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July 14, 2025 – News Podcast


Rene Thomas Folse, JD, Ph.D. is the host for this edition which reports on the following news stories: WCAB Denies Reconsideration of Psyche Claim Take Nothing. Convicted SoCal Comp Fraudster Charged in New $270M Fraud Sweep. DME Supplier Paid $227K in Kickbacks in $5.9M Fraud Case. Five No.Cal. Defendants Charged in Health Care Fraud Sweep. SoCal Healthcare Clinic Operator Sentenced for $20M Fraud. Proposed Bipartisan Law Limits Small Business Predatory ADA Claims. CWCI Finds Independent Medical Reviews Are Trending Up. Physicians Owned Malpractice Insurer Buys NYSE Listed Comp Carrier.

DOL to Rewrite or Repeal More Than 60 “Obsolete” Rules

Multiple news outlets, including PBS, The Washington Post, and The Associated Press, reported that the U.S. Department Of Labor is aiming to rewrite or repeal over 60 workplace regulations. These reports cite a statement from Secretary of Labor Lori Chavez-DeRemer, describing the initiative as the “most ambitious proposal to slash red tape of any department across the federal government.”

The proposed changes cover regulations like minimum wage requirements for home health care workers, standards for exposure to harmful substances, and safety procedures in industries such as construction and mining. The goal, according to the DOL, is to reduce costly and burdensome rules to align with President Donald Trump’s deregulation agenda.

While the exact list of all 60+ changes is not fully detailed in available sources, several significant proposals have been highlighted across reports for their potential impact on workers and industries. The following are notable among the proposed changes.

– – Reversal of Minimum Wage and Overtime Protections for Home Health Care Workers: The proposal would reverse 2013 regulations under President Barack Obama, reverting to a 1975 framework. This could allow an estimated 3.7 million home health care workers to be paid below the federal minimum wage ($7.25/hour) and lose eligibility for overtime pay in states without equivalent protections.

– – Elimination of Retaliation Protections for Migrant Farmworkers: The DOL proposes to reverse a 2024 rule protecting H-2A migrant farmworkers from retaliation for actions like filing complaints or participating in investigations. It also includes rescinding a requirement for seat belts in employer-provided transportation for agricultural workers.

– – Removal of OSHA’s Construction Site Lighting Requirement: The Occupational Safety and Health Administration (OSHA) plans to rescind a rule mandating adequate lighting at construction sites, arguing it doesn’t significantly reduce risks. OSHA would rely on its “general duty clause” to address lighting deficiencies.

– – Limiting OSHA’s Authority in High-Risk Entertainment and Sports:OSHA proposes to limit its “general duty clause” from penalizing employers for injuries or deaths in “inherently risky” activities like movie stunts, animal training, or sports (e.g., NFL punt returns, NASCAR racing). The DOL argues Congress didn’t intend OSHA to regulate such activities.

– – Reduction of Mine Safety and Health Administration (MSHA) Oversight: The proposal would strip MSHA district managers of authority to mandate improvements to mine ventilation or roof collapse prevention plans, arguing this oversteps Congressional intent by allowing unelected officials to create rules without public comment.

– – Repeal of Affirmative Action Requirements for Apprenticeships: The DOL plans to eliminate affirmative action requirements for apprenticeship programs, which aimed to increase diversity and inclusion in training opportunities.

These changes stand out due to their broad reach across industries (healthcare, agriculture, construction, mining, entertainment), their potential to affect millions of workers (e.g., 3.7 million in home care), and their implications for safety, wages, and worker protections. Critics, including labor unions and advocacy groups, argue they disproportionately harm vulnerable populations like women, minorities, and migrant workers, citing increased risks of injury, death, or exploitation. Supporters, including conservative groups and industry leaders, argue they reduce compliance costs and foster economic growth.

The 60+ proposals require public comment periods and further stages before implementation, meaning they’re not yet written, published and finalized.

New California Court Rule and Standard Adopted for Use of AI

The California Judicial Council Artificial Intelligence Task Force is a body established by California Supreme Court Chief Justice Patricia Guerrero in May 2024 to evaluate and develop policy recommendations for the use of generative artificial intelligence (AI) in the state’s judicial branch. Its primary goal is to balance the potential benefits of AI in court operations with safeguards to protect public trust, confidentiality, privacy, and judicial integrity.

