State News

NWCDN is a network of law firms dedicated to protecting employers in workers’ compensation claims.


NWCDN Members regularly post articles and summary judgements in workers’ compensations law in your state.  


Select a state from the dropdown menu below to scroll through the state specific archives for updates and opinions on various workers’ compensation laws in your state.


Contact information for NWCDN members is also located on the state specific links in the event you have additional questions or your company is seeking a workers’ compensation lawyer in your state.


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Indiana Court of Appeals Upholds

Indiana W.C. Board On Issue of

Work vs. Personal Risk

 

In a surprising Memorandum (not precedential) decision, the Indiana Court of Appeals detailed a seldom-addressed work risk vs. personal risk issue.

In Harold E. Smoot v. Lowe’s, 25-A-EX-929, the court found the Indiana Worker’s Compensation Board, in finding plaintiff’s fall from a stool he was sitting on while working with a resulting femur fracture, was caused solely as the result of his diabetes, low blood sugar, and personal decision not to avail himself of his allowed breaks to eat as needed, was correct in that plaintiff meet his burden to support a finding otherwise.

The claim was found not compensable by both the single hearing member and, in review, by the full board.  The court, affirming, discussed risks incidental to the employment and the question of whether Smoot’s risk of injury was personal to him.  It examined the evidence including plaintiff’s health condition, the employer’s accommodations to him allowing him to take breaks when needed, eat candy or snacks at the register while working to adjust his blood levels, and providing him a chair or stool to sit on while working as a cashier.  Despite these accommodations, plaintiff failed use them and make the necessary adjustments to his day to prevent low blood sugar and resulting weakness, causing him to stumble and fall resulting in his injury, a purely personal risk.

The Legislature made no statutory changes to the Workers’ Compensation Act in 2025.  Georgia’s maximum TTD rate remains at $800.00 and maximum TPD rate at $533.00. Additionally, the Georgia Court of Appeals and Supreme Court continue the trend of accepting very few workers’ compensation appeals. Most recently, in McKay v. Inalfa Roof Systems, Inc., 374 Ga. App. 526 (2025), the Court of Appeals addressed the longstanding Rycroft defense. Under Rycroft, an employee’s misrepresentation as to a pre-existing condition will bar benefits if: (a) the employee knowingly and willfully made a false representation as to his/her physical condition; (b) the employer relied upon the false representation as a substantial factor in the hiring process; and (c) there is a causal connection between the false representation and the injury. In McKay, the employee failed to disclose his history of back surgery in a post-offer medical questionnaire. He injured his back at work and disclosed his history after this first accident. The employee continued to work after the disclosure and suffered a second accident involving his back months later. The Court of Appeals confirmed Rycroft applied to bar his first accident. However, the Court of Appeals found the Employer waived its right to assert Rycroft in retaining the claimant after his disclosure thus rendering the second accident compensable. McKay raises the bar for Employers and mandates action to preserve Rycroft once a disclosure is made. 


Thomas Howell HIGHT JR.
 
Thomas Hight, Jr., an Administrative Law Judge at the Dallas field office of the Texas Department of Insurance, Division of Workers’ Compensation, passed away on August 19, 2025.

He was widely regarded as one of the Division’s most knowledgeable ALJs. More important than that, he was a kind and gentle soul. He will be greatly missed.

Copyright 2025, Stone Loughlin & Swanson, LLP

Predicting the Future is Too Often a Swing-and-a-Miss - Connecting the Dots

  

This month DWC published a proposed rule amending Rule 130.102 concerning eligibility for Supplemental Income Benefits. But those of you hoping that DWC would put some teeth in the rule to require a SIBs applicant to prove that he made a genuine effort to find work will be sorely disappointed. It has about as many teeth as our snuff-dipping granny.

The impetus: The proposed revision appears to be in response to a decision from the Austin court of appeals in Texas Dep’t. of Ins., Div. Workers’ Comp. v. Accident Fund Ins. Co. of America, et al., in which Accident Fund, represented by SLS, challenged the validity and applicability of parts of the rule. In that case, the insurance carriers argued that SIBs applicants who claim to be looking for work on their own (without going through a vocational rehabilitation program or requesting the assistance of the Texas Workforce Commission), cannot qualify for SIBs merely by making “work search contacts” (which can be emails or telephone calls) but, instead, they must submit actual job applications to prospective employers. A Travis County district court ruled for the carriers and enjoined DWC from awarding SIBs to applicants who make only work search contacts, and the court of appeals affirmed that injunction. As a result, DWC saw the need to revise its rule.

The new rule is an improvement: The new rule proposed by DWC would require a SIBs applicant to document a work search with job applications submitted. And it would clarify that “job application” means “a physical or electronic form or other document that is submitted to an employer . . .” so that an applicant could not claim that he submitted a job application if he merely called a business by telephone and asked if they are hiring.

