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North Hollywood Cab Driver was Employee

Emanuele Secci was driving his motorcycle through an intersection in the City of West Hollywood when a taxi driven by Aram Tonakanian coming from the opposite direction, turned left directly in front of him causing injury.

At the time Tonakanian was driving a green and white taxi marked with a United Independent Taxi Drivers, Inc. insignia.

The jury found Tonakanian to be United’s agent, but not an employee. The court granted United’s motion for judgment, and Secci appealed. The Court of Appeal reversed in the published opinion of Secci v United Independent Taxi Drivers Inc.  The case involves the application of the rules for establishing an independent contractor status

Like other owner-drivers, Tonakanian owned his taxi and set his own hours. Tonakanian’s contract with United stated he was an independent contractor. Drivers paid monthly dues and other fees to cover United’s expenses.

United provided marketing and advertising. Each United taxi had the company’s phone number painted on it. If a customer called the number, a dispatcher would enter the location information into a computer, and the computer would send out a dispatch request. In order to receive dispatch requests, a driver would check into the zone where he or she was located. Drivers were free to accept or reject dispatch requests, and could pick up passengers on the street, so long as they were licensed to accept fares within that city.

Drivers were required to use uniform credit card and dispatch equipment chosen by United. Credit card charges were initially paid to United, which would deduct credit card processing fees, monthly dues, and a small fee for accounting. Taxi rates were set by meter. Drivers were not free to charge flat or discounted rates. United required its drivers to accept vouchers and coupons that drivers could later submit to United for payment. If a driver transferred ownership of a United taxi, the buyer and seller had to notify United and pay a $500 transfer fee.

United provided a training manual to each of its drivers. It required drivers to keep a copy of the manual in the taxi and to complete a training course before taking the city’s licensing test. The training manual provided specific information about the drivers’ appearance, including a dress code, as well as specifics about driving safely, conducting themselves while waiting in taxi lines, and interacting with passengers politely.

United drivers were expected to abide by the company’s rules and regulations, and drivers acknowledged their relationship with United could be terminated for violations of those rules.

A corporation may be held vicariously liable as a principal for the torts of its agents. (Meyer v. Holley (2003) 537 U.S. 280, 285 – 286.) “Whether a person performing work for another is an agent or an independent contractor depends primarily upon whether the one for whom the work is done has the legal right to control the activities of the alleged agent.”

In Yellow Cab Cooperative, Inc. v. Workers’ Comp. Appeals Bd. (1991) 226 Cal.App.3d 1288 (Yellow Cab), the court held a taxi driver who leased his taxi from the lessor taxi company was an employee, not an independent contractor, for the purpose of workers’ compensation law. (Discussing S. G. Borello & Sons, Inc. v. Department of Industrial Relations, supra, 48 Cal.3d 341}

Viewed in the light most favorable to Secci, the evidence presented at trial was sufficient to support a jury finding that Tonakanian was United’s agent and United was vicariously liable for Tonakanian’s acts.

CWCI Reviews Central Coast Claims

The California Workers’ Compensation Institute (CWCI) has issued a new “Regional Score Card,” the sixth in its research series that looks at workers’ comp claims experience in 8 different regions of California.

The new Score Card provides detailed data from more than 127,000 claims for 2005-2015 injuries filed by residents of the Central Coast — a 300-mile long region encompassing Ventura, Santa Barbara, San Luis Obispo, Monterey, and Santa Cruz Counties — and compares the results to those from 1.7 million claims from the rest of the state.

For the entire 11-year span covered by the Score Card, claims by Central Coast workers represented 6.7% of all California workers’ compensation claims and 6.3% of all claim payments, though with a shift in the state’s population and job market in recent years, the proportion of claims from the region has increased, with Central Coast workers accounting for 7.7% of all California job injury claims in accident year (AY) 2015.

