Articles Posted in Public Benefits

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Six judges who were elected to the superior court in mid-term elections in 2012, but who did not take office until January 7, 2013, claimed entitlement to benefits under the Judges’ Retirement System II (JRS II) as in effect at the time they were elected, rather than at the time they assumed office. On January 1, 2013, JRS II became subject to the California Public Employees’ Pension Reform Act of 2013 (PEPRA), Government Code section 75500, which amended virtually all state employee retirement systems to address the state’s enormous unfunded pension liability and return these systems to actuarially sound footing. PEPRA increases employee contributions, provides for fluctuating contribution rates based on market performance and actuarial projections, and bases the amount of monthly pension payments on an employee’s final three years of compensation, rather than on only the final year. The court of appeal held that the judges did not obtain a vested right in JRS II benefits as judges-elect, but rather obtained a vested right to retirement benefits only upon taking office after PEPRA went into effect. PEPRA’s provisions pertaining to fluctuating pension contributions do not violate the non-diminution clause of the California Constitution nor do they impermissibly delegate legislative authority over judicial compensation. View "McGlynn v. State of California" on Justia Law

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Brown worked for BCP for 10 years. BCP had permitted Brown to wear shirts with BCP patches, rather than a uniform shirt. After discovering that it could order larger-size uniform shirts, BCP purchased such shirts for Brown in 2011. He was fired in January 2012 for wearing the wrong shirt. The Employment Development Department (EDD) denied his application for unemployment benefits. The trial court granted Brown’s writ petition, concluding that Brown had not engaged in misconduct sufficient to disqualify him from benefits because he had offered to go home and change shirts and was terminated on his first violation. In August 2013, EDD responded that EDD had paid Brown “all the benefits for which he has been found eligible,” noting that it was requiring Brown to submit certification forms and that an eligibility issue would need to be resolved before further benefits could be paid. in October 2014, Brown sought enforcement, claiming that EDD had imposed improper conditions, caused extended delays, and continued to withhold benefits. The court found EDD’s failure to comply “without good cause,” levied a $1,000 fine, awarded attorney fees, and determined that the rate of interest for wrongfully withheld unemployment benefits was seven percent, the judgment interest rate (Government Code 965.5(a), (d)). The court of appeal reversed, remanding for calculation of interest at 10 percent under Civil Code 3289(b). EDD’s statutory obligations are like contractual promises, subject to the statutory contractual rate of prejudgment interest. Brown’s right to prejudgment interest gave way to his entitlement to post-judgment interest with the trial court’s order. View "Brown v. California Unemployment Insurance Appeals Board" on Justia Law

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Johnson worked successively as a firefighter for South San Francisco (CSSF) and Pacifica. He developed nasopharyngeal cancer. Labor Code section 3212.11 establishes a presumption that cancer manifesting during and for a specified period following employment in certain public safety positions, including firefighters, arose out of and in the course of that employment. Section 5500.5(a) limits employer liability for a cumulative injury to the employer who employed the applicant during the one year preceding the earliest of the date of injury or the last date of injurious exposure to the hazards that caused the injury, so either CSSF or Pacifica would be potentially responsible for compensation for the entire injury. CSSF settled Johnson's workers’ compensation claim and sought contribution from Pacifica. An arbitrator denied the petition, ruling that evidence of the latency period for Johnson's cancer showed the injurious exposure occurred during Johnson’s earlier employment with CSSF. The Workers’ Compensation Appeals Board adopted the order. CSSF argued the Board erroneously utilized a more lenient preponderance evidentiary standard in applying section 5500.5(a), rather than the more stringent cancer presumption rebuttal standard of section 3212.1. The court of appeal affirmed; the evidence supports the award. Worker protection policies embodied in section 3212.1 are not implicated in the allocation of liability between employers. View "City of South San Francisco v. Workers' Compensation Appeals Board" on Justia Law

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Guzman was operating a soil compactor on a hillside with a 45-degree slope when the compactor hit a rock. The compactor rose in the air, causing Guzman to fall backward, and then fell on top of him. The workers’ compensation judge determined that Guzman sustained an injury to his back and psyche and that the psychiatric injury was caused by a “sudden and extraordinary employment condition,” Lab. Code, 3208.3(d). The workers’ compensation carrier for Guzman’s employer unsuccessfully sought reconsideration by the Workers’ Compensation Appeals Board, arguing that Guzman failed to meet his burden of proving that his psychiatric injury was caused by a “sudden and extraordinary employment condition.” The court of appeal annulled the Board’s order denying reconsideration. Guzman did not provide any evidence establishing that it is “uncommon, unusual, and totally unexpected” for a rock to be in soil, for a compactor to rise when striking a rock, or for an operator to become unbalanced and to fall when the compactor rises on a 45-degree hillside. He did not introduce any evidence regarding what regularly or routinely happens if a compactor hits a rock on a slope. Guzman admitted that he had previously worked on flat surfaces only. View "State Compensation Insurance Fund v. Workers’ Compensation Appeals Board" on Justia Law

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Under California’s workers’ compensation law, effective in 2013, an injured worker may challenge a decision denying medical treatment by requesting a determination of medical necessity from an independent medical review (IMR) organization. (Labor Code 139.5, 4610.5.1) The IMR organization, which is regulated by the Division of Workers’ Compensation and operates under contract with the Division, designates one or more medical professionals to review pertinent medical records, determine whether the disputed treatment is medically necessary, and prepare a written report including statutorily-required findings. The IMR organization is required to describe the qualifications of the medical professionals who prepare the determination of medical necessity and to keep the names of the reviewers confidential in all communications outside the IMR organization. The determination of the IMR organization is deemed to be the determination of the administrative director and is binding on all parties, subject to appeal on narrow statutory grounds. Zuniga availed himself of the IMR process and then petitioned the Workers’ Compensation Appeals Board to disclose the names of the reviewers. The Board declined to do so. The court of appeal upheld that decision. IMR determinations are not testimonial in character; IMR reviewers are not workers’ adversaries and are not subject to cross-examination. View "Zuniga v. Workers' Compensation Appeals Board" on Justia Law

