Breaking News

California Division of Workers’ Compensation Suspends In-Person Hearings Due to COVID-19 Surge

The Department of Industrial Relations, Division of Workers’ Compensation announced on Tuesday, Jan. 11, that all in-person hearings will be paused through the end of the month, when the situation will be re-evaluated.

Read More

California Division of Workers’ Compensation Issues New Proposed Rules for Medical-Legal Evaluations

The California Department of Industrial Relations (DIR), Division of Workers’ Compensation (DWC) has issued a notice that it will file new emergency regulations to allow Qualified Medical Evaluators (QMEs) and Agreed Medical Evaluators (AMEs) to conduct evaluations and visits via telehealth when an in-person examination is not necessary and additional conditions are met.

Read More

California DIR, DWC Announce 2022 Medical-Legal Mileage Rate Increase

The California Department of Industrial Relations, Division of Workers’ Compensation has announced that effective January 1, 2022, the medical-legal mileage reimbursement rate will increase from 56 cents per mile to 58.5 cents per mile, an increase of 2.5 cents.

Read More

Felony Charges Result in 14 Month Prison Sentence for California Doctor

Dr. Amir Friedman, a Calabasas anesthesiologist, has received a sentence of 14 months for his part in the massive New Age Pharmaceuticals fraud conspiracies, after pleading guilty in October of 2019 and admitting that the drugs prescribed were vastly more expensive than available equivalents.

Read More

California DWC Announces Extension of Emergency Regulations Through January 11, 2022

California’s Department of Industrial Relations (DIR) Division of Workers’ Compensation (DWC) has announced that the existing emergency regulations for medical-legal evaluations and reporting will be in effect through January 11, 2022, following approval by the Office of Administrative Law (OAL).

Read More

California DWC Issues Final 90-Day Extension of Emergency Medical-Legal Evaluation and Reporting Regulations

California’s Department of Industrial Relations (DIR) Division of Workers’ Compensation (DWC) has issued a Notice of Emergency Regulation Re-Adoption, extending sections 46.2 and 36.7 for an additional 90 days past the October 12, 2021 end date.

Read More

DIR Division of Workers’ Compensation Announces In-Person Hearings to Resume October 1st, 2021

The California Department of Industrial Relations (DIR) Division of Workers’ Compensation (DWC) announced on September 1st that in-person hearings will resume for trials, lien trials, expedited hearings and special adjudication unit (SAU) trials beginning October 1st, 2021.

Read More

California Prop. 22 Ruled Unconstitutional, Reopening Gig Worker Benefit Questions

On Friday August 20th, Alameda Superior Court Judge Frank Roesch ruled that two sections of California’s Proposition 22 are unconstitutional, rendering the measure unenforceable.

Read More

California Landscaper Faces Felony Charges For Workers’ Compensation Insurance Fraud, Perjury

A 45 year old landscaper from Porter Ranch stands accused of multiple felony counts of workers’ compensation insurance fraud and perjury after a Department of Insurance investigation revealed that he continued to work while collecting over $50,000 in disability payments.

Read More

Landscaping Worker Sentenced For Worker’s Compensation Insurance Fraud After Lying About Injury

Angel Luis Maces, 24, of San Jacinto, pleaded guilty to one count of felony workers’ compensation insurance fraud after a months-long investigation by the Department of Insurance (DOI). Maces had been employed by a landscaping company in Temecula, and claimed to have injured his knee when he slipped and fell, subsequently needing a cane or crutches 100% of the time.

Read More

Liens From Vital Imaging And Others Stayed Pending Workers’ Compensation Kickback Fraud Trial

Liens filed by Vital Imaging, San Diego MRI Institute, and Empire Radiology are stayed pursuant to section 4615 of the Labor Code, which places an automatic stay on liens filed by the associated entities charged with fraud. Federal prosecutors are pursuing charges of conspiracy to commit healthcare fraud, and multiple counts of honest services mail fraud, in a kickback scheme that they allege to have generated almost $300 million in charges stemming from illegal referrals and kickbacks.

Read More

Law Firm Employees, Vocational School Owners Among Seven Indicted In Workers’ Compensation Insurance Fraud Case

The defendants, including two law firm employees, face allegations that they conspired to misuse and misappropriate Supplemental Job Displacement Benefit vouchers, defrauding 20 separate insurers of over $330,000, in part with illegal kickbacks.

