MT - High Court Overturns $25,000 Fine on Comp Carrier
11/13/2026 | 0
The Montana Supreme Court upheld a finding that Victory Insurance Co. violated the state Insurance Code by failing to disclose a federal lawsuit but remanded the case with instructions for regulators to explain why they levied the maximum $25,000 fine.
"When faced with a situation where there has been a demonstrated violation of the Insurance Code but the maximum fine was imposed without explanation, the proper remedy is not to completely dismiss the agency action; it is to remand with instructions to the agency to 'cogently explain why it has exercised its discretion in a given mann
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The New Jersey Superior Court’s Appellate Division upheld the dismissal of a worker’s application for review and modification based on his failure to demonstrate a worsening of his condition.
Case: Tighe v. Tighe Landscape Design Inc., No. A-0915-24, 11/02/2026, unpublished.
Facts and procedural history: John Tighe worked for Tighe Landscape Design Inc., a company owned by his brother.
He suffered injuries at work in October 2015 when he fell from a truck while unloading boulders at a jobsite.
Tighe had right shoulder surgery, followed by physical therapy. His doctor discharged
The Commonwealth Court of Pennsylvania upheld a determination that a worker did not meet his burden of establishing an employer-employee relationship necessary to support an award of benefits for his injuries from a fall while repairing a garage door.
Case: Feliciano v. Montero, No. 646 C.D. 2025, 11/04/2026, unpublished.
Facts: In April 2021, Angel Feliciano fell and suffered injuries while working with Frank Montero to repair a garage door.
Feliciano underwent cervical and lumbar fusion surgeries to treat his injuries.
According to Feliciano, he had worked with Montero as a helper t
A New York appellate court ruled that a Labor Law defendant was entitled to partial summary judgment on a worker’s claims and on its indemnification claim.
Case: Sorto v. SCI Funeral Services of New York Inc., No. 160601/21 595072/22 595771/22 595272/24, 11/05/2026, published.
Facts: Saudy Adonay Alberto Sorto worked for Magella Construction Corp., a sub-subcontractor under OneTeam Restoration Inc.
Sorto and a co-worker were working on the facade of a chapel owned by New York Funeral Chapels LLC, removing and replacing bricks and window lintels, when Sorto tripped over discarded
California lawmakers considered making sweeping changes to the Subsequent Injuries Benefits Trust Fund during the 2026 legislative session but ultimately opted for smaller changes while hinting that more change could be on the way.
Gov. Gavin Newsom signed Senate Bill 171 into law on July 13, 2026, in an attempt to reform and save the beleaguered trust fund from skyrocketing liabilities.
If you’re unfamiliar with the fund and its unusual acronym, SIBTF, it was created to help compensate World War II veterans returning to the workforce. The SIBTF is California&rs
West Virginia’s Intermediate Court of Appeals upheld a 6% permanent partial disability award for a worker’s leg injury.
Case: Day v. Blackhawk Mining, No. 26-ICA-102, 11/10/2026, published.
Facts and procedural history: Jonathan Day worked for Blackhawk Mining. He went to the hospital in January 2024, complaining of significant left calf pain and an inability to walk after his left leg was pinned by a buggy.
A computed tomography scan revealed a significant hematoma in the leg. X-rays revealed no evidence of a fracture, but lab work showed rhabdomyolysis.
Day was admitted
The National Council on Compensation Insurance, as part of its recently launched initiative that aims to answer timely questions from system users, said spending on GLP-1 medications increased by about 39% per year since 2021 but still accounts for just a fraction of total medical costs.
"Despite continued growth, GLP-1 use in workers' compensation remains extremely limited, both in terms of the share of claims with these drugs and the overall volume of losses observed," NCCI said in the latest installment of its "Asked & Answered" series. "We don’t expe
West Virginia’s Intermediate Court of Appeals ruled that a worker failed to establish that he suffered a discrete new injury as a result of a training incident in which he was subjected to being shocked with a Taser.
Raun Bowers worked for West Virginia United Health System Inc. In May 2025, he told his supervisor he was injured during a Taser training incident.
