WorkCompNews

NA - Work Comp driving stress; CA - minimum wage experiment; CA - employer sentenced; CA- Meloxicam driving cost Jeff Cole from Sentry Insurance on Managing Workforce Pressures and C-Suite Stress "evolving workforce pressures are shaping executive concerns." California's Minimum-Wage Experiment Isn't Looking Good - City Journal Substack "The overwhelming majority of the findings—about 96 percent—are negative" Royal Oaks nursery owner sentenced to jail time, fines. - Mountain Democrat "housing workers in poor conditions and evading taxes." High cost pain drug drives California com drug spending "A small number of high-cost prescriptions for the anti-inflammatory drug meloxicam are driving a sharp increase in California workers' compensation prescription drug spending"

AU - false statements in comp; NV-premium relief seen; NA - engaging AI in insurance quotes; CA - planned revisions in utilization Worker sentenced over 'serious' compo scam - Insurance News - insuranceNEWS.com.au "submitted five certificates of capacity containing false or incomplete employment declarations, resulting in payments worth several thousand dollars to which he was not entitled" Balancing Risk and Rate - Nevada Business Magazine "property and workers’ comp, those buyers are finally seeing rate relief." Travelers Companies stock targets faster workers comp quotes with AI - ad-hoc-news.de "The system targets small-business agents." WCIRB plans new methodology for measuring physician services utilization "better account for the complexity of care, an approach that produces “significantly different” results from its existing calculations."

CA - Deposition fee rules;  OH - Pro se claimant held to consistent standard; KY - Guides are not mandatory; NY - understanding class codes.   California proposes revised attorney deposition fee rules - Business Insurance " including lower rates for less-experienced attorneys and provisions allowing payment for travel time and transcript review." Truck driver's glaucoma claim collapses after string of missed deadlines "He appealed, representing himself - as he had done throughout - and raised four grounds for overturning the decision. " Ky. Top Court Upholds Impairment Rating Despite Minor Deviation from AMA Guides "To be grounded in the Guides is not to require a strict adherence to the Guides but rather a general conformity with them" How Class Codes Shape New York Workers' Comp Rates for Employers | Yonkers Times "Every employer with a workers’ comp policy carries a four-digit classification, and that number decides the base rate before any...

NA - Suicide concerns with physicians; NA - 60 tips for claims handling; NA - coincident decisions interacting; NY - corrections officer fabricated injuries.  Montgomery: Calls for Physician Suicide Awareness Highlight Systemic Harms to Providers "seeks to spotlight how systemic inequities harm providers as well as patients" The '60 Tips' Toolbox: Wisdom From Across the Industry - Risk & Insurance "a rapid-fire masterclass in removing obstacles to shorter claim duration" When Optimization Becomes Harm - WorkersCompensation.com "The challenge emerges when individually reasonable decisions combine to create consequences nobody intended. " Former Rikers Officer Jovanny Concepcion Sentenced for $232K Workers' Comp Fraud "ordered to forfeit and repay more than $460,000 after fabricating injuries"

NA- Return to work lauded; NA - Medical inflation significant; NA - changing face of work and the gig; NA - Older workers' claims more expensive Leveraging the Digital Tools to Greatly Reduce Claims Costs - Risk & Insurance "properly managed return to work programs can cut accommodated claims costs by as much as 60%" Medical inflation edges up in comp, with further hikes expected: NCCI - Business Insurance "expects annual price growth to reach 2% to 2.5% over the next several quarters"; "Hospital outpatient prices helped drive the increase" Are we all gig workers now? Or soon? - The Chief Leader "our ranks are growing to now include such traditional work occupations as nurses and home healthcare aides who bid for shift work on an app, lawyers and even dishwashers" Older comp claims require 21% more medical care: NCCI - Business Insurance "claims involving employees aged 65 and older require 21% more medical care on average"

NY - PTSD Standards; CA - Higher penalties on medical providers; NC - Press coverage garners denial reconsideration; TX - Fraud allegations in medical provision; NA - Topical medication challenges; GA - Competent medical evidence. Could Subway Janitor Clean up in Workers' Comp Court after Seeing Mangled Leg? "An emotional stress-induced injury is not compensable in New York if the alleged stressor is one the claimant should reasonably and ordinarily be expected to encounter in the normal work environment" California proposes penalties, tighter rules for medical provider networks "could face new penalties for treatment delays and disclosure failures under proposed rules" Workers' compensation claim approved for NC teacher after ABC11 Troubleshooter investigation "teacher whose workers' compensation claim was denied after he suffered a heart attack at work says he is relieved after his case was approved" Two charged in alleged $19 million federal...

