Tag: 2025 News

For those of us who handle workers’ compensation claims involving knee injuries, there’s a new medical technology we need to know about – because it’s going to start showing up in our cases if it hasn’t already.

It’s called the “smart knee” implant, and the leading device right now is the Zimmer Biomet Persona IQ – the first and currently only FDA-approved knee replacement with built-in sensor technology. From the outside, it looks and functions like any standard total knee replacement. But embedded inside the tibial stem is a tiny wireless sensor that continuously tracks the patient’s recovery in real time.

The implant measures range of motion, step count, walking speed, stride length, and pressure distribution across the joint. That data is wirelessly transmitted to a small base station plugged into the patient’s home Wi-Fi, and from there it uploads to a secure, HIPAA-compliant cloud platform. The treating surgeon can log in and review the data remotely. The patient can see their own progress through a smartphone app, and even compare their recovery metrics against national benchmarks for patients of the same age and stage of recovery.

This isn’t experimental. It’s being used right now at major orthopedic centers across the country, including Mayo Clinic, the Hospital for Special Surgery in New York, UChicago Medicine, and Lee Health in Florida. And adoption is expanding rapidly into smaller community hospitals and ambulatory surgery centers. As recently as June 2025, UP Health System in Michigan’s Upper Peninsula began offering the device for the first time.

So why should workers’ comp practitioners care? Several reasons.

First, this technology replaces subjective recovery assessments with objective data. Historically, post-operative knee recovery has been tracked through periodic office visits and patient self-reports – the surgeon asks patients how they feel, watches them walk across the room, and measures their range of motion with a goniometer. One Mayo Clinic surgeon described the traditional approach as “very, very subjective.”

The smart knee changes that equation entirely. Now the surgeon has daily biomechanical data showing exactly how the knee is performing between visits. For attorneys and adjusters, this means disputes about whether a claimant has reached maximum medical improvement, whether recovery is progressing on schedule, or whether functional limitations are consistent with the objective findings could increasingly be resolved by implant data rather than dueling medical opinions.

Second, the technology enables earlier intervention when recovery stalls. Orthopedic surgeons at UChicago Medicine have emphasized that the first three months after knee replacement are critical – if patients don’t regain adequate strength and range of motion during that window, those losses can be very difficult to make up later. With the smart implant, a surgeon who sees a sudden drop in step count or a plateau in range of motion can reach out to the patient immediately and adjust the rehabilitation plan. That kind of early intervention could shorten disability durations and reduce overall claim costs.

Third, smart implants reduce the need for frequent in-person follow-up visits. The remote monitoring capability means patients who live far from their treating surgeon may not need to travel as often for routine post-operative checks – a meaningful consideration in workers’ comp, where mileage reimbursement, time off work for medical appointments, and delays in scheduling all add friction and cost to the system.

Fourth, consider the long-term implications. The sensor battery is designed to last at least 10 years, and the device can help detect early signs of implant loosening, abnormal wear patterns, or biomechanical changes that might signal a problem before the patient even notices symptoms. Since workers’ comp carriers often remain responsible for future medical treatment related to the original injury – including revision surgery – early detection of developing problems could mean smaller, less invasive, and less expensive interventions down the road.

Finally – and perhaps most significantly for litigators – think about the evidentiary implications. These implants generate a continuous, objective record of the patient’s functional capacity. Daily step counts. Walking speed. Stride length. Range of motion trends over weeks and months. That data could become powerful evidence in disputes over functional limitations, compliance with prescribed physical therapy, and readiness to return to work. It cuts both ways: it could support a claimant who is doing everything right but still struggling, or it could undermine a claim where the reported limitations don’t match the biomechanical data.

The smart knee is not yet the standard of care for every total knee replacement — cost, patient comfort with the technology, and the need for home Wi-Fi are still limiting factors. But adoption is growing quickly, and as it does, workers’ comp professionals on both sides of the aisle will need to understand what this data means, how to obtain it, and how to use it.

This is one worth watching.

Karen Majovski is a deputy city attorney (DCA) in the Los Angeles City Attorney’s Office. The office uses a classification system – DCA-I through DCA-IV – with pay steps within each classification, all governed by memoranda of understanding (MOUs) between the City and DCA labor unions. Within each classification, DCAs automatically advance one step per year. Promotions from DCA-I to DCA-II and from DCA-II to DCA-III could be automatic under certain conditions, but promotions from DCA-III upward were never automatic and were typically granted through competitive Performance Recognition Programs (PRPs) or, more rarely, by discretionary action.