Chaired by Administrative Presiding Justice Brad R. Hill of the Fifth Appellate District, the task force includes judicial officers like Justice Mary J. Greenwood, Judge Arturo Castro, Justice Stacy E. Boulware Eurie, Judge Kyle S. Brodie, and others, along with court executive David Yamasaki and policy advisor Jessica Devencenzi.

On July 18, 2025, the Judicial Council adopted Rule 10.430 and Standard 10.80, effective September 1, 2025. These require courts allowing AI use to develop policies by December 15, 2025, ensuring accountability, transparency, and bias prevention. Courts can either adopt the model policy or create their own, addressing confidentiality, privacy, and accuracy verification.

This rule applies to generative AI tools used for court operations, such as drafting internal documents, research, or administrative tasks (non-adjudicative purposes). Rule 10.430 aims to promote responsible and ethical use of generative AI in court operations while addressing risks like data breaches, biased outputs, and inaccuracies. It responds to the growing integration of AI in judicial systems while prioritizing public trust and fairness.

It does not govern AI use by attorneys, parties, or the public submitting materials to the court, though courts may set related local rules.

AI-generated content must be reviewed by humans to ensure accuracy and prevent reliance on “hallucinations” (inaccurate or fabricated outputs). AI use must align with judicial ethics, ensuring it does not compromise impartiality, due process, or public trust in the judiciary. Judges are restricted from using AI for adjudicative tasks (e.g., drafting rulings) unless explicitly allowed by the court’s policy with safeguards.

Standard 10.80 of the California Rules of Court, also adopted by the California Judicial Council on July 18, 2025, and effective September 1, 2025, provides guidance to support Rule 10.430 in governing the use of generative artificial intelligence (AI) in California’s judicial branch, including superior courts, Courts of Appeal, and the Supreme Court. While Rule 10.430 sets mandatory requirements for courts to develop AI policies, Standard 10.80 offers advisory guidelines to help courts implement those policies effectively.

California’s court system, the largest in the U.S. with 65 courts, 1,800 judges, and five million cases annually, is the first to adopt such comprehensive AI rules, setting a national standard. Other states like Illinois, Delaware, and Arizona have similar policies, while New York, Georgia, and Connecticut are exploring them.

Uber Alleges L.A. Doctors & Lawyers Filed Fraudulent Claims

Uber Technologies filed a lawsuit yesterday in the United States District Court for the Central District of California alleging a fraudulent scheme involving personal injury claims filed against them in California.

The complaint alleges that this “scheme begins when Defendants (Igor) Fradkin, Downtown LA Law Group, Emrani, and Law Offices of Jacob Emrani identify individuals with potential personal injury claims against rideshare companies such as Uber.” And goes on to allege “Both firms aggressively pursue clients to sue Uber, as shown in this online advertisement by Emrani” which appears to be screen grab of an advertisement showing Jacob Emrani next to an UBER/Lyft logo above the words “Uber or Lyft Accident?” followed by a banner that reads “Call Jacob.com.”

Uber then alleges that a “key repeat participant in this fraud is Defendant Greg Khounganian, a spinal surgeon who owns and controls GSK Spine, an orthopedics practice. Working with personal injury coordinators at Defendant Radiance Surgery Center, a surgery center which specializes in treating patients with pending personal injury lawsuits and which also does business as Sherman Oaks Surgery Center, Khounganian accepts referrals from lawyers who have cases against Uber with the understanding that he will perform specific acts to increase the value of their lawsuits and/or claims.”

Uber futher alleges “Both he and Radiance Surgery Center conceal their secret side agreements with the referring lawyers to discount such liens. To increase his desirability as a referral source for the lawyers, Khounganian produces fraudulent records of medical necessity and/or causation that he transmits to the lawyers for the purposes of artificially inflating claimed amounts. These lawyers include Defendants Igor Fradkin and his law firm, Downtown LA Law Group, as well as Jacob Emrani and his law firm, Law Offices of Jacob Emrani.”

Allegedly “Many of Fradkin’s and Emrani’s clients actually have health insurance. But to maximize their eventual recovery in their fraudulent lawsuits, Fradkin and Emrani steer these claimants away from medical providers who would bill their health insurance. Instead, these claimants are directed to specified medical providers, selected by the attorneys, who bill on a lien basis pursuant to a kickback scheme, in which certain medical providers agree to surrender their lien rights in exchange for a steady supply of claimants from the lawyers. “

And “These medical providers then generate bills for their services at above- market, artificially inflated rates that they send to Fradkin, Emrani, and their respective law firms for insurance claims and for use in the litigation against Uber and other targets of the scheme.”

