State News

Nevada Workers’ Compensation Law Update
SB 7 (2025 Special Session): Expansion of First Responder Occupational Disease Presumptions

Nevada enacted Senate Bill 7 during the 2025 Special Session, significantly expanding occupational disease presumptions for first responders.

Senate Bill 7 expands workers’ compensation occupational disease presumptions for firefighters and other first responders, making it easier for them to establish that certain diseases are work-related. The law strengthens the presumption framework by shifting more of the evidentiary burden to employers and insurers.

SB 7 became effective immediately on November 29, 2025 and is structured to apply to claims that were pending and not finally adjudicated as of that date, not just future filings. As a result, active litigation and previously denied claims may be reevaluated under the expanded presumption standard.

https://www.leg.state.nv.us/App/NELIS/REL/36th2025Special/Bill/13004/Overview

• Average Weekly Wage: Based on wages earned in 52 weeks prior to the injury; $30 minimum.  Average annual earnings are equal to 50 times AWW (§102.11(1)(2)).
• Burial Expenses: Effective 05/01/10, maximum burial expense is $10,000 (§102.50).
• Death Benefit: Up to four years’ average annual wage (200 times average weekly wage but see secs. 102.46-51 Wis. Stats. for specific conditions).  Payments are paid weekly at TTD rate (§102.48(3)).  2026 maximum wage rate increases death benefit for fatal injuries occurring on or after January 1, 2026 to $412,500; Un-estranged parents benefit remains at $6,500.00; $20,000 payment into State Fund (§102.49)
• Disfigurement: Up to one year’s wages, subject to maximum ($102,125 max as of 01/01/26, §102.56); only applicable if Applicant does not return to work.
• Fractional Weeks: TTD benefits are paid for each day except Sunday, at the daily rate of one-sixth of the weekly rate (§102.11).
• Maximum Meal Allowance: Breakfast - $8; Lunch - $9; Dinner - $17.
• Medical Records: Health care providers must furnish certified copies of relevant records upon request.  Charges may not exceed the greater of $.45 per page or $7.50 per request, plus actual postage, or $26 per request for electronic records (§102.13(2)(b)).
• Medical Treatment: No limit on medical treatment reasonably and necessarily required to cure or relieve the injury (§102.42(1)).  Please note that Wisconsin does not have a fee schedule.
• Medicare Set Aside Thresholds:  If the Applicant has a “reasonable expectation” of Medicare entitlement within 30 months and the settlement exceeds $250,000 OR if the Applicant is currently a Medicare beneficiary and the settlement exceeds $25,000, a MSA can be submitted to CMS.   “Reasonable expectation” includes Applicants that are 62 ½ years old, or on Social Security Disability, or appealing a Social Security Disability determination.
• Mileage: As of 7/1/12 = $0.51 per mile
• Multiple Injury Variations: Benefits are increased if an injury causes more than one compensable permanent disability (see sec. 102.53, Wis. Stats.).  Schedule applicable to proximal injuries is reduced by disability resulting from more distal injuries (see DWD 80.50).
• Permanent Partial Disability (PPD): Rate is set by statute.  Maximum rate depends on injury date.  Unscheduled injuries are measured by functional limitations or loss of earning capacity, whichever is greater. 
• Statute of Limitations: *6 years prior to 01/01/78       *10 years as of 01/01/78     *12 years as of 05/13/80 *6 years for traumatic injuries as of 3/2/16 (occupational injuries remain at 12 years)

The statute of limitations has been eliminated for injuries resulting in loss or total impairment of hand or any part of rest of arm proximal to hand, foot or any part of rest of leg proximal to foot, any loss of vision, any permanent brain injury or any injury causing need for total or partial knee or hip replacement.  Said claims shall be covered under Work Injury Benefit Supplemental Fund under secs. 102.17(4) and 102.66(1)(2), Stats., if the last date of compensation or injury was before 4/1/06; otherwise, it is the carrier’s responsibility.