Majovski obtained her law degree in 2013 and was admitted to the State Bar in December 2013. In May 2014, with only five months of legal experience and no employment litigation background, the City hired her as a DCA-I in the Workers’ Compensation Division (WCD). She advanced through automatic pay steps over the next two years.

In November 2016, Majovski transferred to the Employment Litigation Division (ELD). At the time of the transfer, she asked Chief Assistant City Attorney Thom Peters to promote her to DCA-III, pointing to another female attorney who had been hired at that level. Peters escalated the request to Chief of Staff Leela Kapur, who declined, explaining that Majovski had come in with no experience and that her workers’ compensation background was not comparable to employment litigation. Kapur noted that both Majovski and male DCA-I George Sami were in similar positions and should be treated similarly. Majovski did not allege gender discrimination at that time.

Majovski was not provided parking at City Hall East (CHE), the ELD workplace. Under a Special Parking MOU, parking priority was given to “Upper Management” (DCA-IIIs and above), electric vehicle owners, and employees with seniority. As a DCA-I without an electric vehicle and without sufficient seniority, Majovski did not qualify. All female attorneys in ELD at that time had parking because they were DCA-IIIs. Male DCA-I George Sami was seen parking at CHE, but undisputed evidence showed he had an electric vehicle, which gave him priority. Female DCA-II Susan Rim, hired in July 2017, was also not provided parking.

In spring 2018, Majovski first complained that she and Rim were underpaid compared to others in ELD – both male and female – and requested promotions to DCA-III for both of them. In July 2018, the City promoted Rim from DCA-II to DCA-III but promoted Majovski only from DCA-I to DCA-II. Kapur explained that promoting an attorney with only about four years of practice and a year and a half of civil litigation experience from DCA-I directly to DCA-III would have been “highly irregular.” No evidence in the record identified any employee who had ever received a DCA-I to DCA-III promotion. Majovski then asked to keep her original salary anniversary date rather than resetting it to the promotion date, but Kapur denied that request as contrary to standard practice. Peters forwarded Majovski’s request to Kapur with the comment “Chutzpah,” to which Kapur responded, “Yup there is a word for it.”

In September 2018, before Majovski’s voluntary transfer from ELD to the Los Angeles World Airports Division (LAWA), Peters initially told her she would be promoted to DCA-III regardless of whether she transferred. After discussing with Kapur, Peters reversed himself and said she would be promoted only if she stayed in ELD. Chief Assistant City Attorney Jim Clark then told Majovski she would be promoted regardless of her decision. Majovski chose to transfer to LAWA in November 2018. She was not promoted at that time.

In October 2019, Majovski applied for a promotion through an office-wide PRP. Of 364 applicants (190 female, 174 male), 93 received promotions or step advancements. Female applicants were selected at a slightly higher rate (26.3%) than male applicants (24.7%). Majovski was among 271 applicants who were not selected. Kapur, whose recommendations the City Attorney always followed, testified that she did not recommend Majovski for several reasons: Majovski had received recent promotion, had relatively short tenure, her division had received a fair number of promotions, and her promotion would not necessarily have advanced the office’s goals for racial and ethnic diversity.

In January 2020, a DCA-III in LAWA resigned, and Majovski took over most of her duties. In March 2020, the COVID-19 pandemic triggered a hiring and promotion freeze. LAWA’s CFO, Tatiana Starostina, determined that LAWA would not fund the vacant DCA-III position because of the freeze. In September 2020, Majovski again requested the promotion, but Kapur declined to seek an exception to the freeze, explaining that the office’s limited exceptions were prioritized for new hires rather than promotions. Majovski then emailed her supervisors stating she believed the front office was intentionally declining to adjust her pay for “personal, retaliatory, and gender related reasons.” An HR investigation found no evidence supporting her complaint.

In March 2021, Majovski filed suit against the City, alleging gender discrimination, associational discrimination, retaliation, and failure to prevent discrimination under FEHA, as well as claims under the Equal Pay Act (Lab. Code, § 1197.5) and the whistleblower protection statute (Lab. Code, § 1102.5). In August 2021, after the hiring freeze was lifted, the City granted Majovski a discretionary step advancement to bring her into pay parity with a similarly experienced individual being brought into the office (whose gender was not identified in the record). In June 2022, through a second PRP, Majovski was promoted to DCA-III.

