Sub rosa surveillance is one of the most powerful tools in a claims adjuster’s arsenal. It is also one of the most expensive. When you capture footage of an applicant performing activities they claimed they could not do, the instinct is to immediately send it to the Qualified Medical Evaluator (QME) to secure a favorable […]
The Workers’ Compensation Appeals Board’s recent en banc decision in DiFusco v. Hands On Spa significantly broadens disclosure requirements for defendants in California workers’ compensation cases. All defendants must now disclose detailed insurance information and potentially liable entities, regardless of whether a third-party administrator is involved—not just the insurance carrier’s name as previously interpreted. The DiFusco Decision: A […]
Key Takeaway: Reese Decision Creates Broader Liability Exposure for Public Entities The Workers’ Compensation Appeals Board’s recent panel decision in Reese v. County of Kern significantly broadens when public entities may be liable for workers’ compensation coverage for volunteer reserve deputies. This decision should prompt immediate review of volunteer programs and coverage elections by public entity risk managers. […]
The Appeals Board’s en banc Opinion and Order Granting Petition for Reconsideration in Tyson Perez v. Chicago Dogs, et al. (ADJ16597333, Aug. 12 & 14, 2025) does far more than press “pause” on a cumulative-trauma case involving a former professional pitcher. By squarely interpreting WCAB Rule 10817(a), the panel charts a state-wide blueprint for when and how witnesses may […]
Independence Day is that glorious twenty‑four‑hour period when the scent of charcoal mixes with the unmistakable aroma of impending litigation. While California revelers juggle sparklers, employers and claims professionals juggle exposure. Allow this tongue‑in‑cheek primer to keep both eyebrows—and your loss ratio—intact. 1. “Mandatory Fun” or Optional Liability? A picnic flier that “strongly encourages” attendance […]
When the Workers’ Compensation Appeals Board issued its panel decision in Eze v. FedEx Ground Package System, Inc., 2025 Cal. Wrk. Comp. P.D. LEXIS 73, many observers focused on the mileage‑penalty discussion. The lasting significance of the case, however, lies in the Board’s clear reaffirmation that the attorney‑client and work‑product privileges apply with full force in workers’ compensation proceedings. […]
California Court of Appeal, Third District — filed May 16 , 2025, certified for publication June 11, 2025 Why This Decision Matters The published opinion in DPR Construction is a sharp reminder that Labor Code section 5502’s discovery cut‑off is jurisdictional. When either side—most frequently an applicant’s attorney (AA)—tries to slip non‑disclosed evidence into the record after the Pre‑Trial Conference […]
A recent Court of Appeal decision, Travelers Indemnity Co. v. Workers’ Compensation Appeals Board (Zeber) (2025), offers a timely reminder of how crucial it is to nail down the correct “date of injury” for cumulative trauma claims under Labor Code Section 5412. While the opinion also addresses whether insurance coverage disputes must proceed to mandatory […]
May 19, 2025 Introduction In a significant en banc decision, Vazquez v. Renteria (Zenith Insurance Co.) (May 19, 2025) ADJ11017003 (Salinas District Office), the Workers’ Compensation Appeals Board (WCAB) clarified when a Qualified Medical Evaluator (QME) in a represented case may be replaced due to unavailability. The decision emphasizes that while Administrative Director (AD) rules […]
Seasonal workers are indispensable to many of California’s industries—particularly agriculture, tourism, and hospitality. When these workers are injured on the job, determining how to calculate Temporary Total Disability (TTD) and Permanent Disability (PD) benefits can be challenging, especially if there is an “off-season” when the worker does not perform services for the employer. Below is […]
