NATL. - WCRI: Services Not Covered by Fee Schedules Contribute to Rising Medical Costs
07/29/2026 | 0
A growing share of medical spending is occurring on services without fee schedule rates, a trend that likely contributed to rising medical payments, according to a new report from the Workers Compensation Research Institute.
Services without fee schedule rates tend to be more expensive than those with set reimbursement rates, and the growing use of and payments for these services is likely driving recent growth in total medical payments, according to report authors Alesya Fomenko and Rebecca Yang.
"In some states, services without fee schedule rates are identified as 'by report'
Read More
The Oregon Occupational Safety and Health Division announced that registration is now open for a two-day event in Bend that will focus on building and maintaining safe and healthy workplaces.
The Central Oregon Occupational Safety & Health Conference in September will cover topics including fall protection, safety committees, heat-illness prevention and wildfire smoke requirements.
Additionally, the Oregon Fire Chiefs Association's Safety and Health Section helped create sessions for emergency service workers and first responders, covering organizational resilience, strengtheni
The Washington Court of Appeals upheld a determination that a worker’s industrial accident proximately caused only a concussion and a cervical sprain/strain, but it didn't cause or aggravate his preexisting conditions.
Case: Calderon v. Department of Labor & Industries, No. 41216-4-III, 07/23/2026, unpublished.
Facts: In October 2018, while working at a potato processing plant, Hernan Calderon slipped on a wet floor and fell backward, hitting a metal pole.
Calderon went to the emergency room, where a neurological examination returned normal results. Computed tomography s
The Commonwealth Court of Pennsylvania upheld an award of disability benefits to a worker for a closed period of time for a foot condition.
Case: Perez-Martinez v. Dart Container Corp. of Pennsylvania (WCAB), No. 283 C.D. 2025, 07/24/2026, unpublished.
Facts: Rodolfo Perez-Martinez began working for the Dart Container Corp. of Pennsylvania in October 2014.
In January 2022, Dart began asking its employees to wear steel-toed boots or to use covers for their shoes.
Perez-Martinez alleged that the steel-toed boots were heavy and caused his feet to swell; he also developed a bump underneath his
At a meeting of California’s Commission on Health and Safety and Workers’ Compensation, a payer and network advocate argued that the state’s chaotic medical provider network system is a sterling success, despite overwhelming evidence to the contrary.
The American Association of Payers, Administrators and Networks claimed that a general provider shortage, not a broken system riddled with pitfalls for providers, is the reason injured workers struggle to find doctors willing to treat them.
AAPAN shared findings from its white paper&n
California workplace safety regulators urge employers to provide water, shade and rest breaks to protect workers as a heat wave sweeps over the state.
The hottest conditions early in the week are expected in the Mojave Desert, where temperatures are forecast to range from 110 to 118 degrees, the Division of Occupational Safety and Health said.
Heat is expected to spread north throughout the week, with triple digits forecast for parts of Central and Northern California.
Cal/OSHA said its heat illness prevention standards require employers to protect workers in both indoor and
A New York appellate court upheld the summary dismissal of a worker’s Labor Law claim for his alleged injuries from a fall off a ladder.
Case: Arias v. Allen J. Reyen Inc., No. 2023-03124 and 2025-14253, 07/22/2026, published.
Facts: Rodrigo Arias allegedly was injured when he fell from a ladder while working on a barn at a property in Pound Ridge.
Procedural history: Arias filed suit against Allen Reyen and Allen J. Reyen Inc., alleging claims for violations of the Labor Law.
The defendants separately moved for summary judgment dismissing the complaint.
Westchester County Supreme C
A New York appellate court ruled that a Labor Law defendant should have been granted summary judgment dismissing part of a worker’s claim for his injuries from a fall into an excavated hole.
Case: Letersky v. Militello Farms Inc., No. 458 CA 25-00451, 07/24/2026, published.
Facts: Kevin Letersky allegedly suffered injuries while he was marking fuel lines at night in preparation for an emergency repair of a water line owned and operated by Erie County Water Authority.
According to Letersky, he was injured when he fell into an excavated hole that was unmarked and unguarded.
