Employee vs. Independent Contractor

In the latest case to weigh in on who is an employee and who is not, we have the case Garcia v. Border Transportation Group just issued on October 22 and decided by the California Fourth Appellate District and certified for partial publication. The case clarifies that the 1989 California Supreme Court case of S.G. Borello & Sons, Inc. v. Department of Industrial Relations still defines the factors to be used to determine who is an employee and who is an independent contractor in the workers’ compensation arena.

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josh heislerCase Law News
Universal Claims Certification Available in California

On September 26, 2018, California Insurance Commissioner Dave Jones announced that California will recognize a new adjuster certification system known as the Universal Claim Certification (UCC). The UCC is also recognized by Florida, Texas, Georgia, Alabama, and Missouri. It was created by the Claims and Litigation Management Alliance (CLM) with the goal of becoming a federally recognized program, in order to eliminate the process and expense of obtaining a separate license to work in each state.

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Department of Corrections and Rehabilitation v. WCAB (Fitzpatrick)

The Court of Appeal, Third Appellate District granted the defendant’s Petition for Writ of Review on the following question: Must a finding of permanent total disability be made in accordance with Labor Code Section 4660 or does Section 4662(b) provide a separate path to such a finding? The Court made it clear that Section 4660 provides the methodology to finding an award of permanent total disability “in accordance with the fact” as stated in Section 4662(b). The Court held that application of Section 4660 is mandatory. Section 4660 applies the 5th Edition of the AMA Guides.

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josh heislerCase Law News
Supreme Court Decision – Exclusive Remedy

On August 23, 2018, the California Supreme Court held in King v. Comppartners, Inc. et. al. (2018) that a utilization review doctor stands in the shoes of the employer while performing duties within the scope of the workers’ compensation scheme and thus may not be sued in tort unless the act falls outside of what is encompassed within the compensation bargain.

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josh heislerCase Law News
Medicare Set-Asides Using Evidence-Based Forecasting

On July 18, 2018, Care Bridge International issued a White Paper entitled Medicare Set-Asides: What is the True Cost of Future Medical Care? Care Bridge International questioned the need to have the Workers Compensation Medicare Set-Aside Arrangement (MSA) reviewed by The Centers for Medicare and Medicaid Services (CMS) prior to settling a workers’ compensation claim. The use of the MSA has become common practice in workers’ compensation in the last 15 years since the creation of the WCMSA. Based on their analysis, Care Bridge International has concluded workers’ compensation payers are paying excessively inflated amounts to close out the future medical treatment of an injured worker’s claim.

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New Regulation for Employers of the Hotel and Lodging Industry

A new safety regulation to prevent industrial injuries suffered by housekeeping workers for the hotel and lodging industry went into effect on July 1, 2018. The intent of this new regulation is to control the risk of musculoskeletal injuries and disorders to housekeepers in hotels and other lodging businesses. The regulation entitled Hotel Housekeeping Musculoskeletal Injury Prevention, requires employers in the hotel and lodging industry to complete an initial workplace evaluation by October 1, 2018 and to identify and create procedures to address hazards for housekeeping workers.

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SAWW Increases for 2019

In 2019 the California State Average Weekly Wage (SAWW) will increase 2.971% for temporary total disability (TTD), permanent total disability (PTD) and other workers’ compensation benefits that are tied to SAWW increases. The SAWW is defined as the average weekly wage paid to employees covered by unemployment insurance as reported by the U.S. Department of Labor for California for the 12 months ending March 31 in the year preceding the injury.

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Mediation Services by Barbara Thompson

Barbara Thompson, Associate in the Woodland Hills Office, was interviewed by Steve Appell on Work Comp Central’s, Work Comp Matters podcast on June 21, 2018. The podcast is titled: Mediation with Barbara Thompson. Barbara discussed the advantages of mediation in Workers’ Compensation Claims, including cost and time savings.

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josh heislerGMK News