IL - Governor Signs Bill to Overhaul UR Requirements
08/11/2026 | 0
Illinois Gov. J.B. Pritzker signed a bill that took effect immediately and created new requirements for utilization review as well as for medical examinations used to determine the necessity of workers' compensation treatment requests.
The governor on Friday signed HB 5228, which also:
Creates a new assessment mechanism targeting $7 million in additional annual revenue for the Illinois Workers' Compensation Commission's Operations Fund in 2026, with the target increasing 3.5% annually thereafter. Assessments will be based on a percentage of carriers' underwriting gains for
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The North Carolina Court of Appeals upheld the dismissal of a worker’s civil claims against his employer, its principal and a supervisory employee for his heat-related injuries.
Case: Moreno v. Florida Orange Gold LLC, No. COA25-574, 08/05/2026, unpublished.
Facts: Florida Orange Gold LLC is a limited liability company that primarily employs agricultural workers. Jose Javier Gutierrez is the company’s president. Gilberto Gutierrez is an FOG employee whose responsibilities primarily include managing FOG’s day-to-day financial operations.
In July 2020, a FOG employee died fr
A New York appellate court revived part of a worker’s Labor Law action and ruled that his employer was entitled to summary judgment dismissing the indemnification and contribution claims against it.
Case: Ordonez v. USM Asset Trust Series-7, No. 52146/19 595472/19 595267/22, 08/06/2026, published.
Facts: Bolivar Carchi Ordonez was working for Victorio’s Contracting Inc. as a carpentry laborer on a renovation project when he slipped or tripped on a crack in a stone step as he descended the building's front exterior staircase.
Ordonez had been directed to use the building
West Virginia’s Intermediate Court of Appeals upheld the expansion of a worker’s claim to include additional conditions.
Case: United Coal Co. LLC v. Plumley, No. 25-ICA-440, 08/06/2026, published.
Facts: Joshua Plumley worked for United Coal Co. LLC. He filed a workers’ compensation claim, asserting that he had injured his back at work in February 2020.
A claims administrator for United’s insurance carrier accepted liability for a lumbar strain.
In June 2010, Plumley was treated after being struck in the head and neck by a falling rock. The assessment was a co
DISCLAIMER: The article is for the 2027 edition of "Lawyer’s Guide to the AMA Guides and California Workers' Compensation" and is excerpted from the manuscript. The opinions expressed in this document are those of the authors and not of the Department of Industrial Relations, Division of Workers’ Compensation, or the Workers’ Compensation Appeals Board.
Introduction
The en banc decision in Vigil v. County of Kern has generated substantial discussion among physicians and attorneys regarding when permanent impairments should be added and when they should be
An Ohio appellate court upheld an award of permanent total disability benefits for a respiratory therapist.
Case: State ex rel. Southwest Community Health System v. Industrial Commission, No. 25AP-127, 08/06/2026, published.
Facts: Elizabeth Edwards worked for Southwest Community Health System as a respiratory therapist. She filed a workers’ compensation claim, and the Bureau of Workers’ Compensation allowed it for a concussion without loss of consciousness, cervical strain and post-concussion syndrome.
In November 2023, Dr. Dominic Haynesworth opined that Edwards was
Growth in average hourly earnings continued to slow last month, the National Council on Compensation Insurance reported, weakening the natural source of premium growth.
Strong wage and employment growth can boost premiums without the need for rate increases, while slowing wage and employment growth limits exposure-driven premium growth and can increase pressure on rates to compensate.
Average hourly earnings in July were up 3.2% compared to July 2025. The growth rate is below the one-year average of 3.6%, the three-year average of 3.9% and the five-year average of 4.4%.
"This softening
Maine’s Supreme Judicial Court ruled that a worker’s ex-wife was entitled to death benefits following his death from complications arising from his work-related injuries, 23 years after their divorce.
Donald Nadeau slipped and fell while working for S.D. Warren Co. in 1985, suffering multiple injuries that caused chronic pain, mobility issues and substantial weight gain.
