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Workers' compensation: What's wrong with using medical insurance to obtain medical care for an on-the-job injury or illness?
 


Anyone who uses their medical insurance to obtain treatment for an on-the-job injury or illness could be making a mistake that might eventually compromise their medical care and cost them many thousands of dollars.

For most workplace injuries and illness, the distinction between treatment funded by workers' compensation and that funded by medical insurance is not important, because the condition will be corrected and that will be the end of it. But if a worker depends on medical insurance to obtain treatment for an injury or illness that produces ongoing disability or that results in a condition that could reoccur months or years later, the worker is taking the risk of someday lacking any coverage to pay for the treatment of a condition that ought to have been put under the ongoing coverage of workers' compensation.

Medical care that is funded by medical insurance might appear to be the same as care that is funded by workers' compensation, but there is a big difference between them. When the treatment of a job-related injury or illness is funded by workers' compensation, then the injured or sick worker is assured of having access to necessary treatment of the same condition or a recurrence of the condition in the future. No such assurance is possible if the treatment is funded by medical insurance, because the insurer could place a cap on the amount of treatment or the injured worker could lose coverage as a result of a change in employment status.

In addition, if an injury or illness prevents a worker from working for more than five days, workers' compensation provides monetary wage-replacement benefits. If the worker's medical care is funded by medical insurance, the worker is not eligible for any wage-replacement payments.

For a directory of additional information about workers' compensation, click here.

 

The “This page was last updated on” line just below reflects the date on which this page was transferred to this redesigned website. The information in this page (as opposed to the design) was last updated on September 27, 2001.

 
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