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Tag: 2025 News

Top Court Says Maritime Law Overrides WC Exclusive Remedy

Brian Ranger was a maintenance worker for the Alamitos Bay Yacht Club. As part of his duties, he painted, cleaned, maintained, and repaired the Club’s fleet of vessels. He also was tasked with hoisting the Club’s vessels in and out of navigable waters and mooring them.

On August 28, 2018, Ranger was assigned to lower a vessel into navigable waters using “a hoist, boom and hook, and thereafter to moor the vessel in navigable waters.” Once the vessel had been lowered into the water, Ranger boarded to unlock the vessel from the boom and moor it to the dock. Ranger alleges that he was required to board “directly onto an uneven, slippery and sloped surface at the bow of the vessel without adequate means of maintaining balance and stability,” causing him to slip and fall, “proximately causing him to sustain serious injuries and damages.”

Ranger applied for state workers’ compensation and then sued the Club in superior court. Ranger’s second amended complaint asserted two claims under general maritime law, which is “a species of judge-made federal common law.”

The first cause of action asserted that the Club negligently failed to provide Ranger with adequate training, policies and procedures for safe docking and boarding, and safe access to the vessel. The second cause of action asserted that the Club caused the vessel to be “unseaworthy, dangerous, unsafe and hazardous to employees . . . who were required to board said vessel.”

The trial court sustained the Club’s demurrer without leave to amend on the ground Ranger had failed to allege facts to implicate federal admiralty jurisdiction. In 2023 The Court of Appeal affirmed in the published case of Ranger v. Alamitos Bay Yacht Club (2023) 95 Cal.App.5th 240, 242.

The California Supreme Court reversed in its 2025 opinion in Ranger v. Alamitos Bay Yacht Club -S282264 (February 2025)

The Club argues that Ranger is barred from asserting these federal common law claims because he does not qualify as a statutory “employee” within the meaning of the Longshore and Harbor Workers’ Compensation Act (LHWCA; 33 U.S.C. § 901 et seq.). The LHWCA, as amended in 1984, excludes from the federal workers’ compensation scheme individuals who (like Ranger) are employed by “a club” and “are subject to coverage under a State workers’ compensation law.” (33 U.S.C. § 902(3)(B).)

The Court of Appeal agreed with the Club and affirmed the order sustaining the Club’s demurrer to Ranger’s complaint without leave to amend. The California Supreme Court reversed, and concluded the Court of Appeal erred.

The 1984 amendments to the LHWCA specify which workers’ compensation scheme – federal or state – applies, but they did not themselves purport to abrogate available general maritime remedies for those outside the LHWCA’s scope. Nor, under the supremacy clause of the federal Constitution, may the exclusive-remedy provision in California’s workers’ compensation scheme be applied to deprive a plaintiff of a substantive federal maritime right.

The exclusive-remedy provision in California’s workers’ compensation law would conflict with the established maritime claim for negligence, a tort that maritime law has recognized. Numerous federal courts have held that state workers’ compensation exclusive-remedy provisions cannot preclude a worker’s general maritime claims for relief.

Scholarly commentary, too, supports the conclusion that general maritime law trumps state workers’ compensation exclusivity provisions. (See Sturley et al., Recent Developments in Admiralty and Maritime Law at the National Level and in the Fifth and Eleventh Circuits (Summer 2024) 48 Tul. Mar. L.J. 329, 336-337.”

“Whether Ranger’s general maritime claims might be barred under other provisions of the LHWCA – and whether Ranger’s claims properly invoked admiralty jurisdiction in the first place – are issues the Court of Appeal has not yet addressed.”

DWC Provides New Update on Virtual Courtroom Transition

The Division of Workers’ Compensation (DWC) announced details on how it continues to work toward its transition to the CourtCall Video Platform, starting on March 3, 2025. All mandatory settlement conferences, status conferences, lien conferences and priority conferences will be moved to the platform.

