Category Archives: Yrulegui & Roberts

Understanding the WCRC Review Process: A Crucial Step in Medicare Set-Asides

When dealing with Workers’ Compensation Medicare Set-Asides (WCMSAs), one critical phase that often determines the outcome is the review process conducted by the Workers’ Compensation Review Contractor (WCRC). The WCRC plays a pivotal role in ensuring that Medicare’s interests are protected by thoroughly evaluating the adequacy of proposed WCMSA amounts. This blog post will explain […]

Understanding the Difference Between Lump-Sum and Structured WCMSAs

When it comes to settling workers’ compensation claims that involve Medicare beneficiaries, one crucial aspect that must be considered is the establishment of a Workers’ Compensation Medicare Set-Aside (WCMSA). A WCMSA allocates a portion of the settlement to cover future medical expenses that would otherwise be paid by Medicare. There are two primary ways to […]

Understanding Medicare Set-Asides: When and Why to Submit to CMS

When settling a workers’ compensation claim, particularly when the claimant is a Medicare beneficiary or may soon become one, it is crucial to consider Medicare’s interests regarding future medical expenses. This is where a Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) comes into play. A WCMSA is designed to allocate a portion of the workers’ compensation […]

Intersecting Legal Precedents: The Synergistic Overlap of Virgil and Kite Cases in Workers’ Compensation Law

The Virgil v. State Compensation Insurance Fund decision has not only clarified aspects of combining impairments in workers’ compensation claims but also creates an interesting dialogue with earlier cases, notably the Kite case. Understanding the relationship between these two cases is critical for defense attorneys, as it provides a broader context for interpreting the WCAB’s […]

Examining the En Banc Decision in Virgil v. County of Kern: A Defense Perspective on Permanent Disability and Apportionment

The recent en banc decision in Virgil v. County of Kern has set a new benchmark in the interpretation of workers’ compensation laws, particularly regarding the evaluation of permanent disabilities and the principles of apportionment. This case provides critical guidance for defense attorneys who navigate the complexities of workers’ compensation claims. Here, the attorneys at […]

Navigating Workers’ Compensation During a Pandemic – A Landmark Decision on Average Weekly Earnings

In the recent case of Hever Rivera Flores v. L.A. Specialty Food Produce Company, Inc., the Workers’ Compensation Appeals Board (WCAB) made a pivotal ruling that underscores the complexity of calculating Average Weekly Earnings (AWE) during extraordinary times, such as the COVID-19 pandemic. Background The applicant, an employee of L.A. Specialty Food Produce Company, Inc., […]

Unpacking Workers’ Compensation: How Lodging and Food Allowances Impact Wage Calculations in Injury Claims

In a recent decision, Hidalgo v. Ducoing Management, Inc., the Workers’ Compensation Appeals Board (WCAB) addressed whether lodging and food allowances should be included in the calculation of a worker’s wages for temporary disability benefits. The case involved an injured laborer who claimed weekly earnings of $1,658.46, while the employer argued that his earnings were […]

Can an Employer in California Deny a Workers’ Compensation Claim because an Employee was Drunk?

A worker who is injured on the job in California has the right to claim no-fault benefits. He or she is covered even if the employer did nothing wrong. With that being said, employers do have certain workers’ compensation defense options. An employer has the right to deny a workers’ compensation claim if the employee’s […]

Does it Cost More for Employers to Get Workers’ Compensation Coverage if They are Uninsured?

The California Department of Industrial Relations (DIR) is very clear: state law “requires all employers to have workers’ compensation insurance.” An uninsured employer in California can face very serious sanctions. Notably, an employer could even be required to pay higher workers’ compensation rates once they get re-insured. Here, our Sacramento workers’ compensation defense law firm […]

California Regulators Accuse Business Owner in Fresno of Workers’ Compensation Fraud

On May 16, 2024, the Fresno Bee reported that California regulators were accusing a business owner in Fresno of workers’ compensation fraud. Heigo Kubar—the former owner of a Fresno-based trucking company—is facing allegations that he underreported company payroll by approximately $2 million. Mr. Kubar is facing three felony criminal counts. He had pleaded not guilty […]