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Injuries That Workers’ Compensation Do Not Cover

Managed Outsource Solutions (MOS) is a reliable provider of medical record review for workers’ compensation attorneys. Our team of reviewers and legal nurse consultants have years of experience in sorting, organizing, and reviewing medical records for medico-legal cases. Error-free review of the injuries or illnesses and timely follow-up helps prevent fraud and ensures that compensation is paid to deserving claimants.

In today’s podcast, Jessica Schwartz, one of our Solutions Managers, discusses the injuries that Workers’ Compensation may not cover.

Read Transcript


This is Jessica with Managed Outsource Solutions. I’m a Solutions Manager, here to talk to you about injuries that Workers’ Compensation may not cover.

00:11 What Does Workers’ Compensation Benefits Cover?

Workers’ Compensation benefit cover medical care expenses, lost wages and disability disfigurement. This can include permanent total, temporary partial and permanent partial. Rules and exceptions vary from one American state to another. The Workers’ Compensation eligibility determination process involves different steps, the most important first step being medical record review. Claimants could work with an injury and its impact which the attorney uses effectively to develop the case. It is important to know which injuries will be covered and which will not.

00:51 What Injuries May Not be Covered?

Injuries that may not be covered by Workers’ Compensation based on individual state’s rules and regulations. These are injuries sustained while commuting to and from work, while intoxicated and on the job, injuries sustained during break when the worker is away from the job site, injuries sustained while partaking in an off-site work event, injuries sustained during fights or horseplay. It also includes minor and underreported injuries, injuries sustained by self-employed persons, independent contractors, stress or other psychiatric injuries, or self-inflicted injuries.

Feel free to contact us at any time. We are here and willing to help.

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