Read More

Insurance Fraud Charges in Referral Conspiracy Block Liens From Multiple Providers Under Labor Code 4615

The charges include conspiracy to commit a crime, insurance fraud, and referral of clients in return for compensation, and activate section 4615 of the Labor Code, which places an automatic stay on liens filed by the associated entities charged with fraud.

Read More

15-Month Sentence For Surgeon Involved In Pacific Hospital Workers’ Compensation Insurance Fraud Case

A Federal Judge has handed down a 15-month prison sentence for Dr. Jeffery David Gross for his role in the Pacific Hospital kickback scheme. In addition to the prison term, Dr. Gross will forfeit over $600,000 as part of his plea deal for conspiracy and fraud charges.

Read More

California Rice Mill Worker Sentenced To Probation And Fined in Workers’ Compensation Fraud Case

A rice mill worker who claimed an abdominal injury from lifting bags of rice has been found guilty of misrepresenting her symptoms and receiving almost $7,000 in undeserved workers’ compensation benefits. The employer’s insurer is said to have paid out $6,893 in undeserved benefits, and lost an additional $8,992 in costs stemming from the investigation and legal proceedings.

Read More

California Tradesman Arraigned on Felony Charges in Workers’ Compensation Fraud Case

The California Department of Insurance (DOI) announced today that Ahmad Zaki Noori, a 41-year old welder from Sacramento, has been arraigned on two felony counts of workers’ compensation insurance fraud. Noori allegedly misrepresented symptoms after a work injury and collected over $20,000 in benefits to which he should not be entitled.

Read More

Melamed, Pharmacist in Workers’ Compensation Kickback Fraud Scheme, Sentenced to 6 Months, $1.4M Forfeiture

Hootan Melamed, the pharmacist whose kickback scheme resulted in losses to insurance carriers of between $9 million and $20 million, has been sentenced to a 6 month jail term, and must repay $1.4 million in an asset forfeiture. The judgment requires Melamed, who entered a plea agreement in November of 2020, to turn himself in and serve his sentence by October 1st, 2021.

Read More

California Legislature Passes SB 95, Providing Supplemental Paid Sick Leave for COVID-19

On March 18, 2021, the California Legislature passed SB 95, which reestablishes and expands supplemental paid sick leave for reasons related to COVID-19.

Read More

Landscaper in San Jancinto Charged with Workers’ Compensation Insurance Fraud

The California Department of Insurance (DOI) has announced that Angel Maces, a San Jacinto landscaper, has been arraigned for felony insurance fraud for falsifying symptoms following a work-related injury. Mr. Maces received over $42,000 in workers’ compensation benefits that he did not deserve.

Read More

Former City of Hollister Employee Faces Four Felony Counts in Workers’ Compensation Insurance Fraud Case

The California Department of Insurance (DOI) has announced that Daniel Clampitt, a former Hollister firefighter, was charged with four felony counts including workers’ compensation insurance fraud, grand theft and perjury. He claimed to be too injured to work and collected over $94,000 in workers’ compensation benefits while continuing to work for another company.

Read More

California DWC Extends Emergency Regulations for Medical-Legal Evaluations and Reporting Through October 12, 2021

California’s Division of Workers’ Compensation (DWC) announced today that its emergency regulations 36.7 and 46.2 for medical-legal evaluations and reporting, which went into effect on May 14, 2020 and were set to expire in January 2021, have been extended until October 12, 2021.

Read More

Nutrition Assistant Arraigned on Four Workers’ Compensation Insurance Fraud Charges in Merced

The California Department of Insurance (DOI) announced on Thursday, March 4, 2021, that Kia Lor, 54, of Merced has been arraigned on multiple counts of workers’ compensation insurance fraud. Lor, a Nutrition Assistant at the Merced Community Action Agency, suffered a back injury at a company picnic in 2018, while lifting a cooler.

Read More

Long Beach Division of Workers’ Compensation (DWC) Office Moves to New Location

The California Department of Industrial Relations (DIR) Division of Workers’ Compensation announced on February 25th that the Long Beach office has moved to a new location, effective immediately.

Read More

School District Employee Faces Charges of Workers’ Compensation Insurance Fraud, Grand Theft in COVID-19 case

The California Department of Insurance (DOI) announced in a bulletin today that Stephanie Medrano, 33, of West Covina, was arraigned on multiple charges of workers’ compensation insurance fraud and grand theft after making false statements about her condition.

