Injured and sickened workers often feel anxious about filing workers’ compensation claims. They worry about their employers punishing them or their claims having a negative impact on the company. In many cases, those trying to avoid a workers’ compensation claim make use of other benefits available through their employment. They request paid leave while undergoing treatment for job injuries and may use their employer-sponsored health insurance to cover their treatment costs.
While that approach may seem reasonable, it unfairly deprives the worker of the ability to use their paid leave for personal reasons as needed. Additionally, the use of private health insurance for an on-the-job injury can end up costing a worker more than they expect.
Insurance expects patients to help pay
Private health insurance provided by an employer often imposes multiple types of cost-sharing. That is a diplomatic way of saying the insurance company makes the policyholder pay for their treatment.
Many policies have requirements that people pay thousands of dollars toward their personal and family deductibles before the insurance company covers any of their costs. They may also need to pay a copay every time they visit a doctor or fill a prescription.
Even after meeting their deductible and paying a copay, they may have additional financial obligations in the form of coinsurance. Insurance companies may require that policyholders pay a specific percentage of their overall treatment costs out of pocket. All of that can add up to thousands of dollars in financial responsibility before the insurance company covers anything.
Workers’ compensation medical coverage is different. Employees are eligible for full coverage for all mandatory treatment expenses. So long as the doctor overseeing their care agrees that the treatment is medically necessary, workers’ compensation can pay for 100% of their medical expenses.
Additionally, the worker may be eligible for disability benefits. Instead of using their paid leave while they undergo treatment or recover from their injuries, they can instead request disability pay. Workers’ compensation can replace a portion of the worker’s lost income until a doctor determines that they are healthy enough to return to work.
A successful workers’ compensation claim can reduce the financial challenges triggered by an on-the-job injury or a work-acquired illness. Having insight into the benefits available and support while filing a claim can make it easier for injured workers to secure the support they require for work-related health challenges.