Average payments on these claims – almost a quarter of which involved agricultural workers — have shown recent increases as well. For example, average 36-month paid losses on Central Coast claims rose from $26,194 for AY 2005-2007 claims to $35,874 for AY 2011-2012 claims. Other Score Card findings show:

1) Time lags from the date of injury to employer notification, claims administrator notification and initial treatment are significantly less on the Central Coast than in other regions, and claim durations are shorter;

2) At 24 months post injury Central Coast claims average more medical visits for evaluation/management, physical therapy, and chiropractic care, while the biggest difference in medical payments is in surgery, where Central Coast claims at the 2-year benchmark average 11.2% more than in the rest of the state;

3) 4 of the top 10 drugs (based on 2014 payments) prescribed to Central Coast injured workers are opioids. Vicodin, Oxycodone, Tramadol, and Fentanyl together account for 20% of the region’s total drug spend.

In addition to providing a profile of Central Coast claimants, the Score Card shows claim distributions for the region broken out by industry, nature and cause of injury, primary diagnostic category, and by employer premium. Claim closure rates at 24 months and average claim durations are provided for med-only claims, lost-time claims, and all claims.

The Score Card also notes claim and payment distributions by claim type (med-only, temporary disability, permanent disability, and death), and attorney involvement rates for all indemnity claims and permanent disability claims that are at least 36 months old, with comparative results shown for the rest of the state.

Recent CWCI Score Cards examined claims from Los Angeles County; the Inland Empire/Orange County; the Central Valley; the Bay Area; and San Diego County. All of the Score Cards and summary Bulletins are available to CWCI members and research subscribers who log on to http://www.cwci.org/, while others may purchase them from www.cwci.org/store.html. The next Score Card in the series will focus on claims from the Northern Counties.

CDI Disallows Advertising Costs for Rate Calculation

At the November 8, 1988, General Election, the voters approved an initiative statute that was designated on the ballot as Proposition 103. The measure made numerous fundamental changes in the regulation of automobile and other forms of insurance in California.

Formerly, the so-called “open competition” system of regulation, rates were set by insurers without prior or subsequent approval by the Insurance Commissioner . Under that system, California had less regulation of insurance than any other state, and in California automobile liability insurance was less regulated than most other forms of insurance.

Proposition 103 instituted a permanent regulatory regime comprising the “prior approval” system, under which the Insurance Commissioner must approve a rate applied for by an insurer before its use, looking to whether the rate in question is excessive, inadequate, unfairly discriminatory or otherwise in violation of’ specified law — considering the investment income of the individual insurer and not considering the degree of competition in the insurance industry generally.

The California Supreme court reviewed and approved Proposition 103 against challenges under the United States and California Constitutions in a series of cases filed by insurance carriers.

In 2009, Mercury Casualty Co. filed an application with the California Insurance Commissioner to increase its homeowners’ insurance rates. Originally, Mercury sought an overall rate increase of either 8.8 percent or 6.9 percent.

In denying the increase Mercury requested, the California Insurance Commissioner made two decisions that are at issue on appeal.

First, the commissioner determined that Mercury’s entire advertising budget had to be excluded from the calculation of the maximum permitted earned premium because “Mercury aims its entire advertising budget at promoting the Mercury Group as whole” rather than seeking to obtain business for a specific insurer and also providing customers with pertinent information about that specific insurer. Second, the commissioner determined that Mercury did not qualify for a variance from the maximum permitted earned premium because Mercury failed to demonstrate the rate decrease that resulted from application of the regulatory formula results in deep financial hardship.

In June 2014, the superior court issued its ruling denying Mercury’s petition for writ of mandate and complaint for declaratory relief in the superior court seeking review of the commissioner’s decision. The judgment was affirmed in the published case of Mercury Casualty Company v Dave Jones, as Insurance Commissioner.

On appeal, Mercury contends the commissioner erred in disallowing all of Mercury’s advertising expenses in the rate calculation. In 2008, 2009 and 2010, Mercury General Corporation’s advertising expenses totaled $26 million, $27 million and $30 million respectively. The Personal Insurance Federation of California intervened in the action on behalf of other industry stakeholders.

