NCCI's Countrywide Court Case Update highlights workers compensation (WC) appellate decisions monitored by NCCI's Legal Team in 2025. This edition covers important industry topics such as exclusive remedy, marijuana, attorney fees, first responder presumptions, COVID-19, and other notable state-specific developments.
For more information on cases reported by NCCI's Legal Team, visit previous Court Case Updates and
Court Case Insights on
ncci.com.
Exclusive remedy—providing employers with immunity from employee tort suits for work-related injuries covered by WC—continues to be a closely watched topic among WC stakeholders.... view more
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Illinois, Exclusive Remedy Under the Occupational Diseases Act
Martin v. Goodrich Corp. (January 24, 2025)
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Maryland, Applicability of Exclusive Remedy to Lawsuit Brought by Nondependents
Ledford v. Jenway Contracting, Inc. (July 1, 2025)
The Supreme Court of Maryland, as a matter of apparent first impression, ruled that WC exclusive remedy bars a wrongful death lawsuit brought by the nondependent child of an employee who died in a work-related accident. The court analyzed the exclusive remedy provision—codified in Maryland statute 9-509—together with prior court decisions and concluded that the employer's liability for the employee's death was exclusively within WC, regardless of whether the nondependent plaintiff was entitled to WC survivor benefits. The court further found that the Workers' Compensation Act does not violate a provision in the Maryland constitution that provides the right to a remedy for injuries to person or property and the right to access the courts.
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Washington, Intentional Injury Exception
Cockrum v. C.H. Murphy/Clark-Ullman, Inc. (May 29, 2025)
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Marijuana legalization and its implications for WC remains a topic of interest. Though marijuana remains illegal at the federal level, at least 15 states have allowed its use solely for medical purposes, while 24 states and the
District of Columbia have legalized both medical and recreational use. In 2025,
Tennessee (HB 872, SB 489/HB 836, SB 809) and
Kansas (HB 2405, SB 294) considered legalizing both forms.
Hawaii (HB 1246, SB 1613),
New Hampshire (HB 75, HB 186), and
Pennsylvania (HB 20, HB 1200) introduced bills to legalize recreational use, while
Idaho (H 401),
Indiana (HB 1178, SB 113),
North Carolina (HB 1011),
South Carolina (S 53), and
Texas (HB 1504, SB 170, SB 734) focused on medical marijuana proposals.... view more
State legislatures continue to evaluate the role of medical marijuana in WC, specifically as it relates to reimbursement. For example, the proposals to legalize medical marijuana in
Idaho,
North Carolina,
South Carolina, and
Tennessee, clarify that they should not be construed to require an insurer, including a casualty and property insurer, to be liable for or reimburse a claim for medical cannabis. On the other hand,
Massachusetts (H 2169) would allow for WC reimbursement where the employee is a qualifying patient.
New York (A 4744, S 6549) deems medical marijuana a prescription drug, a covered drug, or a healthcare service, as necessary to authorize coverage under WC.
Also, on March 20, 2025, the Supreme Court of Pennsylvania, in
Schmidt v. Schmidt, Kirifides and Rassias, PC, ruled that cannabinoid oil (CBD oil) can be reimbursed to an injured employee under the state Workers' Compensation Act.
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This year, courts have reviewed questions related to attorney fees in WC cases. Some of these cases have considered the application of attorney fee statutes and their constitutionality.... view more
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In the last decade, numerous states have enacted laws establishing WC presumptions for first responders—creating a presumption that certain injuries or diseases arise out of the course and scope of employment. Courts have also continued to review issues surrounding how these presumption statutes are applied.... view more
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Arizona, Applicability of First Responder Cancer Presumption Statute
Krol v. The Industrial Commission of Arizona (March 26, 2025)
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Nevada, First Responder Presumption and Predisposing Factors
CCMSI v. Odell (January 30, 2025)The Court of Appeals of Nevada ruled that a first responder seeking a presumption of compensability for heart disease under Nevada statute 617.457 is not required to take remedial action against predisposing conditions that did not cause the disease. In this case, a firefighter with a congenital heart defect suffered from various heart-related diseases throughout the employment. The employer denied the firefighter's WC claim citing the statute's provision allowing an affirmative defense if the employee failed to correct the predisposing conditions that led to the disease.The court concluded that, under the plain language of the statute, the employer's affirmative defense only applies when the predisposing conditions cause the first responder's heart disease. Here, the court found the employer's affirmative defense did not apply because the firefighter's heart diseases stemmed from a congenital defect rather than from other predisposing factors.
