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Does workers compensation pay for my health insurance?

Attorney discusses Michigan workers compensation insurance and health coverage

Many people are confused about who will pay for their medical expenses after an at-work injury. The FAQs below will help you understand your rights to medical treatment, and who will pay for your care.

To speak with one of our workmans comp lawyers now, call us at (855) 221-COMP. You can also fill out our free consultation form. The call is free and the advice is free.

Who is responsible for paying for my medical treatment?
What if my employer/insurance company says my treatment is not work related?
Is it okay for my employer to continue paying my health insurance?
Are there other ways I can receive health insurance?
What if my employer tells me to use my health insurance for an at-work injury?

Q. Who is responsible for paying for my medical treatment?
A. Your employer is responsible for paying all reasonable and necessary medical treatment for your work injury. This does not mean that your employer must provide you or your family with health insurance. Workers compensation medical benefits and health insurance provided by your employer are two different things.

Your employer only has to pay what is required under the Michigan workers compensation law.

Medical treatment under workers compensation can include doctor visits, physical therapy, surgery, hospital stays and medications. It can also include dental care, prosthetics, eyeglasses, hearing aids, wheelchairs and other appliances necessary to cure or relieve the effects of your work injury.

Some individuals also need attendant (nursing care) to help with activities of daily living.

Q. What if my employer/insurance company says my treatment is not work related?
A. Sometimes there are disputes as to what is reasonable and necessary medical treatment under workers compensation. This typically occurs when the employer or the insurance company believe that the medical treatment is not work-related. For example, it's common for someone with arthritis in the spine to be denied treatment for a back injury.

Here's information on many at-work injuries that are commonly disputed under workers comp.

Q. Is it okay for my employer to continue paying my health insurance?
A. Yes. Many employers will continue to provide health insurance, even though it is not required. This is because the cash value of any discontinued fringe benefits can be used to increase the average weekly wage. It may be cheaper for your employer to continue paying health insurance rather than paying you more in wage loss benefits.

Q. Are there other ways I can receive health insurance?
A. A lot of employers will fire an employee who cannot work because of an injury. A federal law called COBRA gives some of the employees the right to continue the group health insurance plan for a period of time. This can be very expensive, as you must pay the premiums.

You might also have the right to health insurance through an employment or union contract. It is very important that you speak with an experienced workmans comp lawyer whenever you are injured at work. If you settle your workers compensation case, this could affect your entitlement to future health insurance. Call us at (855) 221-COMP. The call and the advice are free.

Q. What if my employer tells me to use my health insurance for an at-work injury?
A. Sometimes the problem is not keeping health insurance but getting workers compensation. Your employer may tell you to use your own health insurance for a work injury. This is not correct and you could end up paying the price out of pocket. Workers compensation is unlimited and you should have no deductibles or co-pays. Even if you lose your job, workers compensation should pay reasonable and necessary medical treatment for life.

It is possible to have your group health insurance pay for a work injury when your employer refuses. This allows you to get the medical treatment while you are pursuing workers compensation benefits in court. Most group health insurance companies will agree to pay for medical treatment when you have a pending case. You will need to reimburse the health insurance company if you later receive workers compensation benefits.

In summary, all reasonable and necessary medical treatment should be paid under workers compensation for an injury that occurs at work. Your employer does not have to provide you with health insurance but many continue to do so because it is in their financial interest. When workers compensation is denied, use your own health insurance to pay medical bills and file a case against your employer. If you lose your health insurance, you should explore options under COBRA and any employment or union contract.

Have questions about Michigan workers compensation insurance?

Call our workmans comp lawyers at (855) 221-COMP, or you can fill out our free contact form.

We have been protecting injured workers for more than 35 years. We can see to it that you receive the proper medical treatment, and that your work comp benefits are protected.

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