But it could be so much better: The proposed rule would not require a SIBs applicant to provide the insurance carrier with a copy of the job application he submitted so that the carrier can verify that he submitted a complete application. It would not require a SIBs applicant to cooperate with a prospective employer that asks to set up an interview. And it would not require a SIBs applicant to apply only for jobs that the applicant has a reasonable chance of being able to perform given his education, skills, and functional limitations.
 
Why it matters: The current SIBs rule does not work. Too many claimants abuse it as a hand out, not a hand up. If DWC adopts the new rule as proposed, little, if anything, is likely to change. Those claimants will continue to “go through the motions” to obtain SIBs rather than making a genuine effort to find work. They will continue to submit job applications that are not completely filled out, they will continue to ignore any invitations to interview, and they will continue to apply for jobs that they have no earthly chance of being able to perform with the sole purpose of satisfying the requirements of the rule. And DWC will contribute to their dependency on SIBs by ordering carriers to pay them, quarter after quarter after quarter.

There’s still hope: But there’s still time for DWC to come through. This is just a proposed rule. DWC is requesting oral and written comments at a public hearing on the rule on October 1, 2025, and it will continue to accept written comments until October 6, 2025. SLS will be submitting written comments and we urge other system participants to do the same. Together, let’s urge DWC to revise the rule so that it supports claimants who demonstrate that they are truly trying to find work -- but not those who don’t.

Copyright 2025, Stone Loughlin & Swanson, LLP 


Earthquakes: Facts about why the Earth moves | Live Science
 


The legal landscape in Texas is changing as Texas judges begin to apply the Supreme Court of Texas’ holding in University of Texas Rio Grande Valley v. Oteka, which the Court issued in June.

Flashback: In Oteka, the Court addressed the circumstances under which DWC has exclusive jurisdiction to determine whether a worker was in the course and scope of employment at the time of an injury. The case arose after Rita Oteka, a nursing professor at the university, voluntarily attended a commencement ceremony. Afterward, as she was walking to her car, a vehicle driven by a university police officer struck and injured her.

The university, which is self-insured for purposes of workers’ compensation, reported the injury to its claims administrator which denied the claim asserting, among other things, that Oteka was not in the course and scope of her employment. Oteka did not challenge that denial or file a workers’ compensation claim. Instead, she sued the police officer for negligence.

The university asserted the affirmative defense that recovery of workers’ compensation benefits was Oteka’s exclusive remedy because the injury was related to her work.  Oteka asserted that the injury was not work-related because she voluntarily attended the ceremony and had already left when she was injured.

The parties filed cross-motions for summary judgment on the exclusive remedy defense, but before the trial judge could rule on the motions the university’s claims administrator reversed course and sent a letter to Oteka explaining that her injury had been accepted as compensable and benefits would be paid. Then the university filed a plea to the jurisdiction, arguing that DWC had exclusive jurisdiction to determine whether Oteka was injured in the court and scope of her employment. The trial judge denied the plea to the jurisdiction and the court of appeals affirmed. The supreme court also affirmed and held that DWC does not have exclusive jurisdiction to determine whether an injury occurred in the course and scope of employment when (1) the issued was raised by the employer’s affirmative remedy defense and (2) the employee’s lawsuit does not hinge on entitlement to workers’ compensation benefits.

Where we are now: Now that Texas judges are applying the holding in Oteka, they are reaching some surprising outcomes. One such surprise is a procedural ruling in favor of the injured worker in B & T Dependable Services, LLC v. Santos.
That case arose when Edward Santos, a landscape worker for B & T, finished his work for the day and then jumped into the bed of B & T truck that was towing a trailer carrying B & T equipment.  During the ride, Santos fell out of the truck bed and was run over by the trailer.
 
B & T reported the injury to its workers’ compensation carrier, Texas Mutual Insurance Company, which began paying workers’ compensation income and medical benefits. Santos accepted those benefits, which totaled more than $663, 894. He even applied for eight separate quarters of Supplemental Income Benefits and represented in each application that B & T was his employer. Nevertheless, Sanchez sued B & T for negligence, asserting his district court pleadings that he was not B & T’s employee but was, instead, an independent contractor.

B & T and Texas Mutual filed a plea to the jurisdiction and a motion for summary judgment arguing, among other things, that the suit was barred by the exclusive remedy provision of the Texas Workers’ Compensation Act. The trial court denied the plea to the jurisdiction and the motion for summary judgment. The court of appeals affirmed, citing Oteka, and held that DWC did not have exclusive jurisdiction to determine whether Santos’ injury occurred in the course and scope of employment for B & T. It said “although Oteka is factually distinguishable, it is legally guiding . . . in this case, just like Oteka, Santos’ [district court] claims are not based on his entitlement to benefits.”
                           