• Supplemental Benefits: Maximum benefit rate increased to $669 per week as of 03/02/16 (§102.44(1)).
• Temporary Partial Disability (TPD):  TPD rate is the ratio of actual wage loss during disability to average weekly wage times the TTD rate (i.e., an employee limited to half-time work receives one-half the TTD rate - §102.43(2)(3)).
• Temporary Total and Permanent Total Disability (TTD & PTD): Two-thirds of average weekly wage.  Maximum rate depends on date of injury; PTD benefits are paid for life (§102.11 & 102.44).
• Unreasonable Refusal to Rehire: Maximum penalty of up to one year’s wages. (§102.35(3)).
• Vocational Rehabilitation: TTD and travel expenses are paid during training.  For claims after 4/16/12, also responsible for tuition, books, and fees.  If training takes place away from the employee’s residence, actual and necessary maintenance expenses are also paid (§102.61).
• Vocational Rehabilitation Limit: The maximum annual limit for services provided by private vocational rehabilitation specialists is $2,183.00 (effective 01/01/26).
• Waiting Period: Three days.  If disability (temporary or permanent) exists after 7-calendar days from the date the employee leaves work as a result of the injury, benefits are paid for the waiting period (§102.43).

NWCDN State News – West Virginia

Charity Lawrence and Dill Battle, Spilman Thomas & Battle, PLLC

February 16, 2026

 Upcoming Conferences

The West Virginia Workers’ Compensation Association is hosting its annual conference on April 30, 2026, in Charleston, West Virginia. A featured program will discuss E-Mods and understanding claim and program costs to discuss how a comprehensive workers’ compensation program can impact your E-mod and premium costs from claim avoidance, safety measures and claim management. Another featured speaker is Dr. Chris Martin to debate whether the Rule 20 treatment guidelines are still a valid, including his position on the importance of treatment guidelines to the workers’ compensation system in West Virginia to maintain and keep medical costs low and to help manage a workers’ compensation claim. West Virginia Insurance Commissioner Allan L. McVey will discuss the Insurance Market in West Virginia, and West Virginia State Treasurer Larry Pack will discuss the financial impact of a stable workers’ compensation market to our State’s financial health. More information can be found under the Meetings drop down menu of the WVWCA website: www.wvwca.net

West Virginia Legislature – 2026 Regular Session

 As of February 11, 2026, there are several bills of note related to workers’ compensation submitted in the 2026 Regular Session of the West Virginia Legislature. The West Virginia Workers’ Compensation Association and other business advocacy groups are following several bills related to occupational pneumoconiosis law in West Virginia.

Senate Bill 895 is concerning because it removes the statute of limitations for certain occupational pneumoconiosis (OP) claims and allows unlimited reopening of old claims. It was introduced on February 10, 2026, by Senator Takubo, Senator Smith (Senate President) and others, and was referred to the Judiciary Committee. This bill is similar to bills that have been introduced unsuccessfully for several years. The bill relates to progressive massive fibrosis (PMF) -- the most severe form of coal workers’ pneumoconiosis. The bill removes all time limits for filing or reopening PMF claims. A new section (§23‑4‑8e) allows miners with evidence of PMF to file initial claims or reopen old claims at any time, with no statute of limitations. The bill establishes PMF as a distinct, more severe condition by explicitly recognizing PMF as more serious than simple pneumoconiosis and defines it using radiographic criteria (large opacities >1 cm). The bill creates a mandatory impairment rating where a PMF diagnosis is automatically considered a 15% permanent partial disability under §23‑4‑6(i). This is a fixed statutory award. Finally, the bill allows unlimited reopening of PMF claims. Because PMF is a progressive disease, the bill ties PMF to the “progressive disease” category, which already allows repeated reopening petitions. Senate Bill 895 expands this by eliminating time limits entirely.

Delegates Hall, Jeffries, and Mott introduced House Bill 5515 on February 13, 2026, which mirrors Senate Bill 904 introduced February 10 by Senator Azinger. Both bills are intended to “modernize” Chapter 23 of the West Virginia Code. House Bill 5515 has been referred to the House Finance Committee. Senate Bill 904, introduced by Senator Azinger, has been single-referred to the Senate Banking and Insurance Committee. Both bills propose significant revisions to Articles 4 and 5 of Chapter 23. The Office of the West Virginia Insurance Commissioner drafted the legislation and requested that the respective committee chairs introduce the bills. According to the introductory language, the legislation represents a comprehensive modernization of West Virginia’s workers’ compensation statutes. It updates, reorganizes, and repeals numerous provisions in Articles 4 and 5 to improve administrative clarity, ensure consistency, and align the code with post-2005 reforms. The Commissioner indicated that this bill represents the final phase of a multi-year cleanup effort. In addition to modernizing statutory language, the bill would grant the Governor flexibility to reduce the number of Board of Review members as caseloads decline. The Commissioner has stated that the proposed changes are non-substantive in nature. The West Virginia Workers’ Compensation Association will review and analyze both bills to ensure that no unintended consequences result from the proposed revisions.

