PA - Split Supreme Court Says Prohibition on Self-Dealing Doesn't Apply to Medications
06/18/2026 | 0
A divided Pennsylvania Supreme Court ruled that the statutory prohibition on self-dealing in the Workers’ Compensation Act does not include referrals for prescription drugs and pharmaceutical services.
Section 306(f.1)(3)(iii) makes it illegal for physicians to refer patients for specific services if the provider has a financial interest with the person or in the entity receiving the referral. The statute explicitly applies to lab services, rehabilitation, chiropractic treatment, radiation oncology, psychometric services, diagnostic imaging and other goods or services.
The proper appli
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A Louisiana appellate court upheld an award of supplemental earning benefits for an injured contract nurse, as well as her award of penalties, but partially overturned her award of attorney fees.
Case: Solis v. Baton Rouge General Health Systems, No. 2025 CA 0455, 05/20/2026, published.
Facts: Tonya Solis worked as a contract, part-time nurse at Baton Rouge General Medical Center. She slipped and fell at work in November 2021.
Solis worked the remainder of her shift, which was Friday and Saturday, and continued to work her weekend shifts until Dec. 11, 2021, when she was restricted from reg
West Virginia’s Intermediate Court of Appeals upheld a worker’s 14% permanent partial disability award.
Case: West Virginia Division of Highways v. Gauvin, No. 26-ICA-10, 06/02/2026, published.
Facts: Rodney Gauvin worked for the West Virginia Division of Highways. After he suffered an on-the-job injury in June 2022, a claims administrator for the division’s insurance carrier accepted liability for a biceps strain, neck tendon strain, arm strain, bicipital tendonitis and superior glenoid labrum lesion.
In December 2022, the claims administrator authorized a request by Dr.
A New York appellate court ruled that the guardian of a worker who fell through an unprotected opening at a construction site was entitled to summary judgment on her Labor Law claim.
Case: Graves v. Sava Serbian Orthodox Church, No. 157595/19 595231/20 595121/23, 06/02/2026, published.
Facts: Gregory Graves fell 11 feet through an unprotected opening at a construction site at a property owned by the Sava Serbian Orthodox Church. He was incapacitated as a result of his injuries.
Procedural history: Graves’ guardian filed suit against the church, asserting a claim for a violation of Lab
Pennsylvania employers and insurers pay more for medications under workers’ compensation than do payers in any other state. Drug payments under workers’ compensation can be 100 times higher than payments for the same drugs under Medicare, Medicaid or private health insurance.
Pennsylvania lacks many of the cost controls common in other states, such as formularies, employers' ability to keep injured workers within PBM networks, or fee schedules with stated prices. Instead, charges in Pennsylvania workers’ compensation are based on inflated figures included in an
A New York appellate court ruled that the administrator of a worker’s estate was entitled to partial summary judgment on his Labor Law claim for the worker’s fatal fall at a construction site.
Case: Chang v. 37 Plaza LLC, No. 153252/20 595598/21 595312/23, 06/02/2026, published.
Facts: Deok Hyun Ko suffered fatal injuries at a building construction project in 2019. Ko was attempting to fix a forklift that had stalled when he lost his balance and fell through an opening in the second floor.
Procedural history: The administrator of Ko’s estate filed suit against the owner of
A New York appellate court ruled that a worker struck by a falling object should have been granted summary judgment on his Labor Law claim.
Case: Lapinski v. MIP One Wall Street Acquisition LLC, No. 150585/22, 06/02/2026, published.
Facts: Krzysztof Lapinski suffered injuries when an object fell on his head while he was working as a garbage truck driver at a construction site.
The property was owned by MIP One Wall Street Acquisition LLC, and J.T. Magen & Co. Inc. was the general contractor.
Lapinski worked for Independence Carting, which had contracted with J.T. Magen to perform
NATL. - Litigated Comp Claims Climb as More Injured Workers Lawyer Up
Litigation is creeping deeper into workers' compensation claims, adding cost and complexity for employers, even as the line remains broadly profitable and protected by exclusive remedy.
“We’re operating in a more adversarial claim environment than we ever have,” said Matt Hannon, New York-based national casualty practice leader for Aon in North America. “Litigation is being driven by both economic pressures and shifting societal attitudes toward liability. In other words, ‘I got hurt; someone needs to pay for this.’”
