Category Archives: News

Life After Workers’ Compensation…

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In the 1976 film Logan’s Run, Michael York asked the machine governing a futuristic dystopia, “is there life after workers’ compensation?”  Well, it appears that there just may be.

Former Court Administrator Keven P. Star is gathering support for his bid to become a Superior Court Judge in Sacramento County (Full disclosure: Keven is an old friend of your honest and fully-disclosing blogger, and to the extent that a workers’ compensation defense blog can support a citizen’s candidacy for a superior court position, WCDefenseCA certainly does).

Aside from his work in the California workers’ compensation system, Keven Star has also served as a Major in the Army Reserves (JAG) and a Deputy District Attorney in both Santa Clara County and Sacramento County, where some of his time was spent prosecuting workers’ compensation and insurance fraud.

Keven Star’s opponent is Superior Court Judge Tami R. Bogert, who was appointed by Governor Arnold Schwarzenegger in December of 2010.

The vote is not until June 5, 2012, so an answer to Michael York’s question will have to wait until then.

DIR to Hold Public Forums

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Do you ever get frustrated with California’s workers’ compensation system?  Do you get angry with the ongoing litigation and the ever increasing attorneys’ fees?  What about the way the system turns mildly injured employees into completely system-dependent non-workers, relying on their lawyers to continue pumping unnecessary benefits out of employers and insurers?

Well, if you are frustrated by this and more, there are only so many things you can do.  One option, of a somewhat limited effect, is to start a blog and rant into the internet (you get to meet a lot of nice people that way, actually).  Another, of course, is to bend the ear of the Department of Industrial relations, and tell them: “Now see HERE!”

What’s that? You don’t think the DIR cares what you have to say?  Well, you couldn’t be more wrong – “The Department of Industrial Relations (DIR) and the Division of Workers’ Compensation (DWC) will hold a series of public meetings across the state to provide open forum discussions on the current issues in workers’ compensation and to gather information from stakeholders and members of the public on suggestions for improvements.”

So if you are in Sacramento, Los Angeles, Fresno, San Bernadino, La Mesa, or Oakland (oddly, not San Francisco), don’t miss your chance to attend one of these quasi-town hall meetings.  If your ever-busy blogger can slip away from his desk for a few hours, he will try to sit in on the one in Oakland.  Would anyone care to meet me there?

Testimony will be limited to 3 minutes per speaker, unless the speaker can make his or her testimony rhyme, in which case he or she will receive six minutes and possibly some applause.

I have been personally asked to advise my spirited and passionate readers that pitchforks, torches, huge cauldrons of heated tar, and bags of feathers will not be allowed at the hearings.  

Marguerite Sweeney Appointed to WCAB

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The world of California workers’ compensation is a buzz with news of Governor Brown’s new appointee to the Workers’ Compensation Appeals Board.  Filling one of three vacancies, Governor Brown’s website announced on St. Valentine’s Day that Marguerite Sweeney, of Redding, would be appointed to the WCAB, pending Senate confirmation.

Soon-to-be Commissioner Sweeney is an applicant’s attorney and has received words of praise from former chairman of the WCAB, the Honorable Doug Moore, who calls Sweeney a “straight shooter.”

Commissioner Sweeney, WCDefenseCA will temporarily forgo its customary cynicism to congratulate you, and to hope that your tenure will be one remembered for justice for both applicants and defendants, crushing and punishing defeat for lien claimants, and speedy access to the final resolutions so often sought and so commonly delayed by the workers’ compensation system.

Law firms, lawyers, and all other participants eagerly await to see Commissioner Sweeney in action.

EAMS to Allow e-Filing and Paper Filing

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Are you an EAMS e-filer?  Why not?  If you’re not an e-filer, you have to file everything on paper, let the Board choose a hearing date for you, and have very limited access to those documents already filed.  Until recently, though, you had one decisive advantage even if the system failed- you could still file by paper.  EAMS was an all-or-nothing system in which the entire firm had to e-file or paper file, but not both.