According to the supervisor’s report, Bowers was observing a Taser training class. Bowers was instructed to lie on his stomach in preparation for being shocked. After Bowers positioned himself and indicated he was ready,
An Ohio appellate court upheld a grant of summary judgment dismissing a truck driver’s claim for glaucoma.
Case: Ridgeway v. BWC, No. 116666, 10/29/2026, published.
Facts: Howard Ridgeway filed a workers’ compensation claim based on his glaucoma diagnosis, which he contended was caused by his exposure to headlights and nighttime driving as a truck driver for Spooner Risk Control Services Inc.
Spooner disputed that Ridgeway’s glaucoma diagnosis was work-related.
Procedural history: The Bureau of Workers’ Compensation denied Ridgeway’s claim, and he filed a
The Pennsylvania Superior Court revived a worker’s civil suit for her alleged injuries from a motor vehicle accident, finding that the doctrine of collateral estoppel did not bar her action.
Case: Rehrig v. Hay, No. 1865 EDA 2025, 10/29/2026, unpublished.
Facts: Karon Rehrig was involved in a motor vehicle accident in October 2021.
At the time, Rehrig was working as a licensed practical nurse. She filed a workers’ compensation claim against her employer, asserting injuries to her right wrist, left shoulder, neck, back and head.
A workers’ compensation judge found tha
A Delaware Superior Court judge denied a motion to dismiss a worker’s appeal from an Industrial Accident Board decision as untimely because the worker never received the decision.
Case: Haupt v. State of Delaware, No. S26A-09-001CAK, 10/27/2026, unpublished.
Facts and procedural history: Bryon Haupt worked for the State of Delaware. He filed a petition to determine additional compensation due relating to the compensability of a single medical expense that had already been paid by the state, without prejudice.
The Industrial Accident Board issued a decision in June 2026,
Florida authorities arrested a construction company owner for allegedly underreporting his payroll to fraudulently lower his workers' compensation premiums.
The state's Department of Financial Services announced on Tuesday the arrest of Israel Carballo, who is charged with grand theft, carrying out an organized scheme to defraud and workers' compensation fraud.
Carballo allegedly hid $968,278.71 in payroll by using money services to cash checks totaling more than $1 million, DFS said.
As a result, Carballo dodged $100,565.57 in insurance premiums, the state sa
The California Workers' Compensation Institute reported that independent medical reviews were down in the first nine months of 2026.
CWCI said its review of 1.8 million IMR decision letters since 2015 found that 110,965 letters were issued in the first three quarters of 2026, down 3.1% from the same period last year. Although the dip is the first reduction since IMR volume began rebounding from a historic low in 2022, CWCI noted that the figure is higher than comparable nine-month totals for 2020 through 2024.
The overall uphold rate for utilization review denials and modifications incre
The Workers' Compensation Insurance Rating Bureau is holding a webinar Dec. 9 to discuss findings from its latest study into regional differences in claim patterns and costs throughout California.
The forthcoming report will be the 12th edition of the annual project the WCIRB launched in 2015 to quantify the extent to which claims develop differently in different parts of the state despite operating under the same rules and laws.
The WCIRB said it is adding maps to the 2026 report showing regional claim patterns evaluated 126 months after policy inception, providing a longer-term view of
California's proposed rules for attorney deposition fees have managed to draw objections from both sides of the workers' compensation system, with employers saying the proposed payments are too generous and vulnerable to abuse, and applicants' attorneys saying they are too meager and that the lack of any enforcement mechanism means they're too easily withheld.
Comments submitted in response to the Division of Workers' Compensation's proposed regulations also raise questions about what services should qualify for payment, how attorneys must document their work and wheth
The Commonwealth Court of Pennsylvania upheld the denial of a worker’s claim for carpal tunnel and cubital tunnel syndrome.
Case: Gough v. UGI Utilities Inc., No. 1047 C.D. 2025, 10/27/2026, unpublished.
Facts: Glenn Gough worked for UGI Utilities Inc. for 26 years. His position allegedly required using vibratory tools, such as jackhammers and rock drills.
In January 2019, Gough began experiencing pain and numbness in his hands, particularly whenever he used a jackhammer or rock drill. He was diagnosed with carpal tunnel and cubital tunnel syndrome.
Gough underwent surgery on hi
