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Medical coverage can be a reason to file a workers’ comp claim

On Behalf of | Mar 17, 2024 | Workers' Compensation

Workers get hurt on the job almost daily in Georgia, and many of them don’t seek workers’ compensation benefits even though they may qualify for them. Workers’ compensation is available to those injured at work or diagnosed with a medical condition caused by their employment. Yet, frequently, employees choose not to report an incident or diagnosis. They might choose to use paid leave if they need time off from their job or their own health insurance to pay for their treatment. Workers’ compensation insurance exists for a reason.

It is unfair for employed professionals to have to personally cover the costs of a medical condition caused by their employment. The benefits available through workers’ compensation can diminish the financial impact that a work injury has on an employee. The medical benefits alone might make filing a claim a worthwhile decision.

Why workers’ compensation coverage is different

Those with health insurance may not understand why filing a claim for workers’ compensation is better than using their basic health insurance coverage. The first issue is that if a health insurance company learns about outside liability, the business is likely to subrogate the claim and take action against an outside party.

Health insurance usually doesn’t cover expenses where another party is financially responsible. Workplace injuries are typically the responsibility of workers’ compensation, and therefore health insurance coverage may not actually apply to job-acquired health conditions.

Even if someone manages to secure a diagnosis and treatment without indicating the origins of their health challenges, they might end up paying for a good portion of the treatment they require. Medical insurance policies often include several forms of financial responsibility for patients.

Someone may need to pay thousands of dollars toward a deductible before they are eligible for coverage. They may have to pay a copay for every prescription they require and every appointment they attend. They may even need to pay co-insurance, which is a specific percentage of their total medical bills.

Workers’ compensation benefits in Georgia include 100% coverage for necessary medical costs. In other words, the injured employee does not have to absorb any treatment costs. They may also be eligible for disability benefits to replace the income they can’t earn because of their medical challenges.

Learning about the benefits available through workers’ compensation may help employees see the value of filing a claim. Those who obtain benefits may be able to get medical treatment without paying for the care that they require.