Who Pays for My Health Insurance While I Am Out on Workers’ Compensation?

workers' compensationAfter you’re injured at work, you likely have a long list of concerns weighing on your mind. How much money will you get while you’re out of work? What type of treatment will you need? Will you be able to return to work soon? On top of that, you have to consider the other benefits covered by your employer. While workers’ compensation does cover the cost of medical treatment related to your work injury, you may have other conditions or prescriptions that still have to be paid by your health insurance policy. Additionally, maintaining your health insurance policy is a top priority if it provides coverage to your family.

Maintaining Your Health Insurance Coverage

Florida law outlines the obligations of the employer when an employee is receiving workers’ compensation. Your employer calculates your average wage for the preceding 13 weeks if you have worked in your position for the entire 13-week period. If you have not maintained this position for the 13 weeks prior to your injury, they use the wages of an employee in a similar position to determine your average wage. If you receive permanent or temporary total disability, you are paid 66 2/3 percent of your average weekly wages.

Your health insurance is typically considered a fringe benefit that is part of your weekly wage. As a result, your company may continue paying their portion of the plan until you are able to return to work. The cost of your portion of the monthly premium may be deducted from your workers’ compensation payments.

How Workers’ Compensation Covers These Expenses

You can seek compensation for your health insurance expenses in a variety of ways. While you are receiving workers’ compensation payments for your injury, your company may simply keep you on their group health insurance plan while paying their portion of the monthly premium. If they remove you from the health insurance plan, you may be able to report this to your workers’ compensation lawyer and ask for your payments to be adjusted to cover the loss of a fringe benefit. If you are on FMLA leave, your health benefits are protected until you exhaust your FMLA leave.

COBRA Benefits

If your employer decides to cancel your health insurance, they must follow certain federal statutes to ensure that you are not left without any options for health coverage. Federal law requires that your employer send you a COBRA notice letter before your coverage is terminated. This gives you the option of paying an additional monthly premium to temporarily maintain the same level of health coverage available through your company. If your employer unexpectedly terminates your health coverage, your workers’ compensation attorney can help you with the next step.

Make Sure You’re Getting What You Deserve While Receiving Workers’ Compensation

It can be challenging to figure out how much you’re entitled to after a workplace injury. For further assistance with your workers’ compensation case, contact the West Palm Beach office of Scott J. Sternberg & Associates at 561-687-5660.

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