CA - Fraud, Unfair Competition Claims Not Sufficient to Escape Exclusivity
04/22/2026 | 0
A California appeals court ruled that workers' compensation is the exclusive remedy for an injured worker's claim that a third-party administrator, claims handler and a doctor conspired to improperly characterize the nature of her injuries and need for ongoing treatment or work accommodations.
"If the alleged acts are a normal part of, or collateral to, the workers' compensation process, and the motive behind the acts does not violate a fundamental policy of the state, the cause of action is barred," the 4th District Court of Appeal said in an unpublished decision handed...
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A New York appellate court ruled that workers’ compensation exclusivity did not shield a company as a matter of law without a showing that it was the alter ego of the worker’s employer.
Case: Hernandez-Morataya v. M&L Equities Auto LLC, No. 2024-07654, 04/01/2026, published.
Facts: Francisco Hernandez-Morataya worked for M&L Car Services Inc. as a car wash attendant. He allegedly suffered injuries at work when he was struck by a customer’s vehicle.
Procedural history: Hernandez-Morataya filed suit against M&L Equities Auto LLC, the owner of the property where t...
West Virginia’s Intermediate Court of Appeals upheld a 37% permanent partial disability award for a worker’s electric shock injuries resulting in burns to roughly 3.5% of his body and the amputation of his big toe.
Case: Superior Home Specialists v. Sindledecker, No. 25-ICA-371, 04/07/2026, published.
Facts: Michael Sindledecker worked for Superior Home Specialists. He suffered an electric shock injury on June 6, 2022, while holding on to a gutter that touched a power line.
On June 13, 2022, Dr. Carrie Sims performed excision of the burns and preparation of the wound beds o...
The Oregon Court of Appeals said the Workers’ Compensation Board applied the wrong standard to deny a worker permanent partial disability benefits at claim closure.
Case: Okon v. Broadspire, No. 225, 03/25/2026, published.
Facts and procedural history: Inemesit Okon worked for Broadspire. He suffered injuries at work in January 2022. Broadspire accepted liability for a disabling lumbar sprain, lumbar strain, sacroiliac joint sprain and pelvic strain.
In February 2023, Okon was deemed medically stationary by her attending physician.
The physician saw Okon again in July 2023 and c...
The Buddha reportedly said, “Three things cannot be long hidden: the sun, the moon, and the truth.”
There are only a couple of problems with this. First, although I found it on the internet (so it must be correct, right?), further research confirms this attribution cannot be authenticated. Second, there is — sadly — much evidence to contradict Buddha’s (or whoever’s) assertion.
For example, there is no credible, ABA-backed study estimating the extent to which perjury and fraud soil our legal system. However, anyone who has worked in the workers&rs...
The Delaware Superior Court upheld the reduction of a worker’s benefits for her injuries from a fall based on the evidence that she was physically capable of returning to work and that jobs were available to her.
Case: Scruggs v. Just Food for Dogs, No. N25A-05-002 SSA, 03/26/2026, published.
Facts: Joyce Scruggs worked as a sanitation supervisor for Just Food for Dogs. She suffered injuries when she tripped over a hose and fell.
Procedural history: Scruggs began receiving partial disability payments in 2023, which JFFD petitioned to reduce in July 2024. Scruggs separately petitioned ...
A California lawmaker pared back proposed reforms to the Subsequent Injuries Benefits Trust Fund, removing provisions that would establish filing deadlines and prohibit the consideration of certain conditions in eligibility decisions.
Assemblymember Liz Ortega, D-San Leandro, amended AB 1576 on Monday to eliminate a provision that would have required SIBTF claims to be filed within five years from the date of the subsequent compensable injury or one year from the date that the Workers' Compensation Appeals Board determines the level of permanent disability.
Ortega also stripped from the ...
The Connecticut Supreme Court on Monday held that employers are generally entitled to a lien on the net amount of third-party settlement proceeds deriving from a compensable occupational disease, even if most of the settlements were based on nonoccupational exposure.
The portion of damages for loss of consortium is not subject to a lien because workers' compensation doesn't compensate such damages, but an employer's rights generally mirror its workers' compensation payment obligations, the court reasoned.
