State of the States October 10, 2025

National – The National Council on Compensation Insurance (NCCI) released its Countrywide Court Case Update Report. The report highlights key appellate decisions in workers’ compensation law across the United States throughout 2025. It covers topics such as exclusive remedy protections, marijuana legalization and its impact on workers’ compensation claims, attorney fee disputes, first responder presumptions, and COVID-19-related litigation. The report also notes significant state-specific developments, including proposed legislation in Tennessee, Kansas, Hawaii, and other states concerning medical and recreational marijuana. 

A.M. Best released a report in Business Insurance stating that workers' compensation continues to show strong profits despite pricing cuts. The report highlights a 2024 combined ratio of 88.8, the lowest among major property and casualty lines. Analysts attribute this resilience to workplace safety improvements, enhanced fraud detection, and favorable loss development. While medical inflation is rising, its impact on workers’ comp remains limited due to statutory payment schedules and distinct medical utilization patterns.   

Pie Insurance released its 2025 Small Business Employee Voice on Workplace Safety Report, which reveals that workplace safety remains a major concern among small-business employees. According to the survey, 2/3 of respondents expressed safety concerns, with 58% witnessing injuries and 43% feeling pressured to work in unsafe conditions. While 83% feel comfortable reporting issues, 17% hesitate to report. Notably, mental health topped the list of safety concerns, cited by 32% of workers, ahead of physical injury and environmental hazards. The survey highlights how workplace stress is affecting personal lives, leading to anxiety, reduced motivation, and sleep issues. 

Workers’ Compensation Research Institute (WCRI) released its CompScope Benchmarks 2025 report. The report analyzes workers’ compensation system performance across 18 states, focusing on medical payments, income benefits, benefit utilization, temporary disability duration, benefit delivery expenses, and payment timeliness. The 18 states include: Arkansas, California, Delaware, Florida, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin. The report examines claims through March 2024 for injuries up to and including 2023, excluding COVID-19 claims. The study aims to provide insights into how system metrics have evolved since 2018 and includes individual reports for most participating states. 

Ohio – SB 241, introduced by Sen. Thomas Patton (R-Strongsville), would require judges to assess a $50,000 penalty on an employer that appeals an award of benefits for a firefighter’s presumptive cancer claim if the award is upheld. The penalty goes straight to the firefighter. The bill sits in the Senate Committee on Financial Institutions, Insurance, and Technology, but doesn’t have a hearing scheduled. 

Texas – The Texas Division of Workers' Compensation (DWC) is accepting comments on its proposed Designated Doctor Plan-Based Audit. The proposed plan is here. The division said it will review designated doctors who ordered the highest number of referrals or diagnostic tests between June 1, 2024, and May 31.   

Washington, DC – Bill 26-0061 took effect last Wednesday. The bill allows those receiving work comp benefits from a state system to also seek benefits in DC. The bill does require that the DC award be reduced by the amount received from the state. The bill applies to claims pending or filed after June 28, 2022. 

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