Recent Aon data shows that th
Air ambulances provide fast emergency transport for workers with severe or life-threatening injuries.
An on-demand webinar highlights findings from a 32-state study, Use and Cost of Air Ambulance Transport Services in Workers’ Compensation — A WCRI FlashReport, by the Workers Compensation Research Institute, which examines costs, access to services and differences in use across rural and nonrural areas.
The study addresses:
How frequently air ambulance services are used in workers’ compensation claims and how use differs between rural and nonrural are
May 20, 2026
The Georgia Court of Appeals ruled that a trial judge erred in dismissing a widower’s civil suit against a theme park operator for his wife’s death from falling out of a moving vehicle.
Andrea Crook worked as a seasonal “scare actor” at the annual Fright Fest at Six Flags Over Georgia theme park in 2023.
After she reported for work on Oct. 1, 2023, Crook and other seasonal actors were loaded into the back of a cargo van at the park. Asia Hendricks, a park co-employee, was the driver.
The van’s door remained open throughout the ride. As Hendricks drove up a hill
An Ohio appellate court upheld the denial of a worker’s request for a schedule loss of sight award after he suffered an eye injury.
Case: State ex rel. Tanyhill v. Industrial Commission, No. 25AP-187, 05/19/2026, published.
Facts: Andre Tanyhill worked as a corrections officer for Central Ohio Behavioral Healthcare. He suffered injuries to his face and head in November 2022 when a patient attacked him.
Tanyhill’s workers’ compensation claim was ultimately allowed for a conjunctival hemorrhage, retinal tears, a retinal hole and a concussion.
Tanyhill underw
West Virginia’s Intermediate Court of Appeals upheld the authorization of additional diagnostic tests for an injured worker while also upholding the closure of his temporary total disability benefits.
Case: ACNR Resources Inc. v. Folmsbee, No. 25-ICA-372, Folmsbee v. ACNR Resources Inc., No. 25-ICA-373, 06/02/2026, published.
Facts: Justin Folmsbee worked for ACNR Resources Inc. as a coal miner. He went to Ruby Memorial Hospital's emergency department on Aug. 9, 2024, and reported that an object had fallen from a mine roof, hit his helmet and left him unconscious.
A comp
A New York appellate court upheld a decision of the Workers’ Compensation Board awarding benefits for a worker’s death from COVID-19.
Case: Matter of Dulay v. Oriska Insurance Co., 05/28/2026, published.
Facts: Vincent Dulay was a physical therapy assistant working with nursing home patients in the Bronx. He contracted COVID-19 in late March 2020 and was hospitalized in April 2020. Dulay died on May 10, 2020.
Procedural history: Dulay’s daughter filed a claim for workers’ compensation death benefits on behalf of herself and her siblings.
The daughter also filed a cl
A New York appellate court ruled that a property owner and a general contractor should not have been granted summary judgment on their common-law indemnification claim against a subcontractor over liability for a worker’s injuries.
Case: Suazo v. 501 Madison-Sutton LLC, No. 305735/14, 06/02/2026, published.
Facts: Marco Suazo worked for Atlantic Interiors Inc. He suffered injuries when he fell from a ladder while performing spackling and tape work on drywall at a building owned by 501 Madison-Sutton LLC.
GC Contractors Inc. was the general contractor for the project. It had subco
A New York appellate court upheld summary judgment on a Labor Law claim by a worker injured while accepting a delivery of roofing materials.
Case: Krifca v. Bronx-Lebanon Special Care Center Inc., No. 303938/15, 06/02/2026, affirmed.
Facts: Fuat Krifca was injured while working on a project to replace the roof of a building owned by Bronx-Lebanon Hospital Center. Krifca was employed by Flatiron Contracting Solutions as a foreman and roofing mechanic.
Allied Building Products Corp. was the supplier of roofing materials to Flatiron for the project and delivered them to the construction s
California’s fee schedules keep inflation in check for most medical services, but a new California Workers’ Compensation Institute study finds that treatment is being billed more frequently under codes outside the pricing controls, a new source of medical cost growth.
The CWCI study uses data from its Industry Research Information System database to examine medical payments from 2017 through 2024. Though professional services and facility fees make up about 70% of all California workers’ comp medical spending, the strongest inflationary pressure comes from pro