DWC has launched a webpage that provides a list of links for all judges’ virtual courtrooms, as well as a training video and written guides on using the platform. The courtroom links may also be found on DWC’s home page. Although links to the virtual courtrooms are provided in the DWC hearing notices, these virtual courtrooms were not activated until March 3, 2025.

If you have a hearing notice that does not have a link for a virtual courtroom and the hearing is set for March 3, 2025 or later, please go to the DWC website prior to the hearing and use the link assigned to the DWC workers’ compensation judge to access the virtual courtroom. Participants may also use the judge’s call-in number provided on the website associated with the virtual courtroom. DWC recommends that parties use the link to the virtual courtroom for better access to the platform.

To assist the workers’ compensation community with this transition all district offices will have public wi-fi available in DWC courtrooms.  

California Continues to Limit the SCOTUS Viking River Case

Packers Sanitation Services Ltd., LLC is a food safety solutions company that employed Jose A. Parra Rodriguez (Parra) in California from April 2019 to July 2021.

In February 2022, Parra – acting “in a Representative Capacity only” – filed a complaint against Packers for civil penalties under PAGA based on violations of the Labor Code and California Code of Regulations, including provisions dealing with overtime and meal and rest period requirements. Parra alleged Packers committed these violations against Parra “and all other aggrieved employees.”

In March 2022, Packers moved to compel arbitration based on an agreement Parra assertedly signed shortly after he was hired. Packers filed its motion before the United States Supreme Court decided  Viking River Cruises, Inc. v. Moriana(2022) 596 U.S. 639 (Viking River).

Apparently anticipating that Viking River would require wholesale enforcement of contractual waivers of the right to assert representative claims, Packers argued the action had to be dismissed because it was a “PAGA claim[ ]” and in the arbitration agreement Parra had waived his right to assert “representative claims, including under PAGA.” As an alternative to dismissal, Packers asked the trial court to stay the action pending a decision in Viking River.

The trial court held an evidentiary hearing during which the parties presented conflicting evidence on the genuineness of the electronic signature on the arbitration agreement. The trial court denied the motion. Although it found Parra electronically signed the agreement, it interpreted “current law” to mean the law as it stood in 2019, when the parties entered the agreement.

The Court of Appeal affirmed in the published case of Rodriguez v. Packers Sanitation Services -D083400 (February 2025).

Packers contends on appeal that the trial court erred because it incorrectly equated “current law” with Iskanian’s rule (Iskanian v. CLS Transportation Los Angeles, LLC (2014) 59 Cal.4th 348) against splitting PAGA claims into their individual and non-individual components.

It argues that Viking River held the Iskanian anti-splitting rule was preempted by the FAA, and preemption holdings are retroactive. In Packers’ view, Viking River simply announced how the FAA has always operated, such that its holding should be considered “current law” in 2019, when the parties entered their agreement. Packers argues that the arbitration agreement therefore requires arbitration of Parra’s individual PAGA claim.

Parra responds that Packers’ interpretation of “current law” is incorrect because the phrase is ambiguous and the ambiguity should be construed against the drafter (i.e. Packers). He also contends Packers’ characterization of his complaint is incorrect.

The Court of Appeal wrote that “An individual PAGA claim is the component of a PAGA claim that seeks civil penalties based on Labor Code violations sustained by the plaintiff. (Adolph v. Uber Technologies, Inc. (2023) 14 Cal.5th 1104, 1119 (Adolph); Gregg v. Uber Technologies, Inc. (2023) 89 Cal.App.5th 786, 792.) A non-individual PAGA claim is the component of a PAGA claim that seeks civil penalties based on Labor Code violations sustained by current and former employees other than the plaintiff. (Adolph, at p. 1119; Gregg, at p. 792.)”

In a part of the Viking River decision that has been characterized as “dicta” the Supreme Court stated that when an individual PAGA claim is compelled to arbitration, the non-individual PAGA claims that remain should be dismissed for lack of statutory standing. In Adolph, the California Supreme Court, which has the last word on interpretation of state law standing, disagreed. The Adolph court held that an employee who has been compelled to arbitrate individual PAGA claims maintains statutory standing to pursue non-individual PAGA claims in court.

