What are the Medical Costs for Workers Compensation Presumption COVID-19 Claims?

Generally, Workers Compensation does not cover care and treatment for pandemic or epidemic related communicable diseases because these conditions cannot be directly causally related to a work exposure. The COVID-19 pandemic, however, has created the unique circumstance whereby jobs not typically considered hazardous, have placed certain workers at a high risk of exposure to the virus, probabilistic enough to be work related.

In response, states have acted to expand workers’ compensation coverage to include first responders, health care workers and in some states, essential workers, impacted by COVID-19. Many state policies have been amended (or are pending amendment) so that COVID-19 infections among certain classes of workers are presumed to be work-related and covered under workers’ compensation. This presumption position places the burden on the employer and insurer to prove that the infection was not work-related making it easier for those workers to receive medical treatment for COVID-19 that is paid for under Workers Compensation, as opposed to group health benefits.


The following states have enacted or pending legislation for COVID-19 Presumption Claims: Alaska, Arizona, Arkansas, California, Colorado, District of Columbia, Florida, Illinois, Kentucky, Louisiana, Minnesota, Michigan, Missouri, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Pennsylvania, Puerto Rico, South Carolina, Utah, Washington, Wisconsin and Wyoming.

Where Technology Meets Action

One of the biggest challenges that Workers Compensation payers will face in the coming months will be how to effectively handle the deluge of claims related to COVID-19. For a lot of organizations, this sudden uptick in claims activity will put an enormous strain on resources that are already at capacity.


Fortunately, we live at a time where smart technology and intelligent data enables us to be proactive and tackle some of these challenges head on and at scale. Through the careful integration of People, Process, Technology and Data, we can augment the traditional claims team with innovative and intelligent tools that help reduce friction, increase productivity, and create the opportunity for smarter decision making at scale.

At Care Bridge International, we host the largest independent data set of property and casualty claims accident / injury data. Our data intelligence approach to forecasting medical treatment and costs for claims is setting a new standard in delivering accuracy and reliability in forecasting medical reserves, settlement valuations and Medicare Set Asides involving Medicare beneficiaries. We wanted to understand what the data says about medical exposure for claimants with commonly associated symptoms of COVID-19, leveraging advanced analytics to predict exposures.

COVID19 Medical Exposure Data Available Now

As our public service during this difficult time, Care Bridge International is offering a FREE interactive Analytic-Powered COVID 19 Calculator for claims organizations that need to understand the medical costs associated with a COVID-19 diagnosis for Workers Compensation claims, in a presumption state, using state specific fee schedule pricing.

Our package of COVID-19 services include our FREE Analytic-Powered COVID 19 Calculator and the ONLY data driven medical forecasts in the marketplace, touched by clinical experts that deliver the fastest, easiest, most accurate results. Our dashboard analytics for future measuring and monitor of your COVID-19 claims will make your job easier. Visit our simple MedForecast Referral Portal now!

For More Information:

Visit Our Website at https://www.carebridgeinc.com

Toll-Free: 888-434-9326 Ext. 101

Email: Referral@carebridgeinc.com

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