House Bill 4589 expands time limitations for evaluation before the Occupational Pneumoconiosis Board, and expands indefinitely the current three-year statute of limitations. The bill essentially provides an unlimited time for an employee to file an occupational pneumoconiosis claim and obtain an evaluation at the OP Board, circumventing the current three-year statute of limitations. House Bill 4589 was discussed at a hearing on January 22, 2026, in the Committee on Health and Human Resources. Commissioner McVey testified before the committee hearing and discussed the financial impact of the bill on the operating budget of the OIC, the operating budget of the OP Board, and the solvency of the Old Fund. Calculating insurance reserve information for uncertain claims will be impossible and will increase the cost of obtaining workers’ compensation insurance for all businesses. The bill is problematic to the insurance industry and employers in West Virginia because it will increase the expenses of the Operating Fund of the OIC, will likely adversely affect the efficiency of the OP Board, and will likely increase the cost of obtaining affordable workers’ compensation insurance for businesses in West Virginia. The long-term impact of the bill will be a challenge to the low cost of workers’ compensation insurance for all employers in the state.

Senate Bill 110 creates a West Virginia Black Lung Program that grants pain and suffering for occupational pneumoconiosis. There is already a robust West Virginia Black Lung Program long in existence. Occupational pneumoconiosis is evaluated and compensated under existing state law with generous benefits and medical treatment for qualifying West Virginia employees afflicted with occupational pneumoconiosis. Benefits are already tax-free and not reportable as income to the State or IRS. An additional black lung benefit that has provided over $30 million in direct benefits to West Virginians just in FY2025 is the Federal Black Lung program. All claims for federal black lung benefits are presumed to be filed timely and there is no statute of limitations for filing survivor claims. Monthly benefits are based on the number of dependents as well as generous medical coverage, also all tax-free and not reported as income. The proposed Senate Bill 110 will fund a third, unnecessary State Black Lung scheme through taxes on coal, wind, solar, and other renewables. West Virginia taxpayers are already struggling, asking them to bear the burden of higher energy rates is unnecessary and harmful. The proposed Senate Bill 110 also instructs that a portion of the federal coal excise tax that funds the already-beleaguered Black Lung Disability Trust Fund be redirected to create this redundant program, which would be opposed federally and would further exacerbate this already fiscally problematic Fund’s financial issues. There is no residency requirement for the receipt of pain and suffering benefits under the proposed Senate Bill 110, so West Virginia taxpayers would be subsidizing benefits to countless nonresidents. It is also potentially retroactive, as there is no beginning date specified.

Occupational pneumoconiosis can be a devastating diagnosis to individuals and families. There are two robust, longstanding programs available to afflicted employees and their survivors that provide benefits. Senate Bill 110 is redundant, fiscally irresponsible, and creates a burden on West Virginia taxpayers to provide benefits to out of state residents.

House Bill 4589 is currently in the House Committee on Health and Human Resources. Senate Bill 110 has been referred to the Committee of the Judiciary and then to the Committee on Finance but has not been scheduled on the agenda for either committee.

Supreme Court of Appeals of West Virginia

The Supreme Court of Appeals of West Virginia welcomes a new justice in the first term of 2026. Justice Gerald M. Titus III was appointed on Nov. 21, 2025, by Gov. Patrick Morrisey to fill the seat vacated by Justice Tim Armstead, who passed away in August. Justice Titus was officially sworn in to office during a private ceremony on Dec. 12 in order to begin work ahead of the Court’s spring term. Prior to joining the Court, Justice Titus was a member of Spilman, Thomas & Battle, where he maintained a general litigation practice, including complex business disputes, commercial transportation claims, eminent domain proceedings, environmental matters, criminal investigations and prosecutions, and dispute resolution.

At the beginning of the Spring Term of Court in 2026, the Court has not issued any signed opinions. As of the date of this memo, the Court has issued six memorandum decisions related to workers’ compensation cases.