Section 2644.10(f) provides that institutional advertising expenses shall not be allowed for ratemaking purposes, Institutional advertising means advertising not aimed at obtaining business for a specific insurer and not providing consumers with information pertinent to the decision whether to buy the insurer’s product.”

The Court of Appeal concluded “Finding no merit in these arguments, or any of the other arguments offered to overturn the judgment, we affirm.”

New Back Pain Guidelines Shun Medications

People should try non-drug treatment options like massage or stretching for most cases of chronic low back pain before choosing treatment with over-the-counter or prescription drugs, according to new treatment guidelines promulgated by the American College of Physicians.

The report in Reuters Health says that if the pain began recently, the guidelines recommend superficial heat, massage, acupuncture or spinal manipulation. If patients wish to take medication, they should use nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or skeletal muscle relaxants prescribed by a doctor. Acetaminophen and steroids are not recommended for low back pain, according to the guidelines.

But for chronic low back pain – defined as pain that’s lasted more than 12 weeks – the American College of Physicians (ACP) recommends people hold off on medications.

The new guidelines apply to low back pain that does not radiate to other parts of the body like the legs, said Dr. Nitin Damle of the Alpert Medical School of Brown University in Providence, Rhode Island, who is president of the ACP.

Patients with low back pain that radiates to other parts of the body need further evaluation, he told Reuters Health.

“Most back pain is self-limited,” said Damle. “It’s common, will go away given enough time and patients can help themselves initially by trying some heat and stretching before going to see a physician.”

The new guidelines are based on a review of studies that looked at the use of drug and non-drug therapies for low back pain. The review did not look at creams or injections, however.

Based on the review, the ACP recommends that people who have been suffering with chronic low back pain try non-drug therapies such as exercise, acupuncture, mindfulness-based stress reduction, tai chi, yoga, biofeedback, cognitive behavioral therapy or spinal manipulation.

If those methods don’t work, the guidelines say the next step should be NSAIDs or the pain medications duloxetine, which is marketed as Cymbalta, or tramadol, which is marketed as Ultram.

Opioids should only be considered as last resorts, and only prescribed after doctors discuss their risks and benefits with patients.

“If you’re going to have to use opioids, use them in the smallest dose possible with the least frequency and smallest prescription,” said Damle.

The new recommendations are very reasonable, said Dr. Joel Press, who is physiatrist-in-chief at the Hospital for Special Surgery in New York City.

“Anything you can do with these non-pharmaceuticals that can get you moving faster is going to get you better in the end,” said Press, who was not involved in crafting the new guidelines.

“I hope this reinforces to physicians and patients that a lot of these non-pharmaceutical treatments can have a lot of success,” he told Reuters Health.

15 Arrested in Unlicensed Contractor Sting

The Yolo County District Attorney’s Office Workers’ Compensation Fraud Unit recently coordinated a joint unlicensed contractor sting operation in Woodland, California with the Contractors State License Board, the Sutter County District Attorney’s Office, and the Woodland Police Department.

The goal was to hold unlicensed contractors accountable for violations of contractor’s law and workers’ compensation fraud. The team was specifically looking for individuals who were posting false advertisements as well as those who were providing a contractor’s bid without being properly licensed.

During the two-day operation there were a total of 15 arrests made for violations including contracting without a license, posting false advertisements, and not having workers’ compensation insurance. Those arrested were processed and provided information on how to become a licensed contractor.

According to California law all individuals performing work regulated by the Contractor’s State License Board at $500 or greater must have a valid contractor’s license. If they have any employees working for them they must provide their employees with proper workers’ compensation insurance as well.

Homeowners can be held liable for any medical treatment stemming from injuries sustained by the employee of an unlicensed contractor if the injury occurred while working on the homeowner’s property.

District Attorney Jeff Reisig emphasized the incredible liability homeowners face when hiring uninsured employers or unlicensed contractors, saying “If the employee was injured or killed while working on the homeowner’s property, the homeowner could be personally liable for all of the medical bills. Most homeowner’s insurance policies will not cover these types of injuries, resulting in the homeowner owing hundreds of thousands of dollars and potentially losing their home and life savings to pay for these bills. It is critical that homeowners ensure the contractors they hire are licensed by the Contractor’s State License Board and have proper workers’ compensation insurance for their employees. We are committed to combating this type of fraud in our community.”

