Calif Edition Banner March 2010
Vol 2, Issue 41

Find Solutions & Strategies                         October 10, 2011

WCLC horse's buttThe Thin Line Between Horseplay & the
Initial Physical Aggressor Defense
 
 
In This Issue
* HORSEPLAY & INITIAL PHYSICAL AGGRESSOR
* LEGISLATION: Governor signs & vetoes bills
* TOP 25 BLOGS FOR 2011
* BLOG ROUND UP: Fraud, CCC's, CWCI seminar
* NEWS HEADLINES: SCIF to lay off up to 1,800 workers
* JOB POSTING: Defense Attorney
* eNEWSLETTER ARCHIVES

A Note From the Editor

Robin Kobayashi 2010

Dear WC Professionals: 

   

Legislative Finale: The Governor has signed 14 workers' comp-related bills and vetoed 5 others. See our tracking list in this issue. 

 

Sincerely,
Robin E. Kobayashi, J.D.
LexisNexis Legal & Professional Operations

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horseplay & physical aggressor

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The Thin Line Between Horseplay and the Initial Physical Aggressor Defense

 

Note: Free access to the Nufio panel decision is provided below.

 

Lexis.com subscribers: The cost for subscribing to our panel decisions reporter is currently $204/yr. Click on the banner image above for more information.

 

California Labor Code Section 3600 sets forth a number of conditions that must be met before an employer has liability for an injury. Labor Code Section 3600(a)(7) indicates that an employer will not have liability for an injury where the injury arises out of an altercation in which the employee is the "initial physical aggressor". There are also those cases that establish that an employer will not have liability for an injury that is caused by "horseplay" or what is also referred to as "skylarking". Recently, a panel of commissioners with the California Workers' Compensation Appeals Board addressed the factual scenario where co-workers engaged in "horseplay" that escalated into an altercation.

 

In Nufio v. Bridge Hospitality, LLC (ADJ6808931), 2011 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel upheld the WCJ's finding that Applicant's 3/25/2009 injury was compensable, when the injury occurred during an altercation with a co-worker which ensued following a period of "horseplay." In affirming the WCJ's determination, the WCAB panel concluded that Applicant's injury did not arise out of "horseplay" and was not barred by Labor Code 3600(a)(7), because Applicant was not the initial physical aggressor in the altercation that resulted in his injury. > Read more

legislative  round up: 10/9/2011
Capitol Sacramento

California Workers' Compensation Legislative Round Up - 2011 Regular Session (Oct. 9, 2011)

 

SIGNED BY GOVERNOR:

AB 228 - authorizes State Fund to sell workers' comp polices to cover out of state employees of California- based businesses (Enrolled)

AB 335 - requires DWC to prepare a booklet on workers' compensation claims process (Chaptered)

AB 378 - caps the cost of compounded medications provided by physicians (Chaptered)

AB 397 - requires contractors to show proof of workers' comp insurance coverage or to verify exemption (Chaptered)

AB 436 - authorizes $4.3M loan from Uninsured Employers Benefit Trust Fund to start a DIR program to monitor prevailing wage issues in public works projects (Chaptered)

AB 585 - extends presumption of cancer for active firefighting members of a fire department serving a National Aeronautics and Space Administration installation (Chaptered)

AB 878 - requires a workers' comp insurer to report a contractor whose workers' comp policy is canceled after an investigation shows that a material misrepresentation by the insured resulted in financial harm to the insurer (Enrolled

AB 1168 - adopts fee schedule for Vocational Experts in to cover reports and expert testimony (Chaptered)

AB 1263 - prohibits SCIF officers and directors from engaging in lobbying or contracting activities for two years post employment with the State Fund (Chaptered)

AB 1426 - eliminates the Court Administrator position (Chaptered)

SB 457 - requires WCAB to determine, on the basis of liens filed, reimbursement for benefits paid or services provided by a self-insured employee welfare benefit plan notwithstanding the OMFS for awards of reimbursement for self-procured medical costs (Chaptered)

 

> Read more

TOP 25 BLOGS FOR 2011

Top 25 Blog Cut OutThe Workers' Compensation Law Community's Top 25 Blogs for 2011 - A Call for Your Suggestions. The time has arrived for the LexisNexis Workers' Compensation Law Community Staff to make selections for its annual Top 25 Blogs for Workers' Compensation and Workplace Issues. 

 

The LexisNexis Workers' Compensation Law Community Staff will review all comments through October 21, 2011, and then make final determinations for the top 25 blogs and announce the honorees on the web center. Click here to find out how to talk up your favorite blog!

blogs at the lexisnexis workers' comp law community 

 

Fraud Sign

Workers' Comp Fraud Blotter -  Attorney Indicted for Allegedly Cheating His Professional Athlete Clients, by LexisNexis Workers' Compensation Law Community Staff. Read it.

  

 

    

Cal Comp CasesWCAB Jurisdiction vs. Alternative Dispute Resolution: Cal. Comp. Cases October Advanced Postings (10/6/2011). Here's the second batch of advanced postings for the October 2011 issue. Lexis.com subscribers can link to the complete headnotes and summaries. Read it.

 

 

CWCICWCI Schedules Webinars on Gearing Up For New Medical Billing and E-Billing Standards, by CWCI.  Read it.

 

NEWS HEADLINES
 

Workers' Comp Executive:

FLASH: State Fund Moves to Lay Off 25% of Its Workforce.

Copyright 2011 Providence Publications, LLP. All rights reserved. Reprinted with permission. 