Georgian American Alloys, Inc. v. Mark Davis, No. 25-579 (W.Va. Supreme Court, January 13, 2026) (memorandum decision). The Court affirmed the June 27, 2025, memorandum decision of the Intermediate Court of Appeals (“ICA”). See Georgian American Alloys, Inc. v. Davis, No. 25-ICA-49, 2025 WL 1779770 (W. Va. Ct. App. Jun. 27, 2025) (memorandum decision). The ICA affirmed the January 2, 2025, order of the Workers’ Compensation Board of Review reversing the May 23, 2023, claim administrator’s order granting Mr. Davis a 10% permanent partial disability award (“PPD”). The Board of Review granted an additional 5% PPD award for a total award of 15% PPD, which the ICA affirmed. The Court rejected the employer’s argument that the ICA erred in failing to apportion the claimant’s preexisting impairment when it affirmed the Board of Review’s decision to grant an additional 5% PPD award. The employer asserted that the facts of this case and the evidence of record clearly establish that the claimant has no permanent impairment due to the compensable condition in the claim, which is broken ribs, and that the evidence relied on by the Board was a 15% impairment rating for a noncompensable neurological condition. The employer argued the evidence presented by a Board-certified pulmonologist demonstrated the claimant’s breathing abnormality was the result of his prior smoking habit and not related to the injury. As such, the employer argued that the medical evidence clearly established that the claimant had a definite ascertainable preexisting impairment which should have been deducted from the total impairment rating. Furthermore, the employer contends that the exclusion of the pulmonologist’s report simply because he used a pulmonary criteria to rate the claimant’s pulmonary impairment instead of neurological impairment is improper. The Board of Review found that the pulmonologist’s report included opinions of the claimant’s impairment that were not supported by the American Medical Association’s Guides to the Evaluation of Permanent Impairment (4^th ed. 1993). As a result, his report was found to be unreliable with regard to the claimant’s permanent impairment, and his opinion concerning the alleged preexisting condition was found to be without additional medical support. Thus, the ICA and the Board of Review correctly determined that apportionment was not proper because the pulmonologist’s recommendation of 5% whole-person impairment for pulmonary function was not a valid and reliable rating. The Court reviews questions of law de novo, and accords deference to the Board of Review’s findings of fact unless the findings are clearly wrong. Syl. Pt. 3, Duff v. Kanawha Cnty. Comm’n, 250 W. Va. 510, 905 S.E.2d 528 (2024). Upon consideration of the record and briefs, the Court found no reversible error and therefore summarily affirmed. See W. Va. R. App. P. 21(c).

Terry Kyle v. Patriot Coal Corp., No. 25-605 (W.Va. Supreme Court, January 13, 2026) (memorandum decision) is a January 2026 WV Supreme Court decision regarding a permanent partial disability (“PPD”) rating for occupational pneumoconiosis (“OP”). The claimant had been exposed to occupational dust for 23 years. A chest x-ray was found by the Occupational Pneumoconiosis Board (“the OP Board”) to show insufficient evidence of pleural or parenchymal changes to support a diagnosis of OP. The claimant underwent pulmonary function testing in July 2023, which showed 10% pulmonary impairment. He subsequently underwent pulmonary function testing in April 2024 which showed 0% pulmonary impairment. The OP Board found the two studies to be minimally different from each other, and it noted that such studies frequently show fluctuating values on different days. The OP Board relied on the April 2024 study to find 0% impairment, explaining that the pulmonary function study with the best volumes most accurately shows the extent of a claimant’s breathing capacity. The Intermediate Court of Appeals affirmed the decision. On appeal at the WV Supreme Court level, the claimant argued the Intermediate Court of Appeals had noted that the lower tribunal’s decision “lacks reasoning.” The claimant also argued he should have been granted 10% PPD for OP based on the July 2023 study due to the evidence being in equipoise. This argument was based on W. Va. 23-4-1g(a) which provides that “[i]f, after weighing all of the evidence regarding an issue in which a claimant has an interest, there is a finding that an equal amount of evidentiary weight exists favoring conflicting matters for resolution, the resolution that is most consistent with the claimant’s position will be adopted.” However, the WV Supreme Court found the evidence was not in equipoise and W. Va. Code 23-4-1g(a) does not apply. The April 2024 pulmonary function study showing 0% had the best volumes. Thus, the claimant did not prove the OP Board was clearly wrong in its decision, and the 0% PPD award was affirmed.