Copyright 2025, Stone Loughlin & Swanson, LLP 

 

On July 24, 2025, the Texas Eleventh Court of Appeals in Eastland reversed a judgment awarding an old law claimant $750,000 in “bad faith” damages from his workers’ compensation insurance carrier plus attorney’s fees of $75,950.
 
Donald Bristow was permanently paralyzed in a motor vehicle accident in 1990.  Bristow’s claim is considered an “old law” claim because he was injured prior to January 1, 1991 when the new workers’ compensation law took effect.  Therefore, Bristow’s claim is governed by the law that was in effect prior to 1991.
 
In 1993, Bristow and his workers’ compensation insurance carrier, Sentry Insurance, entered into a compromise settlement agreement that included a provision that Sentry would pay Bristow $3,650 per month for Bristow’s ongoing home health care.
 
This case began in 2018 when Sentry Insurance filed a motion to terminate its obligation to pay Bristow for home health care services on the grounds that he no longer needed the services.  Bristow brought counter-claims against Sentry for bad faith claim handling and violations of the Texas Insurance Code. 
 
In 2022, a Nolan County jury awarded Bristow $250,000 in mental anguish damages and $500,000 in additional damages under the Texas Insurance Code.  Sentry appealed the trial court’s judgment partly on the basis that Bristow’s claims are barred by the Texas Supreme Court’s 2012 holding in Texas Mutual Insurance Company v. Ruttiger. 
 
In Ruttiger, the Texas Supreme Court held that the new workers’ compensation law “prescribes detailed, [DWC]-supervised, time-compressed processes for carriers to handle claims and for dispute resolution” and that it contains “multiple, sometimes redundant but sometimes additive, penalty and sanction provisions for enforcing compliance.”  Therefore, the new law “effectively eliminates the need for a judicially imposed cause of action.”
 
Bristow argued that Ruttiger is limited to new law claims and that a 2016 decision holding otherwise from the 14th Court of Appeals in Houston was wrongly decided.  That case was In Re Illinois Employers Ins. of Wausau (Wausau II).
 
However, the Eastland Court followed Ruttiger and Wausau II and held that Bristow’s statutory and bad faith claims are barred.  The Eastland Court explained that it is the date of the alleged misconduct, not the date of the injury that dictates the applicability of Ruttiger.  You can read the Eastland Court’s decision here.
 
Bristow can petition the Texas Supreme Court to review the Eastland Court’s decision but it may be less likely to hear the case due to its limited impact since it has been over 34 years since the last old law claim.


Copyright 2025, Stone Loughlin & Swanson, LLP 


On June 1, 2025, the revised Texas Administrative Code §133.30 (“Telemedicine, Telehealth, and Teledentistry Services”) went into effect.  As of that date, treating doctors—though not Designated Doctors or Required Medical Examiners—are permitted to perform MMI evaluations remotely via telemedicine.  The certifying doctor is only allowed to determine if MMI has been attained and, if so, to provide a determination of no permanent impairment. 
 
The rule specifies, “The term [telemedicine services] does not include an examination to assign an impairment rating” under Rule 130.1.  The injured worker must have been examined by the treating doctor for the same condition(s) at least once prior to the telemedicine exam, and he/she must agree to be certified in that manner. 
 
Injuries to be rated in this manner must qualify for no impairment, cannot require further treatment, and must be considered “minor” in accordance with Rule 130.2(a)(2).  That subsection allows a treating doctor to provide an MMI certification without scheduling an examination only if the injured employee is not receiving Temporary Income Benefits and has been released from treatment without the expectation of further treatment.

Copyright 2025, Stone Loughlin & Swanson, LLP


The Texas Supreme Court in Ruttiger based its decision to eliminate the common law cause of action for “bad faith” claim handling in workers’ compensation partly on the detailed enforcement process provided to DWC in the new workers’ compensation law. 
 
DWC takes that responsibility seriously as we can see from a review of this month’s disciplinary orders.  DWC issued 17 disciplinary orders in July with all but one against an insurance carrier.  The largest fine against a carrier in July was $51,000 (Disciplinary Order 2025-9389). 
 
To determine the fine amount, DWC considers a number of aggravating factors.  For example, in Disciplinary Order 2025-9393 DWC found the following factors to be aggravating:
 
  1. The violations are serious, involving $ in late medical benefits, income benefits, travel reimbursement, and attorney fees. Further, Respondent did not comply with the interest payment obligation in File No. 36758 until it received notice of enforcement action. Also, Respondent’s failure to comply with six DWC orders is a priority investigation under Tex. Lab. Code § 402.0235;
  2. Respondent has a history of 195 administrative violations since , including 54 violations involving attorney fees, medical bill payment,• and travel reimbursement;
  3. A penalty is necessary to deter future violations considering Respondent has had 195 administrative violations since ;
  4. Respondent received an economic benefit from the prohibited acts to the detriment of multiple system participants; and Respondent is the 11th largest workers’ compensation insurance carrier in Texas and has a heightened awareness of the legal duty to comply with the Texas Workers’ Compensation Act and DWC rules.
 