Read More

Workers’ Compensation Fraud Conviction Upheld in Illegal Kickback Scheme Case People v. Paredes

California’s Court of Appeal for the 4th District has upheld the workers’ compensation fraud conviction of Gonzalo Ernesto Paredes, the former Office Administrator for Advanced Radiology. Paredes had been found guilty of 35 counts of “offering or delivering compensation for workers’ compensation patient referrals” in the illegal kickback scheme.

Read More

Fusion Rx Pharmacy Owner Enters Guilty Plea in Healthcare Fraud Conspiracy Case

Navid Vahedi, owner of Fusion Rx Compounding Pharmacy in Los Angeles, stood accused of conspiring with marketers to commit healthcare fraud and pay kickbacks. Vahedi, 41, pleaded guilty on behalf of himself and his business, and will be sentenced on June 28.

Read More

Buttonwillow Worker Faces Felony Charges in Workers’ Compensation Insurance Fraud Case

The California Department of Insurance has announced that a warehouse worker in Buttonwillow has been arraigned on multiple felony counts, and will be prosecuted by the Kern County District Attorney’s office.

Read More

Fresno Man Faces Felony Workers’ Compensation Insurance Fraud Charges

The California Department of Insurance (DOI) has announced the self-surrender to the Fresno County Jail of a man accused of perjury and workers’ compensation insurance fraud. Jose Zepeda, 45, of Fresno, faces multiple charges stemming from a claim filed after a 2017 injury.

Read More

WCAB Decision Addresses Remote Testimony In Response to the COVID Pandemic

In a significant panel decision (PDF) issued Tuesday, January 12, 2021, the California Workers’ Compensation Appeals Board (WCAB) ruled that continuing a trial indefinitely to get in-person testimony was inappropriate.

Read More

California DIR, Division of Workers’ Compensation Expand District Office Services Effective January 11, 2021

The Department of Industrial Relations (DIR) Division of Workers’ Compensation (DWC) announced on Thursday that beginning Monday, January 11th, walk-through appointments would be made available at District Offices, using the LifeSize video platform.

Read More

Ventura Man Pleads Guilty to Felony Workers Compensation Fraud

Ventura County District Attorney Gregory D. Trotten announced that a sentence of 120 days in jail has been handed down in a case involving a violation of Insurance Code section 1871.4(a). Sergio Ordonez of Ventura pled guilty to making a “false and fraudulent material statement” in order to obtain workers’ compensation benefits.

Read More

Firefighter Pleads Guilty to Felony Workers’ Compensation Fraud

Perry Adam Lieber, 34, has pled guilty in a workers’ compensation fraud case that saw the former Ventura County firefighter receive more than $145,000 in workers’ comp benefits. In June, Lieber had been charged with three felony counts, including workers’ compensation fraud and perjury.

Read More

Orange County Attorney Faces 20 Felony Charges in Workers Compensation Insurance Scheme

The California Department of Insurance announced today that Moses Luna, 73, of Newport Beach was arrested on 20 felony counts after an investigation into his business found that he had fraudulently billed multiple insurance carriers for translation and interpreting services, generating over $300,000 in fraudulent billings.

Read More

13 charged in $20M Supplemental Job Displacement Benefits Fraud Conspiracy

Riverside County prosecutors announced Monday that the first of 13 defendants across three criminal cases have been arraigned, facing a range of charges that include conspiracy, workers’ compensation insurance fraud, caping, and receiving kickbacks.

Read More

Plea Agreement Filed in Melamed Workers’ Compensation Fraud Criminal Case

The criminal case against Hootan Melamed, the former owner of several pharmacies, appears to be coming to a close. A plea agreement for Melamed was filed in the U.S. District Court for Southern California in early November, at the same time that prosecutors filed superseding information that outlines a conspiracy charge and a plan to recover assets in a forfeiture plan.

Read More

Canoga Park Man Arraigned on Three Felony Charges in California Workers’ Compensation Insurance Fraud Case

The California Department of Insurance (DOI) has announced that Alexander Cody Smith, 30, has been arraigned on three felony charges for worker’s compensation insurance fraud stemming from a claim made while working for Engen Enterprises Inc.

