MO - Carrier Must Pay Bill for Worker's Knee Surgery
12/11/2025 | 0
The Missouri Court of Appeals upheld an order from the Labor and Industrial Relations Commission ordering a carrier to pay the full amount billed by a treatment provider for an injured worker’s knee surgery.
An employee of S&B Hauling & Construction suffered a knee injury at work in July 2020. S&B’s insurance carrier authorized The Center for Surgical Specialties PC to perform arthroscopic surgery to repair the employee's knee.
Surgical Specialties billed the carrier $19,763 for its services. The carrier paid Surgical Specialties $11,566.52 but refused to pay...
Read More
A New York appellate court revived a worker’s Labor Law claim for injuries from a falling object and ordered that summary judgment be granted in his favor.
Case: Rivera v. Site 2 DSA Owner LLC, No. 159502/20, 12/02/2025, published.
Facts: Danny Rivera suffered injuries while working with others to lift a 400-to-600-pound gang box into a truck. According to Rivera, the box began to fall, and he was hurt when he used his leg to stop its descent.
Procedural history: Rivera filed suit against Site 2 DSA Owner LLC, Delancey Street Associates LLC and T.G. Nickel & Associates L...
The Arkansas Court of Appeals upheld an award of benefits to a worker who was injured by falling while walking to her car, despite her inconsistent explanations.
Case: Dardanelle Public Schools v. Ewton, No. CV-25-148, 12/03/2025, published.
Facts: Andrea Ewton worked as a substitute custodian for Dardanelle Public Schools.
On Aug. 15, 2023, Ewton arrived at a Dardanelle campus, went into the main office and clocked in.
While she remained on the clock, Ewton walked to her car through the parking lot. She gave differing accounts of whether she was retrieving a water bott...
West Virginia’s Intermediate Court of Appeals upheld the expansion of a worker’s claim to include a neck injury from an accident where he was struck on the head by a falling concrete block.
Case: Marshall County Coal Resources v. Kessler, No. 25-ICA-246, 12/04/2025, published.
Facts: Joshua Kessler worked for Marshall County Coal Resources. A falling concrete block struck him on the head and knocked him off a ladder while he was at work in February 2024.
At the hospital, Kessler denied loss of consciousness, denied neck or back pain and denied any other injury. A computed t...
The Special Investigative Unit of RJN Investigations, Inc. was recently notified of a felony arrest based upon a documented fraud referral. In this case, the claimant was employed as a caretaker of the California Department of Social Services - I.H.S.S. At the time of the claimant's deposition, he appeared wearing a back support and ambulating with the aid of a cane. Proactively,...
In the latest example of how indefensibly corrupt California’s workers’ compensation system has become, a former San Francisco city official pleaded guilty to embezzling $627,118 from municipal coffers by paying a fake company to “audit” workers’ comp claims.
Stanley Ellicott helped manage finances and technology for the San Francisco Department of Human Resources Workers’ Compensation Division.
In his role as a DHR official, Ellicott paid Independent Auditors Group to audit workers’ compensation claims. Ho...
The U.S. Occupational Safety and Health Administration fined an engineering and construction firm in Georgia $20,522 after an investigation into a worker's death.
OSHA cited Hyoungwon E&C America Inc. for serious violations, including failing to protect employees against asphyxiation hazards related to nitrogen gas and not providing effective information and training on hazards related to nitrogen gas and oxygen-deficient atmospheres.
The agency said the citations resulted from an investigation into a worker fatality at Hanwa Q Cells Georgia Inc. in White, but it did not d...
The Oregon Occupational Safety and Health Division fined a contractor $128,345 for numerous violations, including repeated violations of fall protection standards.
Oregon OSHA said on Wednesday that it cited Shrader Homes Inc. for five violations of requirements to protect workers from serious injury or death. One of the violations was a fourth repeat infraction for failing to provide fall protection, the agency said. Another was a second repeat violation of a ladder safety rule.
"Falls are one of the leading causes of death in the construction industry," the agency said. "Ore...
An Idaho transformer manufacturer is facing nearly $1 million in penalties for allegedly not correcting hazards identified by federal inspectors.
The U.S. Occupational Safety and Health Administration said a June 2025 inspection found that Virginia Transformer Corp. in Pocatello exposed its workers to hazards similar to those uncovered during inspections in 2024 involving cranes used to handle heavy loads with faulty brakes and switches.
OSHA said it cited the company for 53 serious and repeat violations for not guarding machines, exposing workers to fall hazards and not providing personal p...