Intermediate Court of Appeals of West Virginia

In the Spring Term of Court in 2026, the ICA has not issued any signed opinions. As of the date of this memo, the Court has issued thirteen memorandum decisions related to workers’ compensation cases.

Joseph Kessler v. West Virginia Paving, Inc., No. 25-ICA-275, (W.Va. Intermediate Court of Appeals, February 3, 2026) (memorandum decision) is a February 2026 Intermediate Court of Appeals decision regarding failure to establish exposure to the hazards of OP. The claimant alleged he was exposed to occupational dust hazards during his employment in coal mines from 1975 to 1982, 1986 to 1987, 2001 to 2002, and 2013 to 2022. While working for West Virginia Paving, Inc., his job activities involved picking up loads of rock, sand, and other materials from a mine quarry and delivering the product to customers. The Board of Review found the claimant failed to establish by a preponderance of the evidence that he was exposed to abnormal quantities of dust during the course of and resulting from his employment. W. Va. Code § 23-4-1(b) states that in order to be eligible for workers’ compensation benefits related to OP, a claimant must have “been exposed to the hazards of occupational pneumoconiosis in the State of West Virginia over a continuous period of not less than two years during the 10 years immediately preceding the date of his or her last exposure to such hazards, or for any five of the 15 years immediately preceding the date of his or her last exposure.” “[A] ‘hazard’ as contemplated by the statute, consists of any condition where it can be demonstrated that there are minute particles of dust in abnormal quantities in the work area.” Meadows v. Workmen’s Comp. Comm’r, 198 S.E.2d 137, 139 (1973). Mere employment at a dusty location, such as a mine site, is not enough to show a claimant has been exposed to a hazard. The Intermediate Court of Appeals held that the claimant experienced only occasional and brief periods of dust exposure during his work. He testified he remained in an enclosed truck cab during loading and unloading, which only took five to ten minutes, and which took place in an open-air environment. He also testified most of his driving occurred on public roads. Thus, the Court found it was not clearly wrong for the Board of Review to find the claimant was not exposed to hazardous dust levels while working for his employer because he failed to establish occupational exposure to abnormal quantities of dust. 

Alliance Coal, LLC v. Ashley Carte, No. 25-ICA-284, (W.Va. Intermediate Court of Appeals, February 3, 2026) (memorandum decision). Alliance appealed the June 10, 2025, order of the Workers’ Compensation Board of Review (“Board”), which reversed two claim administrator’s orders and granted Carte a 12% permanent partial disability (“PPD”) award. On May 17, 2022, Carte was employed by Alliance as an underground fire boss in a coal mine when he injured the bicep/forearm of his left arm while he was repositioning roof straps. The appeal involves the proper interpretation of the AMA Guides Fourth Edition and the Board’s weighing of the evidence of different methods of calculating whole person impairment when using grip strength loss measurements. The ICA was persuaded by the Board’s determination that both Mr. Carte’s statements to Dr. Guberman regarding his loss of grip strength and Dr. Guberman’s evidence showing significant loss of grip strength between the left and right hands were more persuasive measurements of whole person impairment, and Alliance failed to rebut these findings. As the Board noted, the Guides allow the use of grip strength as the basis for an impairment rating in rare cases, and Dr. Guberman concluded that this was such a case. Thus, the ICA found no error in the Board’s determination that Dr. Guberman’s application of loss of grip strength pursuant to the Guides was appropriate in this case. The ICA applied a deferential standard of review and affirmed the Board of Review:

As the Supreme Court of Appeals of West Virginia has set forth, “[t]he ‘clearly wrong’ and the ‘arbitrary and capricious’ standards of review are deferential ones which presume an agency’s actions are valid as long as the decision is supported by substantial evidence or by a rational basis.” Syl. Pt. 3, In re Queen, 196 W. Va. 442, 473 S.E.2d 483 (1996). With this deferential standard of review in mind, we cannot conclude that the Board was clearly wrong in finding Mr. Carte sustained a 12% WPI from loss of grip strength due to the compensable injury.

Alliance Coal, LLC v. Ashley Carte, at p. 4.

