“Lies, damned lies, and statistics” is a famous phrase used to describe the persuasive power of numbers to bolster weak arguments and mislead an audience. While widely-popularized by legendary author Mark Twain, its true origin remains debated.
In his autobiography, Twain famously attributed the quote to British Prime Minister Benjamin Disraeli. Regardless, with the stated aim of avoiding lies (and damned lies), we’re going to use this article as a stage for estimating reasonably accurate statistics regarding the (HUGE) value that B&B partners, Louis Larres and John Kamin, bestowed on the California Workers’ Compensation System with their recent case law success known as “Rodriguez.”
Goodbye “Patterson”
Did you see what Louis and John did at the 2nd District Court of Appeal? If not, check out the highly-important and wildly-successful defense win in Illinois Midwest Insurance Agency v. WCAB (Rodriguez)(2025) 90 Cal.Comp.Cases.
It deep-sixed the despised “Patterson Doctrine” that had been hanging around the collective neck of California defendants for more than 15 years. The doctrine, which arises from the case of Patterson v. The Oaks Farm (2014) 79 Cal.Comp.Cases 910, held that if an employer previously authorized a treatment (like home health care or nurse case management), the defense could not stop it or send it to utilization review without first demonstrating a “change in circumstances” to a WCJ’s satisfaction.
This was almost impossible to do. With a PTP siding with applicant and no utilization review (UR) or Independent Medical Review (IMR) to bolster defense positions, not much of a battle could be fought.
I am certain that virtually every defense attorney reading this article has litigated cases wherein applicant’s attorney demanded – and often received – a premium for a settlement because the (allegedly) injured worker snagged some crazy expensive ongoing treatment, had it authorized, and the defense was precluded from proving it was no longer reasonable and necessary.
Bradford & Barthel LLP’s aforementioned legal eagles, Messrs. Larres and Kamin, employing their ligation, Petition for Reconsideration, and Petition for Writ of Review magic, conjured up “Rodriguez,” which reversed the above and outright rejected the “Patterson Doctrine.” In that case, the 2nd DCA ruled that there is no statutory exception to requiring the parties to use UR/IMR to assess the appropriateness of ongoing treatment.
The happy result? Employers can now submit previously authorized treatment to UR/IMR – and potentially deny it – without needing to prove that the worker’s condition has changed and without going to a WCJ to make such a determination.
Who Cares?
“Rodriguez” should give rise to huge savings (though an exact dollar figure has not been ascertained, thus giving us a fun project to work on). Spitballing, you must consider that there are about 680,000 total new workers’ compensation claims per year in California. Conservatively estimating, if a mere 5% of them are affected by “Rodriguez,” that’s 34,000 cases. With that in mind, there are really only 3 possible scenarios.
Here are the three (which one feels most realistic to you?):
1) Conservative ($5,000/case)
Mainly saving on legal fees and minor prescriptions.
• Total: ~$170 Million
2) Moderate ($20,000/case)
Stopping mid-range treatments (PT, some home care) + legal costs
• Total: ~$680 Million
3) Aggressive ($50,000/case)
Stopping major, high-cost home health care plans and complex treatments
• Total: ~$1.7 Billion
This is where the numbers get truly staggering. In California workers’ compensation, home health care is often the single most expensive ongoing medical cost – even more than surgeries in the long run.
Break That Down For Me
The Cost Breakdown (Per Case)
| Care Level | Shift | Monthly Cost |
| Standard | (8 hrs/day x 5 days = 40 hrs per week) | $6,600 |
| High-level care (skilled nurse needed) | 24/7 (round the clock) | $25,000 |
(Based on 2024-25 California industry averages of approximately $35-$40/hour for agency care.)
Author’s Note: For 2025, the maximum hourly rate for home health aide/attendant care is often capped around $38.00 – $42.00 per hour (depending on the region), not the higher skilled nursing rates. Thus, when I employ a $35-$40/hr, this is clearly on the conservative end. The conservative nature of these figures becomes even more patently clear when one realizes we are not incorporating “Skilled Visits,” which —-depending on the discipline—-can run from $80 (Home Health Aide) to $230 (Speech-Language Pathologist).
If we look back at our 34,000 cases, the potential savings are likely much higher than our initial “Aggressive” estimate if significant home health care is involved.
- If defense stops one 24/7 home care case: Save $300,000 instantly, as that’s the yearly cost at $25,000/month.
- If a standard day-shift aide is stopped: Save $79,200, as that’s the yearly cost at the monthly estimate for standard care.
This suggests our “Average Savings per Case” might actually be closer to $50,000 – $75,000 (blending the big home care wins with smaller prescription disputes).
Conclusion: The Final “Napkin Math”
So if 5% of each year’s cases involve home care, then that’s 34,000 cases. And if the average savings per case is $60,000 (a nice midpoint between $50,000 and $75,000), then we can now estimate that:
- 34,000 cases x $60k (average savings) = $2.04 BILLION in savings
In conclusion, another quote comes to mind: “A billion here and a billion there and pretty soon you are talking about real money.”
The quote is almost universally attributed to Everett Dirksen, a Republican U.S. Senator from Illinois who served from 1951 until his death in 1969. He later denied saying it, but no matter, the thought is valid. If, as the number crunching suggests, “Rodriguez” may save defendants over $2 billion a year, “pretty soon” we will all agree that Louis Larres and John Kamin must be thanked for saving the industry “real money.”
It’s all about preventing medical bills AND avoiding the legal fees to fight them. (Though as the father of 5, I’m dead set against the second source of savings! I have no choice. Who’s going to feed that hungry 6’ 4” 19 year old of mine known as Mr. Always Hungry?)
Here’s hoping – and predicting – the defense will achieve much if not all of the tremendous savings described above (without putting brilliant defense attorneys out of business)!*
*Footnote: In all seriousness, the California courts, legislatures, and governors seem dedicated to the proposition that workers’ compensation rules need to become increasingly complex. We regularly see minor shortcomings in the system met by extravagant changes, thereby complicating things even further. There is no law any more dependable than the law of unintended consequences. As such, regardless of the “Rodriguez” impact on minimizing defense costs, I sleep well knowing Sacramento’s “fixes” will keep me in legal work for the foreseeable future (and then some!).
Don R. Barthel is one of the founding partners of Bradford and Barthel, and is based in the firm’s Sacramento office. He has taken dozens of doctor depositions and analyzed thousands of doctor depositions in order to correct innumerable errors, including misapplications of the AMA Guides, statutory misunderstandings, and other errors making the underlying medical reporting entirely speculative and unreliable. If you have any questions about workers’ compensation defense issues, please feel free to contact him at 818.654.0411 or via email at dbarthel@bradfordbarthel.com.
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