NY - Coverage and benefits with uninsured; KY - Coalminers and the appropriate guidelines; CA - Guilty plea on fraud; ID - Control matters in immunity; NA - Halloween not an environmental risk; NA - Inflation impaccting still.  Construction Workers Injured While Working for Uninsured Contractors May Have Additional ... "a new state fraud program put uninsured employers in the spotlight, along with what their injured workers can still recover." Coal miner's disability award reinstated by Kentucky high court - Business Insurance "reinstated Thursday despite questions about whether his physician followed medical guidelines when assessing his injuries." Monterey Co.: Former Prison Guard Pleads No Contest To Workers' Comp Fraud - SFGATE "pleaded no contest to fraud after receiving more than $200,000 in workers compensation insurance benefits" Idaho Top Court Finds Right to Control Test Applies to Worker's Faulty Railing Lawsuit "the lower court...

NA - GLP-1s in workers' compensation strategy; DE - Another rate reduction; OK - Recouping portion of third-party recovery; KS - Terminating Medical;  IA - Job offer impacts benefits; NA - Benefit ceilings found confusing. Tipping the Scales? GLP-1 Considerations for Workers' Comp - Risk & Insurance "should the workers’ comp industry consider when evaluating and managing these medications?" Delaware workers' compensation insurance rates to drop for 10th year - CoastTV "The new rates, which take effect Dec. 1, include an average 3.99 percent decrease in loss costs for the voluntary insurance market" Workers' comp carriers can recoup death benefits, Oklahoma court rules "Workers’ comp carriers and subrogation professionals in Oklahoma now have definitive state-court authority backing death-benefit recovery from third-party settlements. " Appeals court overturns termination of worker's medical benefits - Business Insurance "Kansas...

NA - increasing relevance of safety; NA - WCRI Study on mental health; VA - New deputy commissioners; NA - NCCI report on treatment delay; TN - Criticism of treatment decisions; NA - Opioids decreasing and pain management questions As workers' comp rates soften, safety records carry more weight at renewal "heading for a 12th year of underwriting profit and premiums flat, a client’s experience mod and safety program are becoming the main levers on price." WorkCompRecap: Mental Modeling! - WorkCompWire "new study from WCRI that examined mental health claims in workers’ comp from 2015 to 2024, provides new evidence on the characteristics, treatment, costs, and disability outcomes associated with such claims." People Moves: Virginia Workers' Comp Commission Names 2 Deputy Commissioners "The Virginia Workers’ Compensation Commission named two new deputy commissioners, Adam L. Katz and Jason A. Mullins" Injured Workers Are Waiting Longer for First Treatm...

NA - Risk and season change; NA - Managing pharmacy in a post-opioid setting; NA - Robotics eliminating blue-collar work; CA - Repetitive trauma; CT - Three charged with coverage issues; DC - Scheduled loss interaction with wage loss. What Autumn Teaches Us About Prevention - WorkersCompensation.com "The larger lesson connecting them is remarkably consistent. Autumn changes several conditions within a short period of time" A Better Way to Manage Workers' Comp Claim Decisions: 6 Steps to More Effective ... "pharmacy decisions have always required nuance. But the nature of that decision-making has evolved significantly over the last decade." W.R. Berkley CEO: AI-Advanced Robotics Could Impact Workers' Comp by Eliminating Jobs "could impact workers' compensation insurance by eliminating blue collar jobs" How to Manage the Growing Complexity of Cumulative Trauma Claims in Workers' Compensation "claims in California are rising sharply. That...

