CA - WCIRB Releases Latest Study of Regional Differences in Claim Characteristics
11/21/2025 | 0
Southern California continues to have higher frequency and a higher concentration of more complex claims involving medical-legal services and litigation, the Workers' Compensation Insurance Rating Bureau said in its 11th annual study of regional differences in claim characteristics.
The WCIRB said the pattern of significant regional differences in indemnity claim frequency, even after adjusting for wages and industry mix, has remained generally stable. While differences widened slightly in the latest analysis, the 2025 Geo Study shows the same fundamental pattern as prior years.
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A New York appellate court overturned a finding that a worker was only entitled to a 12.5% schedule loss of use award for a knee injury due to a prior SLU award he received to an earlier injury to the same knee.
Case: Matter of Krein v. Green Haven Correctional Facility, No. CV-24-1994, 11/13/2025, published.
Facts and procedural history: Kevin Krein worked for the Green Haven Correctional Facility. He injured his right knee at work in 1999 and received a 12.5% schedule loss of use award for his right leg.
In 2003, Krein sustained another work-related injury to his right knee; however, no f...
The Washington Court of Appeals upheld the denial of a worker’s protest to an order closing his claim as untimely.
Case: Mercier v. Department of Labor and Industries, No. 59483-8-II, 11/12/2025, unpublished.
Facts and procedural history: In August 2000, Raymond Mercier injured his back and ankle while working as a bakery manager.
Mercier filed an incident report with the Department of Labor and Industries and began receiving workers’ compensation benefits.
In October 2000, L&I mailed Mercier a notice closing his claim. The notice was mailed to Mercier’s address, but ...
The Indiana Court of Appeals upheld the denial of a worker’s claim for benefits for a fall as she was exiting a car after returning from lunch.
Case: Krutzsch v. Franciscan Alliance, No. 25A-EX-1705, 11/07/2025, unpublished.
Facts: Staci Krutzsch worked as a nurse manager for Franciscan Alliance. On Sept. 23, 2022, Krutzsch fell while exiting the passenger side of a coworker’s vehicle returning to work after lunch.
Procedural history: A single member of the Workers’ Compensation Board found Krutzsch’s injuries from her fall were compensable.
The board reversed, find...
The Special Investigative Unit of RJN Investigations, Inc. was recently notified of a felony arrest based upon a documented fraud referral. In this case, the claimant was employed as a caretaker of the California Department of Social Services - I.H.S.S. At the time of the claimant's deposition, he appeared wearing a back support and ambulating with the aid of a cane. Proactively,...
In 1952 (over 73 years ago) the California Supreme Court upheld the constitutionality of the Subsequent Injuries Benefits Trust Fund in the Patterson case (17 CCC 142). But not only did the court uphold SIBTF constitutionally, they therein set forth the basis of how SIBTF benefits would be paid.
The court gives the example of the one-eyed man, stating:
“Workers’ Compensation laws of various states and the federal government contain provisions for additional compensation to be paid from a fund (rather than by the employer or his workers’ compensation insurance ca...
A federal appellate court overturned an award of damages for a worker’s death from an overdose of illegal drugs after he ran out of his prescription pain medications for his work-related injuries.
Case: Bommarito v. Belle Chasse Marine Transportation LLC, No. 22-30382, 11/13/2025, published.
Facts: Belle Chasse Marine Transportation LLC transports people and goods to and from vessels on the Mississippi River. Belle Chasse Land Transportation Inc. builds Marine’s launch sites. Land is a wholly owned subsidiary of Marine — the two companies share insurance policies, a human r...
The Oregon Workers' Compensation Division adopted changes to its employer and insurer coverage responsibility rules it said are needed to revoke self-insurance authorization when an employer's security deposit expires and to implement legislation exempting school districts from posting a security deposit.
Rules that take effect Jan. 1. require self-insured employers to replace a security deposit at least 15 days before it expires or is nonrenewed by the issuing surety company or bank.
The division said the rules clarify what a self-insured employer that is exempt from security requir...
Officials at the Nevada Occupational Safety and Health Administration rescinded citations levying more than $425,000 in penalties on Elon Musk's The Boring Co. less than a day after they were issued because they failed to assess the reasonableness of the company's mitigation efforts, according to a memo a state attorney wrote earlier this week.
The Nov. 17 memo addressed to the director the Department of Business and Industry, was released along with other documents and a statement from Nevada OSHA denying that Gov. Joe Lombardo, a Republican who endorsed Donald Trump for president in...