Kaiser Permanente Pharmacy Fined for CSA Violations

U.S. Attorney Phillip A. Talbert announced that Kaiser Foundation Health System Inc. has paid $850,000 to settle allegations that a Kaiser Permanente pharmacy at 3800 Dale Road in Modesto violated the Controlled Substances Act (CSA) by improperly filling defective prescriptions and by failing to maintain accurate records.

An investigation into a theft of controlled substances at the pharmacy in December 2013 resulted in prosecution of a Kaiser employee on a grand theft charge. It also led to closer scrutiny of the pharmacy by investigators with the Drug Enforcement Administration diversion control unit in Fresno.

The settlement resolves allegations that a large percentage of prescriptions that the pharmacy filled were incomplete, lacking the patient and dosage information required by the CSA’s implementing regulations.

Additionally, the settlement resolves allegations that the pharmacy failed to maintain accurate documentation of incoming and outgoing controlled substances. The investigation identified discrepancies in comparing the pharmacy’s purchase and dispensing records with the actual controlled substances on hand at the pharmacy.

“One purpose of the CSA is to ensure that pharmacies maintain accurate records to minimize the chance of diversion of powerful and potentially addictive drugs, which wreak havoc on our communities and destroy lives,” U.S. Attorney Talbert said. “Large pharmacy chains and health care conglomerates like Kaiser dispense a high volume of controlled substances to customers and members. Strict compliance with the CSA’s recordkeeping provisions by these entities is imperative.”

“Health care providers and pharmacies that don’t fully comply with the CSA give the public the short end of the stick. DEA will hold entities dispensing controlled substances accountable for their actions to protect public health and safety,” stated DEA Special Agent in Charge John J. Martin.

There was no evidence the violations caused harm to patients. Kaiser cooperated with the investigation and has agreed to implement protocols to minimize the chance of future violations.

In a statement Kaiser Permanente said tracking and management of controlled substances is taken seriously at its pharmacies. “Since bringing this matter to the attention of the Department of Justice, we have reviewed the Modesto pharmacy’s documentation and record-keeping of controlled substances, and have taken a number of steps, including instituting additional security controls.”

This case was the product of an investigation by the Fresno DEA Diversion Group. Assistant U.S. Attorney Vincente A. Tennerelli represented the United States in this matter.

Officials Note Increase in Pharmacy Burglaries

The Ventura County Star reports that in 2015, law enforcement agencies had six pharmacy burglaries in Ventura County. The following year, these burglaries numbered 64, resulting in an average of more than five burglaries per month and leaving law enforcement officials scrambling for answers. Capt. Garo Kuredjian, of the Ventura County Sheriff’s Office, described the 58-burglary increase as a “statistically significant ” change in criminal behavior.

Detective Chip Buttell, of the Oxnard Police Department’s property crimes unit, said most of the burglaries had specific targets, such as opioid-based narcotics, with little variation. The burglars generally have not tried to take everything of value, such as computers or patient information, from a location, officials said.

“It was obvious the criminals were seeking high-priced drugs such as oxycodone,” said Mary Jarvis, a public affairs representative for Kaiser Permanente, whose Oxnard pharmacy was burglarized twice in 2016.

Thieves can potentially make hundreds of dollars from the illicit sale of such opioid drugs on the black market. “Typically, the opioid-based drugs are selling for about 50 cents per milligram,” Kuredjian said. “So it’s $7 to $18 for a 15-milligram pill and $15 to $36 for a 30-milligram pill.”

Indications of the spike began showing up early last year when the Ventura County Sheriff’s Office alerted the public to a string of burglaries in Thousand Oaks and Camarillo. Between January and March, six pharmacies had been burglarized, with the thieves forcing entry into small, independent pharmacies during non-operating hours. They primarily took opioid-based medications, then fled. As the year drew on, the county’s cities – large and small – were plagued by pharmacy break-ins.

