This report details significant state workers’ compensation law and rule changes in 2022. While there were 13 states that reported no legislative or administrative activity, there were 38 state legislatures that enacted workers compensation laws and 14 states that reported administrative rule changes in 2022. Medical exams, costs and fee schedules, employer rates, claim appeal and adjudication, employee versus independent contractor relating to the digital economy as well as drug testing and opioid formulary are the primary areas of law and rule activity.