"The decedent’s occupational disease consequently was fully ...
The Pennsylvania Superior Court denied a property owner’s attempt to take a collateral appeal of its denied request for a stay while the Workers’ Compensation Appeal Board determines whether the owner qualifies as the statutory employer of an injured worker.
Case: Geronimo v. Commonwealth Environmental Systems LP, No. 31 EDA 2025, 03/23/2026, published.
Facts and procedural history: Justo Acala Geronimo, a temporary laborer, filed a civil suit against Commonwealth Environmental Systems LP and Golden Eagle Staffing.
Geronimo alleged that he suffered injuries in February...
A New York appellate court ruled that the defendants in a Labor Law suit were entitled to indemnification from an injured worker’s employer and that their affirmative defense of culpable conduct should not have been dismissed.
Case: Ravelo v. RXR 32 Old Slip Owner LLC, No. 157980/20, 03/31/2026, published.
Facts: RXR 32 Old Slip Owner LLC owns a commercial property in Manhattan. It leased several floors of the premises to Cahill Gordon & Reindel LLP.
Cahill hired Henegan Construction Co. Inc. to serve as the general contractor for a build-out on the leased floo...
The Missouri Court of Appeals upheld a determination that a worker was entitled to permanent partial disability benefits, but it reversed an award of fees and the directive for the employer to pay his medical providers.
Case: Chick v. City of Centralia, No. WD88273, 03/24/2026, published.
Facts: Russell Chick worked for the City of Centralia as an equipment operator.
In February 2014, Chick fell on ice while walking to the city’s maintenance shop. Chick broke his fall with his right arm.
Shortly thereafter, Chick felt numbness in the arm and could not write. He reported an...
A Texas appellate court ruled that a dispute over whether a nonsubscribing employer and an injured employee had to engage in mediation must first be resolved by an arbitrator.
Case: Argyle v. Republic Waste Services of Texas Ltd., No. 05-25-00559-CV, 04/16/2026, published.
Facts: Republic Waste Services of Texas Ltd. is a nonsubscriber to the state workers’ compensation system. Instead, it adopted an occupational injury benefit plan that provides no-fault wage replacement, medical, and accidental death and dismemberment benefits to employees who elect coverage.
Cannon Cochran Man...
The Illinois State House of Representatives passed a bill that would impose civil penalties on certain licensed businesses that fail to maintain workers' compensation coverage.
The House on Friday voted 76-24 to pass HB 5228, which applies to corporations, limited liability companies and partnerships engaged in activities requiring a state license and for which proof of workers' compensation coverage is a prerequisite to the state issuing a license.
Those businesses could face civil penalties if they don't have workers' compensation coverage. They could avoid penalties by sho...
Ken Bollier, a former president of the State Compensation Insurance Fund in California, died at the age of 87.
Bollier died at his family home on April 7, according to an obituary in the San Francisco Chronicle.
Bollier worked for State Fund for 38 years, working his way up from the mailroom to president. He retired as president in 2002.
He is survived by his wife, Janet; their two sons, Casey and Ryan (Stephanie); and many nieces and nephews.
Bollier is a San Francisco native who graduated from Riordan High School, earned his bachelor's degree from the University of San ...
Oklahoma Gov. Kevin Stitt signed a bill giving employers more control over their workplace drug policies.
Oklahoma law prohibits employers from firing those with a license to use medical cannabis solely because of a positive drug test unless they're using drugs at work or working in a safety-sensitive position.
Stitt on Friday signed HB 3127, which allows employers to fire workers based only on a positive drug test for cannabis components or metabolites if the action is taken pursuant to a written drug and alcohol testing policy.
The bill also declares that all safety-sensitive position...
A New York appeals court affirmed the determination that a man's brain and head injuries were compensable even though the mechanism of the injury was unknown.
Although nobody saw James Brognano III fall at work, the Workers' Compensation Board concluded that he was injured during his employment based on medical evidence and witness testimony. This finding required the employer to rebut the presumption of compensability, which the New York Appellate Division's 3rd Department ruled was a burden it failed to carry.
"Although the employer pointed out the uncertainty as to exactl...