Uber seeks restitution of funds obtained through the scheme, treble damages, costs, and attorneys’ fees under RICO (18 U.S.C. § 1964(c)), equitable relief, including injunctions, disgorgement, and appointment of a monitor or receiver to prevent further violations, punitive damages and prejudgment interest. The lawsuit was filed on July 21st by Perkins Coie LLP.

Uber Technologies, Inc. has filed three racketeering lawsuits in 2025 against lawyers and medical providers for alleged fraudulent insurance claims, with this lawsuit against Downtown LA Law Group et al.being the third.

The the first was filed in New York in 2025 targeting a group of lawyers and medical providers in New York for allegedly exploiting Uber’s state-mandated $1 million rideshare insurance policy to file fraudulent personal injury claims. The scheme allegedly involved directing claimants to pre-selected medical providers who produced fraudulent medical records and bills to inflate settlement demands.

The second was filed in South Florida (Uber v. Law Group of South Florida et al., Case No. 25-cv-22635-CMA) and Uber accused the defendants of staging car accidents, manufacturing damages, and pursuing unnecessary medical procedures to exploit insurance policies between 2023 and 2024.

All three lawsuits allege a similar pattern where personal injury lawyers and medical providers collude to inflate claims by directing claimants to providers who perform unnecessary treatments or produce fraudulent medical records. These claims target Uber’s mandatory $1 million liability insurance, leading to inflated settlements or lawsuits.

Aetna Whistleblower Wins $95M FCA Claim Against Major PBM

The case of United States ex rel. Behnke v. CVS Caremark Corp., No. 14-cv-824 (E.D. Pa.), is a qui tam lawsuit filed in 2014 under the False Claims Act (FCA) in the U.S. District Court for the Eastern District of Pennsylvania. The case was initiated by whistleblower Sarah Behnke, a former head actuary for Medicare Part D at Aetna, against CVS Caremark Corporation, a major pharmacy benefit manager (PBM).

This case concerns the complex interplay between the Centers for Medicare and Medicaid Services (“CMS”), health insurers, pharmacy benefits managers (“PBMs”), and pharmacies. It involves health insurers Aetna and SilverScript, PBM Caremark, and pharmacies Walgreens, Rite Aid, and CVS Pharmacy.

Sarah Behnke, initiated this whistleblower case against CVS Caremark Corp. (including its pharmacy benefit manager subsidiary, CVS Caremark) for causing two Medicare Part D Plan Sponsors, Aetna and SilverScript, to report false and inflated drug prices for purchases made at three national chain pharmacies (Walgreens, Rite Aid, and CVS pharmacies), causing the federal government to overpay for these generic drugs.

Caremark argued that Medicare was aware that the actual costs of drugs dispensed to Medicare Part D beneficiaries were lower than the reported costs, but did nothing about it, and continued to pay claims based on the reporting. Therefore, Caremark argued, its alleged misconduct was not material to Medicare’s decision to continue to pay subsidies.

In its summary judgment decision on April 2, 2024, the United States District Court for the Eastern District of Pennsylvania granted partial summary judgment in favor of the whistleblower, ruling as a matter of law that some of the reported prices were false (leaving to the jury to decide whether additional reported prices also were false). The Court also rejected the CVS Health defendants’ attempt to have the claims dismissed without trial.

Three individuals intimately involved in Aetna’s internal investigation of Caremark’s pricing scheme testified at trial: Jean Walker, Sarah Behnke, and Charles Klippel along with other plaintiff and defense witnesses. After an eight-day non-jury trial in March 2025, Chief Judge Mitchell S. Goldberg of the U.S. District Court for the Eastern District of Pennsylvania issued a comprehensive 105 page Memorandum Opinion on June 25, 2025 indicating that CVS Caremark Corporation would be required to pay the U.S. government $95 million in actual damages.

The court found that CVS Caremark knowingly managed drug prices to maximize profits, leading to Medicare overpaying for prescription drugs. Although the court ruled in favor of CVS Caremark on some claims, it held them liable for the overcharges. Judge Goldberg will decide after further briefing whether to triple the damages to $285 million under the False Claims Act. Additionally, the court has not yet determined how many individual false claims were submitted, With mandatory civil penalties under the FCA, this could also increase the final judgment amount.

