Early this year the Court of Appeal opened the Pandora’s box of potential litigation against utilization review physicians in the published case of Kirk King v Comppartners, Inc. Now the California Supreme Court granted a Petition to Review the case, potentially leading to an end to this litigation expansion nightmare.

Kirk King suffered anxiety and depression due to chronic back pain resulting from the back injury at work in 2008. In 2011, he was prescribed an anti-anxiety medication known as Klonopin to be provided through Workers’ Compensation. The request for this medication was sent to UR.

Naresh Sharma, M.D, an anesthesiologist who conducted the utilization review determined the drug was unnecessary and decertified it. As a result, Kirk was required to immediately cease taking the Klonopin. Typically, a person withdraws from Klonopin gradually by slowly reducing the dosage. Due to the sudden cessation of Klonopin, King suffered four seizures, resulting in additional physical injuries.

In September 2013 another request for Klonopin was made by the PTP. Ali, a psychiatrist, conducted a second utilization review and also determined Klonopin was medically unnecessary. Neither Sharma nor Ali examined Kirk in-person, and neither warned Kirk of the dangers of an abrupt withdrawal from Klonopin. Sharma and Ali were employees of CompPartners a Workers’ Compensation utilization review company.

King then sued CompPartners, Inc. and Sharma for (1) professional negligence; (2) negligence; (3) intentional infliction of emotional distress; and (4) negligent infliction of emotional distress. Kirk’s wife, Sara King, sued for loss of consortium. The trial court sustained defendants’ demurrer without leave to amend. The Court of Appeal sustained the demurrer but reversed the denial of leave to amend.

CompPartners contended the Labor Code set forth a procedure for objecting to a utilization review decision, and that procedure preempted the Kings’ complaint. The Kings contend the trial court erred in sustaining the demurrer because their causes of action are not preempted by the Workers Compensation Act.

The Court of Appeal said that “To the extent the Kings are faulting Sharma for not communicating a warning to Kirk, their claims are not preempted by the WCA because that warning would be beyond the “medical necessity” determination made by Sharma. To the extent the Kings are faulting Sharma for incorrectly deciding the medical necessity decision because Klonopin was medically necessary until Kirk was weaned, and thus a particular number of pills, e.g., 10, 20, should have been authorized for weaning, the Kings’ claims are preempted by the WCA because the Kings are directly challenging Sharma’s medical necessity determination.”

The decision concluded that the trial court “should have granted the Kings leave to amend because it is possible… that, when more details are provided they could support a conclusion that, under the circumstances, the scope of Sharma’s duty included some form of warning Kirk of or protecting Kirk from the risk of seizures.”

The King case will be the workers’ compensation high profile case for the remainder of the year. The list of Amicus parties already includes many stakeholder organizations such as the California Workers’ Compensation Institute, the California Chamber of Commerce, the California Applicant’s Attorneys Association and more. Workers’ compensation UR and IMR seems to be constantly under attack. The King case provided another opportunity to open the floodgates of litigation against employers, and vendors in the compensation echosphere.

Five defendants were arraigned in Orange County for committing over $635,000 in tax and insurance fraud and failing to pay employees prevailing wage on public works contracts.

Babak Brian Abghari, 36, Newport Coast, Homayoun Harry Abghari, 57, Huntington Beach, Julio Roberto Alvarado, 47, San Pedro, Cody Lawson, 34, Long Beach, Phyllis Martinez, 51, Anaheim, are each charged with eight felony counts of taking and receiving a portion of a worker’s wage on a public work, 56 felony counts of recording a false or forged instrument, six felony counts of making a false statement to discourage an injured worker from claiming workers’ compensation benefits, and seven felony counts of willful failure to pay taxes, with sentencing enhancement allegations for property loss over $200,000.

Babak Aghari and Homayoun Aghari are also charged with three felony counts of misrepresenting facts to a workers’ compensation insurance company.

If convicted, the defendants face a maximum sentence of 49 years and six months in state prison. The defendants are scheduled for a pre-trial hearing on May 12, 2016, at 8:30 a.m. in Department C-55, Central Justice Center, Santa Ana.

Houmayoun Abghari and Babak Abghari are accused of owning and operating PCN3, a general contracting company that mainly conducts public works projects. Between Jan. 1, 2000, and March 30, 2015, the defendants are accused of fraudulently paying PCN3’s employees less than the prevailing wage in cash, and keeping the extra money owed to their employees. The defendants are accused of “shorting” the victims’ hours on certified payroll reports and/or requiring their victims’ to give cash back.

Martinez is accused of working as an office clerk at PCN3 and knowingly signing fraudulent certified payroll records under penalty of perjury.

