FL - Appeals Court Rejects Rules Equating Dispensing Doctors With Pharmacies
02/27/2026 | 0
A Florida appeals court held that the Department of Financial Services exceeded its rulemaking authority with a 2023 proposal that essentially equated dispensing doctors with pharmacies and pharmacists.
"Dispensing practitioners do not fit within the plain meaning of 'pharmacist,' nor do they engage in the 'practice of the profession of pharmacy,'" the 1st District Court of Appeal said Wednesday.
As a result, proposed rules that would have prohibited carriers from refusing to pay for medications solely because the injured worker had the prescription filled by ...
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The New Jersey Superior Court’s Appellate Division upheld a judge’s order disqualifying a defense firm from representing a professional employer organization in a workers’ compensation coverage dispute due to its brief prior representation of the employer.
Case: Arboleda v. Paychex, No. A-0085-25, 02/25/2026, unpublished.
Facts and procedural history: Prop N Spoon entered a professional employer organization agreement with Paychex. The agreement was for Paychex to administer Prop N Spoon's human resources functions, including providing workers' compensation coverage...
A Texas appellate court ruled that the defendants in an injured worker’s negligence action should have been allowed to designate his employer as a responsible third party.
Case: In re BD Trucking, No. 14-25-00735-CV, 02/24/2026, published.
Facts: Roberto M. Vargas sued BD Trucking and its employee, Basil Odigie, after a 2023 workplace injury.
Vargas was hurt at a well site in New Mexico while working for Halliburton. He claimed that he fell from a lift raised 25 feet in the air as he attempted to collect samples from a sandbox sitting on a BD Trucking tractor-trailer.
According ...
A New York appellate court upheld a grant of summary judgment on a worker’s Labor Law claim for his injuries from being struck by falling objects, and it granted summary judgment dismissing the defendants’ third-party claims.
Case: Siguencia v. The Hudson Cos. Inc., No. 152852/19 595213/20 595187/21, 02/05/2026, published.
Facts: Juan Siguencia allegedly suffered injuries while working on a construction project at a property owned by Athena Housing Associates LLC.
Bruno Frustaci Contracting Inc. was the general contractor for the project.
According to Siguencia, he was working ...
Multi-Year sponsorship Expands Across Texas and California with Educational Resources, Community Leadership, and Patient Support
BAKERSFIELD, Calif. / AUSTIN, Texas - Centre for Neuro Skills (CNS) and the American Heart Association/American Stroke Association have extended their strategic relationship through 2027. CNS support of the Association launched in 2023 to forge stronger connections with...
Workers' comp and Medicaid are intertwined.
First, a few factoids about Medicaid:
One out of four Americans is covered by Medicaid.
Medicaid accounts for about 17% of U.S. medical spend (work comp is about 1%).
It is very state-specific; states have a lot of control over who and what’s covered.
Federal and state funds pay for Medicaid, with the feds covering about 62% of total costs (on average).
Most Medicaid recipients don’t pay deductibles, co-pays, or co-insurance. (Indiana is one exception).
Medicaid covers millions of people in working families.
L...
The West Virginia Intermediate Court of Appeals upheld a determination that a coal miner was entitled to benefits for a knee injury.
Case: ACNR Resources Inc. v. Asturi, No. 25-ICA-270, 02/03/2026, published.
Facts: Joseph Asturi worked for ACNR Resources Inc. as an underground coal miner. He allegedly twisted his knee when he stepped into a hole at work in July 2024.
Asutri claimed he aggravated the knee injury in September 2024 when he tripped over a screen.
Before these incidents, Asturi suffered a medial meniscal tear in his left knee. He underwent knee surgery in August 2018...
The Los Angeles County District Attorney's Office announced that a police officer was charged with two counts of fraud for allegedly exaggerating an on-duty injury to collect disability benefits.
Prosecutors said Los Angeles Police Officer Christopher B. Carnahan, 43, injured his left elbow in May 2023 and was placed on temporary total disability status.
Despite claiming to be totally disabled, Carnahan allegedly completed multiple skydives in Lake Elsinore and worked out at a fitness center.
He faces two counts of felony insurance fraud and is being held on $100,000 bail.
...
The New York Senate on Thursday unanimously passed a bill allowing those entitled to death benefits to receive payments through direct deposit.
The Senate voted 57-0 to pass S4467, which would expand the law allowing direct deposit of other workers' compensation benefits to include death benefits owed to a surviving spouse, domestic partner, dependent child or other beneficiaries.
