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Government Benefits

[04/18] Coventry Health Care of Mo., Inc. v. Nevils
In an insurance class action arising in the context of the Federal Employees Health Benefits Act of 1959 (FEHBA) authorization of the Office of Personnel Management (OPM) to contract with private carriers for federal employees' health insurance, 5 U.S.C. section 8902(a) and (d), the Missouri Supreme Court's decision, preventing federal employee insurance carries from seeking subrogation and reimbursement if there is a conflicting state law, is reversed where, because contractual subrogation and reimbursement prescriptions plainly 'relate to . . . payments with respect to benefits,' section 8902(m)(1), they override state laws barring subrogation and reimbursement.

[04/07] Becker v. OPM
In a spouse's appeal of a decision from the Merit Systems Protection Board affirming the Office of Personnel Management's (OPM) determination that she was ineligible to receive survivor benefits upon the death of her late husband under the Federal Employees Retirement System (FERS), the Board's decision is affirmed where plaintiff has not demonstrated that the Board abused its discretion.

[03/27] Rodriguez v. US
In a suit brought by federal employees challenging the Office of Personnel Management?s (OPM) regulations that exclude cost-of-living allowances (COLAs) from the calculation of retirement and other benefits, the district court's dismissal of the complaint is affirmed over plaintiffs' contentions that allege the regulations are unlawfully discriminatory under Title VII of the Civil Rights Act of 1964, Pub L. No. 88-352, 78 Stat. 241, 253-66, and are arbitrary, capricious, and contrary to law under the Administrative Procedure Act (APA).

[03/24] Bonome v. City of Riverside
In an employment disability action arising out of the termination of a police officer for failing to properly investigate and report an incident involving a sexually abused girl, the trial court's grant of plaintiff's petition for writ of mandate is affirmed over defendants' contentions that the trial court erred when it determined plaintiff was 'honorably retired' within the meaning of Penal Code section 16690 based only on the plain language of the statute and without reviewing the legislative history, where this interpretation leads to an absurd result.

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Labor & Employment Law

[04/21] NLRB v. Pier Sixty, LLC
In petition for enforcement of an order of the National Labor Relations Board (NLRB) and an employer's cross?petition, the NLRB's decision is affirmed where: 1) employer has not shown the existence of an 'extraordinary circumstance' that requires us to waive the ordinary rule against considering arguments not presented to the Board as required by 29 U.S.C. section 160(e); and 2) employer violated Sections 8(a)(1) and 8(a)(3) by discharging the employee since employee's conduct was not so 'opprobrious' as to lose the protection of the NLRA.

[04/21] Pan Am Railways, Inc. v. US Dep't of Labor
In a petition for review, in an underlying Federal Railroad Safety Act (FRSA) whistleblower retaliation action, of an agency decision resulting in the statutory maximum award of punitive damages against a railroad, the petition is denied where substantial evidence supported the ALJ's rejection of the railroad's affirmative defense and the ALJ's decision to impose punitive damages.

[04/19] Featherstone v. S. Cal. Permanente Med. Group
In an action brought by a former employee against her employer, alleging defendant refused to rescind her resignation in violation of the Fair Employment and Housing Act (FEHA), Gov.Code section 12940 et seq., and public policy, the district court's grant of summary judgment in favor of defendants is affirmed where: 1) defendant's refusal to allow plaintiff to rescind her resignation was not an adverse employment action under the FEHA.; and 2) plaintiff failed to raise a triable issue of fact as to whether the defendant employees who accepted and promptly processed her resignation knew of her alleged temporary disability at the time they took those actions.

[04/18] Coventry Health Care of Mo., Inc. v. Nevils
In an insurance class action arising in the context of the Federal Employees Health Benefits Act of 1959 (FEHBA) authorization of the Office of Personnel Management (OPM) to contract with private carriers for federal employees' health insurance, 5 U.S.C. section 8902(a) and (d), the Missouri Supreme Court's decision, preventing federal employee insurance carries from seeking subrogation and reimbursement if there is a conflicting state law, is reversed where, because contractual subrogation and reimbursement prescriptions plainly 'relate to . . . payments with respect to benefits,' section 8902(m)(1), they override state laws barring subrogation and reimbursement.

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Workers' Comp

[03/29] Marin Community Services v. WCAB
In a writ proceeding seeking to set aside the decision of the Workers' Compensation Appeals Board (WCAB) holding that firefighter-petitioner was entitled to the benefit of the rebuttable presumption under Labor Code section 3212.1 that his cancer arose out of his employment, the WCAB's decision is affirmed where: 1) the WCAB's determination that petitioner was an employee of Marinwood was based on a reasonable interpretation of the relevant statutes; and 2) the WCAB's determination that the extension of the cancer presumption ran from the date petitioner last worked as a firefighter for any agency was based on a reasonable interpretation of the relevant statute.

[03/29] Ramirez v. WCAB
In a workers' compensation writ proceeding, seeking review of worker-petitioner's independent medical review on the ground the underlying utilization review was based on an incorrect standard, the order of the administrative law judge (ALJ) taking the matter off calendar is reversed and remanded for further proceedings where: 1) this is not a proper ground for appeal of a utilization review determination because it goes to the heart of the determination of medical necessity; 2) the independent medical reviewer is in the best position to determine whether the proper standard was used to evaluate the medical necessity of the requested treatment, and the statutory scheme requires the independent medical reviewer to use the proper standard in determining medical necessity; and 3) the Legislature's plenary power over the workers' compensation system precludes any separation of powers violation, and the process afforded workers under the system affords sufficient opportunity to present evidence and be heard.

[03/24] Co. of Riverside v. WCAB
In a workers' compensation case involving a sheriff, the findings by the Workers' Compensation Appeals Board are affirmed over a County's challenge where: 1) plaintiff's the application for adjudication of claim was timely filed; and 2) Labor Code section 5500.5(a), did not bar liability on the County?s part.

[03/23] People v. Riddles
Conviction of workers' compensation insurance fraud in violation of Insurance Code section 11760(a) and restitution order are affirmed where: 1) a workers' compensation insurer may recover, as restitution under Penal Code section 1202.4, the premiums it would have earned in the absence of misrepresentations by an insurance applicant; and 2) the court did not err in imposing a fine.

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