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Under California’s workers’ compensation law, effective in 2013, an injured worker may challenge a decision denying medical treatment by requesting a determination of medical necessity from an independent medical review (IMR) organization. (Labor Code 139.5, 4610.5.1) The IMR organization, which is regulated by the Division of Workers’ Compensation and operates under contract with the Division, designates one or more medical professionals to review pertinent medical records, determine whether the disputed treatment is medically necessary, and prepare a written report including statutorily-required findings. The IMR organization is required to describe the qualifications of the medical professionals who prepare the determination of medical necessity and to keep the names of the reviewers confidential in all communications outside the IMR organization. The determination of the IMR organization is deemed to be the determination of the administrative director and is binding on all parties, subject to appeal on narrow statutory grounds. Zuniga availed himself of the IMR process and then petitioned the Workers’ Compensation Appeals Board to disclose the names of the reviewers. The Board declined to do so. The court of appeal upheld that decision. IMR determinations are not testimonial in character; IMR reviewers are not workers’ adversaries and are not subject to cross-examination. View "Zuniga v. Workers' Compensation Appeals Board" on Justia Law

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Christensen, an applicant for aid under the California Work Opportunity and Responsibility to Kids Act (CalWORKs) program, Welf. & Inst. Code, 11200, lives with her husband and her children. Her husband is the noncustodial parent of additional children, and court-ordered child support is garnished from his income for the benefit of these children who do not live in the applicant’s home. Counting the garnished amounts as nonexempt income to the applicant’s family, San Mateo County determined the family’s income was too high to qualify for CalWORKs cash aid and denied the application. The California Department of Social Services affirmed the denial. The trial court granted Christensen’s petition for writ of administrative mandate and request for declaratory relief, finding the Department’s policy of counting child support payments as nonexempt income was invalid on the grounds it was contrary to regulation, and it resulted in improper “double counting” of income among recipients of aid. The court of appeal reversed. No statute or regulation requires the exemption of the husband’s garnished child support from the income of applicant’s family, so the Department properly treated such amounts as income in determining the applicant’s family’s eligibility for CalWORKs cash aid. View "Christensen v. Lightbourne" on Justia Law

Posted in: Public Benefits

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Guerrero applied for workers’ compensation benefits after he was injured in the course of his employment as a construction laborer. He received temporary disability benefits: November 18–December 4, 2005, and January 17–June 15, 2006. His entitlement to permanent disability benefits was contested but settled in December 2014. The resulting agreement provided that Guerrero would receive a lump sum in satisfaction of his employer’s obligation to pay permanent disability benefits, less the amount of permanent disability payments his employer had advanced. Guerrero also applied for benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF), the state fund that pays workers’ compensation benefits to certain permanently disabled workers. A Workers’ Compensation ALJ ordered the SIBTF to pay, finding that Guerrero’s preexisting condition combined with the subsequent injury left him totally and permanently disabled. The ALJ fixed the beginning date for SIBTF payments as June 16, 2006, the day after temporary disability payments ceased, rejecting SIBTF’s argument that its obligation should not begin until January 26, 2011 (when Guerrero’s injuries were deemed permanent and stationary). The Workers’ Compensation Appeals Board denied a petition for review. The court of appeal affirmed, finding that under the controlling statutes, SIBTF benefits commence at the time the employer’s obligation to pay permanent disability benefits begins. View "Baker v. Workers Compensation Appeals Board" on Justia Law

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David, age 17 years 11 months, was a victim of past gun violence and is a wheelchair-bound diabetic in need of day-to-day medical assistance. He was living in a homeless shelter when a dependency petition was filed, alleging that he was abandoned by his mother and left without means of support. An investigation revealed that David had not been forthcoming about his family. The court dismissed the petition, finding that David had a support system in place but had chosen to leave it behind to be on his own. Had the petition not been dismissed, David would likely have qualified for transitional support as a nonminor dependent until age 21. The court of appeals dismissed an appeal. Dependency jurisdiction may not be initiated in the first instance over someone who is over age 18; it must be initiated before age 18, and by the plain terms of the Juvenile Court Law, may only be “retain[ed],” “continu[ed]” or “resum[ed]” for nonminors in certain circumstances until age 21. David’s case is now moot because he is 18 and any error by the juvenile court in failing to assume dependency jurisdiction is effectively unreviewable. View "In re David B." on Justia Law

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The trial court denied appellant's petition for writ of administrative mandamus seeking to overturn the denial of his claim for services under the Lanterman Developmental Disabilities Services Act (Lanterman Act), Welf. & Inst. Code, 4500 et seq. The trial court denied the petition based on the doctrine of res judicata because his ineligibility for services had been previously adjudicated in two prior proceedings. The court agreed, and rejected appellant's claim that res judicata does not apply because the court’s decision in Samantha C. v. State Dept. of Developmental Services and a 2003 amendment to the Lanterman Act constitute an intervening change in the law or a doctrinal change that precludes application of the doctrine. In this case, the court concluded that neither the Samantha C. decision nor the 2003 amendment to section 4512 bars application of res judicata. Accordingly, the court affirmed the judgment. View "Ronald F. v. Department of Developmental Services" on Justia Law

Posted in: Public Benefits