MA - High Court Affirms Commissioner's Discretion Over Rates, but Deviation Requires Explanation
07/07/2026 | 0
The Massachusetts Supreme Judicial Court on Monday held that the insurance commissioner can reject rates proposed by the state's designated ratemaking agency but must explain any deviation he approves.
The commissioner nearly doubled the size of a recommended rate cut in 2024 and, in 2025, rejected a proposed increase and held rates unchanged.
Although the commissioner properly exercised his authority to disapprove the proposed rates, he failed to explain the basis for his decision to order a larger decrease than recommended, the high court said in Workers' Compensation Rating a
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The Wyoming Supreme Court upheld the denial of a worker’s claim for benefits for the pancreatitis he allegedly developed as a result of the medication he took to treat a compensable injury.
Case: McDonald v. State ex rel. Department of Workforce Services, No. S-25-0228, 06/30/2026, published.
Facts: Sam McDonald suffered an injury to his head in 2014 while working as a mechanic. The Workers’ Compensation Division deemed the injury compensable.
McDonald’s injury caused him to suffer debilitating migraines, for which he sought treatment from Dr. George Zinkhan.
Zinkhan note
A divided Louisiana appellate court dismissed an appeal by an injured worker’s statutory employer challenging a determination of no coverage owed to it by its insurance carrier.
Case: Castro v. Church Mutual Insurance Co., No. 2025 CA 0964, 06/12/2026, published.
Facts: Meylin Castro worked for Southern Pro Solutions Inc. Southern had a contract to supply labor to 1 Priority Environmental Services Inc. for an asbestos abatement project at the First United Methodist Church of Denham Springs.
Sunbelt Rentals Scaffold Services Inc. provided a scaffold for the project.
While Castro was s
A New York appellate court ruled that a carpenter should have been granted summary judgment on his Labor Law claim for his fall from a ladder.
Case: Rudzikewycz v. 164 West 79th Street Corp., No. 152685/18, 06/18/2026, published.
Facts: Nick Rudzikewycz worked as a carpenter for Roth Built Works Inc. He allegedly suffered injuries in November 2016 when he fell from a ladder that shifted.
Rudzikewycz said no alternative safety device, such as a Baker scaffold, was available for his use. Although Rudzikewycz testified that he placed the ladder on the floor after ensuring that it&nbs
May 20, 2026
The single most important thing a workers’ compensation program can do to reduce costs and improve outcomes for injured workers is also the simplest: Report claims promptly.
Prompt reporting enables prompt determination of compensability. Prompt compensability determination enables prompt provision of quality medical care. Prompt care shortens recovery. Shorter recovery reduces litigation. And litigation — not medical costs, not indemnity, not administrative expense — is the largest cost driver in the system.
Every other intervention operates downstream of that chain. T
The West Virginia Supreme Court upheld a determination that an administrator unreasonably denied a worker’s claim for injuries from a locker falling on her.
Case: Graham Packaging Co. LP v. Barnes, No. 25-723, 06/23/2026, published.
Facts: Crystal Barnes worked for Graham Packaging Co. LP. She filed a workers’ compensation claim, alleging that she had injured her back and shoulder at work in February 2024.
Barnes went to the hospital two days after the alleged accident. She reported that a section of four lockers fell on her, pinning her to the floor while at work. The diagnosis
The Illinois Workers' Compensation Commission on Monday announced that it has suspended use of its CompFile System until further notice.
The commission said it is working to resolve technical difficulties with the electronic filing system.
"If you have a document that must be filed to fulfill a statutory filing deadline, please make certain that you retain a copy of this memo and notify the commission if there are any issues with your filing," IWCC said in a statement.
CompFile was launched in 2020 to allow electronic filing of case documents, including applications and settle
The Georgia Court of Appeals overturned the denial of a worker’s claim because the denial was premised on an erroneous legal theory.
Curtis Thomas worked for United Electric Co. He allegedly suffered injuries while completing electrical work at a newly constructed medical clinic when an air diffuser fell from the ceiling and struck him on the shoulder.
