covering injuries through 2024. The states include Alabama, Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. The study is free for WCRI members and available for purchase by nonmembers ...

Blake Lively and Justin Baldoni co-starred in the film It Ends With Us, a movie exploring domestic violence based on a Colleen Hoover novel. Baldoni co-founded Wayfarer Studios and also directed the film. Lively's role was negotiated through her loanout company, Blakel, Inc., under an Offer Letter dated May 4, 2023. The parties never executed the contemplated long-form Actor Loanout Agreement ("ALA"), though they negotiated it for over a year while filming proceeded. A separate Contract Rider Agreement ("CRA") was signed in January 2024, setting conditions — including a no-retaliation clause — under which Lively would return to production after the 2023 WGA/SAG-AFTRA strikes. Lively alleged in the lawsuit she filed in the United States District Court Southern District of New York that during the first phase of filming in New Jersey, Baldoni and Wayfarer CEO Jamey Heath subjected her to sexual harassment and a hostile work environment — including comments about her body, an intrusion on her physical privacy while she was undressed, pressure to perform nudity beyond what was agreed, and discussions of personal sexual matters. In November 2023, Lively's attorneys sent a "Protections for Return to Production" letter identifying seventeen conditions for her return to set. A January 4, 2024 all-hands meeting addressed these concerns, and the CRA was signed shortly after. Lively alleged that following the film's August 2024 release, the defendants launched a coordinated public-relations campaign — engaging crisis consultants, digital operatives, and media contacts — to destroy her reputation in retaliation for her complaints. Expert reports submitted by Lively showed statistical evidence of artificially manipulated online content targeting her. In the Opinion and Order on Motions for Judgment on the Pleadings and Summary Judgment in the case of Lively v. Wayfarer Studios LLC No. 24-cv-10049 (S.D.N.Y.) on April 2, 2026, Judge Liman ruled on the Wayfarer Parties' combined motions for judgment on the pleadings and for summary judgment on all thirteen of Lively's claims, which spanned Title VII, California FEHA, California Labor Code § 1102.5, breach of contract, defamation, false light invasion of privacy, and civil conspiracy. The court granted the motions on most claims but denied them on three: (1) Lively's FEHA retaliation claim against IEWUM and Wayfarer (Count Four); (2) her FEHA aiding-and-abetting retaliation claim against The Advocacy Group, LLC (Count Seven); and (3) her breach of the CRA claim against It Ends With Us Movie LLC (Count Nine). All other claims — including Title VII, California Labor Code § 1102.5, FEHA sexual harassment, defamation, false light, civil conspiracy, and breach of the ALA — were dismissed. Employment Status (Title VII and California Labor Code). The court held that Lively was an independent contractor, not an employee, under both the federal Reid factors and California's Borello test. Lively enjoyed extensive contractual approval rights over the script, director, co-lead, wardrobe, marketing, and release pattern; she exercised significant practical control over hiring, firing, editing, and production logistics; she was paid a flat fee plus equity through her loanout entity with no tax withholding or benefits; and her engagement was limited to a single six-week project. Citing Alberty-Velez v. Corporacion de Puerto Rico Para La Difusion Publica, 361 F.3d 1 (1st Cir. 2004), and Lerohl v. Friends of Minnesota Sinfonia, 322 F.3d 486 (8th Cir. 2003), the court reasoned that a director's creative control over an actor does not automatically convert the actor into an employee, and that Lively's independence — both contractual and practical — was overwhelming. Contract Claims. The ALA was found unenforceable because it was never signed, IEWUM consistently insisted on execution as a condition precedent, and Lively could not identify which draft bound the parties or when. The CRA, however, was enforceable: it was signed by both parties, supported by valid consideration (Lively's agreement to return to set when her obligation to do so was doubtful), and its anti-retaliation clause was not dependent on execution of the ALA. Why a New York Federal Court Applied California FEHA. This is the opinion's most significant issue. California law presumes its statutes do not apply extraterritorially, citing Diamond Multimedia Systems, Inc. v. Superior Court, 968 P.2d 539 (Cal. 1999), and courts have consistently held that FEHA does not reach conduct occurring outside California. See Campbell v. Arco Marine, Inc., 50 Cal. Rptr. 2d 626 (Cal. Ct. App. 1996). The ALA's California choice-of-law clause could not resolve this issue because the ALA was never executed. The court therefore applied the Campbell framework, which asks whether the "core of the alleged wrongful conduct" — particularly the "ultimate" or "crucial" discriminatory acts — occurred in California. For the sexual harassment claims, the answer was no: the alleged hostile-work-environment conduct occurred on a New Jersey film set, and California connections such as Heath's text messages or pre-production Zoom calls were too peripheral to constitute "core" wrongdoing. The court rejected Lively's argument that retaliatory acts committed from California could bootstrap her harassment claims into California's territorial reach, noting that the alleged retaliation occurred after the working relationship ended and thus could not create a hostile work environment. For the retaliation claims, however, the court reached the opposite conclusion. The allegedly retaliatory smear campaign was planned, directed, and largely executed from California. Baldoni and Heath — both California residents — directed their California-based PR consultants (TAG, Nathan) to implement the campaign. TAG retained a digital operative (Wallace) from California. The "decision to take retaliatory actions was made in California," which