2025 is shaping up to be a busy year for state work comp and worker safety

As state legislative sessions ramp up, there's been a flurry of proposals related to work comp and workplace safety. Many proposals continue the trend of expanding the coverage of presumption laws for first responders, particularly associated with cancer and PTSD. Other bills relate to protection for warehouse and distribution workers and compensability for MSDs. Reflecting on state actions in 2024, additional action will likely focus on marijuana, workplace-related mental injuries, naloxone, independent contractors, and fee schedules.

In Indiana, lawmakers are considering an interesting bill that would limit the way experience rating modifications are used in the bidding process for contracts. A growing number of experts have raised concerns that it is inappropriate to use E-mods to compare the relative safety of employers.

State executives have begun to prioritize AI governance. Responsible AI can enhance workplace safety providing real-time insights, identifying hazards, predicting possible incidents, and helping employees mitigate risk. Yet, employers should prepare for increased compliance burdens from states, particularly in hiring, employment decisions, job loss, healthcare, privacy, and automation.

In California, Attorney General Rob Bonta issued two separate legal advisories on January 13. The first advisory reminds employers that AI-driven decisions in hiring, lending, healthcare, and advertising are not exempt from anti-discrimination and privacy laws. The second advisory focuses on healthcare, stating that insurers and providers cannot use AI to deny care, override doctors, or impose discriminatory barriers to healthcare access.

In New York, Governor Kathy Hochul announced that businesses with 50+ employees will soon be required to report AI-driven layoffs. This move makes New York the first state to demand transparency on how AI replaces human jobs.

Further, as workplace regulations evolve under the new administration, some state work safety agencies are planning to double down on enforcement efforts. There are currently 22 State Plans covering both private sector and state and local government workers, and seven State Plans covering only state and local government workers. Staying informed is critical to avoid non-compliance.

Here is a non-exhaustive summary of recent state legislative proposals:

Connecticut - presumption cancer and PTSD, substance abuse disorder

• S.B. 1029 would expand the firefighter cancer presumption adding "other worker(s) impacted by similar conditions" as those who qualify when "diagnosed with cancer" that is "presumed to arise out of and in the course of employment as a result of exposures particular to the duties performed as a firefighter." The bill does not define other workers.
• S.B. 228 would expand the list of qualifying incidents for post-traumatic stress disorder presumption for first responders to incidents that don't involve death or loss of a vital body part.
• S.B. 462 would recognize substance use disorder as an occupational illness under the state's workers compensation law.

Florida - presumption cancer, heart disease

• H.B. 87 would add "acute myeloid leukemia" to the list of cancers that qualify under the state's existing presumption law for firefighters.
• S.B. 366 and its companion H.B. 269 would define heart disease as "any organic, mechanical or functional abnormality of the heart, its structures or the coronary arteries for the purpose of a law that presumes certain conditions are compensable for first responders." The fire marshal called for a revision/clarification of the definition, arguing that an appellate court's definition was improper and would lead to unjust results.

Georgia - warehouse and distribution workers

• H.B. 16 would require employers of warehouse operations or distribution centers to provide workers written descriptions of any quota or workplace surveillance measures, prohibit unlawful quotas, limit the collection and use of employee work-speed data, provide paid break time and appropriate training, develop complaint processes and rights to request records and more.

Illinois - Limits compensable injuries, injuries sustained during travel, sole proprietors

• H.B. 1253 provides that an injury arises out of and in the course of employment only if the accident significantly caused or contributed to both the resulting condition and the disability and specifies when an injury does not arise out of and in the course of employment. Limits conditions under which repetitive or cumulative trauma is compensable.
• H.B. 1257 amends the Workers' Compensation Act concerning injuries sustained by employees during travel. Provides that accidental injuries sustained while traveling to or from work do not arise out of and in the course of employment, except under specified circumstances, which are defined.
• S.B. 35 would eliminate the statutory provision that workers comp laws do not apply to sole proprietors or to partners or members of a limited liability company who elect not to be covered.

Indiana - Experience Mod and bidding, subrogation, physician selection, National Guard

• H.B. 1214 provides that, after June 30, 2025, a party may not prohibit an employer from bidding on a contract solely based on the employer's experience rating. Requires insurance companies providing worker's compensation insurance to revise an insured party's prior experience ratings in a specified manner after the insurance company makes a successful subrogation claim.
• H.B. 1182 would allow injured workers to choose a treating physician.
• H.B. 1111 would increase the amount the state must pay for death benefits to an active member of the National Guard from $8,800 to $20,000.

Maine - presumption PTSD

• H.B. 82 would strike the Oct. 1 deadline for repealing the rebuttable presumption for post-traumatic stress disorder suffered by law enforcement and corrections officers, emergency dispatchers, firefighters, or emergency medical services workers, continuing the rebuttable presumption indefinitely.

Maryland - presumption hypertension

• H.B. 0217 and S.B. 0173 establish that certain first responders demonstrate disablement for purposes of workers' compensation and are deemed to have hypertension for purposes of an occupational disease presumption for hypertension if certain requirements are met.

Nebraska - presumption cancer

• L.B. 400 would amend the Workers' Compensation Act by establishing a presumption for both career and volunteer firefighters that cancer resulting in temporary or permanent disability or death is considered an occupational disease if it develops during the course of employment and is linked to exposure to a known carcinogen. The bill outlines a list of substances deemed carcinogenic and associated with various types of cancer.

New York - mental health injuries, COVID-19 death benefits, anti-bullying, stop work

• S.B. 755 proposes significant amendments to narrow the scope of the law passed in December 2024 that went into effect January 1, allowing all workers, not just first responders, to file claims for "extraordinary work-related stress." If passed, the bill would limit eligibility for such claims to first responders only. Claims would also be restricted to stress injuries directly connected to specific "work-related emergencies," removing the more inclusive phrasing of "at work" in the current law.
• S.B. 8408 would allow for the reopening of claims for COVID-19 death benefits for families of those who were considered essential employees, per the state's executive order during the pandemic, from March 2020 to June 2021. A similar bill failed in 2024.
• S.B. 1893 would make it easier for employees who claim to work in a hostile environment to sue their employers, because the action would not have to be predicated on a protected class violation.
• S.B. 162 would require the Workers Compensation Board to issue stop-work orders to any employer that knowingly fails to provide work comp coverage.

Rhode Island - warehouse and distribution workers

• H.B. 5047 aims to protect workers in warehouses and distribution centers by requiring employers to provide workers written descriptions of any quotas and potential adverse employment action that could result from failure to meet the quota. The bill also specifies reasons employers cannot take adverse employment action related to quotas.

Virginia - Mental health presumptions, MSD injuries, medical treatment requests

• S.B. 860 and H.B. 2060 increase from 52 weeks to 500 weeks the maximum duration that workers compensation benefits are payable for post-traumatic stress disorder, anxiety disorder, or depressive disorder incurred by law-enforcement officers and firefighters acting in the line of duty. S.B. 860 also expands the definition of law-enforcement officer.
• S.B. 1112, S.B. 803, and S.B. 788 would classify injuries caused by repetitive and sustained physical stressors as occupational illnesses. The bill also amends workers comp law to eliminate language that defines carpel tunnel syndrome and hearing loss as "ordinary diseases of life."
• H.B. 1749 would require employers to issue a decision on medical treatment requests within 45 calendar days.