National – The Workers’ Compensation Research Institute (WCRI) released a report highlighting that degenerative back and shoulder injuries rank among the most expensive claims in workers' compensation. The study analyzed 194,000 claims involving more than seven days of lost time, with injuries occurring between October 1, 2015, and March 31, 2019.
The American Medical Association (AMA) released an updated analysis showing that four major pharmacy benefit managers (PBMs) control nearly 70% of the national market for rebate negotiation, retail network management, and claims adjudication.
The U.S. Department of Labor’s Occupational Safety and Health Administration will host a Safe + Sound Week from August 11–17, 2025, to promote workplace safety and health. The initiative encourages all-sized businesses to participate by showcasing their safety programs and how to manage hazards. This year’s theme emphasizes emergency preparedness and response, with resources provided to help organizations develop effective emergency action plans. Interested businesses can sign up here.
Enlyte, in celebration of National Adjuster Day, released a new enhancement to its Medical Records Summarization (MRS) solution. This upgraded tool integrates AI automation with clinical review to streamline the bodily injury claims process.
D.C.– B26-0061 was enacted this week and aims to amend the District of Columbia Workers’ Compensation Act to ensure parity in compensation for workers who have received benefits from another state. The bill allows employees or their dependents to file claims under DC’s law even if they have already received compensation from another jurisdiction. However, any award granted under DC law will be reduced by the amount of compensation received from the other state, ensuring that workers do not receive double benefits.
Maine – A recent report by WMTW reveals that 98% of firefighter cancer claims in Maine have been initially denied, despite a 2009 law establishing a presumption that cancer is compensable for firefighters with at least five years of service. According to the report, as of May 2025, only 35% of claimants had received any workers’ compensation benefits, raising concerns about whether the law is fulfilling its intended purpose.
Nevada – Sen. Richard Daly (D) introduced SB 317. The bill aims to reform Nevada’s workers’ compensation system by tripling the payroll cap used to calculate premiums and closing the state’s second injury fund to new claims. Additional provisions include changes to stress-related claim rules, adjustments to penalty schedules, streamlining of provider lists, and other administrative updates designed to modernize and improve system efficiency.
Pennsylvania – HB 1785, which seeks to amend Pennsylvania’s Workers’ Compensation Act to expand compensation eligibility for cancer diagnoses among firefighters, was introduced this week. The bill expands provisions related to cancer as a compensable occupational disease. Specifically, the bill allows firefighters to file cancer-related claims within six hundred weeks after their last date of employment, extending the previous limitation of three hundred weeks for occupational diseases.
Stay connected to all relevant information in workers' compensation and pharmacy by subscribing to our weekly newsletter. For the previous wrap-up, please click here.