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Since the onset of the COVID-19 pandemic, courts have considered cases that address whether contraction of COVID-19 is work related and therefore compensable, or the application of exclusive remedy where employees contract COVID-19 and sue their employers in tort. Some recent decisions include:... view more
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Iowa, Exclusive Remedy Defense for Coworkers and Employers
Mehmedovic v. Tyson Foods, Inc. (May 23, 2025)The Iowa Supreme Court ruled that the estates of employees who died after allegedly contracting COVID-19 while working at a meat processing plant could pursue civil claims of gross negligence and fraudulent misrepresentation against their supervisors but not against the companies that employed them. The court relied on Iowa statute 85.20, which provides that for work-related injuries, WC benefits are the exclusive remedy that employees have (1) against employers and (2) against coworkers, provided that the injuries are not caused by gross negligence. The court reasoned that if the statute expressly permits gross negligence claims against coworkers, including supervisors, then it logically follows that intentional tort claims are also permissible. However, the court noted, the statute does not provide an exception for gross negligence or intentional torts committed by employers. As a result, the estates' claims against the employer companies were dismissed.
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Across the states, courts continue to address other issues related to WC.... view more
Northeastern Zone
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Connecticut, Discretion to Award Temporary Partial Incapacity Benefits
Gardner v. Dept. of Mental Health & Addiction Services (March 18, 2025)
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Pennsylvania, Recovering Overpayments From Medical Providers
Pioneer Construction Co. v. Insight Pharmaceuticals, LLC (May 12, 2025)
The Commonwealth Court of Pennsylvania ruled that a pharmacy could not legally be joined in a WC proceeding initiated by a WC insurer to recover overpayments that it had made to the pharmacy. A WC insurer mistakenly paid the pharmacy for medication dispensed to a claimant after it was determined in a utilization review process that the medication was unreasonable and unnecessary. The WC insurer sought to recover the amounts it had overpaid the pharmacy by filing a billing review petition and moving to join the pharmacy to the proceedings. The court reasoned that the pharmacy could not be a proper party to the petition because the Workers' Compensation Act provides no mechanism for insurers to recover overpayments from medical providers.
Southeastern Zone
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Florida, Calculation of a WC Insurer's Lien Amount
Liberty Mutual Insurance Co. v. Lee (February 7, 2025)
The Sixth District Court of Appeal of Florida ruled that the calculation of a WC insurer's lien amount should be based on the entire amount of the WC benefits paid through the date of the equitable distribution. In this case, a claimant settled a negligence claim against a third-party tortfeasor and sought to limit the WC insurer's lien to the amount of benefits paid up to the date of the settlement and not the later date of the equitable distribution. The court reviewed Florida statute 440.39 providing, in part, that the carrier shall recover from the judgment or settlement a percentage of what it has paid. The court concluded that excluding the amount of benefits paid between the date of the settlement and the date of the equitable distribution contravened the express directive of the statute.
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Florida, Requirement to Seek Initial Relief Within the WC System
Steak 'N Shake, Inc. v. Spears (June 13, 2025)
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Florida, Admissibility of Expert Medical Adviser Opinions in WC Proceedings
Sedgwick Claims Management Services v. Thompson (September 3, 2025)
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Florida, Tolling the Statute of Limitations
Murphy v. Polk County Board of County Commissioners (September 3, 2025)
Midwestern Zone
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Iowa, Calculation of Benefits
Den Hartog Industries v. Dungan (January 9, 2025)
The Court of Appeals of Iowa considered how WC benefits should be calculated when an employee suffers nonscheduled permanent partial disabilities and then voluntarily leaves the employment to begin another job at a higher rate of pay.
The court reviewed Iowa statute 85.34, which provides that compensation for unscheduled injuries is generally calculated using the industrial disability method, which reflects the employee's loss of earning capacity. The statute also states that if the employee returns to work earning the same or higher wages, compensation is limited to the functional impairment rating but, if the employee returns to work and is later terminated by the same employer, the employee may seek additional industrial disability benefits. The court found that the statute does not address the compensation method for employees who return to work but voluntarily leave employment—as opposed to being terminated. In such cases, the court found the functional impairment analysis would not apply and the employee would be entitled to compensation based on the loss of earning capacity.
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Minnesota, Standard to Rebut Presumption of Retirement
Simonson v. Douglas County (April 16, 2025)
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Missouri, Liability of Second Injury Fund (SIF) for Occupational Diseases
Treasurer of the State of Missouri v. Penney (April 29, 2025)
The Supreme Court of Missouri held that occupational diseases do not qualify as preexisting disabilities when triggering the SIF's liability for permanent total disability (PTD) benefits under Missouri statute 287.220.3(2)(a)a(ii). The court reasoned that statute 287.020—which requires that claimants seeking PTD benefits from the SIF establish that they have at least one qualifying preexisting disability that is a direct result of a compensable injury—specifically excludes occupational diseases from the definition of compensable injury. The court found that an employee suffering from three occupational diseases as a result of work-related repetitive traumas was not entitled to PTD benefits from the SIF.
Western Zone
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INSIGHTS.
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