The Wisconsin Court of Appeals ruled that an employer wrongfully refused to rehire an injured employee who was cleared to return to work.
Bruce Belland Trucking Inc. is a company that harvests, hauls and sells wood. Mark Maney worked for Belland as a loader/truck driver.
Maney injured his knee at work in February 2018 and underwent surgery. Maney was released to return to work without restrictions as of April 18, 2018.
On April 16, 2018, Maney informed Belland that he was cleared to return to work in two days but that he would be out of town for his daughter’s wedding until ...
San Diego, California - 11/14/2025 - Dietz, Gilmor & Chazen, APC, a California statewide law firm practicing exclusively in workers' compensation defense, subrogation, asbestos, Labor Code §132a, and serious and willful misconduct claims, promotes Peter M. Golden, Esq. to Partner.
Mr. Golden is a Partner based out of the San Diego office of Die...
A divided federal appellate court upheld an award of black lung benefits to a miner’s widow.
Case: Clinchfield Coal Co. v. Mullins, No. 23-1644, 12/02/2025, published.
Facts: Donald Mullins worked as a coal miner for nearly 28 years before his death in February 2014.
Procedural history: Mullins’ widow filed a claim for survivor’s benefits under the Black Lung Benefits Act.
A district director issued a proposed decision and order awarding benefits payable by Clinchfield Coal Co.
An administrative law judge found that the widow was not entitled to the act’s rebuttabl...
A New York appellate court upheld the summary dismissal of claims by a worker who said he was injured while working aboard a navigable vessel.
Case: Badloo v. City of New York, No. 2025-01110, 11/26/2025, published.
Facts: Deoraj Badloo allegedly suffered injuries while performing electrical maintenance work on a vessel owned by the City of New York.
HNY Ferry LLC operated the vessel and was Badloo’s employer.
Procedural history: Badloo filed a suit against the city, HNY and Hornblower Group Inc., HNY’s corporate parent. He asserted claims for...
The West Virginia Supreme Court upheld the denial of a worker's request to expand her claim.
Case: Walker v. Goodwill Industries of Kanawha Valley Inc., No. 25-503, 11/25/2025, published.
Facts: Karen Walker worked for Goodwill Industries of Kanawha Valley Inc. She tripped over a clothing rack at work and injured her knee in July 2020.
A claims administrator for Goodwill’s insurance carrier accepted liability for a left knee contusion.
Walker saw Dr. David Felder twice in August 2020. Felder diagnosed a contusion of the left anterior thigh and a strain of the left tibialis anteri...
The Los Angeles County Superior Court erred when it found that California's insurance commissioner could require an insurer of last resort to offer incidental workers' compensation as part of its basic property insurance, an appeals court ruled.
In 2021, Insurance Commissioner Ricardo Lara issued an order directing the California FAIR Plan Association to include premises liability and incidental workers' compensation coverage in homeowners' policies.
The association petitioned the Los Angeles County Superior Court for a writ of mandate, arguing that the order improperly excee...
A Washington state lawmaker introduced legislation that would explicitly prohibit employers from steering injured workers to a specific provider by making such conduct a violation of good faith claims-handling laws.
Injured workers in Washington are allowed to choose any provider from the network administered by the Department of Labor and Industries, or from their employer's network if they work for a self-insured business.
SB 5847, introduced Monday by Sen. Rebecca Saldana, D-Seattle, would require employers to notify injured workers of their right to pick a treating provider and expre...
A companion measure to a proposal to explicitly provide workers' compensation coverage for volunteer firefighters and paramedics injured during fundraising events was introduced in the Pennsylvania House of Representatives.
Rep. Robert Freeman, D-Easton, on Monday introduced HB 2087, which would declare that volunteer firefighters and paramedics are considered "employees" when they're engaged in fundraising activities.
The bill appears to be an identical companion measure to SB 1053, which Sen. Scott Hutchinson, R-Oil City, introduced in October.
Hutchinson said in a s...
The International Association of Industrial Accident Boards and Commissions opened registration for its 2026 Forum, set for April 20-22 in Greenville, South Carolina.
The annual event features roundtable discussions and educational presentations while also providing an opportunity for IAIABC committees and councils to discuss policy and administrative issues.
The event encourages discussion and collaboration and provides an opportunity for workers’ compensation peers to share insights and information, and generate ideas and strategies, IAIABC said.
Early bird registration is $790 for ...