For any questions, please contact:

Charity K. Lawrence

CLawrence@spilmanlaw.com

304-720-4056

Dill Battle

Spilman Thomas & Battle, PLLC

hdbattle@spilmanlaw.com

304-340-3823

Arizona implemented several Workers’ Compensation rules that took effect on December 6, 2025. This change includes Article 1, 2, 3, and 7 that have now been reorganized by divisions administering the rules (Article 1 – Claims Division; Article 2 – Administrative Law Judge Division; Article 3 – Commission Rules; Article 7 – Legal Division). The definition of “Claimant” has been updated under R20-5-102 to “any person who is entitled to apply for benefits under the Act.” The process of service via email between parties with their consent is now included in R20-5-214. New rules under Article 7 have been drafted to incorporate the established workers’ compensation fraud unit. Several other changes have been made including the repeal of R20-5-133, R20-5-134, R20-5-135 and R20-5-147 that became unnecessary. The full list of rule changes can be found on the Industrial Commission of Arizona website.

On February 11, 2026, the Industrial Commission of Arizona announced that a new and improved 108 Wage Form will be released soon.

By Jenny Green, Ritsema Law 

For employers and their workers compensation insurance carriers, the denial of a claim for permanent total disability (PTD) benefits prompts a major sigh of relief. However, it’s important to manage expectations by keeping in mind that a claimant may be allowed to relitigate the issue of whether they’re entitled to PTD benefits if the claimant proves that their physical condition has changed since their initial claim for PTD was denied.

This issue was considered in MHM Support Servs. v. Miller, 2025 Ark. App. 546, where Claimant Tammy Miller filed a claim alleging permanent and total disability due to compensable injuries she sustained in January 2016 despite a previous ruling denying that Miller was entitled to PTD benefits as a result of her compensable injuries. Respondents argued that the issue had already been decided and could not be adjudicated for a second time based on the legal doctrine known as res judicata which bars relitigation of a judicial or administrative determination unless there is a change following the Order. However, the presiding Administrative Law Judge, Full Commission, and Court of Appeals disagreed with Respondents, finding that Miller’s second claim for PTD benefits was not barred by res judicata because she proved that her physical condition had changed after the Commission made its first ruling denying PTD benefits in August 2021.

In an Opinion filed on November 12, 2025, the Arkansas Court of Appeals affirmed the ALJ’s and Full Commission’s award of PTD benefits reasoning that she presented objective evidence supporting several new conditions and injuries that she was diagnosed with after her first claim for PTD benefits was denied in August of 2021. The Court of Appeals also relied heavily on the ruling made by an ALJ in June of 2022 finding that Miller had entered into a second healing period a few months after her first PTD claim was denied when she began to suffer complications from the surgery she previously had to repair her compensable hip injury including a partial torn tendon and pelvic floor dysfunction that her surgeon attributed to the hip injury. Given that Respondents did not appeal the ALJ’s Opinion awarding Miller TTD benefits for her second healing period, the Court found no merit in Respondents’ argument that Miller had failed to establish a change in her condition sufficient to warrant a second adjudication for PTD benefits, and instead considered the ALJ’s Opinion to be clear evidence that Miller’s physical condition had changed following the Commission’s initial PTD determination. 

The WCA will be implementing amendments to Parts 4 and 7 of the WCA rules effective April 7, 2026. Redline versions of the proposed changes are available on the WCA website.

Proposed changes to Part 4. More specifically, Rule 11.4.4.15 regarding approval of attorney fees. The change adds criteria or factors to list on contested attorney fee applications or petitions seeking attorney fees in excess of the statutory cap. The factors include the time and effort expended by the attorney, the extent to which issues in the case were contested, ability, skill and experience of the attorney, relative success of the outcome, etc. The list is not meant to be exhaustive as the final factor listed is “any other relevant information for the determination of the attorney fee award in question.”

Proposed changes to Part 7. More specifically, Part 11.4.7.12 regarding payment for health care services and case management. The change eliminates the requirement that a case management contractor give reasonable notice and an opportunity to the worker or worker’s attorney to be present during or to participate in, any and all contact by the case management with a provider.

© Copyright 2026 by Craig Campos Ritsema Law, LLC. All rights reserved. Reprinted with permission. 

The Division has issued a few important updates recently. On October 24, 2025, the Division relocated to 707 17^th St., Suite 2300, Denver, CO 80202-3404. As part of the move, the Division has updated its external documents and webpages to reflect the new address. There has also been a change regarding the Electronic Data Interchange (EDI) transition. Starting July 9, 2026, carriers and third-party administrators (TPAs) can submit claims using the EDI 3.1 format. July 8, 2026, is the last day to submit EDI data with EDI 1.0 standards. Also, effective January 1, 2026, mileage has been updated from 0.60 to 0.63, and Rules 16 and 18 have been updated.