According to a review of this case by Duane Morris LLP, the ruling is notable since PBMs have rarely been named defendants in FCA cases. In controlling the flow of medications between drug manufacturers, health insurance companies and pharmacies, and ultimately to pharmacy customers, PBMs obviously yield a substantial amount of power within the drug-pricing space.

Medicare relies on PBMs providing accurate information and reporting in order to keep drug costs within reasonable ranges. This case demonstrates the consequences when these entities, which are historically meant to lower drug prices, actually illegally inflate them. It also speaks to the ability of the FCA to serve as a remedy when that trust is breached.

Third, this ruling sheds more light on the all-too-opaque process of drug pricing. In recent years, the federal government has taken action in an attempt to halt these pricing practices. Beginning in 2024, CMS banned direct and indirect renumeration fees, which previously allowed PBMs to claw back reimbursements remitted to pharmacies based on undisclosed metrics.

Just recently, attorneys from the U.S. Department of Health and Human Services and the U.S. Department of Justice announced the formation of a working group focused on enforcing the FCA. Priority areas for enforcement include Medicare Advantage and drug pricing, two areas in which PBMs and pharmacies are directly involved.

Two of the pharmacies allegedly involved in Caremark’s scheme include Rite-Aid and Walgreens. Rite-Aid recently filed for bankruptcy, and Walgreens is closing over 1,000 stores nationwide in response to financial difficulties.

Cal OSHA Audit Finds Multiple Processing & Staffing Deficiencies

As directed by the Joint Legislative Audit Committee, the office of the California State Auditor conducted an audit of the Division of Occupational Safety and Health (Cal/OSHA) and its efforts to enforce health and safety standards that protect California’s nearly 20 million workers.

It reviewed 60 case files that Cal/OSHA handled from fiscal years 2019–20 through 2023–24 and reported that it found deficiencies in Cal/OSHA’s enforcement processes and staffing levels that may undermine some of California’s workplace protections.

In a letter sent to the Governor and Legislative Leaders by Grant Parks, the California State Auditor said that in general “Cal/OSHA did not demonstrate that it had sufficient reasons for closing some workplace complaints and accidents without conducting an on-site inspection.” In nine of the 30 uninspected complaints it reviewed it questioned Cal/OSHA’s rationale for deciding not to inspect “because the case files lacked evidence to support that Cal/OSHA had complied with its own policies. Some accident cases also lacked support for Cal/OSHA’s decision not to inspect.”

Parks wrote that his office also “observed some critical weaknesses among the on-site inspections that Cal/OSHA did conduct. It reported that Cal/OSHA did not consistently document effective reviews of employers’ injury and illness prevention programs,” causing the Auditor to question whether it may have overlooked potential violations in some instances.

“When Cal/OSHA identified hazards and cited employers for violations, it did not always document that those employers had abated the hazards. Furthermore, the fines that Cal/OSHA assessed employers were sometimes less than the violations may have warranted, and Cal/OSHA often did not document a clear rationale for further reducing fines in post-citation negotiations with employers.”

Cal/OSHA’s process deficiencies and staffing shortages are root causes for many of the concerns we identified. Cal/OSHA has left key policy documents unrevised for years, conducted internal audits inconsistently, and relied on paper-based case files. Cal/OSHA had a 32 percent vacancy rate in fiscal year 2023–24 and even higher vacancy rates in many of its district offices, significantly limiting its ability to protect workers.”

Katrina S. Hagen, Director Department of Industrial Relations, responded to the report. “Prior to the audit commencing, many positive changes were in progress. The recommendations in the audit align with these ongoing efforts.”

Understaffing contributed to several of the findings identified in the audit. In recent years, DIR has been working to address structural and process issues, as well as recruitment and retention issues, that have contributed to staffing shortages at Cal/OSHA.”

One challenge with recruiting Associate Safety Engineers is the lack of candidates with safety knowledge, skills, abilities and experience – especially in the geographic locations Cal/OSHA needs them in. To address this gap, we broadened our search to include entry-level positions, offer on-the-job training, and created partnerships with educational institutions to help develop the skills needed for the job. “

“Findings related to the enforcement branch’s onsite inspections were largely based on deficiencies in case files. Cal/OSHA is working to immediately address these deficiencies through training.”

