WorkCompNews

NA - Health care costs rising; NA - Heat injury goals shift; MO - the waiting period highlighted Health Care Is Fixable: Workers' Compensations Shows Employers Don't Need to Wait for ... "Health care is more complex, but the lesson is clear. When incentives are aligned around results, better performance follows." Inspection Goals Removed from Trump Administration Heat Program "the program will now focus on a 'continued need for heat-related outreach and compliance assistance activities, as well as on-site consultation visits and programmed enforcement.'" Cole County ends extra workers comp pay | Jefferson City News Tribune "It's a three-day waiting period, plain and simple,"

PA - Self-referral does not cover pharmacy; NJ - Jurisdiction over neighbors' claims; CA - claims fraud guilty plea Workers' Comp Self-Referral Ban Doesn't Cover Prescription Drugs, Pa. High Court Rules "The majority ruled that physicians aren't barred from referring patients to pharmacies they own or have a financial interest in" NJ Clarifies Medical Provider Claims in Cross-Border Workers' Comp Cases | JD Supra "holding that because New Jersey did not have jurisdiction over the underlying workers’ compensation injury, it also lacked jurisdiction over the derivative medical provider claim." UPS Mechanic Pleads to Workers' Comp Fraud - Sacramento County District Attorney's Office "sentenced to 90 days in jail, 2 years of formal probation and was ordered to pay $50,000 in restitution"

NA - Litigation prevalence increasing; CA - Cumulative Trauma driving news; NA - Transport and translation are critical elements. Litigated comp claims climb as more injured workers lawyer up - Business Insurance “the share of workers compensation claims in litigation rose to 12.3% of the brokerage’s total claims inventory in 2024, up from 7.6% in 2018,” California Cumulative Trauma Claims Surge, Now Represent a Quarter of Workers' Comp ... "Total pure premium costs attributable to CT claims have more than doubled since 2021, while costs for non-CT claims have increased by more than 30% since 2020" Why Transportation and Language Services Are Essential to Injured Worker Recovery "Missed health care appointments can derail recovery and drive up claim costs."

NA - severity, inflation, and demographics creating claim pressure; CA - Medical inflation driven by new unlisted treatment codes; TX - nonsubscription and next steps Workers' comp's golden era may be ending as claims severity climbs | Insurance Business "a combination of rising claim severity, medical inflation, and workforce demographic shifts is creating new pressures that could gradually overhaul underwriting and claims strategies." CWCI: California Workers' Comp Medical Inflation Driven by Growing Use of Unlisted Codes "a growing share of treatment rendered to injured workers in the state is billed under unlisted codes that fall outside fee schedule pricing controls" Hurt at work? What to do if your employer doesn't have workers' comp - KSAT "what it means to work for a “non-subscriber,” why reporting an injury quickly matters, and when a case may need to be filed in court"

GA - Comp shields employer of teenager; CA - premises deemed controlling; KY - Notice and filing in retaliation Georgia court says comp bar applies in teen worker's fatal heavy equipment accident "a 16-year-old worker who was killed while operating heavy machinery at a construction site, (the court) ruling that the state’s workers compensation law provided the exclusive remedy." Could Parents of Taco Bell Worker Stabbed in Parking Lot Sue for Wrongful Death? "The court pointed out that a parking lot is generally considered to be part of an employer’s premises. Thus, the worker in this case never left the premises." Kentucky court upholds coal miner's comp retaliation verdict - Business Insurance "a worker does not need to formally file a comp claim to bring a retaliation claim if there is evidence the worker was pursuing benefits."

AZ - the "comma bill"; OR - Burden of proof; FD - Formulary burdens Arizona's 'comma bill' faces last-minute insurance opposition "Firefighters say a missing comma in Arizona law is threatening workers' compensation coverage" Oregon appeals court revives worker's combined-condition comp claim "the state Workers’ Compensation Board applied the wrong burden of proof in denying a combined-condition claim" Nonformulary Misstep: ECAB Upholds Denial of Brand-Name Pain Patch "As neither the claimant nor her physician pursued prior authorization or provided a rationalized medical explanation establishing the necessity of the nonformulary medication over available formulary alternatives"

NA- Labor market strong; NA - Fall prevention and losses; CA - Cumulative trauma is increasing U.S. Labor Market Shows Signs of Acceleration, Pointing to Stronger Workers' Comp Payrolls "approaches the pre-pandemic average of 191,000 monthly jobs. The trend carries direct implications for workers’ compensation exposures" Understanding fall accident: Prevention tips and legal rights | Daily Inter Lake "In 2024, 43,020 adults aged 65 and older died from preventable falls" California cumulative trauma comp claims rise sharply - Business Insurance "the share of indemnity claims involving cumulative trauma was relatively stable before the pandemic but has risen sharply since then, reaching a high in 2024 of 26% of indemnity claims, up from 13% in 2012."

