Workers Compensation or Health Insurance for Injury?

When an employee is injured or becomes ill, mentally or physically while working in his job, including injuries arising due to workplace crimes, he may be entitled to worker’s compensation benefits depending on the nature of his injury and benefits compensating him for lost wages.

Employee Injuries

Workers Comp Claim

The employer may take the worker’s compensation claim and pay for all of the related medical care and treatment arising from the illness or injury. The employer would then have the right to access all of the employee’s medical records that relate in any way to that injury or illness. The worker, in order to receive worker’s compensation benefits covering the cost of care and treatment of his injury or illness, must give up all of his privacy in his medical record information.

Health Insurance Claim

Alternatively, a worker may use his privately purchased health insurance or employer provided health insurance to seek medical care and treatment for his work related illness or injury. The employee could then, at least initially, retain the privacy of his medical record data and information concerning his general health and his work related injury or illness.

Employer Requirements for Workers Compensation

Employers are required to carry worker’s compensation insurance and payment of medical claims for work related injury or illness is mandatory unless the employer can prove that the injury was not work related. OSHA or the Occupational Safety and Health Administration can provide in depth information and data that may be of assistance in providing the necessary proof of the workplace cause of an injury or illness. An employee with private medical insurance would also be able to legitimately file a claim for the care and treatment required for his injury under his own private health insurance carrier. The difference is essentially where the bills for medical care and services will be received and who will initially pay for that medical care and treatment.

Workers Comp Claim vs. Private Medical Care

The two main issues to be weighed pro and con by an employee considering a claim for a worker’s compensation covered illness or injury is whether or not he should seek to preserve the privacy of his medical data and information and whether the claim for medical services and treatment should be initially paid by the employer or the employee’s health care insurance carrier.

This situation clearly invites a timely discussion with a worker’s compensation attorney. An attorney can advise an injured or ill employee on the best methods to protect his rights and interests while obtaining all of the compensation and benefits concerning the care and treatment of his injury and lost wages which he is entitled to receive.

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