In total for 2016, Ventura saw 14 break-ins and Camarillo had 12, while both Oxnard and Thousand Oaks finished the year with 10. Santa Paula reported five and Simi Valley had six pharmacy burglaries. Newbury Park saw two.

Law enforcement officials stressed that the problem is not confined to Ventura County. Regions such as Santa Barbara County, which was unaffected in 2015, reported multiple instances last year, according to the Santa Barbara County Sheriff’s Office. Five pharmacy burglaries were reported in 2016, four in Santa Barbara and one in Montecito.

While law enforcement officials have noted the likely financial motive for the burglaries, there are challenges in alleviating the issue. Authorities are unsure precisely why Ventura County and other parts of Southern California have seen a sudden surge in incidents.

Most of the burglaries have occurred at smaller, independent pharmacies, not chain stores such as CVS or Rite Aid where traffic is higher and security is more prevalent.  A Kaiser Permanente representative confirmed that measures had been taken at its Oxnard location to avoid further incidents, although specifics were not shared.

The decreased supply of legitimate drugs has increased the demand from illicit sources, according to authorities. Burglars are only too happy to fill the void left behind by a decline in prescriptions.

FS&K Announces 7th Annual Employment Law Conference

Floyd, Skeren & Kelly’s “Annual Employment Law Conference” now enters its 7th year. This year the firm has another stellar group of employment law and workers’ compensation experts to present a comprehensive learning experience for employers, human resource administrators, risk managers and claims adjusters on important topics impacting the workplace.

Kevin Kish, Director of the Department of Fair Employment and Housing (DFEH) will be the keynote speaker during an important year for employers as we transition to a new President and federal administration, along with the inevitable changes in employment law and regulations that will follow.

Tina Walker, Regional Administrator for the DFEH will be joining Mr. Kish to provide her valuable input on the topics covered.

Mark ‘RX Professor’ Pew from PRIUM, will cover recent developments impacting employer policies on marijuana in the workplace and to address the many questions that have arisen since the passage of Proposition 64.

This years conference sessions will include:

1) Expanded Employee Protections: Key Developments on Conducting Lawful Background Checks, Transgender Protections, and Discrimination, Harassment and Retaliation Policies
2) New Laws Impacting Work Place Drug Testing- The Good, the Bad and the Unknown
3) HR Compliance is Complicated – 2017 Update Includes New Legislation, Cases and Key Trends Impacting the Workplace
4) Reducing the Risk of Costly Disability Discrimination Claims – Recommendations for Employer Best Practices (Legislative and Case Law Update Included)
5) Workers’ Compensation Case Law Update
6) Employer’s Fraud Task Force Update
7) Post Brinker-Costly Class Actions For Meal And Rest Period Violations Continue- Key Strategies For Avoiding Liability
8) Is My Employee Drunk, Sick or Simply Sleeping- Training Managers on ‘Reasonable Suspicion’ Based Drug Testing
9) Defending Good Faith Personnel Actions and Post-Termination Workers’ Compensation Claims
10) 2017 Hot Topics in Workers’ Compensation

Please see our Complete Agenda for more details.

The Conference is set for April 28, 2017 from 8:00 am to 5:00 pm at the Disneyland Hotel, 1150 Magic Way in Anaheim. Our conference is in the approval process for MCLE, CE, SPHR, HRCI and Credits for ARPM, CPDM and CCMP.

Employers Must Post Annual Injury and Illness Summaries

Cal/OSHA is reminding employers in California with more than 10 employees to post their 2016 annual summaries of work-related injuries and illnesses. These employers must post the annual summary no later than February 1 of the year following the year covered by the records and keep the posting in place until April 30.

“This important posting requirement increases awareness of health and safety hazards in the workplace and helps employers and employees understand how to reduce risks,” said Cal/OSHA Chief Juliann Sum.

Employers’ requirements to record occupational fatalities, injuries, and illnesses are in the California Code of Regulations, Title 8, Sections 14300 through 14300.48. Section 14300.32 describes the annual posting requirement. Section 14300.2 lists exempted industries.