courts have held satisfies the territorial nexus. See eShares, Inc. v. Talton, 2025 WL 936921, at *15 (S.D.N.Y. Mar. 27, 2025). The court further noted that FEHA's anti-retaliation provision protects "any person" — not just employees — meaning Lively's independent-contractor status did not bar her FEHA retaliation claim. See Fitzsimons v. California Emergency Physicians Medical Group, 141 Cal. Rptr. 3d 265, 269 (Cal. Ct. App. 2012). Retaliation — Triable Issues. The court found genuine factual disputes on all three elements of the FEHA retaliation claim: (1) Lively engaged in protected activity through the Protections Letter and all-hands meeting, and it was reasonable for her to believe she was opposing sexual harassment; (2) the Wayfarer Parties' campaign — including statements about wanting to "bury" and "destroy" Lively, coordination with digital operatives whose work would be "untraceable," and expert evidence of artificially manipulated online content — could constitute adverse employment action materially impairing her career prospects; and (3) a jury could infer retaliatory motive from the sequence of events and the Wayfarer Parties' documented anger over Lively's complaints. Remaining Claims Dismissed. The defamation claim was barred by New York's fair-report privilege because all challenged statements were made by counsel in connection with judicial proceedings. The false-light claim failed because New York law — which governed under choice-of-law analysis focused on Lively's New York domicile — does not recognize the tort. Civil conspiracy claims fell with the underlying torts they were predicated on. Individual aiding-and-abetting claims against Nathan and Abel were barred under Reno v. Baird, 957 P.2d 1333 (Cal. 1998), which prohibits personal liability for individual nonemployer agents, though the court reserved judgment on TAG's potential liability as a business-entity agent under Raines v. U.S. Healthworks Medical Group, 534 P.3d 40 (Cal. 2023). The case is scheduled to proceed to trial on May 18, 2026 in New York ...

James Heaps served as a gynecologist and oncologist affiliated with U.C.L.A. for nearly 35 years. At various times, he saw patients at the Ronald Reagan U.C.L.A. Medical Center and at his office at 100 Medical Plaza. Heaps was reportedly at one time the highest paid physician in the entire U.C. system and had treated approximately 6,000 patients. In October 2022, Heaps was convicted of three counts of sexual battery by fraud and two counts of sexual penetration of an unconscious person. Those charges involved two former patients. He was sentenced to 11 years in prison in April 2023. But that conviction did not stand. On February 6, 2026, the California Second District Court of Appeal overturned the conviction and ordered a new trial in the published case of People versus Heaps -B329296 (February 2026). The key issue on appeal was a violation of the defendant's Sixth Amendment rights, specifically the right to a fair trial and an impartial jury. During deliberations, the trial court received a note indicating that an alternate juror had limited English proficiency, which potentially affected their ability to understand the proceedings and participate fully. The court did not disclose this note to the parties or allow input from the defense and prosecution before proceeding. That procedural error was deemed reversible. So following that reversal, Heaps pleaded guilty this April in case number SA100560 to thirteen counts. Those counts include six felony counts of sexual penetration of an unconscious person, five felony counts of sexual battery by fraud, and two felony counts of sexual exploitation of a patient. The plea came at a pretrial hearing just two months after the appeals court overturned his original conviction. Los Angeles County Superior Court Judge Charlaine Olmedo sentenced Heaps to 11 years in prison. He is also required to register as a sex offender for life. The charges involved five female patients who were assaulted between 2011 and 2018 while Heaps was working as an obstetrician and gynecologist at U.C.L.A. Los Angeles County District Attorney Nathan J. Hochman commented on the sentence, saying, quote, today marks the second time that we're holding James Heaps responsible for the unconscionable crimes he committed while being entrusted with the safety of his patients, end quote. Hochman added that for years, Heaps exploited the sacred trust between a doctor and patient to prey on vulnerable victims during medical procedures. He said the sentence ensures Heaps will finally be held accountable for the harm he inflicted under the guise of care. Hochman addressed the survivors directly, expressing hope that the outcome brings them closure, and stating, quote, to all survivors, please know that we believe you and we will fight for you, end quote. This criminal case is just one piece of a much larger scandal at U.C.L.A. involving Heaps. Hundreds of women accused him of inappropriate exams and abuse over many years, leading to his removal from practice and massive civil settlements. More than 500 lawsuits were filed against Heaps and U.C.L.A., accusing the school of failing to protect patients after becoming aware of the misconduct. During the course of the criminal prosecution, attorneys for 312 former patients announced a $374 million settlement of abuse lawsuits against the University of California on May 24, 2022. That came on top of a $243.6 million resolution involving about 200 patients announced in February of that year, and a $73 million settlement of federal lawsuits involving roughly 5,500 plaintiffs. By that point, U.C.L.A. had paid out approximately $700 million in total settlements to hundreds of former patients over related sexual misconduct claims spanning decades. And for context, this is not the only case of its kind in the U.C. system or in higher education more broadly. In March 2021, in a similar case, U.S.C. agreed to pay more than $1.1 billion to about 17,000 former patients of former campus gynecologist George Tyndall. That remains the largest sex abuse payout in higher education history ...