In 2015, Claimant sustained a thoracic spine injury while employed for Belvedere Fire Company. He was compensated for thoracic spine permanency. He voluntarily closed the claim by global commutation in 2018. In 2023, while working for the City of Wilmington, climbing stairs with a pack of gear during a call, he felt pain in his thoracic spine area, missed several weeks from work, and received conservative care to the thoracic spine area. Claimant filed a Petition seeking acknowledgement of the 2023 injury, relying on the opinion of claimant’s family physician. Employer denied the claim based upon the factual circumstances of the event, and medical opinion of Dr. Samuel Matz. Board Hearing was held. The Board issued a Decision accepting Employer’s position that the successive workers’ compensation carrier standard set forth in Nally v. Standard Distributing, 630 A.2d 640 (Del. 1993), applied, denying the Petition, as claimant failed to satisfy that there was both (1) an untoward event, that (2) was the proximate cause of a new injury. 

Claimant appealed to the Superior Court, arguing Nally does not apply when the first work injury claim is resolved by global commutation, and in the alternative, asserting that if Nally applies, the Board applied it incorrectly. The Superior Court rejected both arguments.

Claimant appealed to the Delaware Supreme Court. On 12/4/25, the Court issued a Decision affirming the Board’s ruling. The Court was clear that Nally assigns liability between successive insurance carriers in cases where an employee seeks compensation for a work-related injury that is causally related to an injury compensated by a previous employer or carrier. In order to shift liability, Nally requires an (1) untoward event and (2) new injury. The question of whether Nally was correctly applied was not a close one. As Dr. Matz testified, the injury was to the same area of the spine, and diagnoses very similar. The nuance of claimant’s first claim being commuted does not mean that the Board applied the wrong standard. The fact that there was no record evidence of symptoms for several years pre-2023 injury also did not change the standard, especially considering claimant’s acceptance of compensation for a permanent injury associated with the 2015 claim, which presupposes that the injury had not healed.

Should you have any questions regarding this Decision, please contact Greg Skolnik, or any other attorney in our Workers’ Compensation Department.

Corey Ferrell v. City of Wilmington, No. 152, 2025 (Del. Dec. 4, 2025). 

The Oklahoma Supreme Court found recently there is no limit on the number of Form A's that an injured worker can be granted to change the treating physician, as long as the Administrative Law Judge agrees.

In the case of St. Anthony v. Goodwin, 2026 OK 3, the Court examined 85A O.S. Sec. 56(B) which the insurance carrier argued allowed only one Form A per case. The ALJ ordered a second Form A. That was appealed, and the ALJ's decision was reversed 2-1 by the Court of Civil Appeals. The Supreme Court granted certiorari and reversed COCA.

Justice Kane, writing for the 6-2 majority, said the statute does not say what happens after the ALJ grants the first automatic Form A. The Supreme Court said it should be up to the ALJ to determine if further changes of the treating physician for different body parts are warranted.  Justice Kane wrote:

   "The statute does not limit the number of applications that may be filed, the number of changes that may be ordered per claim, or the number of changes per injured body part. Nor does the statute require the ALJ to order one change per body part."

Bottomline, the ALJ and the Commission shall make the judgment call on changes in the treating physician based upon the facts in each individual case.  The case grants the ALJ a lot of discretion regarding the treating physician on a claim.

Death investigation professionals aka last responders must have a powerful lobby.  DWC adopted rule amendments that take effect January 29, 2026 to implement Texas Labor Code Section 504.057 which requires expedited medical benefits and accelerated medical dispute resolution for claims for medical benefits by a “death investigation professional” who sustains a serious bodily injury in the course and scope of employment, and requires that the death investigation professional inform DWC and the independent review organization that a contested case hearing or appeal involves a death investigation professional. 
 
When the legislature enacts laws that provide preferential treatment for such a narrowly defined class of injured workers, it can cause more problems than it solves with increased regulatory complexity, among other things.  We recommend doing a study in a year or two to see how many times these new “last responder” rules are invoked.  Let us know your prediction!       
 

Copyright 2026, Stone Loughlin & Swanson, LLP