NATL. - WCRI Study Analyzes Effect of Losing Medicaid Coverage
11/04/2026 | 0
Medicaid disenrollment was associated with higher medical payments in workers' compensation claims during the period when enrollees were losing coverage, the Workers Compensation Research Institute said in a new study.
The findings could offer insight into the potential effects of H.R. 1, but the extent to which those results translate to the new law remains uncertain, WCRI said.
During the COVID-19 pandemic, the federal government encouraged states to maintain continuous coverage for Medicaid enrollees, resulting in an increase in working-age adults covered by the program. When the pand
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A New York appellate court ruled that the defendants in a Labor Law action should not have been granted summary judgment dismissing all the claims against them.
Case: DaSilva v. Delshah-OTL-Start 22 Chapel Property Owner LLC, No. 2024-11300, 10/21/2026, published.
Facts: Evando Magalhaes DaSilva worked for Manhattan Concrete Inc. In July 2020, DaSilva and his co-workers were building walls, passing plywood forms from the sixth floor to DaSilva on the seventh floor.
DaSilva allegedly was injured while carrying plywood through an open area on the seventh floor when his left foot twisted
The Commonwealth Court of Pennsylvania upheld the denial of a demolition worker’s claim for benefits for a heart attack.
Case: Torres v. The Giant Co. LLC (WCAB), No. 958 C.D. 2025, 10/26/2026, unpublished.
Facts: Angel Torres worked for Power Component Systems Inc. In May 2023, he was part of a small demolition crew removing flooring and drywall at a construction site.
According to Power employee David Sibbach, drywall removal is a medium-duty task, which is more physically demanding than light-duty work such as painting or fixing carts, but less demanding than heavy-duty work s
A New York appellate court ruled that a plumber’s assistant should have been granted summary judgment on his Labor Law claim for his injuries from falling over a ground-level barrier into a below-ground entranceway.
Case: Nunez v. The Hispanic Society of America, Nos. 161031/18 595424/19 595337/20 595360/20 595622/20 595626/20, 10/16/2026, published.
Facts: Hector Nunez suffered injuries while working as a plumber’s assistant at a construction site when he fell over a barrier from the sidewalk level into a below-ground entranceway while attempting to retrieve a pipe at the
Workers’ compensation subrogation is one of the few areas of insurance recovery in which a carrier can have a perfectly valid statutory right to reimbursement and still walk away empty-handed.
In many states, the law imposes procedural requirements that can be just as important as the underlying right to recover. A missed deadline, an improperly perfected lien, an unanticipated settlement, an overlooked assignment or a failure to intervene can turn a substantial reimbursement opportunity into an expensive lesson. A recently published California appellate decision illustrates ju
The North Carolina Court of Appeals ruled that a worker’s claim for further compensation was properly denied as untimely.
Case: Brown v. North Carolina Department of Public Instruction, No. COA25-869, 10/21/2026, published.
Facts: Curtis Brown worked as a high school teacher for the North Carolina Department of Public Instruction. He injured his back in December 2009 while attempting to break up a fight.
The department began paying medical compensation to Brown in February 2010.
In September 2013, the department submitted an admission of Brown’s right to permanent partial disab
The Supreme Court of Tennessee’s Special Workers’ Compensation Appeals Panel upheld the denial of a worker’s request for extraordinary benefits.
Case: Burkes v. Sysco Knoxville LLC, No. E2025-02007-SC-R3-WC, 10/22/2026, published.
Facts: Jerry Burkes worked for Sysco Knoxville LLC. He slipped and fell while working, injuring his left knee. Sysco accepted liability for the injury and provided medical care by Dr. Michal McCollum, who diagnosed partial medial and lateral meniscus tears and osteoarthritis. He recommended surgery.
Following surgery, McCollum placed Burkes
Twenty-eight congressional Democrats are protesting planned rollbacks of regulations regarding respirator masks as proposed by the Trump administration.