Balderas v. Fresh Start Harvesting, Inc. (2024) 101 Cal.App.5th 533, 536 (Balderas) took the implications of Adolph a step further. It explained that under Adolph, there are only two standing requirements, and an individual action seeking PAGA relief is not a standing requirement. And after reviewing Parra’s complaint, the Court of Appeal found that “aspects of the complaint are consistent with Parra’s position that he has not asserted an individual PAGA claim.”

The Court of Appeal affirmed the order on the ground that Parra is not asserting individual PAGA claims in this case, and the trial court therefore could not have erred by failing to compel such claims to arbitration.

Providers Say 70% of Healthcare U.R Denials are Overturned

Group Purchasing Organization (GPO) Premier Inc,.conducted a voluntary, national survey of member hospitals and health systems from August 8, 2024 to February 4, 2025. Respondents represented 280 hospitals across 23 states, accounting for over 48,000 acute care beds. Respondents were asked to consider all claims from January 1, 2023 to December 31, 2023, the last full year of completed payment data. Findings are presented as averages, weighted by acute bed capacity of the respondent. Respondents ranged in size from single-facility hospitals to large, multi-state health systems.

An analysis of the survey data by Premier shows that claims adjudication costs healthcare providers more than $25.7 billion, according to a new national survey of hospitals, health systems and post-acute care providers conducted by Premier, Inc. This figure represents a 23 percent increase over the $19.7 billion in costs reported in the previous year.

Claims move into the adjudication process after payers issue an initial denial on the submission. While denial rates remained consistent at nearly 15 percent, according to survey data, they ranged as high as 49 percent in certain instances.

In addition, the administrative costs associated with fighting them increased dramatically – from $43.84 per claim in 2022 to $57.23 in 2023. Additional costs primarily resulted from added labor, responsible for 90 percent of claims processing expenses incurred by providers.

Health insurers process about three billion medical claims annually, and approximately 70 percent of denials are overturned and paid. This means that nearly $18 billion was potentially wasted arguing over claims that should have been paid at the time of submission (see Methodology section for more detail).

This continued burden has a tremendous impact on providers’ financial viability. Over the past year, the average number of days of cash on hand for hospitals and health systems overall dropped to 196.8 days, the lowest level in a decade. When providers lack cash on hand, they are unable to re-invest in patient care and may also suffer from downgrades in bond ratings, making cash more expensive and harder to obtain.

In addition, the cost of adjudicating claims reported by Premier’s research does not include those incurred by payers, which average $40 to $50 per submission. Similar to providers, these costs contributed to a 7 percent (or $4 billion) increase in net administrative costs in 2023 across the insurance sector. The added administrative costs match premium increases in 2023, which also grew by 7 percent. Cutting these administrative costs from the healthcare landscape could potentially reduce premium increases faced by consumers.

Payers required prior authorization on a higher percentage of claims in 2023 (more than 20 percent vs. to 17 percent in 2022). However, in certain areas, the increase was more pronounced. In Medicare Advantage (MA), for instance, 30.5 percent of claims required prior authorization in 2023 compared to 25 percent in 2022.

Despite prior authorization becoming more pervasive, the number of denials for these claims after receiving prior authorization increased across the board, often doubling or tripling the rate reported in 2022. An average of 10.4 percent of claims denied included those that were pre-approved via the prior authorization process – up from 3.2 percent in 2022.

Healthcare lacks a unified system for claims submissions, making the process of filing for reimbursement notoriously complicated. Each claim requires multiple data elements to comply, which frequently change. At the same time, each payer has its own unique rules regarding covered services, coding requirements and necessary documentation, making it difficult for providers to navigate. These inconsistencies create room for error, requiring providers to allocate more time to compliance tasks – particularly in a world where patient volumes (and the number of claims) are on the rise.

