Do I have to pay for my own health insurance while I'm off on workers' comp?
UPDATED: February 7, 2020
It’s all about you. We want to help you make the right legal decisions.
We strive to help you make confident law decisions. Finding trusted and reliable legal advice should be easy. This doesn't influence our content. Our opinions are our own.
Whether or not your employer needs to provide you with health insurance while you are off on workers comp is a very complicated question to answer, and one you are going to need a lawyer for. While many states, including Alabama, Alaska, Colorado, Connecticut, Florida, Kansas, Maine, Rhode Island, and Washington DC have laws mandating that employers either pay for health insurance for workers comp employees or compensate for lost health insurance benefits along with lost wages, the Employee Retirement Income Security Act of 1974 (ERISA) preempts these state laws. Thus, you will need to determine if you and your employer are covered by ERISA.
Understanding Workers Comp and Health Insurance
Workers comp benefits apply to any worker who suffers a qualifying work injury. They guarantee that the worker's health insurance (which includes medical bills, lost wages, and disability benefits) will be paid by his employer's workers comp insurer. However, the "medical bills" requirement applies only to medical bills relating to the injury, so you may still need your health insurance if you have a family who is covered under the policy or if you need routine care while on workers comp.
You will have to check both the rules of your state law, and also determine if ERISA applies to you, in order to determine whether your employer has to pay for the continuing health insurance coverage or not. If your employer isn't obligated to pay, then you may also be able to take advantage of COBRA provisions that allow you to continue to keep your existing health insurance coverage, while on workers comp, if you pay the full premiums (i.e. you get the same coverage at the same discounted group rate as before, but now you're picking up the whole bill for the premiums instead of your employer paying some).
To get help with determining which laws will apply to your workers comp case, consult with a lawyer as soon as possible