MA - Court Finds Reinsurer Entitled to COLA Reimbursement
02/03/2026 | 0
The Massachusetts Appeals Court reversed a Department of Industrial Accidents Reviewing Board decision holding that a reinsurer was not entitled to reimbursement from the Workers' Compensation Trust Fund for cost-of-living adjustments paid to an injured worker.
Although case law at the time supported denying Employers Reinsurance Corp.'s reimbursement requests, the board's decision was based on an appellate court ruling that the state's high court overruled for improperly expanding the list of entities that are not eligible for reimbursement from the trust fund.
In addition t...
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The Arizona Court of Appeals upheld the denial of a worker’s claim for benefits for the partial amputation of his leg, finding he did not prove that the surgery was related to a work accident as opposed to his preexisting medical issues.
Case: Merkley v. Industrial Commission, No. 1 CA-IC 25-0014, 01/16/2026, unpublished.
Facts: Stephen Merkley worked as the director of operations for the PAM Health Rehabilitation Hospital of Surprise, an acute inpatient rehabilitation facility.
In 2022, Merkley underwent five surgeries on his right foot and ankle, including an ankle fusion that place...
A federal appellate court upheld an award of black lung benefits to a coal miner, finding no error in the Benefits Review Board’s interlocutory order or final order.
Case: Dominion Coal Corp. v. OWCP, No. 23-2310. 01/15/2026, published.
Facts and procedural history: Darrell Meade worked as a coal miner for 37 years. He filed a claim for compensation under the Black Lung Benefits Act.
A Labor Department claims examiner reviewed his application and issued a proposed decision and order, finding that Meade contracted pneumoconiosis on the job and that Dominion Coal Corp. was liable for hi...
A New York appellate court upheld the denial of a worker’s application for reconsideration and/or full board review.
Case: Matter of Wagner v. Bobley Publishing Corp., No. CV-24-2041, 01/15/2026, published.
Facts and procedural history: Wendy Wagner worked for Bobley Publishing Corp. She slipped and fell at work in 1977, suffering serious injuries.
Wagner established a workers’ compensation claim for injuries to her head and back.
In 1980, Wagner was classified with a permanent partial disability and was referred to vocational rehabilitation.
In 1991, Wagner was classified wit...
Sacramento, CA [December 10, 2025] Today, POWER proudly announced its official launch as a laser-focused non-profit organized to take direct action against fraud and criminal activity in California's temporary staffing industry.
"One of the biggest crimes taking place in California's workforce is hiding in plain sight. The temporary staffing industry has become a largely unregulated playground for cri...
Ah, good old liens. Love them or hate them, they are a major component of workers’ compensation claims, and failure to timely address them can result in tens of thousands of dollars being owed by claims adjusters.
Liens defined
A lien is essentially a bill from a third party to be reimbursed for benefits paid (such as medical care, interpreter services or EDD) to prevent the applicant from being paid twice for the same thing.
The most common liens one will typically see during WC claims are:
EDD lien. When an applicant gets money from the state disability program (une...
A New York appellate court upheld a grant of summary judgment to a worker on his Labor Law claim for his injuries from a fall from a ladder.
Case: Rosario v. Franklin Plaza Apartments Inc., No. 21132/20, 01/13/2026, published.
Facts: Jose Rosario allegedly suffered injuries when he fell from a ladder while working on a construction project.
According to Rosario, the ladder he was using suddenly shifted, causing him to fall.
Procedural history: Rosario filed suit against Franklin Plaza Apartments Inc., asserting a claim under Labor Law Section 240(1).
Section 240(1) imposes absolute liabil...
A Hawaii lawmaker introduced a bill that would expand the list of cancers for which providers are entitled to enhanced reimbursement rates on firefighter workers' compensation claims.
Hawaii law authorizes reimbursement rates ranging from 110% to 150% of the Medicare Resource-Based Relative Value Scale rate if a claim for certain cancers filed by a firefighter with at least five years of experience is accepted or determined to be compensable.
HB 2387 would add to the list of covered conditions adenocarcinoma or mesothelioma of the respiratory system, malignant melanoma and canc...
GA - Bill Addresses Worker Heat Protection
A bill in Georgia would impose new workplace safety requirements to protect employees from extreme heat.