“Furthermore, Cal/OSHA is prioritizing the modernization and automation of its data management system, which we anticipate will reduce documentation failures and other deficiencies identified in the audit. Cal/OSHA is the largest state-run OSHA program in the country, yet the division lags behind other states in terms of technology and automation. Currently, Cal/OSHA uses the Federal Occupational Safety and Health Information System (OIS), which does not meet our state-mandated needs, and we still rely heavily on paper case files to capture many California requirements not captured in OIS. The limitations of this system were especially felt during the pandemic when Cal/OSHA received a record number of complaints and had challenges accessing information on our enforcement activities.”

Insurance Executive Fraud Leads to Insurance Company Collapse

Former insurance executive Jasbir Thandi pleaded guilty in federal court for his role in fraud schemes that led to the collapse of two insurance companies, Global Hawk Risk Retention Group (Global Hawk) and Houston General Insurance Exchange (HGIE).

Thandi, 69, of San Francisco, was indicted by a federal grand jury on Nov. 16, 2023.  In pleading guilty, Thandi admitted to two counts of conspiracy to commit insurance fraud.

According to court documents and the plea agreement, Thandi founded Global Century Insurance Brokers, an insurance brokerage based in Livermore, Calif., which helped manage the insurance business of Global Hawk.  Beginning no later than May 2018, Thandi and his co-conspirators conspired to create fraudulent financial records, including bank and brokerage records, that falsely overstated the amount of insurance capital and reserves held by Global Hawk, which were submitted to the Vermont Department of Financial Regulation, Global Hawk’s insurance regulator.  In May 2020, after regulators discovered the fraud, Global Hawk was declared insolvent and liquidated.

Thandi misappropriated more than $1.5 million in Global Hawk funds for personal use, including the purchase of a house and a luxury vehicle.  He also bought and sold stocks using Global Hawk funds that were required by law to be maintained as insurance reserves to cover future losses or insurance claims.  

Thandi also admitted that in August 2016, he obtained a $6.4 million line of credit, later increased to $14 million, on behalf of Global Hawk, which the company’s board of directors had not authorized.  Around March 2017, Thandi applied for a second line of credit in the name of Global Hawk in the amount of $14.75 million, again misrepresenting that the line of credit had been authorized by the board of directors.  

In addition, Thandi admitted to engaging in a similar fraud conspiracy with HGIE, a Texas-domiciled insurance company. Thandi and his co-conspirators created fraudulent financial documents that were used to create false financial statements submitted to the Texas Department of Insurance on behalf of HGIE.  These false documents included bank statements and brokerage statements that falsely represented that HGIE had millions of dollars in insurance reserves and capital assets.  These false financial documents were used to deceive the Texas Department of Insurance into believing that HGIE had more assets and monies than it in fact had, and to conceal the fact that HGIE did not have the capital reserves required by Texas law.

Thandi is the fourth and final defendant to plead guilty to charges related to these insurance fraud schemes.  Co-defendants Sandeep Sahota, Jaspreet Padda, and Gunjan Aggarwal all previously entered guilty pleas to the same charges.

Thandi is currently released on bail.  He is next scheduled to appear in district court on Aug. 29, 2025, for a status hearing on sentencing before U.S. District Judge Jon S. Tigar.  Defendant faces a maximum statutory penalty of five years in prison and a $250,000 fine for each count of conspiracy to commit insurance fraud.  Any sentence will be imposed by the court after consideration of the U.S. Sentencing Guidelines and the federal statute governing the imposition of a sentence, 18 U.S.C. § 3553.

The Department of Justice is notifying identified victims of these crimes through the Department of Justice Victim Notification System (VNS).  If you believe you are a victim and have not received communication from the VNS at notify@usdoj.gov, please contact the Mega Victim Case Assistance Program (MCAP) toll free number 1-844-527-5299 (Monday through Friday from 8:30 am to 5:30 pm Eastern), or send an email to USAEO.MCAP@usdoj.gov.  

Assistant U.S. Attorneys David Ward and Evan Mateer are prosecuting the case with the assistance of Kevin Costello and Amala James.  The prosecution is the result of an investigation by the FBI and USPIS.

California Receives $4.1M From Gilead Sciences for Illegal Kickbacks

Gilead Sciences, Inc. is an American biopharmaceutical company headquartered in Foster City, California, that focuses on researching and developing antiviral drugs used in the treatment of HIV/AIDS, hepatitis B, hepatitis C, influenza, and COVID-19, including ledipasvir/sofosbuvir and sofosbuvir. Gilead is a member of the Nasdaq-100 and the S&P 100.