Between 2016 and 2022, the City’s statistical evidence showed that of 240 discretionary promotions, 52.5% went to women and 47.5% to men. For promotions specifically from DCA-II to DCA-III, 55.5% went to women. The City moved for summary judgment. The trial court sustained 31 of the City’s 55 evidentiary objections, including an objection to an undated draft gender equity report by the former City Controller. After a hearing, the court granted summary judgment in favor of the City on all claims.

The Court of Appeal affirmed the summary judgment in its entirety in the  unpublished case Majovski v. City of Los Angeles, No. B335739 (February 2026).

The court held that Majovski forfeited her challenge to the trial court’s evidentiary rulings by raising it for the first time in her reply brief without adequate citations or argument, relying on High Sierra Rural Alliance v. County of Plumas (2018) 29 Cal.App.5th 102, 111, fn. 2, and Lee v. Kim (2019) 41 Cal.App.5th 705, 721. This meant that key evidence, including the former City Controller’s draft gender equity report, was properly excluded from consideration.

The court applied the framework from Hall v. County of Los Angeles (2007) 148 Cal.App.4th 318, 324–325, which requires a plaintiff to show she was paid less than a male comparator for substantially similar work. Majovski failed to identify any proper male comparator with less experience who was promoted or classified higher. The court found that George Sami’s parking at CHE was explained by his electric vehicle priority under the Special Parking MOU, not gender. The court also found that the City’s 2021 discretionary step advancement did not constitute an admission of gender-based pay disparity, as there was no evidence the individual with whom Majovski was brought into parity was male. Three comparators raised for the first time in the reply brief were rejected as forfeited and, in any event, insufficient – one was female, and the other two had demonstrably more experience.

With regard to her FEHA discrimination claims the court applied the three-stage burden-shifting framework from McDonnell Douglas Corp. v. Green (1973) 411 U.S. 792, as applied in California under Guz v.  Bechtel National, Inc.(2000) 24 Cal.4th 317, 334, and Arnold v. Dignity Health (2020) 53 Cal.App.5th 412, 424–425. The City met its second-stage burden by producing evidence that Majovski’s level of experience explained the promotion decisions, and that women received discretionary promotions at equal or higher rates than men. Majovski failed to meet her third-stage burden to show pretext.

Because all underlying discrimination and retaliation claims failed, the derivative failure-to-prevent claim under Government Code section 12940, subdivision (k) necessarily failed as well, consistent with Department of Fair Employment & Housing v. M&N Financing Corp. (2021) 69 Cal.App.5th 434, 444.

The Postal Service added a new section (DMM 608.11) to the Domestic Mail Manual that formally defines the postmark for the first time in a regulation and explains what information it does and doesn’t convey. It took effect December 24, 2025.

A postmark confirms USPS had possession of a mailpiece on the stamped date, but the postmark date does not necessarily match the date USPS first received the mailpiece. Most postmarks are applied by automated machines at processing facilities, and the date reflects when the mail was processed at that facility – not when it was initially deposited. This discrepancy has grown more common under USPS’s Regional Transportation Optimization (RTO) initiative, which adds flexibility between collection and processing schedules.

This is a significant practical problem with perhaps significant legal consequences, even though USPS insists the rule is “just clarification.” For example Internal Revenue Code § 7502, also known as the “mailbox rule.” IRC § 7502 says that if a tax return or payment arrives at the IRS after the deadline, it’s still considered timely if the USPS postmark date is on or before the due date. Courts interpret this strictly – the postmark date controls, regardless of when the taxpayer actually deposited the document.

The problem is that § 7502 and its regulations never actually defined “postmark.” As a result, the USPS’s new DMM 608.11 effectively supplies the operative definition for § 7502 purposes. And that definition now makes clear that a machine-applied postmark reflects the date of first automated processing at a regional facility – not when you dropped it in the mailbox or handed it to a postal carrier. Tax professionals have been calling for the IRS to address this, but nothing had been issued as of the most recent reporting.

And it’s just now getting attention from employment and benefits lawyers. Here’s how the new postmark rule ripples into employer notice obligations. Under federal laws like ERISA, COBRA, HIPAA, and the ACA, employers are required to send a variety of notices to employees concerning health insurance coverage, retirement benefits, and other employee benefits.