NY - assessing mental health law; NA - Return to work; MS - Effect of bankruptcy discharge Weighing the Impact of New York's Amended Mental Injury Workers' Comp Legislation 18 ... "There is reason to believe that the law has already spurred positive change, with employers expanding mental health benefits for their workers." Moving Return to Work Forward - Risk & Insurance "Too many return-to-work programs still rely on outmoded systems." Mississippi high court revives injured worker's third-party suit - Business Insurance "because the bankruptcy case was dismissed without discharge, the bankruptcy court’s acceptance of Mr. Strong’s prior representations was revoked"

VA - Misclassification; NA - Combined ratio results for 2025; ND - Res Judicata Virginia Court of Appeals Reverses Worker Misclassification Decision - The Des Moines Register "court’s ruling overturned a previous finding that had labeled the worker an independent contractor," Workers' Comp Calendar Year Combined Ratio at 91; Accident Year Combined Ratio 102: NCCI "workers’ compensation net written premium decreased 0.2% in 2025" Without Ripe Acceleration Claim, N.D. Worker didn't Run into Res Judicata Wall "the ALJ addressed res judicata only in a footnote, concluding that it was inapplicable"

CA - Legislative change for athletes?; NA - Violence against teachers; NA - Addressing worker stress Rams, Chargers and 49ers Back California Workers' Comp Proposal - Sportscasting "a proposal that would significantly restrict how professional athletes access workers’ compensation benefits" Violence against teachers has been on the rise - Tri-State Alert "violence is on the rise in schools – and a lot of it is aimed at teachers." How employee assistance programs drive better workers' comp outcomes - Insurance Journal "addressing an injured worker’s stress can speed up recovery"

NA - Congress votes on pot in comp; NA - Hartford the new first place; NA - Stop Loss Claims increasing Congressional Committee Votes To Block Medical Marijuana From Being Covered Under ... "to 'authorize, provide, reimburse, or otherwise recognize marijuana or any cannabis-derived substance as a compensable medical treatment or benefit' under any federal workers’ compensation program" Best's Rankings: Hartford Eclipses Travelers as Top US Workers' Comp Carrier "with $3.73 billion in direct premiums written, according to a new Best’s Rankings report." Medical Stop Loss Claims Above $2 Million Have Tripled Since 2020, Report Finds "Accelerating claim frequency, catastrophic condition costs, and specialty pharmacy inflation are pressuring rates"

CA - Systems costs up; TN - Causation and credibility; NA - Workers' Comp premium renewal rates decreased California's workers' comp system is broken — and cities are paying for it - The Business Journal "The system now covers 17.7 million workers and costs more than $24 billion" Volkswagen loses workers' compensation fight over causation of employee's preexisting hip "The case came down to two competing medical opinions. A referral orthopedist concluded the hip arthritis was not work-related. The surgeon who performed the replacement, Dr. Timothy Ballard, disagreed. " Ivans Index May 2026 Results Released - Yahoo Finance "premium renewal rates decreased for Workers’ Compensation."

TN - Credibility determinations; FL - Statute of Limitations; NA - Fraud Court orders employer to authorize worker's knee surgery despite review denials "A judge sided with the doctor who actually examined her." Could Delivery Driver Pick Up Neurosurgeon Benefits more than 2 Years after Accident? "In many states, injured employees have two years to file a petition for benefits. That includes Florida." The New Face of Insurance Fraud Looks Just Like a Legitimate Claim "we’ve had to learn how to ask is whether it’s actually real or just posing as legitimate enough to move through the system."

TN Heart attack claims; NA - Workers' Compensation complexity; NA - Safety agency to shutter Could Wife get Benefits for Truck Driver's Heart Attack During Traffic Stop? "The driver climbed in the summer heat into and out of the very tall trailer." Multiple Factors Affecting Auto, Workers Comp Claim Complexity: Report "Factors including litigation, workforce transformation, and evolving medical " Trump Administration Moves to Shutter Federal Chemical Safety Watchdog "the latest budget from the Trump administration proposes to cut funding for the federal agency that investigates"

NA - Medical payments show significant variance, LA - New bill headed to Governor, CAN - Reform proposals Workers' Comp Medical Prices Vary Dramatically by State, With Fee Schedules Proving Key ... "Prices paid for nonhospital professional services ranged from 28% below the multistate median to 174% above" Lawmakers Deliver Big Wins for Small Business - NFIB "legislation to modernize the state’s workers’ compensation system and create a new workforce training program." Injured Workers' Day Arrives Amid New Attacks On Compensation System | Markets Insider "events are taking place while Ontario’s Bill 105 proposes the largest changes to the compensation system since 1998"

