Work Comp Update

REACH OF LABOR CODE 4615 "STAYS" ADDRESSED

Labor Code Sections 139.21 and 4615 state that a provider's liens can be "stayed" by the Administrative Director if an officer, director, or shareholder who owns at least 10% of that entity is indicted for workers' compensation or Medicare fraud.

In an interesting recent case, the question as to what extent should the alleged criminal conduct of an individual in one company result in a "stay" order being issued against related companies was addressed in a three member panel decision in De La Rosa v. County of Los Angeles (2018) where the lien of Mesa Pharmacy had been "stayed" because of Medicare fraud charges being filed against a director of Praxsyn, the parent company of Mesa. The WCAB ruled the stay was inappropriate because the indicted individual was never a director of Mesa Pharmacy nor did his criminal conduct involve the pharmacy.

WORK COMP IN THE NEWS

FEHA AND TALE OF TWO C&Rs

In the separate but very similar cases of Camacho v. Target Corp. and Elguea v. Southern California Pizza Co. (2018) 46 CWCR 142, 147 the applicants filed a work comp case for stress that was settled by C&R, and then filed a FEHA civil claim on essentially the same grounds. Defense asserted in both cases that the C&R addendum language basically resolved or barred the FEHA claim. Defense prevailed in the case where the waiver expressly mentioned the FEHA claim, but lost in the case where the C&R merely mentions waiving any related claims.

[ Comment: Cases reaffirm the position that specificity is critical in resolving issues by C&R and a general waiver of vague "related claims" basically waives nothing.]

DEBIT CARD PAYMENTS IN 2019 ?

The Assembly Appropriations Committee has approved by a 17-0 vote SB 880 which authorizes all payers to use debit cards for all indemnity benefits (no longer limited to just SCIF and TD benefits as initially proposed). The bill now goes to the Assembly floor for a vote and then the Senate (which approved an earlier version of the bill).

[ Comment: If the issue of using the debit card without the applicant incurring any bank fees can be resolved, indemnity paid via debit card may become a reality in 2019.]

BENSON APPORTIONMENT LIVES

There is a growing trend of med-legal report writers to circumvent Benson apportionment between different dates of injury by merely stating that the PD is "inextricably intertwined" between the dates, resulting in a singular PD amount to the benefit of the applicant. However, in

Chavez v. Autozone (2018) 46 CWCR 139, the WCAB confirmed that apportionment as between dates of injury must be applied except in "limited circumstances" in which the medical provider must clearly state a reasonable justification for combining rather than separating the PD as between dates of injury.

CWC&R: The California Workers Compensation and Risk Conference is coming up next month from September 4 - 7, 2018 in Dana Point, CA. Over 1500 work comp professionals attend this dynamic event featuring the top speakers in the industry. HEW&S is proud to be a sponsor, and will have a booth in the exhibit hall which will be manned by Ilene Sheldon, Angela Currie and Michelle Waters.

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HEW&S NEWS

After review of our law firm's quality legal programs, the State Bar of California has officially renewed HEW&S's status as an approved MCLE provider for the next three (3) years.

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San Diego (858) 753-1984 (sdo@hmplc.com)

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