MO - Court: Employer Liable for Medical Expenses After Ignoring Demand for Treatment
10/06/2026 | 0
The Missouri Court of Appeals ruled that an employer was liable for a worker’s medical expenses from providers of his choosing after ignoring his demand for treatment.
Ronald Wills began working for Fixture Contracting Co. Inc. in 2015. His job required bending at the waist, stooping, lifting from the ground to a workbench, reaching overhead and bending over to clean up.
In September 2017, Wills began experiencing soreness in his low back. After his symptoms worsened the next month, he went to see a chiropractor.
The chiropractor ordered an MRI that showed two bulging or protrudi
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A federal appellate court rejected a worker’s petition challenging the denial of his claim for post-traumatic stress disorder allegedly based on his employment in Afghanistan.
Case: Apostolovski v. U.S. Department of Labor, No. 25-2168, 09/30/2026, unpublished.
Facts: Marjan Apostolovski, a citizen of North Macedonia, worked for DynCorp International fueling helicopters and armored vehicles at a forward operating base in Afghanistan.
Apostolovski allegedly experienced multiple mortar and grenade attacks while working at the base before his contract ended in 2012.
Apostolovski re
The Wisconsin Court of Appeals upheld the dismissal of an injured worker’s disability discrimination claim as untimely.
Case: Neidlein v. Labor and Industry Review Commission, No. 2025AP2134, 10/02/2026, unpublished.
Facts: Pamela Neidlein began working for Greeneway Inc. in 2012. She allegedly injured her left shoulder at work and filed a workers’ compensation claim.
In March 2022, Neidlein underwent an independent medical evaluation with Dr. Kevin Kulwicki, who opined that her shoulder condition was due to preexisting degenerative conditions and was not the result of a work-re
A Louisiana appellate court upheld a determination that a worker forfeited her entitlement to benefits by providing her employer with false responses to inquiries about her medical history.
Case: Rodriguez v. Willis Knighton Health, No. 57,022-WCA, 09/30/2026, published.
Facts: Willis Knighton Health System hired Rae Rodriguez in September 2022.
Before her first day of work, Rodriguez underwent a preemployment physical, which determined that she was able to perform essential job functions without accommodations.
Rodriguez also completed a post-hire questionnaire in 2022 and another in 2024
A study of 400,000 workers’ comp claims from Crosstie, a claims management technology company that identifies workers’ comp cases likely to descend into litigation, reveals a telling pattern that could help explain excessive claim costs nationwide, especially in California.
Litigation consumes a significant percentage of the employer dollars spent on comp claims, with injured workers lawyering up and going to the mat when payers delay or deny care and benefits, particularly over the objections of their treating physicians.
Crosstie’s research de
The California Division of Occupational Safety and Health said rising temperatures throughout the state resulted in extreme heat warnings running through Thursday and reminded employers to implement cool-down areas, rest breaks and to provide drinking water for employees.
An extreme heat warning is in effect throughout the Los Angeles and San Diego regions and is expected to drive temperatures into the mid-90s along the coast to as high as 107 in the valleys during the day.
At the same time, a heat advisory has also been issued for Northern California, including parts of the San Franci
The California Division of Workers' Compensation updated the physician services and nonphysician practitioner services, and the pathology and clinical laboratories sections of the Official Medical Fee Schedule.
The division announced that it adopted the following fourth-quarter Medicare updates to the physician services and nonphysician practitioner services section:
CMS Medicare National Physician Fee Schedule Relative Value File quarterly update, effective Oct. 1, 2026.
Updated Practitioner Procedure-to-Procedure Edits.
Updated Medically Unlikely Edits.
The DWC also said it
The California Workers' Compensation Institute posted a summary of bills enacted during the 2026 session that may be of interest to the workers' compensation community.
The big news from the session was Gov. Gavin Newsom enacting a budget trailer bill that included major reforms to the Subsequent Injuries Benefits Trust Fund and also permanently amended the deadline for the Workers' Compensation Appeals Board to act on petitions for reconsideration.
Newsom signed SB 171 in July.