At the time of the accident, Nadeau was married to Carol Brewster. During their marriage and until the date of his injury, Nadeau worked full time at S.D. Warren, while Brewster worked part time as a nu
The North Carolina Court of Appeals overturned a trial judge’s determination that an employer’s lien against a worker’s proposed settlement was $0.
Case: Saunders v. Woolard, No. COA25-182, 08/05/2026, published.
Facts: Richard Saunders worked for Orano USA LLC. He suffered injuries while working on a jobsite for Orano, allegedly because of the negligence of Phillip E. Woolard and Woolard’s Welding Service.
Woolard’s Welding Service is a contractor, not affiliated with Orano, which was working on the same jobsite.
Saunders received workers’ compensation
Jacksonville, FL – July 10, 2026 – PhysNet welcomes Michelle Despres, PT, EMBA as Chief Operating Officer, strengthening its leadership team as the company enters its next stage of national growth.
A licensed physical therapist and seasoned healthcare executive, Michelle brings a strong blend of clinical insight, operational leadership, and people-centered strategy. S
A New York appellate court partially revived a worker’s Labor Law and negligence claims for his alleged injuries from being struck by a delivery gate.
Case: Vasquez v. 1719 27 ST LLC, No. 2021-08595, 08/05/2026, published.
Facts: Hector Vasquez allegedly suffered injuries when a delivery gate struck him at a construction site at which he was working.
Procedural history: Vasquez filed suit against 1719 27 ST LLC, 27 ST CON LLC, J. Petrocelli & Sons Construction Inc. and J. Petrocelli Construction Inc., asserting claims for negligence and a violation of Labor Law Sect
A New York appellate court ruled that a worker’s Labor Law claims were properly dismissed because of the homeowner exemption from liability.
Case: Palma v. Cheer Hall LLC, No. 2023-10915, 08/05/2026, published.
Facts: Jose Figueroa Palma allegedly sustained injuries while performing work on property owned by Cheer Hall LLC.
Procedural history: Palma filed suit against Cheer Hall, asserting claims for violations of the Labor Law.
Cheer Hall moved for summary judgment dismissing the claims.
Rockland County Supreme Court Justice Sherri L. Eisenpress granted the motion.
Analy
A U.S. Senate committee passed a bill that would allow physician assistants and nurse practitioners to certify injuries and oversee treatment of injured federal workers.
The voice vote by the Senate Committee on Homeland Security and Government Affairs Thursday sends the bipartisan "Improving Access to Workers' Compensation for Injured Federal Workers Act" to the floor of the Senate for consideration by the full body.
The Federal Employees' Compensation Act allows only physicians to treat injured workers and defines the term to mean only medical doctors and doctors of
North Carolina Commissioner of Labor Luke Farley designated Tyler Younts as chairman of the Industrial Commission.
Younts was appointed to the commission by the North Carolina General Assembly earlier this year. He previously served a six-year term as a deputy commissioner and has also worked as a law clerk for the Industrial Commission.
Most recently, Younts was deputy general counsel for litigation at the North Carolina Department of Labor, where he represented the agency in occupational safety and health, wage and hour, and retaliatory employment discrimination matters.
As chair
A California appeals court on Thursday held that a workers’ compensation insurer properly canceled an employer’s policy after the employer failed to respond to repeated requests for payroll records needed for a premium audit, reversing a Workers’ Compensation Appeals Board ruling to the contrary.
Although the exact phrase "failure to permit an audit" is not defined in the Insurance Code and was not defined in the policy, the Court of Appeal for the 3rd District of California said provisions in the policy imposed a clear obligation to provide payroll records upon re
The Washington Court of Appeals upheld an offset against a worker’s temporary total disability benefits based on her receipt of Social Security disability insurance benefits.
Case: Smith-Gill v. Department of Labor & Industries, No. 60535-0-II. 08/04/2026, unpublished.
Facts and procedural history: Kimberly Smith-Gill contracted bacterial meningitis as a young child. It caused brain damage that resulted in difficulties with reading, writing and comprehending paperwork.
In 1994, Smith-Gill began receiving Social Security disability benefits for her condition.
In 2018, she sus