Well, it appears the Electronic Adjudication Management System is moving to a new stage.  Workers’ compensation attorneys, both defense and applicant, will be allowed to both e-file and paper file, as they like.  In other words, you can sign up to be an e-filer, reap the benefits of online access to filed documents and choosing your own hearing date, and yet still file by paper whenever you like, at least according to this release by the DWC.

In order to become an e-filer, parties will still be required to go through the EAMS training and register.

So, have you made the switch to EAMS?  Do you wish you could switch back out?

California is Hiring WCJs!

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Are you tired of the seemingly powerless life of a workers’ compensation defense attorney?  Do you grow weary of pitting workers’ compensation Judges against commissioners, and commissioners against Court of Appeal Judges in a desperate effort to secure some tiny sliver of justice for you client?  Perhaps it’s time you took up the gavel yourself and stemmed the flow of blood being drained from the veins of California’s employers.

No, I’m not suggesting we form some sort of vigilante workers’ compensation Board or somehow privatize the Workers’ Compensation Appeals Board (oh, if only!).  As a matter of fact, after discovering a surplus in the pension budget California is looking to hire some more judges.   But you better hurry – the deadline is, in a gentle nod to that secret spot in our hearts that is home to the more romantic things in life, February 14th.

The venues are San Jose, Marina Del Ray, and Long Beach.  Benefits include the use of two flat-screen monitors in every courtroom, the endless droning of lien claimants, the threat of removal or reconsideration at every step, and semi-celebrity status when you suffer occasional ridicule on this blog.

But, do not get your hopes ups – with a 1/31 post date and a 2/14 deadline, I’m guessing there are already some candidates in mind; but what does a private-sector-dweller like your speculative blogger know?

Good luck!

New Study Shows that AMA Guides Were a Big Win for CA

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Is it still news if it’s not particularly “new”?

The Center for Study of Social Insurance has provided an estimate of the effect of the adoption of the AMA Guides for California’s workers’ compensation system.  Your typical California workers’ compensation defense attorney should be thanking his or her lucky stars for the adoption of the AMA Guides – a actual, scientific approach to rating disability, with a limit of quack doctors puffing up liability and impairment – a dream come true!

The estimate looked at the years of 2010 through June of 2011 as compared to the years 2003-2004, specifically looking for total rating, total pay-outs, and other indicators of that sort.  The results are no particularly surprising but still deliciously wonderful to hear:

A 40% drop in ratings before apportionment for unrepresented cases and a 28% drop in represented cases (it appears that it is worth it for applicant’s to retain an attorney).

A 52% drop in compensation for unrepresented cases and a 37% drop in represented cases.

And, the best part of all, a 25% reduction in cases that would have had some rating of permanent disability.  Bear in mind – that is with Almaraz/Guzman trying to worm its way through the heart of the AMA Guides and the 2005 reforms.

The governance of California is a book riddled with errors big and small – it does not appear that history will regard moving from the 1997 schedule to the AMA Guides to be among them.

Comp Slickers: The Legend of Harder’s Gold

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California owes some of its prosperity to Man’s never-ending search for gold.  The process of mining gold, from a complex company operation to one gritty solo prospector, reminds many Californians of our own collection and adopted heritage.

So what separates Stephen Eugene Harder of Woodland from these brave gold hunters who pierced the Earth with their gaze and their mining equipment?  Well, Curly the Gold Miner probably never filed a workers’ compensation claim, and also didn’t claim disability in between swings of his pickaxe.

Harder was arrested after footage was obtained of his engaging in, among other things, gold mining activities.  Before any confusion ensues and a possible libel action arises, Mr. Harder was NOT caught in an effort to marry a wealthy, significantly older, spouse in the hopes of a profitable divorce.  This is the old-fashioned type of gold-digging that includes retrieving precious metals from the Earth.

The Yolo County District Attorney’s Office scored a conviction of five counts of workers’ compensation fraud.  Sentencing is scheduled for March 23.

While WCDefenseCA thanks Mr. Harder for keeping California’s gold-mining heritage alive, a much bigger (and considerably less sarcastic) salute goes to Yolo County District Attorney’s Office.