NA - Workplace violence explained; NA - National premium declined; KY - Retaliation alleged; PA - Pension concerns; NA - Failed surgery syndrome Potential Implications for Workplace Violence and Workers' Comp - Insurance Journal "from threats and verbal abuse to physical assault and homicide. But the two ends of that spectrum are moving in opposite directions" Update the State! - WorkCompRecap "countrywide private carrier net written premium for CY 2025 declined 0.2% to approximately $41.6 billion" Baker Hughes worker alleges retaliation for seeking workers' comp after frac tank incident "she filed for workers compensation after a superior allegedly told her to stick her head in multiple frac tanks." Allegheny County Joins Long List of States Shouldering Massive Unfunded Worker Pensions "Nationwide, 47 of the 50 states had unfunded pensions in 2024, according to Reason Foundation’s" When Chronic Pain Changes a Life, Don't Let Friends...

CT- Three accused of comp violations; NY - Corrections Department payouts publicized; NA - Understanding terrorrism coverage; NY - Bus driver award affirmed despite allegations; TX - Employee alleges coverage hidden.  3 Connecticut business owners arrested for alleged workers' comp violations - WTNH.com "employees who were not reported to the insurance carrier" and "did not have an active workers’ compensation insurance policy." Workers' comp payments to state prison employees top $255 million - Mid Hudson News "New York State Department of Corrections and Community Supervision paid more than $255 million in workers’ compensation to employees during the 2026 fiscal year, a 20.2 percent increase from the previous year" Terrorism Risk Insurance Program: What You Need to Know - WorkersCompensation.com "TRIP serves as a vital backstop for workers' compensation insurers because state laws mandate that workers' compensation policies cover te...

NA - Spych claims increasing; NA - Social determinants back in the news; NA - Pay as you go, real wage comp coverage; NA - Seasonal Affective Disorder's variable impacts Investigations key as employers navigate rising psych comp claims - Business Insurance "Workers compensation claims for mental injuries are rising due to expanding state laws and shifting workforce demographics" John Peters: Social Determinants of Health, Injury Recovery, and Claim Litigation "Social determinants of health (SDOH), including economic stability, housing, food security, transportation, and social support, are increasingly recognized as major drivers of recovery after injury, independent of the injury itself. " Coverdash embeds pay-as-you-go workers' comp into 7shifts Payroll - FinTech Global "The partnership addresses a longstanding challenge for restaurants, where hourly staffing, seasonal hiring and employee turnover can cause payroll costs to fluctuate significantly thr...

NA - Mental health needs higher in some populations; CA - Cumulative trauma a challenge; NA - Severity rises 4% while frequency is down 2%; OK - Accommodated worker refused lower paying position; CT - Increases for on the job assault victims What a decade of workers' comp data shows about mental health claimants - HR Executive "mental health conditions account for a larger share of workers' comp claims among higher-paid workers, women and employees with several years on the job." Cumulative trauma: Managing CA's Workers Comp exposure - Marsh "shifted in the past three years from a background concern to a front-line financial exposure." Workers comp medical, indemnity severity each up 4%: NCCI - Business Insurance "indemnity and medical lost-time claim severity each increased an estimated 4% in accident year 2025" Oklahoma high court upholds firing of worker who declined reassignment "could no longer perform his duties because of medical re...

NA - Workers' compensation still profitable; NA - Younger and Older workers having most injuries; NA - Differences in group health, Comp celebrated; MN - Fee schedule cuts flatten medical costs.  Workers' comp's profit streak is intact, but the math is changing - Insurance Business "posted a combined ratio below 100 for twelve consecutive years among private carriers, according to NCCI. The run of underwriting profits has made it the most reliable casualty line in the US market" Younger and Older Workers Drive Shift in Workers' Comp Claims Mix, WCRI Finds "claims are increasingly concentrated among the youngest and oldest segments of the workforce, according to a report from WCRI" National Comp 2026: What Group Health Can Learn From Comp - Risk & Insurance “Workers’ compensation is much more than a health benefit. It’s a liability-driven benefit,” Minnesota workers' comp medical costs flat in 2025 after 2 years of increases "WCRI points ...

