Health Insurance While on Workers’ Comp in New York

You get hurt at work and need time off to recover. Even if you can return to your job, the injury might limit your physical or mental abilities, leading to a smaller paycheck. Wondering whether collecting workers’ compensation benefits will affect your employment status and benefits like health insurance is normal.

Keep reading to learn about the relationship between health insurance and workers’ comp, the benefits you are entitled to, and your legal rights if your employer fires you for filing a workers’ comp claim.

Can I Continue Health Insurance Coverage if an Injury Keeps Me Out of Work?

You might be unable to return to work after a work-related injury or illness. Or your employer might be unable to accommodate your doctor-prescribed limitations. Either way, you might not receive paychecks if you don’t get paid time off (PTO). When you stop getting paychecks from your employer, you’ll need to pay your health insurance premiums yourself to maintain health insurance coverage.

If you cannot work because of your work-related injury, you could receive lost wages benefits from your employer’s workers’ compensation insurer. You can pay your health insurance premiums from the lost wage benefits you receive from workers’ compensation.

Who Will Pay for My Health Insurance If I Can’t Work?

You must speak with your employer immediately after discovering you can’t work after an accident. If an amount is automatically deducted from your paychecks for health insurance contributions, you must understand how to keep making those payments while you’re not working. You can also talk to the insurance company to confirm what you need to do to keep your health insurance coverage despite being out on workers’ comp.

How the Family and Medical Leave Act (FMLA) Can Protect You

FMLA provides specific protections to eligible employees who get hurt at work and need time off to heal. If you are an eligible employee of a covered employer, you can take job-protected, unpaid leave for qualifying medical and family reasons. You should receive continued health insurance coverage as if you had not taken leave, but you still must talk with HR to be sure you know how to make your health insurance premium payments.

Under FMLA, you are entitled to twelve unpaid weeks off work in twelve months under these circumstances:

• To care for a spouse, child, or parent with a serious health condition
• For the birth of a child and to care for them within one year after the birth
• A serious health condition preventing you from completing the essential functions of your work
• To receive child placement for foster care or adoption and care for the child within one year after the placement
• Any qualifying urgency resulting from a spouse, parent, or child going on covered active duty as a covered military member

FMLA also entitles a qualified employee who is also the spouse, parent, child, or next of kin of a covered service member with a serious illness or injury to twenty-six weeks of unpaid leave in a twelve-month period to care for that service member.

Can My Employer Fire Me for Filing a Workers’ Compensation Claim?

Although the law prohibits employers from firing employees because they seek workers’ compensation benefits or take time off to recover from a job-related injury, your employer might fire you anyway. If that happens, your health insurance coverage will also terminate.

You can continue your coverage temporarily under the Consolidated Omnibus Budget Reconciliation Act (COBRA). You don’t have to worry about suddenly finding yourself without health insurance. Your employer’s human benefits administrator must notify you of your right to choose continued coverage through COBRA. Once you receive the notice, you’ll have 60 days to accept.

If your employer terminates you because you filed a workers’ comp claim, took family or medical leave, or required time off due to your on-the-job injury or illness, you can seek legal action against them. Retaliation is a form of discrimination that is prohibited under federal law.

Contact an Experienced Workers’ Compensation Attorney Today

You suffered enough after the workplace accident. You shouldn’t face additional consequences for something that isn’t your fault. State and federal laws are supposed to protect you when an injury or illness leaves you unable to earn a living. Fusco, Brandenstein & Rada, P.C. can help protect your rights, figure out how you can continue to pay for your health insurance premiums if you are out of work, and pursue the benefits you deserve.

Call the New York workers’ compensation attorneys of Fusco, Brandenstein & Rada, P.C. at 516-496-0400 for a free consultation if you sustained an injury at work and want to learn more about maintaining your health insurance while you’re getting workers’ compensation benefits. Our legal team is ready to help you with your claim.