Lawson is accused of working as a superintendent and Alvarado is accused of working as a foreman for PCN3 on public work’s projects. Lawson and Alvarado are accused of not paying employment taxes. Lawson and Alvarado are accused of giving paychecks or cash to victims for their work on the projects.

Houmayoun Abghari and Babak Abghari are accused of discouraging the victims from filing for workers’ compensation benefits after being injured on the work. Houmayoun Abghari and Babak Abghari are accused of knowingly filing false tax returns in which they understated the pay and amount of hours that their employees received.

One of the victims contacted the International Brotherhood of Electrical Workers, who notified the Orange County District Attorney’s Office (OCDA). The OCDA and the Department of Industrial Relations and Labor Commissioners Office investigated this case.

Deputy District Attorney Donde McCament of the Insurance Fraud Unit is prosecuting this case.

When a paralyzed mother crossed the finish line of the 26.2-mile London Marathon in a bionic suit, it marked a watershed moment for wearable technology; the exoskeleton had arrived.

The recent FDA approval of the exoskeleton, which enables paraplegics, amputees and people with muscle or nerve damage to walk, is the latest milestone in the new world of wearable technology for injured workers, according to Zack Craft, ATP, Vice President of Rehab Solutions and Complex Care Education at One Call Care Management (“One Call”).

Craft spoke on wearable technology and workers’ compensation at the RIMS 2016 Annual Conference held April 10 – 13 in San Diego, California, along with Felicia Amenta, Workers’ Compensation Program Manager for San Diego County and Imperial Schools. Their presentation, “The New Game Changer in Managing Worksite Health: Wearable Technology,” introduced attendees to ways in which wearable technology can benefit injured workers, their employers and payers.

Speaking about the exoskeleton, Craft noted: “For an employee with catastrophic injuries, the exoskeleton holds enormous potential to give them back a part of their lives they thought was lost forever.”

Other types of wearable technology that are applicable in the workplace range from postural devices to activity trackers to GPS locators. Benefits of these devices include wellness, prevention of injuries, increased productivity, compliance with treatment regimes to prevent injury and avoid re-injury, and enhanced independence and quality of life.

As wearable technologies are introduced into the workplace, and especially for the treatment of injured workers, specialists such as assistive technology experts can advise claims managers on which technologies may be most appropriate, taking into consideration the long-term view of the injury, the home environment, and patients’ needs for functionality and independence.

Assistive technology is an umbrella term that includes assistive, adaptive, and rehabilitative devices for people with disabilities and also includes the process used in selecting, locating, and using them. Assistive technology promotes greater independence by enabling people to perform tasks that they were formerly unable to accomplish, or had great difficulty accomplishing, by providing enhancements to, or changing methods of interacting with, the technology needed to accomplish such tasks.

RESNA, the Rehabilitation Engineering and Assistive Technology Society of North America, advances the field by offering certification, continuing education, and professional development; developing assistive technology standards; promoting research and public policy; and sponsoring forums for the exchange of information and ideas to meet the needs of our multidisciplinary constituency. RESNA certified assistive technology experts can be located nationwide by using the search tool on the RESNA website.

California State University in Northridge, Center on Disabilities just finished its 31st Annual International Technology and Persons with Disabilities Conference last month in San Diego. For over 30 years, the Annual International Technology and Persons with Disabilities Conference, has provided an inclusive setting for researchers, practitioners, exhibitors, end users, speakers and other participants to share knowledge and best practices in the field of assistive technology. In 2015, the conference drew more than 4,800 people to San Diego. The annual conference is a forum that showcases cutting edge technology and practical solutions.The conference is the largest of its kind in the world. The 32nd Annual CSUN Conference is scheduled for February 27 to March 4, 2017 at the Manchester Grand Hyatt Hotel in San Diego.

CSUN also just launched two new master’s degrees in assistive technology. It says that assistive technology is “one of the fastest-growing segments of the rapidly expanding health and human services field.”

Workers’ Compensation Appeals Board Chairwoman Ronnie Caplane is retiring from state service at the end of April. She was appointed commissioner in 2003 by Governor Gray Davis, reappointed in 2009 by Governor Arnold Schwarzenegger, and appointed Chairwoman by Governor Jerry Brown in 2011.

During her tenure on the Appeals Board, the California workers’ compensation laws underwent two major reforms. The first came with SB 899 in 2004; later, as Chairwoman, she presided over the first judicial body to review cases that fell under SB 863’s landmark 2013 reforms.

“Ronnie Caplane managed WCAB through significant legislative changes, and has made valuable contributions to improving the workers’ compensation system,” said DIR Director Christine Baker.