California joined a coalition of 48 other attorneys general in securing $202 million from Gilead Sciences, Inc. (Gilead), for running an illegal kickback scheme to promote its HIV medications. Gilead allegedly violated federal law by illegally providing incentives – including awards, meals, and travel expenses – to healthcare providers to prescribe Gilead’s medications, resulting in millions of dollars of false claims submitted to government health care programs, including Medi-Cal.

The settlement in principle, reached in coordination with the U.S. Department of Justice and approved by the U.S. District Court for the Southern District of New York, provides $49 million for Medicaid programs nationwide, including $4,118,184 for California, with the remainder going to Medicare, Tricare, and the AIDS Drug Assistance Program (ADAP).

From January 2011 to November 2017, Gilead allegedly violated federal anti-kickback laws by providing gifts to healthcare providers who attended and spoke at promotional speaker programs for Gilead’s HIV drugs: Stribild, Genvoya, Complera, Odefsey, Descovy, and Biktarvy. Gilead paid high-volume prescribers tens to hundreds of thousands of dollars to present as “HIV Speakers.” The company also covered travel expenses for speakers, including those traveling long distances and to attractive destinations, such as Hawaii, Miami, and New Orleans, and hosted dinners at high-end restaurants.

Gilead’s internal compliance mechanisms failed to halt these violations. The company’s internal policies and procedures failed to prevent its sales representatives from improperly offering incentives to induce prescriptions.

The Division of Medi-Cal Fraud and Elder Abuse receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $69,244,976 for Federal fiscal year (FY) 2025. The remaining 25 percent is funded by the State of California. FY 2025 is from October 1, 2024 through September 30, 2025.

Gilead Sciences has had at least one prior problem with resolving claims for illegal kickbacks. Back in 2020 Gilead agreed to pay $97 million to resolve claims that it violated the False Claims Act by illegally using a foundation, Caring Voice Coalition (CVC), as a conduit to pay the Medicare co-pays for its own drug, Letairis.

In that prior case the government alleged that Gilead used CVC, which claimed 501(c)(3) status for tax purposes, as a conduit to pay the co-pay obligations of thousands of Medicare patients taking Letairis, which is approved to treat pulmonary arterial hypertension (PAH). According to the government’s allegations, Gilead used CVC to cover the patients’ co-pays in order to induce those patients’ purchases of Letairis. Gilead knew that the prices it set for Letairis otherwise could have posed a barrier to those purchases.

Liberty Mutual Releases 2025 Workplace Safety Index

Liberty Mutual Insurance has released its 2025 Workplace Safety Index, revealing the leading causes and financial impact of the most serious workplace injuries in the US.

For 25 years the Index has identified the top ten causes of workplace injuries – those causing an employee to miss more than five days of work – and ranked them by their medical and lost-wage payments. These ten causes account for over 86% of the total cost of all workplace injuries, $58.78B.

“The Index provides employers a trusted roadmap for improving workplace safety,” said Liberty Mutual Senior Vice President and General Manager, Risk Control, Dorothy Doyle. “We’re proud to provide this important report, which offers valuable data and insights to help employers prevent injuries and manage risks more effectively, underscoring our commitment to protecting workers and supporting safer, more resilient businesses.”

Its objective data and actionable insights have never been more important because companies today face fewer but more expensive workplace injuries. In fact, the rate of serious workplace accidents fell by about 40 percent over the 25 years represented by the Index, while the total cost of workers compensation benefits increased by 30 percent, according to data from the Bureau of Labor Statistics and National Academy of Social Insurance.  Key Findings:

Top Injury Causes:

– – Overexertion involving outside sources remains the #1 cause, accounting for $13.7 billion in costs, largely due to manual material handling.
– – Falls on the same level is the #2 cause, with $10.5 billion in costs, emphasizing the need for slip, trip, and fall prevention strategies.
– – Struck by object or equipment and Falls to a lower level also continue to be major injury drivers, together accounting for nearly $11.6 billion in costs.
– – Injuries due to Other exertions and bodily reactions, Roadway incidents, and Caught-in or compressed by equipment also feature prominently in the top 10, underlining the diverse risks present in today’s workplaces.