Thomas filed a workers’ compensation claim seeking authorization for medical treatment from a doctor who was not listed on the panel provided by his employer, temporary total disability benefits and attorney fees.
At the
A divided Louisiana Supreme Court ruled that the dismissal of a case due to a plaintiff’s failure to amend a petition is self-executing.
Case: LUBA Workers’ Compensation v. Sears, Nos. 2025-C-01379 and 2026-C-0057, 06/29/2026, published.
Facts and procedural history: Rebecca Sears worked for TruCare Home Health. She suffered injuries at work in 2014 and received workers’ compensation benefits from TruCare’s insurance provider, LUBA Workers’ Compensation.
In 2023, LUBA alleged that Sears fraudulently misrepresented her injuries to obtain additional benefits
The West Virginia Supreme Court upheld the denial of a worker’s claim for a knee injury.
Case: Underwood v. ACNR Resources Inc., No. 26-76, 06/23/2026, published.
Facts: Aaron Underwood worked for ACNR Resources Inc. He filed a workers’ compensation claim, alleging that he twisted his right knee at work on July 31, 2024, when he was going through a door.
Before the alleged injury, Underwood was treated for pain, swelling and osteoarthritis of the right knee.
In April 2023, a magnetic resonance imaging scan revealed a fracture of the right medial tibial plateau, a marrow/soft ti
TX - Court Says Comp Bar Blocks Worker's Truck Crash Suit
A Texas appeals court on Tuesday ruled that the workers' compensation exclusive-remedy bar blocked an injured worker’s lawsuit against his employer over a company truck crash.
In Huerta v. Swabco Inc., the Court of Appeals for the 8th District of Texas upheld summary judgment for Swabco, holding that Roberto Huerta failed to show the company was substantially certain he would be injured.
Huerta sued Swabco in June 2022 after he and a co-worker were injured in October 2021 when a Swabco truck veered off a highway. He alleged that he had reported suspension and steering pro
A New York appellate court upheld a grant of summary judgment for a worker on his Labor Law claim for his injuries from a fall from a ladder.
Case: Prado v. BP Cyrus LLC, No. 22777/20, 06/18/2026, published.
Facts: Edison Gutierrez Prado allegedly suffered injuries when he fell from a ladder while removing fencing at a construction site.
Prado said he was standing on an A-frame ladder and using a saw to cut part of the 12-foot metal fencing when a piece of fencing hit the ladder, pushing it over and causing him to fall.
Procedural history: Prado filed suit against BP Cyrus LLC an
A New York appellate court upheld a grant of summary judgment on a worker’s Labor Law claim for his fall from a ladder.
Case: Hernandez v. Bushwick Realty Holdings LLC, No. 23014/18, 06/18/2026, published.
Facts: Roberto Hernandez allegedly suffered injuries when he fell from a ladder while he was using it to descend to the basement of a jobsite.
Hernandez initially testified that he was facing the rungs of the ladder with both hands on the rails as he descended, but later testified that he descended facing away from the ladder with only his right hand on it.
According to Hernandez,
The Nevada Workers’ Compensation Section has set dates for training sessions during July.
All training is held electronically via Microsoft Teams. There is no charge, and all materials are provided.
Times, dates and topics are as follows:
11 a.m. Pacific Wednesday, Workers’ Compensation and Nevada Employers.
11 a.m. Pacific July 15, C-4 Form Healthcare Provider Responsibilities and Coverage Verification Service (CVS).
11 a.m. Pacific July 22, Deep Dive Into D-35.
11 a.m. Pacific July 29, Medical Billing.
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The Louisiana Supreme Court ruled that a worker’s forfeiture of benefits for making a willful misrepresentation applies prospectively from the date of the misrepresentation, not retroactively to the date of injury.
Johnny Cousain worked for Smitty’s Supply Inc. He was involved in a work-related motor vehicle accident in June 2021.
Cousain reported the accident to his employer on the day it happened, and he denied having any injuries at that time.
He was terminated two days later. Cousain then reported neck and back injuries to Smitty’s by letter, through counsel, demanding