Claims submission also remains a largely manual process. This further exacerbates the problem, particularly as providers grapple with widespread staffing shortages. In fact, in a recent survey of 200 providers, every respondent indicated that staffing shortages are having a significant, negative impact on their ability to submit accurate claims for payment. Furthermore, 83 percent said staff shortages impede their ability to follow up on late payments or offer assistance to patients struggling to get services covered by insurance.

The lengthy process to adjudicate claims adds insult to injury. Even a small error can flag a claim for denial. Premier survey respondents reported that once denied, they went through an average of three rounds of reviews with insurers, with each review cycle taking between 45 and 60 days.

According to leading insurers, minor clerical and/or data errors are the top reason to deny claims approved via prior authorization. Small mistakes include misspelled names, missing information, documentation and coding mistakes, and inverted numbers (i.e., social security numbers, dates of birth and other vital information). These denials are particularly frustrating, since they should be largely avoidable.

Insurance Commissioner Sets Moratorium on Policy Non-Renewals

The California Insurance Commissioner has expanded emergency insurance protections for Southern California homeowners affected by recent wildfires to include those impacted by the Hughes Fire. The Commissioner’s latest Bulletin includes ZIP Codes for those residents near the Hughes Fire who are now covered under the mandatory one-year moratorium on insurance non-renewals and cancellations, ensuring more wildfire survivors have continued access to coverage.

This moratorium order shields those within the perimeters or adjoining ZIP Codes of the Hughes Fire in Los Angeles County for one year from the Governor’s Executive Order N-14-25 on January 27, 2025. This is in addition to the Commissioner’s moratorium orders in January which protect residents in and adjacent to ZIP Codes of the Palisades, Eaton, Hurst, Lidia, Sunset, and Woodley fires in Los Angeles County, regardless of whether they suffered direct property loss.

With ongoing recovery efforts across the region, the Commissioner said he remains committed to issuing additional supplemental bulletins as necessary to cover more areas in Los Angeles and Ventura counties impacted by wildfires.

Residents can go to the Department of Insurance website to see if their ZIP Code is included in the mandatory moratorium. Consumers should contact the Department of Insurance at 800-927-4357 at insurance.ca.gov if they believe their insurance company is in violation of this law, or have additional claims-related questions.

In addition, given the overwhelming support by local elected leaders and consumers for the residential moratorium law that Commissioner Lara has implemented since 2019 to protect millions of homeowners across the state, Commissioner Lara is sponsoring the Business Insurance Protection Act (SB 547) this year jointly authored by Senator Sasha Renée Pérez and Senator Susan Rubio to expand this law to include commercial policies. This measure will cover businesses, homeowners’ and condominiums associations, affordable housing units and residential developments, and non-profits, among other essential businesses.

Since these wildfires started, the Insurance Commissioner claims to have taken multiple actions to speed recovery and prevent fraud including:

– – Increasing insurance coverage in high-risk areas: Commissioner Lara, as part of his Sustainable Insurance Strategy, issued his Net Cost of Reinsurance in Ratemaking Regulation and Catastrophic Modeling in Ratemaking Regulation which require insurance companies — for the first time — to increase coverage in high-risk areas, ensuring more options for Californians while limiting the costs passed on to consumers. These regulations work hand-in-hand with other reforms that Commissioner Lara has spearheaded that will have the effect of maintaining and increasing insurance coverage options for Californians across the state. Under the regulations, insurance companies using reinsurance costs and/or catastrophic modeling must increase coverage in wildfire-prone regions.
– – Pause on non-renewing and cancelling policies: Commissioner Lara issued a Notice calling on all insurance companies to stop any pending non-renewals or cancellations for any properties located near wildfires, if they are not already protected by the mandatory moratorium. This includes non-renewals issued up to 90 days prior to January 7, but taking effect after the start of the wildfires. This pause on non-renewing and cancelling policies would last six months as impacted communities begin the recovery process. In addition, Commissioner Lara called on insurers to offer beyond the 60-day grace period under existing law for policyholders in the immediate affected wildfire areas, to pay their home insurance premiums given the challenges that many policyholders in these areas are having right now.
– – Insurance support workshops: Commissioner Lara announced two more insurance support workshops on March 8 in Los Angeles and March 15 in Pasadena to help survivors understand their insurance policies and the claims process, while also providing information about available resources for rebuilding and recovery. These workshops are open to all those impacted by the recent wildfires. Call 800-927-4357 to schedule a one-on-one appointment with a Department of Insurance expert.
– – Protecting Access to Medically Necessary Health Care and Medication: Commissioner Lara issued a Notice directing companies to submit emergency plans detailing how they will ensure continued access to medically necessary health care services, including prescription drugs, for the duration of the declared State of Emergency due to the Palisades, Eaton, and other fires.
– – Cracking Down on Fraud: Commissioner Lara sent the Department’s enforcement team to safeguard Angelenos from fraudsters who are targeting wildfire survivors and issued a warning against illegal activities including soliciting by public adjusters for seven days after evacuation orders end.
– – Alerting Residents to Evacuation Benefits: Many consumers are unaware that they may have coverage under their homeowners’ and renters’ insurance policies to help them with evacuation and recovery expenses. Commissioner Lara reminded residents in Los Angeles County who have been ordered to evacuate due to the wildfires that their homeowners’ or renters’ insurance may help with evacuation and relocation costs under Additional Living Expenses coverage, known as ALE. ALE coverage typically includes food and housing costs, furniture rental, relocation and storage, and extra transportation expenses, among other costs. Also, those with uninhabitable homes — even if there is no wildfire damage — could have coverage under ALE.
– – Ensuring no out-of-pocket insurance costs for debris removal: Commissioner Lara worked closely with local, state, and federal leaders to ensure that the program’s costs are not deducted from a policyholder’s primary insurance benefits needed to rebuild. He also issued a Consumer Alert and Notice detailing how the program will interact with insurance — a benefit available to all eligible property owners who choose to participate in the 2025 Los Angeles Wildfires Debris Removal Program.

California Judicial Council Reports on AI Task Force Progress

At its business meeting on February 21, 2025, the Judicial Council got a preview of a new model policy that will help ensure the responsible and safe use of generative AI by California courts. Courts will be able to adopt or modify the model policy as needed.

“This is a positive step in a rapidly developing area,” said Chief Justice Patricia Guerrero, who last year announced the launch of the Artificial Intelligence Task Force to evaluate generative AI for its potential benefits to courts and court users while mitigating risks to safeguard the public. “We must balance the issues you’ve identified: accountability, transparency, confidentiality, and privacy protection.”

The California Judicial Council’s Artificial Intelligence Task Force conducted a survey of courts to understand their current use of AI and their policies regarding generative AI. Here are some key findings from the survey:

– – Generative AI Usage: 19 courts are already using generative AI, and 19 more plan to start using it. Seven courts did not answer this question.
– – Policies: Six courts have a use policy in place, while 21 courts are planning to create one. Many courts are waiting for a model policy from the task force.
– – Model Policy: The task force has developed a model policy for the use of generative AI, which courts can adopt or modify to suit their needs. This policy includes guidelines for reviewing AI-generated material for accuracy, ensuring it is not biased or harmful, and disclosing if AI outputs make up a substantial portion of a work provided to the public.
– – Future Plans: The task force is working on further guidance for courts adopting their own generative AI policies and for judicial officers using AI in their adjudicative roles. They plan to develop a rule of court and a standard of judicial administration on these issues, with an anticipated effective date of September 1, 2025.

We learned what topics courts intended to cover in their use policies, but also that many were waiting for guidance from the task force and the Judicial Council before drafting their own,” said Justice Mary J. Greenwood, a member of the AI task force. “That helped us establish what the task force should be working on.”

Justice Greenwood shared that the model policy will provide courts with general guidelines for using generative AI in their daily, non-adjudicative duties, which includes direction on:

– – Reviewing generative AI material for accuracy, completeness, errors, and hallucinations
– – Ensuring AI material is not biased, offensive, or harmful
– – Disclosing if generative AI outputs make up a substantial portion of a written or visual work provided to the public

In addition to introducing the model AI policy, the task force also detailed its ongoing work. The task force plans to develop further direction for courts adopting their own generative AI policies, as well as guidance for judicial officers using AI in their adjudicative role.