To satisfy this requirements, at the end of each calendar year, employers must:

(1) Review the Cal/OSHA Form 300 to verify that the entries are complete and accurate, and correct any deficiencies identified;
(2) Create an annual summary of injuries and illnesses recorded on the Cal/OSHA Form 300 using the Cal/OSHA Form 300A Annual Summary of Work-related Injuries and Illnesses;
(3) Certify the annual summary; and
(4) Post the annual summary.

The employer must review the entries as extensively as necessary to make sure that they are complete and correct. A company executive (as defined) must certify that he or she has examined the Cal/OSHA Form 300 and that he or she reasonably believes, based on his or her knowledge of the process by which the information was recorded, that the annual summary is correct and complete.

The employer must then post a copy of the annual summary in each establishment in a conspicuous place or places where notices to employees are customarily posted. The employer must ensure that the posted annual summary is not altered, defaced or covered by other material.

Instructions and form templates can be downloaded for free on Cal/OSHA’s Record Keeping Overview. The overview includes the summary template, Form 300A, which is the required workplace posting that must be placed in a visible, easily accessible location at each worksite. Current and former employees, including employee representatives, have the right to review the summary in its entirety.

Senators Probe Overdose Antidote 550% Price Surge

First came Martin Shkreli, the brash young pharmaceutical entrepreneur who raised the price for an AIDS treatment by 5,000 percent. Then, Heather Bresch, the CEO of Mylan, who oversaw the price hike for its signature Epi-Pen to more than $600 for a twin-pack, though its active ingredient costs pennies by comparison.

Now a small Virginia company called Kaleo is joining their ranks. It makes an injector device that is suddenly in demand because of the nation’s epidemic use of opioids, a class of drugs that includes heavy painkillers and heroin.

Called Evzio, it is used to deliver naloxone, a life-saving antidote to overdoses of opioids. And as demand for Kaleo’s product has grown, the privately held firm has raised its twin-pack price to $4,500, from $690 in 2014. Founded by twin brothers Eric and Evan Edwards, 36, the company first sought to develop an Epi-Pen competitor, thanks to their own food allergies. Now, they’ve taken that model and marketed it for a major public health crisis. It’s another auto-injector that delivers an inexpensive medicine.

And the cost of generic, injectable naloxone – which has been on the market since 1971 – has been climbing. A 10-mililiter vial sold by one of the dominant vendors costs close to $150, more than double its price from even a few years ago, and far beyond the production costs of the naloxone chemical, researchers say. The other common injectable, which comes in a smaller but more potent dose, costs closer to $40, still about double its 2009 cost.

U.S. Senator Claire McCaskill on Thursday asked Kaleo Pharmaceuticals to justify the more than 550 percent surge in the price of its device to treat painkiller overdoses, becoming the second senator to question Evzio’s $4,500 price tag.  Senator Amy Klobuchar sent Kaleo a letter earlier this month, voicing similar concerns.

Evzio contains the overdose-reversing drug naloxone and can be used in emergencies by people without medical training. Privately held Kaleo has raised the price of a twin-pack to $4,500, from $690 in 2014, according to a Kaiser Health News report.

The concerns over Evzio’s price comes at a time when pharmaceutical companies are facing intense scrutiny over “price-gouging”, and as lawmakers struggle with the epidemic of opioid abuse.

“At a time when Congress has worked to expand access to naloxone products and to assist state and local communities to equip first responders with this life-saving drug, this startling price hike is very concerning,” McCaskill said in a letter to Kaleo Chief Executive Spencer Williamson. The letter, which was signed by 30 U.S. senators, asked Kaleo for information on Evzio’s price structure and why the company chose to adjust prices.

“We received the letter from the Senators and are in communication with them to ensure all questions are addressed,” Williamson told Reuters in an e-mailed statement.

“There’s absolutely nothing that warrants them charging what they’re charging,” said Leo Beletsky, an associate professor of law and health sciences at Northeastern University in Boston.