Can I Lose My Health Insurance While Receiving Workers’ Compensation Benefits?

Sadly, you might lose employer sponsored health insurance coverage while you receive workers’ compensation benefits. Massachusetts state law protects injured workers from any retaliation they might face simply because they exercised their right to file a workers’ compensation claim, however it does not provide general protection to ensure that they will be able to maintain health coverage. However, there are some federal laws that are available to protect workers in certain circumstances. Additionally, workers who suffer long-term disability may have options available to seek health coverage through Medicare.

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Protections Provided By the Family and Medical Leave Act (FMLA)

The Family and Medical Leave Act (FMLA) provides some seriously injured employees with certain legal protections. More specifically, injured employees may be able to take up to 12 weeks of leave. During the leave period, an employee’s job status as well as their health insurance coverage is legally protected. To qualify for this protection under the FMLA, an injured worker must have been with their employer for at least one year and must have worked at least 1250 hours over the previous year. Additionally, it should also be noted that the FMLA does not apply to all employers. Indeed, the law only applies to public agencies, schools and companies with at least 50 workers in a 75-mile radius.

Protections Provided By COBRA Health Coverage Continuation

In many situations, injured workers are forced to miss far more than 12 weeks on the job. This means that the protections available under the FMLA will expire for these workers. Injured workers who find themselves in this type of scenario may still be able to protect their health insurance coverage. Specifically, this is done through COBRA Continuation. Injured employees can continue their group coverage for an additional 18 months using this tool. However, it should be noted that COBRA Continuation requires injured employees to pay the cost of maintaining their coverage on their own. While this can be frustrating, the cost to continue on your employer’s group health plan is often significantly less expensive than any other health insurance plans that will be available on the market.

Other Health Insurance for Injured Workers

Injured workers who are not entitled to FMLA or COBRA benefits may find themselves in a difficult position. Certainly, Massachusetts workers’ compensation benefits will provide coverage for any medical treatment that is needed in relation to the work-related injury or condition. However, injured workers may still need to obtain health insurance coverage from an outside source to cover themselves, as well as their family. For those whose injuries have kept them off the job for at least one year (or will keep them off the job for this long), applying for Social Security Disability Insurance (SSDI) may be the best available option. If you qualify for SSDI, health insurance may be available through Medicare. To learn more about this particular option, you should speak an experienced Massachusetts Social Security disability attorney.

Request Your Free Consultation Today

Work injury cases are notoriously complex. At Fitzpatrick & Associates, our team is prepared to handle all of the details of your claim, including issues related to health insurance. To learn more about what we can do for you, please do not hesitate to call our Boston office today at (617) 825-0965.