Helping Injured Workers Since 1981

Why workers’ compensation is usually better than health insurance

On Behalf of | Jun 7, 2023 | Workers' Compensation

Even though there are benefits that exist to support injured workers, many people try to avoid using them. A worker who has been hurt on the job in Ohio may dislike the idea of filing a workers’ compensation claim. Employees often fear the possibility of retaliation from their employer and the involvement of a state program in their medical treatment.

Some workers try to bypass the workers’ compensation program entirely by using their standard health insurance to pay for the treatment they require after an injury at work. After all, their health insurance can cover the same care that workers’ compensation would cover. These employees may think that they have protected themselves and taken a step that will benefit their careers. What these workers may fail to consider is how much of their treatment will end up being their financial responsibility if they use health insurance.

Insurance companies pass the costs back to patients

There are many ways for a company that provides health insurance coverage to reduce how much it has to pay for someone’s treatment. Most policy contracts include multiple rules that let the insurance company pass the care costs back to the patient.

Many policies have a sizable deductible attached. The person undergoing treatment will need to pay several thousand dollars for their care with their own funds before the insurance company will cover their costs. Every appointment that they have or prescription that they purchase may trigger a copay. There could also be a coinsurance that involves the company passing a certain percentage of the total medical bill to the patient as their responsibility.

Getting a broken bone set and then going through physical therapy afterward might lead to $1,000 or more in patient expenses when using standard health insurance. However, workers’ compensation coverage in Ohio does not pass those expenses on to the patient. There should be full coverage available to pay for 100% of someone’s treatment costs for a job-related medical issue. Additionally, workers who require a leave of absence while recovering can potentially also claim disability benefits until they can return to work.

Making use of workers’ compensation benefits can reduce the financial hardship that a work-related medical issue can cause for an employee. As a result, seeking legal guidance – instead of simply using health insurance – is generally a good idea.