MICHAEL SULLIVAN & ASSOCIATES BLOG

For more than two decades, the law governing the identification of liable parties has been shaped by the Workers' Compensation Appeals Board’s en banc decisions in Coldiron v. Compuware Corp. In Coldiron I,^[1] the WCAB held that a third-party administrator (TPA) has a duty to disclose the identity of its client — whether a self-insured employer or an insurance carrier. Crucially, if the client is an insurance carrier, the TPA also must disclose whether the policy includes a "high self-insured retention," a large deductible or any other provision that affects the identity of the entity ultimately liable for payment. The WCAB warned that failure to do so could result in sanctions.

In Coldiron II,^[2] the WCAB declined to impose sanctions, as it was a case of first impression, but reiterated that the disclosure holdings remained in full force and effect.

The use of sub rosa surveillance video is a powerful tool in workers' compensation, often used to challenge an applicant’s credibility regarding the claimed level of disability. The timing and procedure for providing such evidence can be a point of significant dispute.

The Workers' Compensation Appeals Board (WCAB) has long recognized that a defendant may withhold surveillance video until after an applicant's deposition. In Downing v. City of Hayward (1988) 16 CWCR 76 (panel decision), the WCAB explained:

The use of artificial intelligence (AI) is increasing throughout society, and its use in law is no exception. AI provides tools for lawyers to quickly and effectively deliver legal services. Many lawyers use AI for both routine and complicated legal tasks, and those who do not risk falling behind.

As an emerging technology, however, AI is not infallible. Even the most advanced AI models have limitations and might not be familiar with all of the procedural and substantive court rules. A recent Workers' Compensation Appeals Board (WCAB) panel decision illustrates the dangers of relying entirely on AI to draft legal pleadings, and provides a stark warning about attorney oversight in an era of increasing reliance on AI.

Effective Jan. 1, 2022, the Workers' Compensation Appeals Board (WCAB) adopted regulations regarding electronic hearings. Remote hearings initially were used during the COVID-19 pandemic, but because such proceedings increased access to the workers' compensation system for parties, their representatives and the public, the WCAB believed that making the changes permanent would benefit the public and the administration of the workers' compensation adjudicatory system.

California Code of Regulations, Title 8, § 10745 states that the WCAB "may order that hearings be conducted electronically." CCR 10750 states that a notice of hearing must include "whether the hearing will be conducted electronically and how to access any electronic hearing."

The procedural rules governing discovery in workers' compensation cases serve critical purposes in ensuring fair and efficient adjudication. In particular, Labor Code 5502(d)(3) establishes that discovery closes on the date of the mandatory settlement conference (MSC), with strict limitations on the admission of evidence not disclosed in pretrial conference statements. Those rules are fundamental to the workers' compensation system's goal of expeditious resolution while maintaining due process protections.

On May 16, 2025, the 3rd District Court of Appeal in DPR Construction v. WCAB (McClanahan) (2025) 111 Cal. App. 5th 1136 issued a decision clarifying the discovery rules and addressing the standards for credibility findings under LC 5313. The decision was certified for publication June 11, 2025, ensuring its precedential value across California's workers' compensation system.

Under the going and coming rule, an employee's injury while commuting to and from work is not compensable under the workers' compensation system, absent special or extraordinary circumstances. That's because long ago, the California Supreme Court believed that an employee going to and from the place of employment did not render any service for the employer. (Ocean Accident and Guarantee Co. v. IAC (1916) 173 Cal. 313, 322.) Although the going and coming rule remains, "It has generated a multitude of exceptions which threaten, at times, to defeat the rule entirely." (Santa Rosa Junior College v. WCAB (Smythe) (1985) 40 Cal. 3d 345, 348.) So, the Workers' Compensation Appeals Board (WCAB) frequently finds injuries incurred while traveling to and from work to be compensable.

California has seen an increase in the number of workers who work remotely from home. In response to the COVID-19 pandemic and the statewide stay-at-home order, employers across the state implemented changes to allow employees to work from home to keep their businesses running during the pandemic. Those changes are still being felt, as many employees want to work from home, and many employers continue to allow them to do so, either fully or partially.

California Code of Regulations 31.3 establishes the rules for scheduling appointments with a qualified medical evaluator (QME) selected from a panel. CCR 31.3(e) establishes when a QME must be available for an appointment and states, "If a party with the legal right to schedule an appointment with a QME is unable to obtain an appointment with a selected QME within ninety (90) days of the date of the appointment request, that party may waive the right to a replacement in order to accept an appointment no more than one-hundred-twenty (120) days after the date of the party's initial request for an appointment." CCR 31.3(e) also allows either party to report the QME's unavailability and requires a replacement panel to issue "when the selected QME is unable to schedule the evaluation within one-hundred-twenty (120) days of the date of that party's initial request for an appointment" unless the parties waive the time limit for scheduling an initial or subsequent evaluation. CCR 31.3(f) applies the provisions in CCR 31.3(e) to both comprehensive medical-legal evaluation by a QME and follow-up comprehensive medical-legal evaluations by a QME.