LE - Westlaw provides update tool; CA - Reform sought; AU - reforms and social involvement with recovery Roundup: Key developments in insurance law for the week ending May 29 - Westlaw Today "Westlaw Today recaps insurance developments covered in the preceding week" Does part of California's workers' compensation need an overhaul? What to know - Yahoo "pushing to reform the Subsequent Injuries Benefit Trust Fund through a budget trailer bill" National push to tighten workers' comp risks super insurance crisis - AFR "reforms in states including Victoria and NSW to reduce the cost of psychosocial injury claims are adding to cost pressures and fee increases"

CA  - IMR report published; NA- Concerns about AI persist; CA - Employment Development Department offices leaving DIR Workers' Comp Independent Medical Review "in 2025, ... most treatment denials reviewed through IMR continued to be upheld" From Automation to Augmentation: How AI Reshapes Workers' Compensation "workers’ compensation professionals caution that the role of artificial intelligence must be limited" Kamin: Attorneys Are Worried About EDD's Exit From WCAB Offices - WorkCompCentral "we found that the DIR leased spaces were not being regularly used, which prompted EDD to conduct an operational review."

OR - High earner resigns; NA - Augmentation is impacting AI; FL - Costs Rising The Story Behind the Abrupt Departure of One of Oregon's Highest-Paid Public Employees "It’s not every day that a public employee in Oregon walks away from a job that pays nearly $850,000 a year." From Automation to Augmentation: How AI Reshapes Workers' Compensation "Technology is shifting from digitizing processes to actively shaping claim outcomes." Florida Comp Costs Are on the Rise. End to Physician Dispensing May Help "costs may no longer be falling, thanks in part to higher wages and escalating medical payments, a new study from the Workers Compensation Research Institute shows."

LA - Reform bill passes; CO - Pnnacol layoffs; NA - stress on safety. Lawmakers Agree on Much-Needed Workers' Comp Reform - NFIB is legislation takes important steps to create a more balanced system that supports injured workers while helping employers manage rising costs. " Pinnacol lays off workers, backers pull privatization ballot measure - Loveland Reporter-Herald "The layoffs were announced internally May 14 and happened across the organization. The job cuts accounted for about 7.5% of the company’s 578 employees." Safety culture may lower insurance premiums "An insurer outlines seven steps businesses can take to reduce workplace risks"

NA - prescription costs rise; MD - debating presumptions; CA - Changing the law Workers' Comp Drug Costs Reverse Course, Rising Sharply Across Most States "prescription payments per medical claim increased in the majority of states studied between 2022 and 2025" Beyond the Original Grand Bargain: Maryland's Evolving Workers' Comp System "The trajectory of Maryland workers’ compensation policy suggests these debates will continue intensifying." Should state's workers' comp be fixed? Or is that a 'wrecking ball to a safety net'? - Sacramento Bee " California Gov. Gavin Newsom is pressing to overhaul the program through a budget trailer bill"

NA - Protecting healthcare workers from violence; WA - explosion with fatalities may be state's worst; PA - Top court upholds limitation on claim filing time. Lawmakers Work to Protect Healthcare Workers - WorkersCompensation.com "while healthcare professionals make up only 10 percent of the U.S. workforce, they are the subject of nearly half (48 percent) of the recorded nonfatal injuries due to workplace violence" Fatalities Reported in Washington Packaging Facility Explosion "The nine people who are still unaccounted for in the Longview incident are all employees of the company" Pennsylvania top court slams door on late asbestos claims targeting parent company "They argued CLI should answer for Dravo's liabilities under a veil-piercing theory, pointing to what they described as a multi-year asset-stripping campaign."

NA - increasing claim complexity; NY - retroactive application of law approved, NA - Pharmacy changing and evolving. State Regulatory Surge, Federal Shifts Reshaping Workers' Comp - Claims Journal "Workers’ compensation is entering a period of heightened complexity as regulatory changes and policy shifts continue to unfold" New York Court of Appeals Holds That Justice for Injured Workers Act Applies Retroactively ... "even though, usually, a law cannot be applied retroactively, here there was no right that a party possessed at the time it acted that would be disturbed, no increase in a party’s liability for past conduct, and no imposition of new duties" Don't Miss These 3 Important Changes in Workers' Comp Pharmacy This Month — May 2026 "Two have immediate operational impacts, while the third represents a gradual but significant national shift on the horizon."