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FL - Split Court Says Tolled Limitations Period is Suspended, Not Extended

03/25/2026 | 0

A divided Florida appellate court, sitting en banc, ruled that the statute of limitations for a worker to seek benefits is suspended by the payment of benefits, as opposed to just being extended for a discrete period. Nancy Estes worked for the Palm Beach County School District as a teacher. She tripped and fell while at work in September 2021. The school district accepted liability for her injuries. The school district paid benefits to Estes from October 2021 to January 2023. In February 2023, the school district issued a notice of denial, signaling its intention to deny any additional fu... Read More

IL - Employer Gets Credit for Benefits Paid for Amputation of Worker's Foot

03/25/2026 | 0

The Illinois Appellate Court upheld an award of benefits for the partial amputation of a worker’s leg, but also ruled that the employer was due a credit for the amount it had voluntarily paid him for the scheduled loss of a foot. Case: Azcon Metals v. IWCC, No. 5-25-0301WC, 02/26/2026, published. Facts: Tom Snyder worked for Azcon Metals. His right foot was crushed between two rail cars while he was working in March 2020. Doctors initially amputated four toes on Snyder’s foot, but eventually he had his leg amputated below the knee. Azcon paid Snyder a total of $97,010.30 in per... Read More

NY - Justice for Injured Workers Act Applies Retroactively to Bar Estoppel Defense

03/25/2026 | 0

A New York appellate court ruled that the Justice for Injured Workers Act applied retroactively to bar the defendants in a civil case from asserting a collateral estoppel defense based on the proceedings from the plaintiff’s workers’ compensation claim. Case: Pacheco v. P.V.E. Co. LLC, No. 2023-11543, 02/25/2026, published. Facts: Oscar Rene Pacheco allegedly suffered injuries while using a spray gun to apply fireproofing material to wooden beams when the ladder on which he was standing shifted, causing him to discharge the spray gun onto his right index finger. The property whe... Read More

NY - Court Revives Labor Law Claim by Estate of Worker Killed Servicing Order Picker

03/25/2026 | 0

A New York appellate court revived a Labor Law claim filed by the estate of a worker killed while servicing an order picker. Case: Wissert v. Medline Industries Inc., No. CV-24-1635, 02/26/2026, published. Facts: William Wissert worked for Pengate Handling Systems of New York Inc. In October 2019, he went to a facility owned by Medline Industries Inc. to service an order picker. The picker was fitted with a platform for standing that could be hydraulically raised and lowered.  After Wissert disassembled the picker, the raised platform fell on him and caused fatal injuries. Procedural ... Read More

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Press - APEX Investigation CLAIMANT CONVICTION for Workers' Compensation Insurance Fraud - Mono County, California

03/10/2026 | 0

FOR IMMEDIATE RELEASE Workers’ Compensation Insurance Fraud Conviction – Mono County, California A workers’ compensation insurance fraud investigation conducted by Apex Investigation Special Investigation Unit (SIU) has resulted in a felony conviction in Mono County, California. The case involved a 53-year-old female employed as a Small Branch Coordinator with the Mono County Office of Education who reported an alleged workplace injury on October 18, 2024. The claimant stated she tripped on the reading-pit stairs while carrying books at the Bridgeport Library, reportedly s... Read More

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Industry Insights

NATL. - Tainton: The Right AI Doesn't Just Make Claims Professionals Faster, It Makes Them Better

By Mark Tainton
03/25/2026 | 0

Earlier this year, I was on a panel at the California DWC annual Educational Conference in Oakland and then again in Los Angeles, a session on the state of AI in workers’ compensation. Those sessions brought together clinical, legal, technical and operational perspectives, and that range made it one of the richer conversations I’ve been part of. The sessions moved through questions that don’t get raised often enough: What happens when an AI-generated summary becomes the only record decision-makers actually review, and what critical information gets lost in that compression? ... Read More

CA - Hearing Set for Prepaid Card Bill

03/25/2026 | 0

California lawmakers scheduled the first hearing on a bill that would permanently allow employers to use prepaid debit cards to deliver indemnity benefits indefinitely. The Assembly Insurance Committee in February introduced AB 1683, which would make permanent the debit card pilot program created in 2018. The 2018 measure allowed all payers to use prepaid debit cards with the injured worker's written consent. The pilot program was scheduled to sunset in 2023, but a series of legislative extensions pushed the sunset date back to the start of 2027. A study the Commission on Health and Saf... Read More

ID - Bill Would Extend PTSD Coverage to Coroners, Death Investigators

03/25/2026 | 0

Idaho lawmakers introduced legislation that would expand the definition of “first responder” under the state’s workers' compensation law to include coroners and certain death investigation personnel for purposes of post-traumatic stress disorder coverage. SB 1425, introduced Monday, would add coroners, medicolegal death investigators and qualifying coroner employees — workers whose duties “include and primarily consist of the determination of cause and manner of death, including death investigation, forensic pathology and related duties, and supportive admini... Read More

KY - Supreme Court Upholds AWW Calculation, Revives Billing Dispute, Clarifies Amicus Rules

03/24/2026 | 0

The Kentucky Supreme Court ruled that a worker’s average weekly wage properly excluded her mileage reimbursements, that her appeal of an unpaid medical bill should not have been dismissed, and that an amicus brief should not have been deemed an unauthorized filing. Tamala Harris worked for Mercy Home Health as a certified nursing assistant. She worked 30 to 40 hours a week and cared for an average of four to five patients. Mercy reimbursed her for the mileage she drove during her shifts to reach each patient’s location. On April 27, 2022, Harris strained her right... Read More

