CA - High Court to Review Rodriguez Ruling on WCAB Jurisdiction Over Medical Care
01/26/2026 | 0
The California Supreme Court granted a petition to review an appellate court decision holding that utilization review and independent medical review must be used to determine the necessity for ongoing medical services.
The high court on Wednesday agreed to hear a challenge to the 2nd District Court of Appeal decision in Illinois Midwest Insurance Agency v. WCAB (Rodriguez), which rejected the so-called Patterson doctrine that the Workers' Compensation Appeals Board has relied on to retain jurisdiction over authorized requests for ongoing treatment.
According to a summary the high court p...
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The Oregon Court of Appeals ruled that a state employee could not proceed with civil claims against his employer for his alleged injuries from being attacked at work.
Case: Dumanovskiy v. Oregon Youth Authority, No. 1136, 12/31/2025, published.
Facts: Samson Dumanovskiy worked for the Oregon Youth Authority. He alleged that he was attacked by two youths in OYA custody who were attempting to steal his keys to free another inmate and escape.
Dumanovskiy sustained cuts to his face and lip, for which he later received medical attention. He also filed a workers’ compensation clai...
A New York appellate court upheld a decision by the Workers’ Compensation Board denying a worker’s application for reconsideration and/or full board review.
Case: Matter of Sylvester v. Department of Corrections and Community Supervision, No. CV-24-2093, 12/18/2025, published.
Facts: David Sylvester worked for the Department of Corrections and Community Supervision. He injured his left shoulder at work in 2017 and was awarded a 10% schedule loss of use for his left arm.
In 2021, Sylvester suffered work-related injuries to his head, left knee and left shoulder. After performing s...
A New York appellate court upheld a 22.5% schedule loss of use award for a worker’s ruptured Achilles tendon.
Case: Matter of Maini v. Nassau County Police Department, No. CV-24-2052, 12/18/2025, published.
Facts: John Maini worked for the Nassau County Police Department. He established a workers' compensation claim resulting from suffering a ruptured left Achilles tendon while working in June 2022.
In August 2023, Maini’s doctor opined that he had reached maximum medical improvement and that he had a 40% schedule loss of use of the left foot.
A medical expert hired by the ...
There’s an opinion piece in HealthAffairs from last week calling for providers to add “mobility” to the list of quality indicators assessed by governments, employers and health care practitioners.
Three thoughts:
First, it's not just "mobility," it's functional capacity. Can the person pick up a grandchild, dance with a partner, carry groceries?
Second, health care's "outcomes" are lacking what's important to the patient. Does the result of the treatment enable the patient to function — use the bathr...
The West Virginia Supreme Court upheld a 15% permanent partial disability award to a worker for his injuries from a fall, without any apportionment to any prior condition.
Case: Georgian American Alloys Inc. v. Davis, No. 25-579, 01/13/2026, published.
Facts: In February 1998, Mark Davis was treated for bronchitis, sinusitis, and rib and thoracic pain.
In September 2020, Davis was examined by Dr. Wesley Lieving. Medical records from the visit indicate that Davis’ complaints were hypertension, moderate persistent asthma without complication, asthma due to environmenta...
The Department of Industrial Relations and its divisions — the California Labor Commissioner’s Office and Cal/OSHA — say contractors working in connection with all wildfire responses must follow state labor and workplace safety laws.
Primary employers remain responsible for ensuring that labor laws are heeded, even in cases where subcontractors and labor providers are used.
Those who work in wildfire support are protected by California's labor laws, which include minimum wage, overtime, meal and rest breaks, and protection from misclassification and retaliatio...
The California Division of Workers' Compensation is moving the Santa Barbara District Office to Goleta.
The division announced last week that the District Office will be located at 120 Cremona Drive No. 270.
"All hearings, filings and walk-throughs will be at the new Goleta address as of Jan. 22," the division said. "However, the DWC Electronic Adjudication Management System will continue to show Santa Barbara until a system update occurs at the end of March."
An updated list of district offices showing the new Goleta location is here.
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NATL. - 2024 Work Injuries Lowest in Two Decades
U.S. private industry employers reported 2.5 million nonfatal workplace injuries and illnesses in 2024, a 3.1% decline from 2023 and the lowest total recorded since the Bureau of Labor Statistics began tracking the data in 2003, according to the latest report released Thursday.