Some key examples of these deadlines:

– – General COBRA notices must be sent to new plan participants within 90 days of health coverage starting. COBRA election notices must be sent within 14 days after an employer notifies the plan administrator about a qualifying event, such as a layoff, discharge, divorce, or reduction in hours.
– – Health plans must send HIPAA notices of privacy practices to enrollees within 60 days of any substantial change.
– – HIPAA-covered entities must notify affected individuals without unreasonable delay, or no later than 60 calendar days after discovering a security breach.
– – Other ERISA-required communications include summary plan descriptions (SPDs), summaries of benefits and coverage (SBCs), formulary notices, and annual disclosures – all with their own timing requirements.
– – COBRA regulations specifically say that the initial notice, election notice, and notice of unavailability are considered “provided” on the date they are postmarked. So if the postmark date is delayed by a day or two at a regional processing center, a notice that was mailed on time could be deemed late

Some options to avoid this problem include requesting a free manual (local) postmark at any Post Office retail counter. This stamp will align with the date the customer hands over the mail. Registered Mail and Certified Mail also provide mailing receipts.

The Postal Service claims this rule does not change any actual postmarking operations or procedures. USPS says it’s purely an educational/transparency measure codifying longstanding practices. The era of dropping a deadline-sensitive document in a blue mailbox on the last day and trusting the postmark is effectively over. It would be wise for employers to take affirmative steps to secure proof of the actual mailing date.

A federal jury convicted a Texas laboratory owner and former NFL player for his role in a $328 million cardiovascular genetic testing fraud scheme.

According to court documents and evidence presented at trial, Keith J. Gray, 39, of McKinney, Texas, orchestrated a scheme to bill Medicare for medically unnecessary genetic tests designed to evaluate the risk of various cardiovascular diseases and conditions. Gray, the owner and operator of two clinical laboratories, Axis Professional Labs LLC, and Kingdom Health Laboratory LLC, offered and paid kickbacks to marketers in exchange for their referral of Medicare beneficiaries’ DNA samples, personally identifiable information (including Medicare numbers) and signed test orders from medical providers authorizing the medically unnecessary genetic tests.

As part of the scheme, the marketers engaged other companies to solicit Medicare beneficiaries through telemarketing and to engage in “doctor chase,” to obtain the identity of beneficiaries’ primary care physicians and pressure them into approving genetic testing orders for patients who purportedly had already been “qualified” for the testing during telephone calls conducted by non-medical personnel at one of the companies retained by the marketers – not by their physicians.

In an effort to conceal the kickback payments, Gray used sham contracts and invoices that purported to charge for “marketing” hours but that in reality were reverse-engineered to match the amounts agreed to under the illegal per-sample kickback arrangement. Gray also sought to conceal the scheme by referring to the payments as being for “software” and loans that never existed. Evidence at trial included text messages between Gray and his co-conspirator becoming giddy over the amount of money they were making from Medicare.

Axis and Kingdom billed Medicare approximately $328 million for the false, fraudulent and kickback-tainted genetic testing claims, of which Medicare paid approximately $54 million. Gray laundered some of the proceeds by purchasing expensive luxury vehicles, including a Dodge Ram truck worth more than $142,000 and a Mercedes Benz SUV worth more than $145,000.

The jury convicted Gray of conspiracy to defraud the United States and to pay and receive health care kickbacks, five counts of violating the Anti-Kickback Statute and three counts of money laundering. He is scheduled to be sentenced at a later date. Gray faces a maximum penalty of 10 years in prison on each count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

The FBI, HHS-OIG, MFCU and VA-OIG investigated the case.Trial Attorneys Ethan Womble and Adam Tisdall of the Criminal Division’s Fraud Section are prosecuting the case.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of eight strike forces operating in federal districts across the country, has charged more than 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes.

The City of San Diego leased several floors of a downtown high-rise office building in 2017 where it stationed many employees. The City knew the building contained asbestos. That July, the building owner began a window renovation project that would involve the removal of approximately 40 tons of asbestos-containing materials. The City notified employees by email about the project, explained that air quality would be monitored daily, and designated Karen Johnson, a manager in its Real Estate Asset Department, as the liaison between employees and the building owner and renovation contractors.