The propert
The Minnesota Supreme Court ruled that an employer is not limited to rebutting the statutory presumption of industrial causation for a police officer's post-traumatic stress disorder with an independent psychological evaluation, and that an evaluation based on outdated guidelines can be considered.
Nicholas Rowe served the City of Minneapolis as a police officer for 25 years. Over the course of his career, he responded to five mass shootings, six officer-involved shootings, hundreds of homicide calls and six incidents involving deceased children.
Before Rowe was hired, a psycho
Jacksonville, FL – July 10, 2026 – PhysNet welcomes Michelle Despres, PT, EMBA as Chief Operating Officer, strengthening its leadership team as the company enters its next stage of national growth.
A licensed physical therapist and seasoned healthcare executive, Michelle brings a strong blend of clinical insight, operational leadership, and people-centered strategy. S
A Texas appellate court upheld the dismissal of a self-represented worker’s claims against his former employer due to governmental immunity.
Case: Everett v. Cleveland Independent School District, No. 09-25-00142-CV, 07/23/2026, published.
Facts: Thomas W. Everett worked for the Cleveland Independent School District. He alleged that he was wrongfully forced to resign under duress, and that the district fraudulently filed a workers’ compensation claim on his behalf.
Procedural history: Acting as his own attorney, Everett filed suit against CISD, asserting claims for wro
A Texas appellate court ruled that the Division of Workers’ Compensation may penalize a chiropractor for continuing to bill for services provided after his license expired.
Case: Vanderwerff v. Texas Department of Insurance, No. 15-25-00026-CV, 07/23/2026, published.
Facts: Eric Vanderwerff has provided chiropractic services to patients within the workers’ compensation system for more than 25 years.
Chiropractic licenses expire every two years unless renewed.
The Texas Board of Chiropractic Examiners issued a notice of biennial license renewal to Vanderwerff in August
A New York appellate court ruled that a worker should have been granted summary judgment on his Labor Law claim, and that the defendants were entitled to conditional summary judgment on their third-party indemnification claims.
Case: Canales v. Noble Construction Group LLC, No. 161247/19, 595182/20, 595970/21, 596029/21, 07/16/2026, published.
Facts: Jose Canales worked for C&L Concrete Corp. He allegedly suffered injuries while helping to carry an 800-pound end box, a type of electrical cabinet.
According to Canales, when his supervisor instructed him to assemble a team of co-work
Don Hofer was appointed to the Workers' Compensation Insurance Rating Bureau Governing Committee, the Department of Insurance announced.
The department also announced that Andrea Hecht and Jim Taylor were appointed to represent insurers on the California Insurance Guarantee Association board of governors.
Hofer, vice president for Shea Homes Northern California Division, joins the WCIRB Governing Committee in the insured employer representative seat with a term ending on July 16, 2028, the department said.
According to the WCIRB website, Hofer was appointed to serve as a public member o
The National Council on Compensation Insurance reported that medical inflation softened in June, but added that the trend is likely only temporary.
NCCI reported that overall workers' compensation medical costs in June 2026 are 1% higher than they were at the same point in 2025.
The 1% growth rate compared to a 1.9% average inflation rate over the last 12 months and three- and five-year averages of 2.5%. NCCI said it anticipates that the softening in June is temporary and that inflation "will move up toward a 2% to 2.5% range over the next several quarters."
Hospital out
Florida's Statewide Nominating Commission for Judges of Compensation Claims is meeting Aug. 24 to interview two candidates for reappointment and to consider applications for new appointments.
Commission members will interview judges Ray Holley and Rita Young, who are up for reappointment.
Holley has served as a judge of compensation claims since 2010. He earned his bachelor’s degree from Stetson University, his master’s degree from the University of North Florida and his juris doctor from Stetson University. Holley was last reappointed to the Jacksonville office in 2023.
You
The Oregon Court of Appeals granted reconsideration of its decision that had overturned a ruling by the Workers’ Compensation Board eliminating a worker’s impairment award, and it adhered to its conclusion that reversal of the board was required.
Isa Dean underwent a magnetic resonance imaging scan in 2006 that showed degenerative changes in her lumbar spine.
In 2009, Dean began working for Multnomah County. After a few years, she sought chiropractic treatment for low-back pain, which her providers associated with ergonomic conditions at her workstation.
In 2017, Dean began a di