The task force hopes to develop a rule of court and a standard of judicial administration on these additional issues in the coming months.

You may watch the video recording of this presentation for further details.

Employer Cannot Use Choice-of-Law Provisions to Avoid EFAA

Kristin Casey began working in 2015 as a real estate agent for D.R. Horton, a national homebuilding company. She agreed to binding arbitration of disputes with her employer. A separate clause in her agreement, titled “Governing Law,” provides in full: “The construction and interpretation of this Agreement shall at all times and in all respects be governed by the laws of the State of California.”

She was a successful agent for D.R. Horton and became one of the company’s top performers. In late 2022 she was assigned to work with Kris Hansen at a remote development site in Fairfield.

Starting on their second day working together, Hansen made a series of unwanted sexual remarks, and Casey felt unsafe and became physically nauseous when she was around Hansen. Casey ultimately went on medical leave because of the strain, and she resigned in September 2023.

Casey filed a lawsuit against D.R. Horton and Hansen. She alleged several causes of action under the Fair Employment and Housing Act based upon sexual harassment.

D.R. Horton filed a motion to compel arbitration, which was joined by Hansen. Casey opposed the motion, relying on the Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act of 2021 (9 U.S.C. §§ 401–402, EFAA or Act). The trial court granted the motion to compel, reasoning that the EFAA was inapplicable because the parties’ employment agreement specified that California law governed. Casey then filed this petition for a writ of mandate.

The Court of Appeal granted Casey’s petition and directed the trial court to vacate its order granting the motion to compel arbitration in the published case of Casey v. Superior Court -A170650 (February 2025). In doing so, it held that the EFAA preempts attempts under state law to compel arbitration of cases relating to a sexual harassment dispute, and parties cannot contract around the law by way of a choice-of-law provision.

D.R. Horton’s argument is essentially that parties who select state law in their arbitration agreements effectively opt out of the FAA and the EFAA even if their contracts involve interstate commerce.

The Federal Arbitration Act (FAA) and California’s corollary, the California Arbitration Act (Code Civ. Proc., § 12803 et seq., CAA), generally embody a liberal policy in favor of the enforcement of arbitration agreements. The statutes can work in tandem. Thus, where the FAA applies to an arbitration agreement in California, the CAA may provide the procedures to enforce such an agreement if the parties selected California law and the state procedures do not offend policies embodied in the FAA.

But the federal and state schemes differ in one key aspect that controls the resolution of this case: whereas both the FAA and CAA provide exceptions to the enforcement of arbitration agreements when grounds exist for the revocation of any contract (section 2; § 1281), the FAA, unlike the CAA, also excepts agreements “as otherwise provided in [the EFAA]”—i.e., all cases relating to a sexual harassment dispute. (Section 2.)

The EFAA, a relatively new statute enacted in 2022, provides that a “person alleging conduct constituting a sexual harassment dispute” may elect that “no predispute arbitration agreement . . . shall be valid or enforceable with respect to the case which is filed under Federal, Tribal, or State law and relates to the . . . sexual harassment dispute.” (9 U.S.C. § 402(a).).

In general, there are three situations in which state law is preempted, one of which is conflict preemption, where it is impossible to comply with both state and federal requirements, or where state law stands as an obstacle to the accomplishment and execution of the full purpose. The Court of Appeal concluded that “The EFAA’s purpose is plainly obstructed by an attempt to use state law to force a person who is alleging sexual harassment to arbitrate their dispute.”

CSLB Walnut Creek Sting Leads to 13 Unlicensed Contractors

The Contractors State License Board (CSLB) recently teamed up with the Contra Costa County District Attorney’s Office and the San Mateo Police Department in an undercover sting targeting unlicensed contractors in Walnut Creek.