For carriers that are slow learners, it can be costly.  Therefore, we recommend perusing DWC’s disciplinary orders as one of the best ways for system participants to learn what to do and what not to do.
 
The takeaway here is that we can all learn a lot from “Ruttiger”: https://youtu.be/1S2D431Gbks?si=Ft1jyZU9oCfLWCeU

Copyright 2025, Stone Loughlin & Swanson, LLP

New Rollout: ICA Introduces Updated Form 101 – Employer’s Report of Accident

The Industrial Commission of Arizona (ICA) has officially launched its newly updated Form 101 – Employer’s Report of Accident as part of a modernization initiative directed by the Governor’s Office. A recent presentation by the ICA introduced the changes and provided important rollout details for employers and stakeholders.

What’s New?

This updated form aims to simplify the reporting process while ensuring critical information is captured:

  • Simplified layout and removal of outdated or unnecessary fields.
  • New fields added, such as dominant upper extremity, which plays a role in determining permanent disability awards.
  • Web-based submission only – The Commission will not accept service via fax or mail.

Compliance Deadline

Per ARS § 23-908(G), employers must report workplace injuries within 10 days.
The new online-only form was released on April 7, 2025, and the ICA is allowing a 90-day transition period.
Effective Monday, July 7, 2025, the ICA will no longer accept faxed or mailed versions of Form 101.

Complete the new form here:
https://www.azica.gov/forms/employers-report-injury-form

Signature Process & Confirmation

After the form is completed:

  1. The submitter will receive an email requesting a digital signature.
  2. Once signed, a confirmation email will be sent along with the option to download a copy for records.

Access Issues

There was some confusion about the form’s visibility on the ICA Community page:

  • It is supposed to appear under “Claims” as the second form at the bottom.
  • However, if logged into the ICA account, the form may not appear due to a technical issue. ICA is working to resolve this.
  • In the meantime, the direct link above remains functional.

Employer Outreach & TPA Clarification

ICA encourages carriers to notify employers of this change and recommend attending upcoming training sessions. More presentations are scheduled next week, and ICA may add additional sessions based on demand.

At the present time, Third-Party Administrators (TPAs) can submit this form on behalf of employers. The Commission has indicated they will issue separate direction concerning TPA processing of this form. Ritsema will update clients regarding any administrative guidance received from the Commission.


New Rollout: ICA Introduces Updated Form 105 – New Notice of Suspension Informational Meeting

The Industrial Commission of Arizona (ICA) has proposed a new Form 105 – Notice of Suspension, intended for use by carriers or self‑insured employers to formally notify injured workers when their workers’ compensation benefits are suspended (e.g. due to noncompliance or missed medical requirements).

⚠️ The form is not yet effective. To review and provide feedback, the ICA is hosting an informational stakeholder meeting on October 8, 2025.
🔗 Join the stakeholder meeting on 10/08/2025

Why this matters:

  • Stakeholders can ask questions, offer commentary, and help shape how Form 105 will be implemented.

  • Employers, claims professionals, attorneys, providers, and injured worker advocates should participate to stay ahead of compliance changes.

  • After the meeting, ICA will issue a formal announcement of the effective date and procedural guidelines.

The N.Y.S. Board is in a "form frenzy" lately, with required use of the CMS-1500, two recent updates to the C-32 cover sheet for settlements, and a forthcoming overhaul of the medical bill objection C-8.1 form. 

Providers are now required to submit medical reports and bills electronically on the CMS-1500. The form, and accompanied narrative if desired, are submitted to the Board and carriers or self-insured employers via Board approved electronic partners, engaged by the providers.  The providers may bill the carriers and self-insured employers to cover the cost of the electronic submission partner. 

The new C-32 is extended from one to two pages. Parties are required to check boxes addressing outstanding medical present in a file before settlement, as well as resolution of C-8.1 bill objections. Both issues have long been addressed in the narrative portions of full and final or medical only settlement agreements. 

The revised C-8.1 requires the objecting party to specifically cite the basis of the objection, such as documentation in the Board file or specific sections of the Medical Treatment Guidelines. The enhancement contrasts sharply with the earlier C-8.1s which provided stock objections in boxes that could simply be checked by the submitter. 

The CMS-1500, C-32 and C-8.1 are available on the N.Y.S. Workers Compensation Board website. 

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