CA - Rand Report Finds Modest Effect for SB 1160, Calls for Database of UR Decisions
07/21/2026 | 0
Rand Corp. on Monday reported statistically significant increases in some guideline-concordant care that was exempted from prospective utilization review in the first 30 days of an injury, but the generally modest effects indicate that approval rates for early treatment requests in California were already above 90%.
In addition to recommending that the Legislature consider expanding the types of treatments that are exempt from prospective review beyond those included in SB 1160, researchers also recommended that the Department of Industrial Relations establish standardized data collection req
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A Louisiana appellate court ruled that a temporary elections worker was not a state employee and that the parish registrar of voters was liable for her benefits.
Case: Negrete v. Parish of Caddo, No. 56,933-WCA, 07/15/2026, published.
Facts: The Caddo Parish Registrar of Voters hired Judy Negrete as a temporary employee in July 2019. Negrete earned $11.50 an hour working as needed around election times.
On March 11, 2021, Negrete was in a storage room filing absentee ballots in large plastic bins. After moving a bin on a metal shelf, she crouched to sit, but her office chair had rolled
An Ohio appellate court granted writ relief to a self-employed worker, finding that the Industrial Commission erred in calculating his average weekly wage without considering income from his wholly owned corporation.
Case: State ex rel. Parente v. Industrial Commission, No. 24AP-652, 07/14/2026, published.
Facts and procedural history: Joseph Parente is the owner and sole employee of Parente Homes Inc. PHI is an “S” corporation, or “pass-through” entity.
As the owner and an employee, Parente pays himself a yearly salary, reported on a W-2, and he receives a share of
A New York appellate court upheld the exclusion of evidence presented by a Labor Law defendant and a grant of summary judgment for the injured worker.
Case: Intriago v. 18th Highline Associates LLC, No. 2025-00322, 07/08/2026, published.
Facts: Walter Intriago allegedly was injured when he fell from a stack of doors at a construction site.
Intriago said he was directed by a supervisor to move a stack of doors, piled approximately 7 feet high, and other garbage to a container, and that there were 2 to 3 feet of snow covering the stack.
Intriago asserted that a
When determining whether a psychiatric impairment may be compensable, it’s important to understand the “violent act” exception.
In a previous article, “If Everything Is Catastrophic, Is Anything?", we explored the “catastrophic injury” exception under Labor Code § 4660.1(c)(2)(B). This article examines the other exception: the “violent act.”
Labor Code § 4660.1(c) provides:
(c)(1) Except as provided in paragraph (2), there shall be no increase in impairment ratings for sleep dysfunction, sexual dysfunction or psychiatr
A New York appellate court ruled that a worker was entitled to partial summary judgment on his Labor Law claim and that other parts of his claim were properly dismissed.
Case: Barbosa v. 1169 Hoe LLC, No. 805465/21, 07/09/2026, published.
Facts: Elisito De Jesus Lopez Barbosa allegedly injured his back while lifting concrete forms. According to Barbosa, he was pulling concrete forms to the third floor of a building when his foot slipped on rainwater and oil. Barbosa testified that a form was halfway through an opening when he slipped and that he did not know why he held onto it.
P
Professional administration and post-settlement medical care coordination provider Ametros announced Monday that President Andrea Mills was elected to the board of directors for Kids’ Chance of America.
KCOA is a charitable workers’ compensation industry organization dedicated to providing college scholarships to the children of workers who have been seriously or fatally injured on the job. It has awarded 11,000 scholarships totaling more than $42 million through its network of state chapters since its founding in 1988.
As a board member, Mills will join a group of indus
Illinois Gov. J.B. Pritzker reappointed Gerald Napleton to serve as an arbitrator on the Workers' Compensation Commission.
Napleton was an associate attorney at Ridge & Downes, where he handled workers' compensation and personal injury claims for clients before he was first appointed to serve as an arbitrator in 2020.
Napleton currently serves on the Illinois State Bar Association and is chairman of its Workers' Compensation Section.
He earned his bachelor's degree from Saint Xavier University and his law degree from DePaul University College of Law.