In a letter addressed to David Keeling, an assistant secretary within the Department of Labor, the lawmakers said the Occupational Safety and Health Administration is moving quickly and without sound evidence to weaken requirements involving respirators for those who work with hazardous substances such as lead, asbestos, dust, formaldehyde and inorganic arsenic, among other chemicals.
Specifically, the federal g
The Arkansas Court of Appeals affirmed a Workers' Compensation Commission decision awarding a fee to an injured worker's attorney, finding that the employer had controverted the compensability of an employee's back injury.
Though the employer voluntarily paid temporary total disability benefits when the employee had surgery, the appellate court explained that Gregory Roberson still had to litigate compensability. A maxim in Arkansas workers' compensation law is that when the commission finds a case has been controverted in whole or in part, it shall order the employer or
The Kentucky Supreme Court ruled that an excavation contractor was liable for damages to the company that hired it and that it committed a material breach of contract by failing to maintain workers’ compensation coverage.
Case: Scott Excavating Inc. v. Menard Inc., No. 2025-CA-1065-MR, 10/23/2026, unpublished.
Facts: In January 2017, Menard Inc. purchased land in Richmond, Kentucky, for a new retail store. Three months later, Menard contracted with Scott Excavating Inc. for the construction and installation of storm and sanitary sewers.
The total estimated cost of the contract wa
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: Bolanos v. 50 Clinton Property Owner LLC, No. 2025-02105, 10/21/2026, published.
Facts: Hector Bolanos allegedly was injured at a construction site when a cross brace of scaffolding fell from above, causing him to fall.
Procedural history: Bolanos filed suit against 50 Clinton Property Owner LLC, asserting a claim for a violation of Labor Law Section 240(1).
Section 240(1) imposes absolute liability on property owners, general contractors or their agents
The New York State Workers' Compensation Board has developed what it says is a new, improved website search tool.
The new search tool is accessible from anywhere within the website and is touted as quickly producing improved accuracy and more relevant results. Additionally, the old follow-up search function has been removed so that results remain relevant to the original query instead of producing too many irrelevant returns, the WCB said.
The board says it wants to ensure that information is accessible for all website users. A user surve
About 40% of the insurance carriers that the Texas Division of Workers' Compensation reviewed in its 2026 performance-based oversight assessments were deemed "high-tier" performers.
PBO results posted to the division's website show 50 of the 124 carriers evaluated last year were placed in the highest performance category. Another 72 were designated "average-tier" performers, and two were labeled "poor-tier" performers.
The 2026 assessment plan focused primarily on the timeliness of paying temporary income benefits, with a maximum of 40 points available,
The National Council on Compensation Insurance is recommending that the Alabama Department of Insurance decrease workers' compensation loss costs by an average of 2.2%, effective March 1.
In a summary of the filing posted to its website, NCCI said it has also recommended a 1.6% increase in assigned risk market rates.
NCCI said the proposed loss cost decrease is primarily driven by a continued decline in claim frequency.
At the same time, the average cost per lost-time claim, after adjusting for inflation, has remained consistent from 2021 through 2024, with no strong upward o
The National Council on Compensation Insurance is recommending a 1.2% decrease in voluntary market loss costs in South Carolina, effective April 1.
In a summary of the loss cost filing submitted to the South Carolina Department of Insurance in October, NCCI said the state has historically experienced a significant number of large claims, particularly those involving severe burns.
The pattern of large claims, both burn- and non-burn related, persisted into 2025 and required selecting an experience period, development and loss ratio trends that reduce the effect of large claims within a single
The Workers' Compensation Insurance Rating Bureau on Friday announced a new methodology for measuring physician services utilization that produces substantially different results than its traditional measurement based on the number of medical transactions per claim.
The WCIRB said in its report, "A New Measure of Medical Service Utilization: Physician Services and the Factors Driving Change," that under its new resource-based measurement, "utilization" of physician services increased 8% from 2020 through 2025, compared with a 5% decline using the traditional measuremen