Consistency of findings 2001-2025:

– – Overexertion and Falls on same level have been the #1 and #2 causes in each Index.
– – Seven of this year’s top 10 injury causes appeared in all 25 indices.

Liberty Mutual also produces eight industry-specific indices detailing injury causes and costs in Manufacturing, Construction, Healthcare & Social Services, Professional & Business Services, Retail, Wholesale, Leisure & Hospitality and Transportation & Warehousing.

The Liberty Mutual Workplace Safety Index is based on information from Liberty Mutual, customized data from the U.S. Bureau of Labor Statistics (BLS) Office of Safety, Health, and Working Conditions, and the National Academy of Social Insurance (NASI). BLS non-fatal injury data are analyzed with the Liberty Mutual data to determine which events caused employees to miss more than five days of work, and then to rank those events by workers compensation costs, which are then scaled to the NASI total cost. To capture accurate injury cost data, each index is based on data three years prior. Accordingly, the 2025 index reflects 2022 data.

Private Self-Insured Claim Counts Are Down But Losses Are Up

California’s private self-insured employers reported 7,026 fewer workers’ compensation claims in 2024 than in 2023 (-7.4%), pushing private self-insured claim frequency to a 4-year low, but for the second year in a row the average paid and incurred losses on these claims increased, driving total paid and incurred losses higher according to a California Workers’ Compensation Institute (CWCI) review of initial data from the state Office of Self-Insurance Plans (OSIP).

The annual summary of private self-insured data posted on OSIP’s website last week, offers an initial snapshot of California private, self-insured claims experience for cases reported in 2024, noting the number of covered employees, medical-only and indemnity claim counts, and total paid and incurred losses on those claims through the end of the year. The 2024 summary shows the experience of private self-insured employers who covered 2.25 million California employees last year (down from 2.34 million in the 2023 first report) and who reported 87,360 claims in 2023, down from 94,386 claims in the 2023 initial report.

According to the latest summary, private self-insured employers reported 45,170 medical-only claims in 2024 (down 7.1% from 48,404 in 2023, the first full year following pandemic), though that was still 3.2% above the 43,779 med-only claims noted in 2020, when med-only claim volume plummeted during the brief, pandemic-driven recession. At the same time, the number of private self-insured indemnity claims, which spiked during the pandemic due to the flood of COVID-19 lost-time claims then fell 13.0% as COVID claim volume dropped in 2023, fell for the second year in a row, declining by 8.2% to 42,190 claims in 2024.

The 2024 claim count translates to an overall frequency rate of 3.88 claims (2.01 med-only and 1.87 indemnity) per 100 private self-insured employees, down from an overall rate of 4.03 in 2023 (2.07 med-only and 1.96 indemnity), marking the second consecutive year-over-year decline in private self-insured claim frequency, and pushing the overall rate to the lowest level since 2020.    

Despite decreasing claim volume and claim frequency, private self-insured’s first report total paid and incurred losses both increased for the second year in a row last year. Paid losses on the 2024 private self-insured claims through the end of the year totaled $353.6 million, up 3.9% from the first report total for 2023, as total paid medical increased by $10.2 million (6.1%) to $177.6 million, and total paid indemnity (primarily temporary disability payments) increased by $3.2 million (1.9%) to $176.0 million. First report total incurred losses (paid benefits plus reserves for future payments) on 2024 private self-insured claims rose to $934.3 million, up $30.6 million, or 3.5% from the 2023 total, as first report incurred medical increased by $39.8 million (7.9%) to $542.3 million and total incurred indemnity increased by $30.6 million (8.5%) to $392.0 million.

Even though there were 7,026 fewer private self-insured claims in 2024 than in 2023 (including 3,792 fewer indemnity claims) the growth in private self-insureds’ total paid and incurred losses in 2024 can be traced to the growth in average paid and incurred losses at the first report, as average paid losses per claim rose 12.3% to $4,047 while average incurred losses rose 16.8% to $10,695.

OSIP’s summary of private self-insured’s calendar year 2024 data, follows the December 2024 release of public self-insured claims data for fiscal year 2023/2024. OSIP private and public self-insured claim summaries from the past 20 years are posted at https://www.dir.ca.gov/SIP/StatewideTotals.html. CWCI members and subscribers may log on to the Communications section of the CWCI website www.cwci.org to view a summary Bulletin with more details, analyses, and graphics.