NY - Worker Who Backed Car Into Trench Gets Part of Labor Law Action Reinstated

03/24/2026 | 0

A New York appellate court partially revived a Labor Law action by a worker who suffered injuries when he backed his personal vehicle into an unguarded trench at a construction site. Case: Palacios v. McEvoy, No. 2023-04963, 02/25/2026, published. Facts: Jose Leon Palacios suffered injuries when he reversed his personal vehicle into an unguarded trench at a construction site where a home was being built. Farrell Building Co. Inc was the general contractor for the project. Robert and Sabrina McEvoy were the owners of the property. Procedural history: Palacios filed suit against the McEvoys ... Read More

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Press - Office Files Felony Insurance Fraud Charges Against Couple

03/13/2026 | 0

March 12th, 2026 The special investigative unit of RJN investigations, Inc. was formally notified by the Ventura County District Attorney's office as to formal criminal charges being filed based upon a documented SIU referral submitted. In this particular case, the claimant alleged to have suffered extensive injuries as a result of a trip and fall at work . She was placed on total temporary disability and alleged to have needed a walker to ambulate. A subsequent surveillance investigation performed by the RJN SIU resulted in extensive video evidence directly contradicting the claima... Read More

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NY - Court Overturns State's Win Against Worker Allegedly Hurt While Exiting Moving Vehicle

03/24/2026 | 0

A New York appellate court overturned a grant of summary judgment for the state on a worker’s Labor Law claim for her alleged injuries from attempting to exit a moving vehicle. Case: Mendes v. New York, No. 2024-05544, 02/25/2026, published. Facts: Nizia Florencia Silva Mendes was allegedly injured while mixing paint inside the back of a box truck when the truck began to move. According to Mendes, she tried to exit through the back of the truck, but at the same time, a co-worker began to raise the lift gate. Mendes alleged that she ran toward the back of the truck, lost her ... Read More

AL - Exclusivity Bars Worker's Claim for Injury From Being Hit by Truck While Jogging

03/24/2026 | 0

The Alabama Supreme Court upheld the summary dismissal of a Walmart worker’s civil suit seeking damages for his injuries from being struck by a truck while jogging in a distribution center parking lot. Case: Duke v. Walmart Inc., No. SC-2026-0074, 03/20/2026, published. Facts: Phillip Duke and Qeon Gray both worked for Walmart Inc. On Oct. 2, 2024, Duke was allegedly jogging in the parking lot of a Walmart distribution center when he was struck by a tractor-trailer truck being driven by Gray.  Gray was acting in the course and scope of his employment at the time. Although Duke l... Read More

CA - Bill Would Expand AI Disclosure Requirements

03/24/2026 | 0

A California lawmaker introduced legislation that would modify what employers are required to disclose about their use of artificial intelligence for workplace surveillance. California Privacy Protection Agency regulations that took effect at the start of the year require businesses to notify customers, including employees and applicants, when they're using automated technology to make "significant decisions." The regulations require employers to conduct and document assessments to ensure that the benefits of the technology outweigh potential risks to privacy and fairness.&nbs... Read More

CA - Hearing on WCIRB Regulatory Filing April 28

03/24/2026 | 0

The California Department of Insurance is holding a public hearing April 28 to consider the Workers' Compensation Insurance Rating Bureau's latest regulatory filing. The bureau in February proposed changes to payroll minimum and maximum limitations, dual wage thresholds, expected loss rates and the experience rating threshold that would take effect Sept. 1. The Insurance Department virtual hearing is at 10:30 a.m. April 28. A link to register to attend is here. Written comments can be submitted during the public comment period that closes at 5 p.m. April 28.  Comments can be s... Read More

AZ - Bill Would Require Attestation of Applicant for Zero-Exposure Policies

03/24/2026 | 0

The Arizona state House of Representatives on Monday passed a bill that would require insurers issuing zero estimated exposure policies to include a statement from the applicant attesting to the accuracy of the information provided to secure coverage. HB 2680, which the House passed 55-1, would require applicants to sign a statement saying they have no employees, no estimated exposure and that they will provide written notification within 60 days of hiring workers. The attestation would also include a statement that intentional omissions or misrepresentations are illegal. Employers with... Read More

OR - WCD Posts Updated Hospital Cost-to-Charge Ratios

03/24/2026 | 0

The Oregon Workers’ Compensation Division published new cost-to-charge ratios used to calculate reimbursement owed to hospitals for treating injured workers starting April 1. Hospital payments are calculated by multiplying the total bill by the ratio assigned to the specific facility providing services. For rural in-state hospitals as well as facilities outside of the state, the ratio is 1, meaning the bill is paid in full. Cost-to-charge ratios range from 0.243 to 0.583 for other hospitals. Bulletin No. 290 with revised hospital cost-to-charge ratios is here. ... Read More

MD - Bills to Expand Presumptions Pass First Chamber

03/24/2026 | 0

Bills that would expand Maryland's hypertension presumption for firefighters and extend the heart disease and hypertension presumption to correctional officers in another county are moving through the General Assembly. The House of Delegates on Thursday voted 129-2 to pass HB 347, which would revise the hypertension presumption for firefighters. The same day, the Senate voted 45-0 to pass companion measure SB 90. The House on Thursday also voted 130-1 to pass HB 878, which would apply heart and hypertension presumptions to correctional workers in Carroll County, while the Senate... Read More