The appointment
The Utah Supreme Court said the Labor Commission Appeals Board lacked the discretion to dismiss an injured worker's claim after finding a pattern of antagonistic and obstructive behavior over three failed independent medical examinations.
Though the board characterized the behavior as a discovery violation to find the authority to dismiss the claim entirely, the high court said the Legislature specified that the penalty for obstructing an IME is to suspend the claim until the claimant comes into compliance.
"It follows that the only sanction available for obstruction of a medical ex
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
The Illinois Appellate Court ruled that if an employer receives the full amount of a worker’s third-party settlement via subrogation, it is properly assessed with the full amount of the worker’s costs and expenses.
Case: Larsen v. Vaid, No. 1-25-2100, 07/14/2026, published.
Facts and procedural history: Amada Larsen suffered injuries in an automobile accident with Vishal Vaid.
Larsen was acting within the course and scope of her employment as an officer with the Village of Carol Stream Police Department at the time of the crash.
The Intergovernmental Risk Management Agency
A New York appellate court ruled that a worker struck by a falling object was entitled to summary judgment on his Labor Law claim.
Case: Gutierrez v. 80 Winthrop Street Owners Corp., No. 23823/16, 07/02/2026, published.
Facts: Armando Gutierrez was injured when a piece of terra cotta coping, which was secured to a parapet wall and anchored a suspended scaffold by C-hooks, dislodged and struck him while he was working below on the suspended scaffold.
According to the president of 80 Winthrop Street Owners Corp., a third party had replaced the piece of terra cotta coping before the accident,
The New York Department of Financial Services approved a workers' compensation filing that state officials said will reduce employer premiums by an average of 22%, beginning in October.
The New York Compensation Insurance Rating Board recommended a 21.9% decrease in the overall loss cost level for policies with effective dates on or after Oct. 1.
The department approved the filing on Wednesday, Gov. Kathy Hochul said in a statement.
Hochul said the loss cost reduction will save employers an estimated $1 billion in premiums, or an average of $1,779 per policyholder.
The governor's o
The Commonwealth Court of Pennsylvania upheld the denial of a worker’s claim for benefits from a fall based on her lack of credibility and an expert medical opinion that she had not suffered a work-related injury.
Case: Niculcea v. Susquehanna Valley Nursing and Rehabilitation Center (WCAB), No. 1645 C.D. 2024, 07/10/2026, published.
Facts and procedural history: Monica Niculcea worked for the Susquehanna Valley Nursing and Rehabilitation Center. She fell at work in November 2017.
Susquehanna Valley paid benefits under several notices of temporary compensation until February 2018
A New York appellate court overturned a grant of summary judgment for a worker struck by a falling object.
Case: Rolka v. Neelam Construction Corp., No. 2024-08597, 07/08/2026, published.
Facts: Marcin Rolka allegedly sustained injuries while working for Ladi Construction, a subcontractor hired by Neelam Construction Corp. to perform waterproofing, demolition and debris removal work at Long Island City High School in Queens.
Rolka claimed that as he was bent over and picking up debris from a scaffold beneath another scaffold that other demolition workers were standing on, an object str
A surge in cumulative trauma claims is reshaping California workers' compensation trends, contributing to higher claim frequency, rising frictional costs and renewed pressure on insurer results, according to WCIRB Executive Vice President and Chief Actuary Tony Milano.
Milano said Thursday during the WCIRB's annual conference that written premium, which came in around $15.6 billion for 2025, has been uncharacteristically stable over the past four years, with modest growth in employee payroll largely offsetting the effect of modest decreases in average charged rates.
"I would
A California appellate court ruled that an insurance carrier validly cancelled an employer’s policy for failing to comply with a payroll audit before its employee was injured.
Case: Employers Preferred Insurance Co. v. WCAB (Purchase Green Artificial Grass), No. C104263, 07/14/26, unpublished.
Facts: Employers Preferred Insurance Co. provided a workers’ compensation policy to Purchase Green Artificial Grass in 2020. The policy was set to expire in May 2021.
In March 2021, Employers issued a renewal policy to Purchase.
This policy stated that the premium listed was “an est