"SB 171 narrows SIBTF eligibility by requiring that preexisting disabilities be 'l
The Illinois Appellate Court has published its decision from late this summer finding that an insurance carrier owed no coverage to an employer for a worker’s fatal accident at a construction site.
According to a complaint filed by the estate of Ramiro Godinez, Godinez was an “invitee” on a construction site in Waukegan in September 2017.
He was allegedly directed to the third floor of the building to perform certain carpentry work. While he was unloading tools and materials from a raised forklift, Godinez fell and suffered severe injuries. He died six days later.
The esta
A New York appellate court ruled that a Labor Law defendant timely paid a settlement to an injured worker.
Case: Carranza v. Memorial Hospital for Cancer and Allied Diseases, No. 300322/17, 09/29/2026, published.
Facts and procedural history: Delis Vasquez Carranza suffered injuries while working in an elevator shaft. He filed a Labor Law suit against multiple defendants, including Memorial Hospital for Cancer and Allied Diseases.
The hospital reached a settlement agreement with Carranza, and his attorney, in open court, said the hospital would have until Aug. 1, 2025, to provide a draft &q
West Virginia’s Intermediate Court of Appeals upheld a determination that an injured worker was entitled to a magnetic resonance imaging scan and surgery to address an ankle injury.
Case: Marshall County Coal Resources v. Yarbrough, No. 26-ICA-135, 09/25/2026, published.
Facts: Colby Yarbrough worked for Marshall County Coal Resources. He slipped on a rock and rolled his left ankle at work in October 2023.
He sought medical treatment and was diagnosed with a left ankle sprain.
A claims administrator for Marshall’s insurance carrier accepted liability for a sprain of an unspecif
West Virginia’s Intermediate Court of Appeals overturned a determination that a worker failed to prove a sufficient length of exposure to dust hazards to give rise to a presumption that he had occupational pneumoconiosis.
Case: King v. Justice Family Group LLC, No. 26-ICA-76, 09/25/2026, published.
Facts and procedural history: David King II filed a benefits claim for occupational pneumoconiosis. He indicated that his last date of exposure to the hazards of occupational pneumoconiosis was in January 2020.
King reported exposures to the hazards of occupational pneumoconiosis while work
Texas Mutual Insurance Co. announced Friday the promotion of John Grube to vice president of regional operations for the Austin region.
Grube will direct and coordinate all regional office operations, including underwriting, claims, safety services, premium audit and business development in the new role he assumed in May.
Grube, who joined Texas Mutual in 2013, has held a variety of roles including underwriter, territory manager and underwriting supervisor. Most recently, he served as senior manager of agency operations, overseeing the management of the company's safety group program
A workers' compensation carrier cannot pursue conversion and related claims to recover a disputed lien from an injured worker's third-party settlement before the employer's comparative negligence has been adjudicated, a California appellate court ruled.
The 3rd Appellate District Court of Appeal, in affirming a trial court decision granting summary judgment in favor of Guadalupe Reyes-Cano on Wednesday, explained that a determination of the employer's liability was a necessary prerequisite to determine what, if anything, he was required to pay Federal Insurance Co.
"The
An Ohio appellate court upheld a determination that a worker was not entitled to an enhanced award of benefits for his employer’s alleged violation of a specific safety regulation, resulting in his electric shock injury.
Case: State ex rel. Mattox v. Industrial Commission, No. 24AP-703, 09/29/2026, published.
Facts: Andrew Mattox worked for Armstrong Utilities Inc. In August 2021, Mattox was working in a wooded area stringing fiber-optic cable onto wooden telephone poles as part of Armstrong’s conversion of its network from coaxial cable.
Mattox was working in a bucket truck, an
The New Hampshire Supreme Court ruled that an insurance carrier was not entitled to reimbursement from the Special Fund for Second Injuries for the benefits paid to an injured worker.
Case: Appeal of the Commissioner of the New Hampshire Department of Labor, No. 2025-0503, 09/30/2026, unpublished.
Facts: ESIS Inc. provided workers’ compensation insurance coverage to BAE Systems Inc. It paid benefits to a BAE employee who suffered a back injury at work and then sought reimbursement from the Special Fund for Second Injuries.
Under New Hampshire law, if an employee who has a permane