HB 1071 would amend state labor law to require employers by 2027 or 2028, depending on the size of the business, to adopt heat illness prevention programs when conditions are hazardous. The legislation specifies triggers for “extreme heat environments” and sets minimum standards for written plans, water access, shaded rest areas, mandatory breaks and employee training.
Employers would be subject to civil penalties of up to $5,000 for violations and could enter into settlement ...
Independent bill review awarded additional payment on 94% of the nearly 6,000 disputes resolved on the merits in 2023 and 2024, finding that only about 6% of medical bills challenged through the administrative process were correctly paid, according to calculations based on data in a new report by the California Division of Workers' Compensation.
“We hope the findings of this report will encourage health care providers to consider using IBR for payment disputes where the only issue is the amount of the bill,” DWC Administrative Director George Parisotto said in a statement.
Th...
The Illinois Appellate Court upheld a determination that a truck driver was permanently and totally disabled under the odd-lot doctrine.
Case: Standard Forwarding v. IWCC (Conner), No. 23MR470, 01/12/2026, unpublished.
Facts: Jerry Conner worked for Standard Forwarding as a linehaul driver.
He tripped and fell while at work in September 2019, striking his head on a metal support.
Conner received medical treatment, and he reported pain in his shoulders.
He later underwent shoulder surgery and vocational rehabilitation.
Conner then underwent a commercial driver’s license exam, which ...
An Ohio appellate court ruled that a trial judge committed an abuse of discretion in entering judgment against an employer after its attorney failed to appear at a case management conference.
Case: Fulkroad v. Greater Cleveland Regional Transit Authority, Nos. 114570 and 115257, 01/08/2026, published.
Facts and procedural history: Jacob Fulkroad worked for the Greater Cleveland Regional Transit Authority. He filed a workers’ compensation claim, alleging that he injured his right knee in July 2020.
The Bureau of Workers’ Compensation accepted liability for the claim.
Fulkroad th...
A New York appellate court ruled that a worker was entitled to summary judgment on his Labor Law claim for his injuries from a fall on a staircase.
Case: Batista-Rosa v. 1230 Franklin LLC, No. 30656/19, 01/13/2026, published.
Facts: Juan Batista-Rosa allegedly suffered injuries when he fell down a staircase at a construction site.
Batista-Rosa said he was connecting small pieces of pipe on the first floor and then carrying assembled pieces up to the second floor. The sole means of access between the two floors was an interior staircase.
Batista-Rosa walked up the staircase to the second fl...
A New York appellate court ruled that the defendants in a Labor Law action were entitled to summary judgment dismissing part of a claim against them and on their claim for indemnification from a worker’s employer.
Case: Izquierdo v. Amsterdam Avenue Redevelopment Associates LLC, No. 159051/18, 5959707/20, 01/13/2026, published.
Facts: Anthony J. Izquierdo allegedly suffered injuries when he fell from an extension ladder when it moved under him.
According to Izquierdo, the accident occurred while he was working for ECD NY Inc. on a construction project at a property owned by Amste...
The Ohio Bureau of Workers' Compensation announced that its board of directors is considering a 1% reduction in private employer rates.
If approved, the eighth consecutive rate reduction and the 17th decrease in the last 18 years would save private sector employers about $10 million in premiums, the bureau said.
The proposed 1% rate cut represents an average statewide premium change, including administrative costs. The actual premium paid by individual private employers would depend on several factors, including their expected future claims costs, recent claims history and their pa...
Insurance Commissioner Ricardo Lara on Friday announced the appointments of Stephanie Chan and Timothy Hyman to represent insurers on the board of governors for the California Insurance Guarantee Association.
Chan is chief investment officer at State Compensation Insurance Fund, where she manages the carrier's $20 billion investment portfolio and its treasury and investment operations. Before working at SCIF, Chan had several years of public accounting and auditing experience working at the California Bureau of State Audits as senior auditor.
Hyman is the vice president of prod...
A persistent shortage of Occupational Safety and Health Administration inspectors is a key challenge in enforcing workplace safety, according to an internal report.
The report, from the Labor Department’s Office of Inspector General, highlights OSHA’s difficulty in deploying enough inspectors to oversee the roughly 8 million worksites under its jurisdiction.
The number of OSHA inspectors fell from 846 in February 2024 to 736 in June 2025.
“As we have reported since 2022, a lack of available inspectors can lead to fewer inspections, diminished enforcement in high-risk indus...