Within days, employees began expressing concerns. Over the following months, they reported to Johnson and other City officials that they were experiencing respiratory problems. Employees also reported that renovation workers were wearing protective masks, that plastic barriers meant to contain dust and debris were failing, and that a ventilator for a sealed asbestos-containing area was blowing exhaust into the employee parking structure. Johnson relayed these complaints to the building owner, the contractors, and Ronald Villa, the City’s deputy chief operating officer. Despite the ongoing complaints, the City decided not to relocate employees because it had no legal grounds to break its lease and no alternative space available.

That changed on January 25, 2018, when the San Diego County Air Pollution Control District received a complaint and took samples from multiple floors of the building. The samples tested positive for asbestos the following day. On January 26, the City notified its employees of the results and instructed them to stay out of the building. Over the next several weeks, the District confirmed widespread asbestos contamination throughout the building and found that air samples collected between February 1 and 5 contained asbestos fibers exceeding permissible levels.

On March 2, 2018, City officials held a meeting with affected employees. Villa told them the asbestos found on January 25 was not airborne and that prior air testing had shown levels within EPA tolerances. George Katsikaris of the City’s Environmental Services Department similarly told employees that air samples collected before the evacuation were within safe, breathable levels and that dust samples had come back clean. A toxicologist told employees they should not worry about adverse health effects. Nevertheless, Villa acknowledged employees’ concerns and encouraged anyone worried about cancer to take whatever steps they needed, and a workers’ compensation manager explained how to file claims.

Alina Cadena and other City employees who had worked in the building during the renovations sued the City and Villa in his official capacity. They alleged the City intentionally exposed them to asbestos and concealed the extent of the exposure because it determined their health and safety were not worth the cost of breaking the lease. They asserted causes of action for intentional infliction of emotional distress and fraudulent concealment, sought compensatory damages, costs, and attorney fees, and sought punitive damages against Villa.

The City moved for summary judgment, arguing that workers’ compensation was the employees’ exclusive remedy under Labor Code section 3602, subdivision (a), and that the employees could not establish the fraudulent concealment exception to that exclusivity rule under subdivision (b)(2). The City alternatively sought summary adjudication of the emotional distress claim and the punitive damages claim against Villa. In support, the City submitted declarations from Johnson and Villa stating they had no knowledge of loose or uncontrolled asbestos before January 26, 2018, and that the renovation project manager had regularly reported air samples at normal background levels. The City also submitted deposition testimony, including from employees themselves, who admitted they had no evidence the City knew of loose asbestos debris before that date.

The court granted summary judgment, finding the fraudulent concealment exception did not apply and workers’ compensation was the exclusive remedy. The Court of Appeal affirmed the judgment in its entirety, reviewing the summary judgment de novo in the unpublished case of Cadena v. City of San Diego, – D084784 (February, 2026).

The court explained that under the workers’ compensation exclusivity rule, when an employee suffers an injury arising out of and in the course of employment, workers’ compensation is the sole and exclusive remedy against the employer. (Charles J. Vacanti, M.D., Inc. v. State Comp. Ins. Fund (2001) 24 Cal.4th 800, 812–813.) The fraudulent concealment exception in Labor Code section 3602, subdivision (b)(2), requires the employee to prove three elements: the employer knew of the employee’s work-related injury, the employer concealed that knowledge, and the concealment aggravated the injury.

The court found the employees failed to raise a triable issue on the first element – actual prior knowledge of their injuries. Citing Ashdown v. Ameron Internat. Corp. (2000) 83 Cal.App.4th 868, 880, and Hughes Aircraft Co. v. Superior Court (1996) 44 Cal.App.4th 1790, 1797,  the court emphasized that constructive or imputed knowledge is insufficient; only actual knowledge will do. The City’s evidence showed it did not know about loose asbestos debris until January 26, 2018, the same day it notified employees. The employees themselves admitted they had no evidence the City knew earlier. Moreover, since employees had the same information the City did, the fraudulent concealment exception did not apply, because the exception requires the employer to have known of the injury before the employee.

The employees argued their emotional distress claim should proceed to trial because the City’s conduct in knowingly exposing them to a known carcinogen was not a normal part of the employment relationship. The court disagreed, surveying a line of California Supreme Court decisions holding that workers’ compensation is the exclusive remedy for intentional infliction of emotional distress claims against employers.
The court further relied on Johns-Manville Products Corp. v. Superior Court (1980) 27 Cal.3d 465, 474–475, where the California Supreme Court held that even if an employer knowingly concealed asbestos dangers from employees, workers’ compensation was the only remedy.