Read More

30 Month Prison Sentence in California Disability Fraud Scheme

Angela Stubblefield, 49, of Tacoma Washington was sentenced on Monday to two and half years in prison for disability fraud and identity theft. She and Katherine Decker, who worked for the California Employment Development Department, filed multiple fraudulent diability claims, and illegally extended benefits for existing claims, using real identities.

Read More

California Workers’ Compensation Appeals Board Reinstates Rules Previously Suspended During COVID-19 Pandemic

On Tuesday, the California Department of Industrial Relations Workers’ Compensation Appeals Board (WCAB) issued two en banc decisions which lift the suspensions of rules on lien claims and documentary trial exhibits.

Read More

Emergency COVID-19 Medical-Legal Reporting Regulations To Expire March 12, 2021

California Division of Workers’ Compensation has announced that Emergency Regulations 36.7 and 46.2, which took effect on May 14, 2020 in response to the COVID-19 pandemic, will expire in March, in accordance with Governor Newsom’s Executive Orders.

Read More

$18 Million in Liens Dismissed in Case Involving Workers Compensation Fraud

A judge has dismissed liens totaling over $18 million in the case of Michael E. Barri, who pled guilty in 2016 to multiple federal charges, including conspiracy and receiving illegal kickbacks from Pacific Hospital.

Read More

Gov. Newsom Signs SB1159 Into Law, Creating COVID-19 Presumption for Workers’ Compensation

Governor Newsom has now signed SB1159 into law, as anticipated, creating a rebuttable presumption of compensability for COVID-19 cases. An urgency measure, the law goes into effect immediately.

Read More

California DWC and WCAB Further Expand Hearing Options to Include Lien Trials

California’s Department of Industrial Relations announced today that judges will resume hearing a limited number of lien trials beginning on September 14th.

Read More

California Senate Sends SB 1159 Coronavirus Presumption Bill to Governor Newsom for Signature

The legislature’s passage of the bill through both houses in the final hours of the legislative session sends the urgency measure to the governor’s desk, where it will take effect upon his signature.

Read More

California Division of Workers’ Compensation Suspends Three Doctors, Three Nurses

Among the grounds for suspension were a failure to respond to allegations from Florida regulators that the nurse in question was diverting Fentanyl, and a failure to report that the physician in question was seeing patients seeking medical marijuana recommendations (the physician was already on probation).

Read More

Three Bills on COVID-19 Workers’ Compensation Presumptions Under Review by Appropriations Committees

The California legislature will hear testimony today on the costs for the three California bills under consideration to create workers’ compensation compensability presumptions for coronavirus (COVID-19) cases.

Read More

California DWC and WCAB Further Expand Workers’ Compensation Hearing Options to Include Video

In a statement released today, the California Department of Industrial Relations announced that the Division of Workers’ Compensation (DWC) and the Workers’ Compensation Appeals Board (WCAB) will expand their capabilities for remote hearings with a video option.

Read More

Federal Charges Brought in Opioid Trafficking and Fraud Case

Ten individuals, including Dr. John Michael Korzelius of Camarillo, face federal drug trafficking and fraud charges after a two-year investigation by DEA and IRS agents resulted in two federal grand jury indictments. The charges allege that the individuals were part of a narcotics scam that sold illegal opioids for cash through fraudulent pain clinics.

Read More

COVID19 Compensability Presumption Could Extend to 2024 For Some Workers

A new amendment to Senate Bill 1159 by Sen. Jerry Hill of San Mateo would extend the presumption that COVID-19 is compensable, through July 1, 2024, for certain workers, including those on the front line of the pandemic.

Read More

California DIR, WCAB Rescind COVID-19 Rules Suspension of Timeframes for Reconsiderations, Effective 9/1

The California Department of Industrial Relations Workers’ Compensation Appeals Board has issued an en banc ruling, reinstating the requirements and time frames for the WCJ’s Report and Recommendation on a party’s Petition for Reconsideration, effective 9/1.

Read More

California Division of Workers’ Compensation and WCAB Expand Hearing Schedule to Include Lien Conferences, Effective June 8

California’s Department of Industrial Relations (DIR) Division of Workers’ Compensation (DWC) and Workers’ Compensation Appeals Board (WCAB) have announced updated hearing procedures, effective June 8th, in an effort to improve operations during the coronavirus (COVID-19) pandemic. 

Read More