Overtime Costs More Than Time and a Half

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How long is your work day?  The attorneys I see slaving away over their files, your humble lawyer/blogger included, often put in ten to twelve-hour days, sometimes including evenings and weekends.  And, unless there is some extensive and complicated conspiracy amongst all the adjusters dealing with California workers’ compensation, the adjusters are seeing similar hours and overflowing work load.  Often enough, I hear surprise on the other end of the phone when a 7:00 am phone call is answered, but if you’re at work and making the call, why wouldn’t I be at work and taking it?

LinkedIn discussions place the problem with third-party administrators, underbidding and then overworking their employees, but the blame can be placed on the industry – higher costs, lower business revenues, and a worse situation for all involved.  A recent study by the Finnish Institute of Occupational Health and the University College of London, draws a link between overtime work and depression and higher risk of coronary heart disease.

Why should this matter for the workers’ compensation defense community?  Well, for one, we should all be keeping an eye on our own health (remember those New Year resolutions that have yet to gather the dust of a single month?)  Another reason this matters is that, if true (and even if it isn’t), you can expect to see psyche claims based on overtime, especially if the scent of layoffs is in the air.

Recently, we saw a case in which an applicant was awarded treatment and PD for a psyche “injury” because he couldn’t keep up with the requirement of using computers to do his work.  How long before we see regular claims for being asked (or volunteering) to work overtime?

Picture the applicant giddy at the prospect of earning more money through overtime pay, then collecting benefits after filing a claim based on being asked to work overtime.

So, when are you quitting tonight?

No Workers’ Comp, No Cops!

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Have you ever heard of Isleton, California?  It is a small town in Sacramento County with a population of roughly 800 people.  Recently, the town lost its police department because it allowed its workers’ compensation insurance to lapse – its previous coverage was canceled after some time of failing to pay.

The town just doesn’t have the money.

Efforts are being made to find a new policy, but until one is in place, the town must rely on Sacramento County Sheriff’s deputies as its police force.

Many cities self-insure, but this takes at least some funds as well, and if there’s no money, there’s no money.

When a California business must close its doors because regulatory costs are too high, such as the costs of workers’ compensation insurance, the business disappears and the effect of “out of sight, out of mind” renders it quickly forgotten.

When a city can not afford workers’ compensation for its police force, the city lingers and the effects are witnessed by all.  Perhaps this is a good opportunity for the neighboring city of Sacramento, overflowing with fine statesmen and skilled legislators, to fix the problem (and quickly) or at least come to grips with the fact that a problem exists.

Too Disabled for Working; Not Disabled Enough for Gardening

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No one likes a double-dipper, as your humble blogger’s oft-referenced show clearly pointed out.  Workers’ compensation, in particular, suffers double-dippers not at all!  A Redlands man is being charged with just that – not soiling the salsa or contaminating the punch, but working while receiving disability benefits.

Andres Gonzalez, according to InstantRiverside.com, is being charged with collecting disability benefits after (allegedly) sustaining an injury while working for a small business, while, at the same time, working as a self-employed gardener.  It appears that Mr. Gonzalez may have “misrepresented his abilities to work and to perform certain tasks.”

Mr. Gonzalez was arrested and is out on $50,000 bail.  The arraignment is scheduled for March 1.

As your ever-justice-thirsty blogger has remarked in the past, these fraud cases are a lose-lose for the law-abiding citizenry.  By the time of the arrest, a fraudster will have already spent his or her money, or, in the alternative, use that money to fund his or her criminal defense.  In either case, that employers, insurers, and law enforcement budgets will never see that money restored.  Usually, a substantial portion of jail time is given away in exchange for a tiny portion of the money in restitution.

Hopefully, when fraudsters file claims in the future, past fraud convictions can be used to shut them out.

As always, I wish the San Bernardino County District Attorney’s Office good hunting in catching these folks and pulling the ticks out of the sides of employers and insurers.

Will Mr. Gonzalez’s employer still see an increase in its workers’ compensation insurance premiums, if the injury turns out to be a fraud?  Does anyone know?  Just curios:  gregory@grinberglawoffice.com.