You may be entitled to workers’ compensation benefits if you have been injured at work or because of your job. Many people do not understand whether you can receive your regular benefits, such as health insurance, while receiving workers’ compensation. To further your understanding of your particular benefits and what you are entitled to, finding an experienced workers’ compensation attorney who can explore all options and guide you through the process is a good idea.
Workers’ Compensation: Basic Benefits Explained
Workers’ Compensation is a specific category of benefits you are entitled to if you are injured while working or become ill due to your job. Here are the basic types of workers’ compensation benefits that employers are allowed to provide in California:
Workers’ compensation insurance provides five essential:
- Medical care: Benefits for needed medical care while you recover from a verified injury or illness caused by work.
- Temporary disability: Payments to offset some of your lost wages if your injury prevents you from doing everyday tasks while recovering.
- Permanent disability: Payments if you don’t recover completely from your work-related injury or illness.
- Supplemental job displacement benefits (if your injury happened during or after 2004): Payments in vouchers to help pay for retraining or skill improvements if you don’t fully recover and do not return to work for your employer.
- Death benefits: Payments to a spouse, children, or other dependents if a job injury or illness results in death.
So What Happens to Regular Health Insurance Benefits?
Before 2002, an employer in California could not terminate an employee’s regular health benefits if they were receiving workers’ compensation benefits. However, in 2002, a Federal Court ruled in the case of Navarro v. A&A Farming. In the ruling, they stated that the Employee Retirement Income Security Act (ERISA), the federal act governing health benefit plans, preempted the state law.
The panel also decided that if an employee goes out on workers’ compensation leave, the resulting reduction in hours can trigger the Consolidated Omnibus Budget Reconciliation Act (COBRA). Therefore, the regular health benefit plan of an employee receiving workers’ compensation is not protected unless other exceptions apply.
Family Leave Acts Matter
Other factors can affect whether an employer receiving workers’ compensation benefits can retain regular health benefits. Those factors include the Federal Family and Medical Leave Act (FMLA) in California, the California Family Rights Act (CFRA), as well as pregnancy disability leave (PDL). Details regarding when certain types of leaves start and stop can affect whether regular benefits remain in place and for how long.
The Bottom Line
It’s clear that how workers’ compensation benefits and regular benefit plans work when and if they overlap is not a cookie-cutter situation for everyone. Your best strategy is to find out how your specific type of coverage works by finding an experienced and skilled workers’ compensation attorney.
To schedule a free consultation today, call Eason & Tambornini at (916) 288-9193.