 

Other News:  

CA: SCIF President/CEO Tom Rowe's Email to Employees re Lay Offs Posted Online.

CA: Expert Warns 1.8 Percent Rate Decrease Could Lead to Average Increase of 36 Percent.

CA: Court Leaves Unclear Whether L.A. Elected Officials Can Be Audited by City Hall.

CA: MSC Care Management Acquires Integrated Healthcare Services.

CA: IRS Says Oakland Marijuana Dispensary Owes $2.5M in Taxes.

CA: L.A. County Investigating Workers Comp Fraud at Probation Dept.

CA: DWC Posts Interim Pharmaceutical Fee Schedule Data File.

CA: Editorial Says Governor Brown Hasn't Always Sided With Labor in Signing, Vetoing Bills.

CA: Governor Signs SB 617 to Require Economic Analysis of Proposed Regulations.

CA: Insurance Commissioner Applauds Signing of Bill to Help Reduce Workers Comp Costs.

CA: ACIC Applauds Gov. Brown's Workers' Comp Signature and Vetoes.

AIA Commends CMS for Phasing In MSP Reporting Requirements.

Federal Agents Arrest 2 Dozen Boeing Employees in Prescription Drug Abuse Sting.

Moody's Affirms A2 Insurer Rating of NCCI Holdings, Inc.

Todd DeStefano Named to Board of AMCOMP.

JOB POSTING: DEFENSE ATTORNEY
Bradford Barthel logoReady for the Next Step in Your Career? Bradford and Barthel LLP, recognizes that our people make the difference and are our most important resource. We dedicate ourselves to continually attracting, retaining and developing exceptional and diverse attorneys. Our well-established firm has locations throughout the state, and we focus our expertise in all areas of the practice of workers compensation defense. Our attorneys work within their local venue therefore travel is close to home. We offer highly competitive compensation and benefit packages and a collegial, ethical working environment. We currently have an opening for a workers' compensation defense attorney at our San Diego location.

 

If you have 2+ years experience in defense work, and the desire to develop to your full potential, talk to us about your most important investment, your career. With Bradford and Barthel, you will be on the road to exciting professional challenges and opportunities. Please e-mail your resume to sbradford@bradfordbarthel.com.

legislation, cont.

LEG

SIGNED BY GOVERNOR, CONT.:

SB 459 - prohibits the willful misclassification of individuals as independent contractors (Enrolled)

SB 684 - requires insurers to disclose, when giving a written quote, any dispute resolution or arbitration agreement requiring the policy holder to resolve disputes outside of California, among other things (Chaptered)

SB 826 - authorizes DWC to assess fines up to $5,000 a year against claims administrators that fail to comply with Workers' Compensation Information System reporting requirements (Chaptered)

 

Vetoed stamp

AB 211 - would have provided supplemental job displacement vouchers to injured workers who are permanent and stationary, rather than when they receive a permanent disability rating (Enrolled version) - Veto Message.

AB 584 - would have required UR physicians to be licensed in California in order to provide Utilization Review Services and prohibited the use of physicians licensed only in other states (Enrolled version) - Veto Message.

AB 947 - would have eliminated the 104-week cap on TTD for a limited number of cases involving surgery occurring after the 104 of payments had expired (Enrolled version) - Veto Message.

AB 1155 - would have prohibited consideration of race, religion, gender, age and other personal characteristics in apportionment to non-work related causes under Labor Code 4663 (Enrolled version) -  Veto Message.

SB 127 - would have required DWC to annually adopt CPT codes in the Official Medical Fee Schedule (Enrolled version) - Veto Message.

P2548 CA WC HotDocs
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enewsletter archives

Take a deep dive into our past eNewsletters for 2011 and prior...warning - some links to articles may not work...report any linking problems to Robin.E.Kobayashi@lexisnexis.com.

October 3, 2011: The Race to Request a Panel QME.
September 26, 2011: The Neutral Risk Doctrine.
September 6, 2011: QME Panel Requests.
August 29, 2011: A Primer on Depositions.
August 15, 2011: Supreme Court COLA Decision.

July 11, 2011: QME Regulations: Face to Face Meetings.

July 5, 2011: PQME Supplemental Reports.

June 20, 2011: Sanctions: Three-Cent Dispute.

June 13, 2011: A Balanced Approach to Litigation.

June 6, 2011: Post-Valdez Defense Protocols.

May 31, 2011: Stress-Related Compensable Consequence Injuries.

May 23, 2011: Developing the Record.

May 16, 2011: Overpayments.

May 9, 2011: Third Party Cases.

May 2, 2011: Temporary Total Disability.

April 25, 2011: Non-MPN Physician Reports.

April 18, 2011: 2011 Alphabet Soup.

April 11, 2011: Rule 38 and Medical Examiner Reports.

April 4, 2011: Penalties Post SB-899.

March 21, 2011: Workers' Comp and Earthquakes.

March 14, 2011: LC 5710 Attorney's Fees.

March 7, 2011: Mediation.

February 28, 2011: Arbitrations.

February 14, 2011: In Memoriam: Carrie Nevans.
February 7, 2011: Good Faith Personnel Actions.
January 31, 2011: Service in EAMS.

January 24, 2011 (addendum): Sanctions; EAMS rules.

January 24, 2011: Public Self-Insured Employers.

January 17, 2011: CHSWC Report on Liens.

January 10, 2011: Temporary Workers.

January 3, 2011: Permanent Total Disability & Total Loss of Future Earning Capacity.

 

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