MT - Worker Fails to Prove Financial Need for Lump-Sum Benefits Conversion
04/01/2026 | 0
The Montana Workers’ Compensation Court denied a worker’s request to have his permanent total disability benefits converted to a lump sum.
Derek Trogden is a 40-year-old married father of four. His two eldest children are adults who do not live with him and his wife.
The two youngest children have jobs at a manufacturing plant where they are supervised by Trogden’s brother. Neither contributes any earnings toward the family’s living expenses.
Trogden’s wife is a full-time pharmacy technician. She suffers from multiple medical conditions that alle...
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A federal appellate court denied an employer’s petition for review of black lung benefits to a worker with totally disabling legal pneumoconiosis.
Case: Cedar Coal Co. v. OWCP, No. 24-1063, 03/06/2026, published.
Facts and procedural history: Roger Mullins filed a claim under the Black Lung Benefits Act in 2012, alleging that he was totally disabled due to pulmonary disease caused by coal dust.
After his claim was denied, Mullins filed a request for modification in 2019 in which he alleged that the earlier administrative law judge had made a mistake of fact and that th...
A divided Illinois Appellate Court ruled that the mother of a worker killed in an underground water vault sufficiently and plausibly pleaded intentional conduct by the employer such that exclusivity did not bar her civil action.
Case: Heiden v. Village of Westmont, No. 3-25-0071, 03/05/2026, published.
Facts: Matthew Heiden worked for the Village of Westmont as a water maintenance worker.
In February 2023, the village became aware of a leaking valve in an underground water vault. The vault was a confined space, as defined under the general provisions of the Occupational Safety and Health Ac...
A New York appellate court ruled that the construction manager for a project was entitled to partial summary judgment dismissing an injured worker’s negligence and Labor Law claims against it.
Case: Veloso v. Scaturro Brothers Inc., No. 153222/17, 595235/19, 03/10/2026, published.
Facts: Alexandre Veloso allegedly suffered injuries while performing lead abatement work at a construction site.
The Hunter Roberts Construction Group LLC was the construction manager for the project.
Procedural history: Veloso filed suit against HRCG, asserting negligence and violations of the Labor Law.
...
A Colorado grand jury indicted an insurance broker for allegedly diverting more than $100,000 in insurance premiums intended for nine insurance companies, including the state-chartered workers' compensation carrier.
The grand jury indictment handed down Friday alleges that Jorge Gonzalez-Hermosillo, who is also known as George Gonzalez and owns brokerage Amerimex Insurance LLC, failed to remit to Pinnacol Assurance at least $2,954 in workers' compensation premiums paid by employers between Feb. 28, 2022, and Jan. 8, 2024.
Pinnacol in January 2024 reported 55-year-old Gonzalez to...
NATL. - WCRI: Medical Provider Networks Tied to Lower Comp Costs, Faster Care
Medical provider networks in workers' compensation are associated with significantly lower claim costs, faster access to care and shorter disability durations, according to a report released Tuesday by the Workers Compensation Research Institute.
The study found that claims treated within networks had 26% lower total costs — about $11,800 less per claim — compared with out-of-network claims at 36 months of maturity. Medical payments alone were 27% lower, or roughly $3,500 per claim, at 12 months.
Researchers also found that injured workers receiving in-network care accessed t...
The California Division of Workers' Compensation posted an order updating the Medical Treatment Utilization Schedule drug list.
The division said the order adopts updates to the American College of Occupational and Environmental Medicine's practice guidelines based on the revised Traumatic Brain Injury guideline.
The MTUS list identifies medications that are designated as exempt from prospective utilization review when prescribed in accordance with the treatment guidelines. Drugs not designated as exempt are subject to prospective UR.
The list also identifies certain drugs that are ...
Claims administration and risk management provider North American Risk Services Inc. appointed Alice Wells as head of workers’ compensation.
Wells will lead the strategic direction and operational performance of the company’s workers’ compensation division, directing a team of managers and claims professionals while managing claim outcomes for clients. She will report directly to CEO Robert Ruryk.
Wells joins NARS with more than two decades of experience in claims management and third-party administration operations. Most recently, she served in senior executive le...
The Alaska Supreme Court reinstated an injured schoolteacher’s claims for negligence, employment discrimination, intentional infliction of emotional distress, and defamation against his former employer and supervising principal.
David Mitchell worked for the Bering Strait School District as a teacher in Savoonga, and he signed a landlord-tenant agreement with the district for housing.
At some point, the district removed one of the railings on the stairs of Mitchell’s residence. He complained, but the district did not repair or replace the railing.
One day in November 2021, ...
A New York appellate court ruled that a commercial general liability insurance provider had a duty to defend a property owner in a worker’s Labor Law action for injuries allegedly sustained at the property.
Case: Kedex Properties LLC v. Trisura Specialty Insurance Co., No. 2024-04725, 03/11/2026, published.
Facts: Kedex Properties LLC owned a property in Jackson Heights. Trisura Specialty Insurance Co. issued a commercial general liability policy to Kedex, effective from Dec. 10, 2020, through Dec. 10, 2021.
Following a fire at the property in April 2021, Kedex hired First R...
A Texas appellate court upheld a directed verdict denying a worker’s claim of injury.
Case: Sharman v. American Zurich, No. 05-24-01394-CV, 03/25/2026, published.
Facts: Anita Sharman worked for Fry’s Electronics Inc. On April 1, 2020, Sharman allegedly slipped and hit her lower left leg on a metal object while closing the store.
Sharman did not report the incident that day, nor in the week that followed.
On April 8, 2020, Sharman was informed that she was being furloughed due to the COVID-19 pandemic. She refused to sign a letter confirming the furlough.
The next day, Sharman...
The North Carolina Court of Appeals vacated the denial of the workers’ compensation claims filed by the family of a police officer who died after contracting COVID-19.
Case: McDonald v. City of Winston-Salem, No. COA25-582, 03/04/206, published.
Facts: Michael McDonald worked for the City of Winston-Salem as a police officer. He served on the department’s impaired driving task force.
In September 2021, McDonald worked at least 17 10-hour shifts, conducting numerous traffic stops, arrests and alcohol sensor tests.
Body camera footage showed that McDonald typically wore a ma...
Firing or threatening to fire an injured worker for getting treatment during the workday would be expressly added to the list of conduct prohibited by California Labor Code Section 132a, under a recently amended bill.
Assemblymember Ash Kalra, D-San Jose, earlier in March amended AB 2098 to bring back language from a failed 2024 measure that would have made denying an injured worker's request to receive treatment during working hours a form of discrimination.
Kalra on Friday amended the bill to propose adding a new Labor Code Section 4600.03 that would require injured workers ...
Wisconsin Gov. Tony Evers on Monday signed a multifaceted workers' compensation reform bill increasing benefits, expanding coverage for first responder mental health claims and boosting penalties for businesses that operate without insurance.
Reforms in AB 651, negotiated by labor and management, also reverse a state Supreme Court decision that allows stacking disability percentages and clarify that the statutory deadline for filing occupational disease claims can't be tolled indefinitely.
Evers said in a statement that the bill "reflects recommendations of the Workers&rsquo...
The Kentucky General Assembly passed a bill that would remove the Department of Workers' Claims from the Education and Labor Cabinet and administratively attach it to the governor's office.
If SB 343 is enacted, the department would still be led by a commissioner who is appointed by the governor and confirmed by the Senate; however, the commissioner would not work directly under the supervision of the governor's Education and Labor Cabinet.
The bill would also create a new requirement that the department's commissioner must have at least eight years of experience in work...