On January 22 and 23, 13 individuals were cited with a Notice to Appear in criminal court after allegedly offering contracting services without a valid contractor’s license. One of these individuals was arrested on an outstanding warrant in Santa Clara County for contracting without a license.

Their bids ranged from $1,200 for a bathroom remodel to $12,000 for a painting project. Under California law, a contractor’s license is required for any construction project valued over $1,000, including labor and materials. If the project requires workers or a permit, a contractor’s license is required no matter the project cost.

The individuals could face legal consequences including administrative fines up to $15,000 and misdemeanor charges with sentences of up to six months in jail and a $5,000 criminal fine. Repeat offenders face harsher penalties, including a mandatory 90-day jail sentence and a fine of $5,000 or 20 percent of the contract price – whichever is greater.

Those caught in this sting may also face administrative or criminal charges for illegally advertising construction services without a valid license. California law requires all licensed contractors to display their license number on business materials, including advertisements, vehicles, and business cards. Unlicensed individuals may only advertise for jobs under $1,000 (including materials and labor), and they must clearly state in all advertisements that they are not licensed.

Additionally, one stop order was issued where the individual failed to provide workers’ compensation insurance for their employees. The individual had brought the worker to the sting site.

“CSLB remains committed to safeguarding homeowners from the dangers of hiring unlicensed contractors,” said CSLB Registrar David Fogt. “Educating consumers about the importance of working with licensed professionals is a top priority. We strongly encourage all California homeowners to verify a contractor’s license before beginning any construction project.”

Contra Costa District Attorney Diana Becton said: “Unlicensed contractors, or contractors who do not carry workers’ compensation insurance, put homeowners at risk of financial and safety hazards. Our office is committed to holding them accountable and ensuring that consumers are not taken advantage of.”

Supreme Court Rules IDL Pay Not Included in S&W Penalty

In August 2002, Michael Ayala was severely injured in a preplanned attack by inmates while at his job as a correctional officer at the Lancaster State Prison

He filed a workers’ compensation claim and alleged that the injury was caused by the serious and willful misconduct of his employer, California Department of Corrections and Rehabilitation (CDCR).

Labor Code section 4553 provides that ‘[t]he amount of compensation otherwise recoverable shall be increased one-half . . . where the employee is injured by reason of serious and willful misconduct” by the employer. Ayala and CDCR agreed that the injury caused Ayala 85 percent permanent disability, but they could not agree whether CDCR engaged in serious and willful misconduct.

A WJC found that CDCR did not engage in serious and willful misconduct. However, on reconsideration, the Workers’ Compensation Appeals Board (the Board) rescinded the decision and reversed, finding that CDCR had engaged in serious and willful misconduct. Over a dissent, a Board majority found that CDCR “failed to act on a credible threat of inmate violence that was specifically reported to be planned for the day of the attack and took the facility off lockdown despite this threat even though it possessed additional information . . . that this had long been planned.”

The Board’s determination established Ayala’s entitlement to an additional 50 percent of “compensation otherwise recoverable” per section 4553. Ayala and CDCR disagreed, however, about what constituted the “amount of compensation otherwise recoverable” under that section.

While he was temporarily totally disabled Ayala was paid his full salary because he was on industrial disability leave and enhanced industrial disability leave. However the WCJ found that the compensation upon which the penalty applies was what Ayala would have been paid in temporary disability. But on reconsideration, the Board again rescinded and reversed the workers’ compensation judge’s decision, this time finding that the base compensation was what Ayala was paid on industrial disability leave and enhanced industrial disability leave.

The Court of Appeal reversed in the published case of Cal. Dept. Corrections & Rehabilitation v. Workers’ Comp. App. Bd. -E079076 (August 2023).

The Court of Appeal concluded that “Compensation,” as the term is used in section 4553, includes only items provided by Division 4 of the Labor Code, but industrial disability leave is provided by the Government Code. Accordingly, the “amount of compensation otherwise recoverable” under section 4553 does not include industrial disability leave.

