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WCRI COVID-19 Impact and Effect on Claims and Medical Treatment


WCRI COVID-19 Session – Assessing the Impact

Impact of COVID-19 and the Shutdown on Claims and the Delivery of Medical Care

WCRI COVID-19 Session – Speakers: John Ruser, Ph.D., Olesya Fomenko, Ph.D.

Dr. Fomenko covered much ground very quickly in her presentation.  She is probably one of the best presenters on data in a webinar setting. 

WCRI COVID-19 session pic of Modena vaccine
(c) US Air Force – Public Domain

I took handwritten notes as I could not watch the video and type at the same time.  

MA, NJ, and SC – A dichotomy 

The percentage of claims that were COVID-19 was led by Massachusetts at 59% – likely due to the pay-without-prejudice payments made in the state.   New Jersey was a close second in the highest total of COVID-19 claims at 58% of reported claims. 

The pay-without-prejudice period in MA is a very long 180 days without having to accept liability or make a liability decision on a Workers Comp claim. 

South Carolina’s COVID-19 claim reporting rate came in the lowest at 5%.  

One has to watch the amplification of the percentages.  As the number of claims was reduced significantly, the percentages may be inflated when you divide out the total number of COVID-19 claims by the total of all claims.  

# of COVID-19 Claims / Total Number of Claims = COVID-19 % 

NM, IL, MI, and CT may have had an increased number of COVID-19 claims due to the presumption laws in effect during the pandemic.  

WCRI COVID-19 Shocking Statistic 

Nationwide, 60% of the claims came from high-risk industries.  Those claims mainly originated with assisted living centers, hospitals, and physician’s offices.    In CT, NJ, and MA 65% of the healthcare industry claims were COVID-19 related.  

A side statistic was that MA showed a 50% drop in non-COVID-19 claims during the pandemic. 

There were no or little delays in treatment for workers ‘ comp claims due to the COVID1-9 pandemic.  Even CT, MA, and NJ had no increases in medical treatment delays

Q&A WCRI COVID-19 session – The overall industry that was least affected when measuring the number of claims was the construction industries.


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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications


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