The Illinois Appellate Court upheld the denial of a massage therapist’s claim for bilateral carpal tunnel syndrome and trigger fingers.
Case: Williams v. IWCC (Terminal Gateway Spa), No. 1-24-2111WC, 11/07/2025, unpublished.
Facts: Onree Williams worked for the Terminal Getaway Spa as a massage therapist. His hours varied, depending on how many customers came in, but typically, he worked seven hours a day, five days a week. He gave eight to 20 massages a day. The duration of a massage ranged from ten minutes to ninety minutes.
After about six months on the job, Williams claims his han...
San Diego, California - 11/14/2025 - Dietz, Gilmor & Chazen, APC, a California statewide law firm practicing exclusively in workers' compensation defense, subrogation, asbestos, Labor Code §132a, and serious and willful misconduct claims, promotes Peter M. Golden, Esq. to Partner.
Mr. Golden is a Partner based out of the San Diego office of Die...
A New York appellate court upheld a determination that a worker lying about his entrepreneurial exploits warranted a forfeiture of benefits.
Case: Matter of Qureshi v. Rite Aid Corp., No. CV-23-2455, 11/13/2025, published.
Facts and procedural history: Abid Qureshi worked for the Rite Aid Corp. He established a workers' compensation claim for various physical injuries stemming from a February 2017 work-related accident and was awarded temporary partial disability benefits.
Qureshi later established a second workers' compensation claim for major depressive disorder stemming from hara...
The West Virginia Supreme Court overturned a denial of authorization for a worker’s knee surgery.
Case: Comas v. Bass Pro Group LLC, No. 24-290, 11/12/2025, published.
Facts: Charles Comas worked for the Bass Pro Group LLC. He slipped and fell on a wet concrete loading dock at work in September 2022.
Comas immediately reported the incident to his supervisor, but he didn't seek medical treatment until five days later when X-rays showed the existence of mild degenerative joint disease but no fracture.
Ten days later, Comas saw a nurse practitioner who suspected a meniscus tear and ...
The Arkansas Court of Appeals upheld an award of permanent total disability benefits for an injured nurse.
Case: MLM Support Services v. Miller, No. CV-25-61, 11/12/2025, published.
Facts and procedural history: Tammy Miller worked as a nurse for the Sisters of Mercy Health System. She fell while at work in January 2016.
An administrative law judge in February 2021 found Miller failed to prove she was permanently and totally disabled. However, the judge also found she suffered a significant loss of wage-earning capacity equal to a 60% loss of overall work capacity.
The Workers Compen...
The Missouri Department of Commerce and Insurance announced that workers' compensation rates will increase by an average of 1.3% in 2026.
DCI Director Angela Nelson said in a statement that the increase, the second in six years, reflects the year-to-year fluctuations the agency expects in a healthy insurance market.
The department said the long-term trend of declining frequency continues and employers continue to benefit from a competitive market and stable prices.
“Although we’re seeing a small uptick in rates this year, the overall trend continues to show that Missouri wor...
Senators from California and Utah introduced a bipartisan bill they say would create the first national respiratory protection standards for wildland firefighters.
The Healthy Lungs for Heroes Act, by Sens. Adam Schiff, D-Calif., and John Curtis, R-Utah, would direct the U.S. Forest Service and Department of Interior to work with the Occupational Safety and Health Administration and the National Institute of Occupational Safety and Health to determine appropriate protective equipment for wildland firefighters and support staff.
The bill would also direct the Forest Service and Interior Depar...
The Illinois Appellate Court upheld a determination that a worker’s condition of ill-being was only partially related to his work injury.
Wilfredo Cruz worked for Rizza Cadillac as an auto technician. In November 2020, he allegedly slipped and fell while performing a tire rotation. Cruz claimed he fell backwards, hitting his head on the ground, and that a tire fell on his head. According to Cruz, he lost consciousness.
The next day, Cruz went to the hospital complaining of pain in the back right side of his head, nausea, and headache. Cruz did not mention losing consciousness. A comput...
A Louisiana appellate court revived a school district employee’s intentional tort claim against her employer for her injuries from being attacked by a student.
Case: Bernier v. St. Tammany Parish School Board, No. 2025 CA 0260, 11/07/2025, published.
Facts: Lori Bernier worked for the St. Tammany Parish School Board as a paraprofessional at Covington Elementary.
She claimed she was injured when a third-grade student attacked her in October 2022. She alleged the student had stabbed another student with a fork earlier that same day.
Procedural history: Bernier filed a civil suit agains...