Commissioner Caplane was admitted to the State Bar in 1975 after graduating from the University of Wisconsin, Madison and UC Hastings College of Law. She was an associate attorney for Lewis, Rouda and Lewis from 1976 to 1978 and then a trial attorney for the U.S. Department of Justice’s Civil Division from 1979 to 1982. Caplane was also a partner with Bruyneel and Caplane from 1983 to 1985, and a freelance writer and columnist for East Bay area publications the Piedmonter and the Montclarion from 1992 to 2006. She has published essays in newspapers throughout the country including the San Francisco Chronicle, the Cleveland Plain Dealer, the Chicago Tribune, the Detroit Free Press, the Recorder, Legal Times, and various Jewish publications. Her essays have also appeared in several anthologies.

She has also served as a member and President of the Piedmont School Board. Her leadership in education and work to improve the East Bay community led Assemblywoman Wilma Chan to name her Woman of the Year in 2004. Her commitment to public education and to restore California to its status as a national leader led Caplane to pursue a run for the California Assembly.

In 2006, she made an unsuccessful run for a seat in the Assembly, coming in third with 12.5 percent of the vote in a five-way Democratic primary won by Assembly Member Sandré Swanson.

Commissioner Caplane suffered the tragic loss of her husband Joe Remcho – a prominent Bay Area lawyer and influential adviser to many of California’s most powerful politicians – in January 2003 as a result of a helicopter crash in the Sacramento-San Joaquin River Delta while he was the solo pilot of the craft. At the time of his death he was a partner in the San Leandro law firm of Remcho, Johansen & Purcell. For two decades, the firm has represented the state Legislature in redistricting matters and other cases involving voter initiatives, term limits and campaign finance. Remcho’s clients included Gov. Gray Davis, Attorney General Lockyer, Sen. Dianne Feinstein and Mayor Willie Brown, the former state Assembly speaker. After his death she wrote a series of “grief columns” that drew an overwhelming response from readers.

Commissioner Caplane volunteered thousands of hours for a myriad of community organizations including Oakland’s Temple Sinai, HEROS, the Henry Robinson Center and the Piedmont schools. She created a minority law school scholarship through the Bar Association of San Francisco in her husband’s honor.

Following retirement, she will be joining Zenith Insurance Company as a Vice President.

A Napa doctor has agreed this month to pay the U.S. government $400,000 to settle allegations that he filed false claims for Medicare reimbursement,. The agreement with Ali Vaziri, M.D., a gastroenterologist, settles the civil allegations but it provides that , while agreeing to pay the $400,000, Vaziri does not admit to any liability. Vaziri is a board-certified gastroenterologist with a practice called the “Center For Digestive & Liver” in Napa.

Federal attorneys said that between 2007 and 2011, Vaziri billed Medicare for patient office visits that were longer and included more services than the consultations he actually provided. He was also alleged to have billed separately for office visits that were required to be billed together with colonoscopies.

Vaziri, a 1990 graduate of the Tufts University School of Medicine, has faced a number of legal challenges in recent years.

In June 2015, the Medical Board of California placed Vaziri on seven years’ probation and prohibited him from supervising physician assistants because of a criminal conviction for tax fraud.

In June 2014, Vaziri was sentenced to a year and a day in federal prison for tax fraud after cheating the IRS of more than $116,700, according to federal prosecutors. Vaziri, who was indicted in 2012, served his sentence at a federal facility in Lompoc, said his attorney, Malcolm Segal of Sacramento, in a 2015 interview.

The physician was sentenced under a plea agreement reached in early 2014, when he agreed to plead guilty to four counts of filing false income tax returns between 2005 and 2008. The charges were filed in connection with income and expenses from his medical practice. In 2005, Vaziri falsely inflated his business expenses, causing the IRS to lose $14,535 in taxes and then repeated the fraud for the next three years, underpaying $60,620 in 2006, $27,476 in 2007 and $14,072 in 2008, according to U.S. Attorney Melinda Haag.

In exchange for his guilty plea, entered in the U.S. District Court for the Northern District of California, federal officials dropped health care fraud allegations.

Vaziri attracted the attention of federal officials beginning in June 2009 when he was suspected of overbilling and falsely billing Medicare, according to a sentencing memorandum filed by prosecutors. As the investigation progressed, federal investigators delved into potential income tax fraud. In June, 2012 he was was charged by a federal grand jury in San Francisco with nine counts of health care fraud and six counts of filing a false federal income tax return.

“Dr. Vaziri will be fully permitted to practice medicine. Any restrictions will not impede his ability to practice,” said Segal according to the 2015 report in the Napa Valley Register.