Ayala petitioned the California Supreme Court for review, supported by the Board as amicus curiae. The Supreme Court granted the petition. However it agreed with and affirmed the Court of Appeal in the case of Dept. of Corrections & Rehabilitation v. Workers’ Comp. Appeals Bd -S282013 (February 2024)

The question in this case is whether, for purposes of calculating the 50 percent premium under Labor Code section 4553, “compensation otherwise recoverable” includes industrial disability leave payments, a benefit that the Government Code makes available to certain public employees in lieu of workers’ compensation disability payments.

The Workers’ Compensation Appeals Board answered yes to this question. The Court of Appeal, however, disagreed, explaining that the board’s conclusion is plainly inconsistent with the statutory definition of “ ‘compensation’ ” as limited to “compensation under” the workers’ compensation law. (Lab. Code, § 3207.)

“We agree with the Court of Appeal and affirm its judgment.” The California Supreme Court went on to say “we are mindful of our obligation to give appropriate deference to the Board’s reasoned interpretations of the statute it administers. We have accordingly given careful consideration to the Board’s position that the section 4553 award should be calculated based on the IDL payments Ayala received.”

“But we cannot give effect to that position because it is contrary to the plain language of the statute. (Larkin, supra, 62 Cal.4th at p. 158.) The Board does not convincingly contend otherwise. Neither its decision in this case nor its amicus curiae submission to this court ever explains how the statutory definition of “compensation” as including only “compensation under” division 4 of the Labor Code can be stretched to cover IDL payments provided by the Government Code.”

“The Board’s position instead relies largely on … cases that did not purport to answer the question now before us, and whose holdings create no conflict with the straightforward reading of the statutory text we adopt today.”

Amity In-Home Care Cited $2.3M for Caregiver Misclassification

Amity In-Home Care Services is located in Torrance California. They provide non-medical in-home care services in the Torrance area and surrounding regions. Their services include personal hygiene, light housekeeping, mobility assistance, companionship, and general assistance in daily living activities.

The California Labor Commissioner’s Office (LCO) has cited Amity In-Home Care Services more than $2.3 million for misclassifying caregivers as independent contractors.

The LCO, which operates under the Department of Industrial Relations (DIR), issued the citations under Labor Code Section 181 as established by Assembly Bill 594, making this the first enforcement action under this new law. Previously, the civil penalties collected from employers for these violations were solely payable to the state. Now, the state can collect these amounts as damages payable to affected misclassified workers.

The LCO also uncovered additional serious violations, including failing to properly pay workers overtime wages, not providing required workers’ compensation insurance, and neglecting to give misclassified workers proper wage statements.

The violations came to light after the LCO received a referral of suspected worker misclassification from Bet Tzedek Legal Services in April 2023. In response, an inspection was conducted at Amity In-Home Care Services, which resulted in an immediate Stop Order Penalty Assessment due to the company’s failure to provide workers’ compensation insurance for its employees.

Bet Tzedek Legal Services is a nonprofit law firm based in Los Angeles, California. Their mission is to provide free legal services to those who need it most, ensuring equitable access to justice for all.

The LCO found that Amity In-Home Care Services, Inc. violated multiple labor laws, resulting in:

– – $422,033 in unpaid minimum wages*
– – $424,809 in unpaid overtime wages*
– – $165,162 in meal and rest period premiums*
– – $27,400 in wage statement penalties
– – $108,094 in waiting time penalties for delayed final wages
– – $550,000 in penalties for willful worker misclassification
– – $81,673 in penalties for no workers’ compensation insurance for the misclassified employees
– – $422,033 in liquidated damages
– – $18,950 for other civil penalties
*Includes interest payable to the misclassified employees

The total amount cited was $2,327,257, which includes interest and additional penalties, with $2,203,384 payable to the misclassified workers.

California Labor Commissioner Lilia García-Brower said: “Misclassifying workers is not a simple paperwork error. It is a deliberate violation of the law that denies employees earned wages, protections, and benefits they are legally owed and entitled to. My office is committed to holding employers accountable and ensuring all workers, especially caregivers, receive the pay they deserve.”