Employers or carriers that fail to enroll an eligible person in direct deposit within 25 days of receiving a request would be subject to a penalty of 25% of the compensation due per pay period, plus $300 f...
The Arizona House of Representatives on Thursday passed bills that would restrict when insurers covering firefighters can file a uniform rate deviation and direct the state to establish a registry to collect data on cancer trends among state firefighters.
The House voted 52-1 to pass HB 2271, which would allow insurers covering firefighters and fire investigators to file one uniform percentage deviation only if they are not reimbursed for claims by the Municipal Firefighter Cancer Reimbursement Fund.
Carriers are typically required to adhere to statewide workers' compensation insurance r...
CT - Bill Would Require Study of Delays in First Responder Claims
Connecticut lawmakers are considering legislation that would require a formal study of delays in workers' compensation claims filed by police officers and firefighters.
HB 5385, introduced Thursday and referred to the Joint Committee on Labor and Public Employees, would direct the state Workers’ Compensation Commission to examine the causes of undue delay in such claims.
Under the proposal, the commission would study factors contributing to delays, including administrative processing issues, medical provider availability and scheduling limitations, and insurer authorization require...
Louisiana lawmakers are considering legislation that would restrict the evidence parties may introduce when appealing certain workers' compensation medical treatment decisions.
SB 162, introduced Wednesday, would amend Louisiana law governing the state’s workers' compensation medical treatment schedule.
Under current law, disputes over whether recommended care complies with the medical treatment schedule, or whether a variance is reasonably required, may be appealed to the Office of Workers’ Compensation Administration’s medical director or associate medical directo...
A Texas appellate court ruled that a district court judge could not enjoin an administrative law judge’s issuance of a discovery subpoena in a contested case about compensability.
Lauren Smith worked for Fort Bend County as a paramedic. She died at home in April 2023 after working a 48-hour shift.
Smith’s husband filed a claim for death benefits, which the county contested.
The husband initiated a contested case proceeding with the Division of Workers’ Compensation. Fort Bend sought a subpoena for Smith’s mental health records from Dr. John Marcellus, the doct...
A Texas appellate court ruled that the family of a worker killed in a refinery accident had to arbitrate their gross negligence claims, pursuant to an agreement the worker signed when he was hired.
Case: Turner Specialty Services LLC v. Horn, No. 01-24-00097-CV, 02/24/2026, published.
Facts: Turner Specialty Services LLC provides turnaround maintenance services at refineries and petrochemical facilities in states along the Gulf of Mexico, including Alabama, Mississippi, Louisiana and Texas. Justin Horn worked for TSS.
When he was hired, Horn signed an arbitration agreement. It required...
A Texas appellate court affirmed a trial court's take-nothing judgment in favor of a non-subscribing employer that was sued for negligence and premises liability.
Case: Kimberly Cotton v. A&D Interests, 14-25-00120-CV, 02/24/2026, published.
Facts and procedural history: Kimberly Cotton was injured on what she described as a "soupy" night in December 2020 after she clocked out and exited Heartbreakers nightclub in Dickinson, roughly halfway between Houston and Galveston. After stopping to talk to a club patron outside the business, she began to step off the curb to continue...
A New York appellate court ruled that a worker should have been granted summary judgment on his Labor Law claim for his injuries from falling off a ladder after suffering an electric shock.
Case: Szczesiak v. Ery Tenant LLC, No. 153101/20, 02/05/2026, published.
Facts: Mikolaj Szczesiak worked as an electrician. He allegedly suffered injuries in September 2019 when he fell from a 10-foot ladder.
According to Szczesiak, Crana Electric Inc. directed him to work on the lighting on the 11th floor of a building owned by Ery Tenant LLC. Szczesiak searched for a ladder that wou...
The West Virginia Intermediate Court of Appeals vacated an award of benefits to a coal lab employee, finding that the Board of Review failed to provide sufficient analysis of the evidence.
Case: SGS North America Inc. v. Vandall, No. 25-ICA-266, 02/03/2026, published.
Facts: Kevin Vandall worked as a lab tech and prep tech for SGS North America Inc., doing coal testing. He was allegedly exposed to dust in this job.
Vandall was laid off in June 2020.
In August 2021, Vandall underwent pulmonary function testing and X-rays. Dr. Afzal Ahmed diagnosed him with simple pneumoconiosis after v...