The drop was driven largely by a sharp decline in reported illness cases, which fell 26% to 148,000. Respiratory illnesses accounted for much of the decrease, plunging 46.1% to 54,000 cases, the lowest level for that category since 2019, all according to data from the BLS Survey of Occupational Injuries and Illnes...
An Arizona appeals court cited a decision that the California Supreme Court handed down during World War I in finding that a person working at an auto body repair shop was not entitled to benefits for a self-inflicted gunshot wound.
Kenyatta Goins assessed the extent of damage to vehicles for Chaney's Collision Center, an auto body repair shop in Glendale.
He was working on an estimated cost to repair a pickup when he decided he needed to move the vehicle. As he was getting into the truck, the semi-automatic pistol he carried for personal protection discharged and shot him in the l...
The Oregon Court of Appeals upheld a determination that a worker with a history of back issues did not prove the compensability of his new alleged conditions.
Case: Robey v. Weir ESCO, No. 1141, 12/31/2025, published.
Facts: Joseph Robey worked as a parts inspector for Weir ESCO in a steel foundry. He had several low-back injuries as an adult unrelated to his work for this employer, and he suffered from chronic low-back pain.
Robey’s pain worsened toward the end of 2020 after a few weeks of being busier than usual at work. His doctor diagnosed him with a lumbar strain.
Weir ESCO...
The owner of Hawkeye Waste Systems admitted to not having workers' compensation insurance in response to criminal charges stemming from a fatal accident in 2024, the Iowa City Press-Citizen reports.
Matthew Reuwsaat died of severe head trauma on Oct. 31, 2024, while working for the eastern Iowa waste management company. A subsequent investigation determined that Hawkeye Waste Systems did not have workers' compensation insurance and was not approved to be self-insured.
James Watts, the owner of the company, pleaded guilty on Jan. 16 to a felony count of failure to maintain workers'...
A New York appellate court upheld a determination that a worker waived the right to cross-examine her employer’s expert witness.
Case: Matter of Rodin v. Department of Parks and Recreation, No. CV-24-0993, 12/18/2025, published.
Facts: Daphyne Rodin worked for the Department of Parks and Recreation. She established a workers’ compensation claim for an injury to her left shoulder.
In 2022, Rodin’s treating doctor opined that she had maximum medical improvement and sustained a 7.5% schedule loss of use of the shoulder.
The department submitted a report from its own medical ...
Legislation in South Carolina would double the minimum temporary disability benefit and require annual increases, starting in 2027.
H 4820, by Rep. Tiffany Spann-Wilder, D-Charleston, would increase the minimum TD benefit to $150 per week from $75, effective July 1, 2027.
The bill would also require the Workers' Compensation Commission to increase the minimum benefit by the same percentage as the annual increase to the state's maximum average weekly wage.
The first increase to account for changes made to the average wage would have to be adopted before Oct. 1, 2027, with subsequ...
The West Virginia Supreme Court upheld a finding that a worker failed to prove that his cervical disc displacement was a compensable injury.
Case: Morgan v. Cornerstone Labor Services Inc., No. 25-604, 01/13/2026, published.
Facts: Darrell Morgan worked for Cornerstone Labor Services Inc. In June 2023, he was working as an equipment operator when his truck hit a large rock, which allegedly caused injury to his neck and back.
Morgan went to the hospital, and he was diagnosed with a cervical sprain, back pain and muscle spasms.
A claims administrator for Cornerstone’s insurance carrier...
The Delaware Superior Court remanded a dispute over the reasonableness of a worker’s surgery to the Industrial Accident Board.
Case: Smith v. Wells Fargo Bank N.A., No. N25A-04-008 SSA, 01/06/2026, published.
Facts: Kelly Smith worked for Wells Fargo Bank N.A. She suffered injuries at work in 2023.
In August 2024, Smith saw Dr. Mark Eskander, and she underwent X-rays. The images showed 12 degrees and 4 millimeters of instability on flexion and extension.
Eskander recommended cervical spine surgery, which he performed in September 2024.
Wells Fargo sought utilization review...