CA - time limit for reconsideration; OH - Fraud requires restitution; TN - Fee schedule applies to past care; VA - Change of leadership in adjudications; NSW - Changes in psychological burdens. California high court says comp board missed review deadline - Business Insurance "the board had 60 days to act on the employer’s request, but it did not agree to reconsider the award until 144 days after the request was filed." Ohio Woman Ordered to Pay Over $53k in Restitution for Workers' Comp Fraud "Special Investigations Department determined she had collected disability benefits while simultaneously providing non-medical in-home care services for multiple employers." Appeals board says comp fee schedule applies to unauthorized care - Business Insurance "An employer ordered to pay for previously denied medical treatment is not required to pay more than the amounts allowed under the state’s workers' compensation medical fee schedule" VA Workers' Comp...

CA- Combined ratio highest in 20 years; AZ - Proving the obvious causation; TN - Lawsuits over 2025 explosion; TN - Delay in self-represented case. California Workers' Comp Combined Ratio Highest in More Than 20 Years "combined ratio for California workers’ compensation insurers reached 127% in 2025, the highest in more than 20 years" Did Staggering Trucker have to Prove Exhaust Leak Sickened Him? - WorkersCompensation.com "A case involving a driver who breathed in toxic fumes during a three-hour trip examines just how obvious that link needs to be." Lawsuits mount ahead of 1-year anniversary of AES plant explosion - WSMV "The blast killed 16 AES employees, making it one of the deadliest industrial disasters in recent years." Comp board backs delay in Walgreens worker's robbery-related claim - Business Insurance "The board said the judge had a valid concern about the self-represented worker’s capacity to pursue benefits"

NA - evidence of fraud decreasing; NA - Accommodated return to work produced positive results; NA- Industry mix changed after COVID; NC- Leased employee could sue the workplace, as he was not their employee. Report Shows Fraud Referral Rates Declined, Severity Increased - Claims Journal "as the frequency of fraud may be decreasing, the severity and cost of those claims continue to drive substantial losses." Study: Structured return-to-work programs foster workers' comp claim resolution "three common barriers: employers may lack appropriate modified-duty jobs, workers' compensation expertise may be limited, and there may be no standardized process for managing accommodations." WCRI Study Finds Workers' Comp Injury Industry Mix Shifted After Pandemic “This study provides a view of the composition of workers’ compensation claims across a period of significant change in the workforce and economy,” Temp worker's injury lawsuit survives after company's...

NA - Labor market looks soft; IL - Work rules are for work, compensation is broader; NA - Tips on claims success; NC - Supervisor's assault and battery supports lawsuit Labor Lookin! - WorkCompRecap "At an industry level, the job market looked like it was at a standstill, with very little gain or loss across industries." Worker keeps comp benefits for fall in sandals while heading to charge phone Prohibitions and rules "apply while working," and workers' compensation applies whether working or not. Communication, Finding 'Why' Top Tipsters' List of how to Improve Workers' Comp Empathy, timeliness, dignity, and setting the tone Comp exclusivity does not bar suit over supervisor's alleged violent acts "allegations of repeated blows to the head and neck fell within an exception to workers compensation exclusivity."

NSW - Evidence-based medicine; NA - Compliance and consistency challenges; NA - Is AI improving outcomes? KO - Cancer claims up, acceptance down; NY - Mandating ADR NSW scheme implements 'reasonable and necessary' rule - insuranceNEWS.com.au "This change is designed to improve consistency in decision-making about evidence-based treatment and support across the scheme." Tracking Workers' Comp Regulation Changes Across States in 2026 "a structured, practical approach to tracking workers' compensation compliance across state lines." Comp industry looks beyond AI time savings to worker outcomes - Business Insurance "determining whether those savings translate into better outcomes for injured workers remains a challenge." Occupational cancer workers' comp claims up 5.8-fold in 7 years, but approval rate slides into the 30s Korean "Claims for workers' compensation recognition of occupational cancer have surged, but the approval rat...