Tag Archives: ObamaCare

Workers Without Insurance?: Sign up for ObamaCare!

Enroll in ObamaCare

Worker’s compensation is not a guarantee of health insurance coverage.  At least not under Wisconsin law.  Many injured workers mistake worker’s compensation insurance for health insurance after suffering a work injury.  Not true.  Worker’s compensation is just insurance for the specific body part injured.  It is not general health insurance for any other illiness/sickenss, and it certainly is not insurance for the worker’s family or children.

There is no obligation under Wisconsin law for an employer to continue to pay health insurance premiums or provide health insurance coverage when a worker is out after a work injury.  A recent attempt to require an employer to continue its health insurance coverage while a worker is recovering failed at the legislative level.  Thus, a worker could be off work after an injury and find that their health insurance benefits have been terminated (or that the employer is not paying their premium portion…which could be cost prohibitive).

In many worker’s compensation claims, the worker’s compensation carrier sends an injured worker to an “independent” medical examiner who denies the injury or extent of disability.  The injured worker–still recovering from an injury–is then left without worker’s compensation coverage.  If the employer did not continue health insurance benefits, the worker then takes a double hit–no worker’s compensation covearge and no health coverage.  The injured worker then has limited means to obtain the necessary medical treatment.

As an attorney, we have the ability to file for prospective medical treatment and have a judge order the treatment be paid by worker’s compensation.  That process, however, could take a year or more.

The best practical route is for the worker to obtain the medical treatment through their own health insurance (and we have a claim for reimbursement to the health insurance company).  Thus, if a worker has no health insurance coverage, my advice is: get covered if you can.  In Wisconsin, that means applying for state insurance/Medicaid (eligibility based on income levels).  The alternative, is ObamaCare.

ObamaCare’s open enrollment period begin a few weeks ago and goes until February 15, 2015.  Wisconsin’s governor, Scott Walker, made the short-sighted decision to reject Medicaid expansion or create our own state exchanges, so Wisconsin residents need to obtain ObamaCare insurance on the federal exchanges.   If an injured worker has no health insurance, I strongly encourage them to get coverage.  Apply for ObamaCare right now.  Get covered.

 

 

 

 

 

Workers Without Insurance?: Sign up for ObamaCare!

Enroll in ObamaCare

Worker’s compensation is not a guarantee of health insurance coverage.  At least not under Wisconsin law.  Many injured workers mistake worker’s compensation insurance for health insurance after suffering a work injury.  Not true.  Worker’s compensation is just insurance for the specific body part injured.  It is not general health insurance for any other illiness/sickenss, and it certainly is not insurance for the worker’s family or children.

There is no obligation under Wisconsin law for an employer to continue to pay health insurance premiums or provide health insurance coverage when a worker is out after a work injury.  A recent attempt to require an employer to continue its health insurance coverage while a worker is recovering failed at the legislative level.  Thus, a worker could be off work after an injury and find that their health insurance benefits have been terminated (or that the employer is not paying their premium portion…which could be cost prohibitive).

In many worker’s compensation claims, the worker’s compensation carrier sends an injured worker to an “independent” medical examiner who denies the injury or extent of disability.  The injured worker–still recovering from an injury–is then left without worker’s compensation coverage.  If the employer did not continue health insurance benefits, the worker then takes a double hit–no worker’s compensation covearge and no health coverage.  The injured worker then has limited means to obtain the necessary medical treatment.

As an attorney, we have the ability to file for prospective medical treatment and have a judge order the treatment be paid by worker’s compensation.  That process, however, could take a year or more.

The best practical route is for the worker to obtain the medical treatment through their own health insurance (and we have a claim for reimbursement to the health insurance company).  Thus, if a worker has no health insurance coverage, my advice is: get covered if you can.  In Wisconsin, that means applying for state insurance/Medicaid (eligibility based on income levels).  The alternative, is ObamaCare.

ObamaCare’s open enrollment period begin a few weeks ago and goes until February 15, 2015.  Wisconsin’s governor, Scott Walker, made the short-sighted decision to reject Medicaid expansion or create our own state exchanges, so Wisconsin residents need to obtain ObamaCare insurance on the federal exchanges.   If an injured worker has no health insurance, I strongly encourage them to get coverage.  Apply for ObamaCare right now.  Get covered.

 

 

 

 

 

Medical Care Politics in Worker’s Compensation

The mythology surrounding employee fraud in worker’s compensation is pervasive. Many of my clients begin their conversations with me indicating the following: “I’m not one of those folks faking their worker’s compensation claim.”  The exaggerated media publicity concerning employee fraud has also resulted in outright worker intimidation regarding filing a claim. I had this conversation today with a prospective client.

Attorney: Why didn’t you report the incident?
Client: I didn’t want to have that on my record.  Nobody will hire me if I have a worker’s comp injury.
Attorney: Why didn’t you seek medical treatment?
Client: I do not have insurance.
Attorney: Can you obtain insurance under the Affordable Care Act?
Client: You mean Obamacare?  No way!

Fear of being stigmatized as a complainer, whiner, or simply a recipient of worker’s compensation benefits has prompted many legitimately injured workers from filing a worker’s compensation claim.

The adverse publicity concerning the Affordable Care Act (and its pejorative popular name “Obamacare”) results in many otherwise qualified workers from obtaining the health care they need, especially when denied by a worker’s compensation insurance carrier. 

The politics of medical care intrudes in the worker’s compensation arena daily.

Wisconsin High-Risk Insurance Program Closing Down

I read with bittersweet thoughts that the state’s high-risk insurance program was winding down, in anticipation of the implementation of the insurance exchanges through the Affordable Care Act (“ObamaCare”).  Health insurance–or lack thereof–is crucial to the lives and health of injured workers.  In this space, I’ve written in the past about the problems faced by workers without health insurance.  

There is no provision under the Wisconsin worker’s compensation system that requires an employer to continue an employee’s health insurance while recovering from a work injury.  Also, if a claim is denied and the worker is terminated (a situation that happens all too frequently), the employee generally loses health insurance coverage because continuing COBRA premiums is too costly.  Of course, there are also the multitudes of workers that simply have no employer-provided health insurance at all.   In all of these situations, an injured worker may be faced with the situation of needing medical treatment for their injury but unable to get it without insurance.

In many of these situations, some of my clients have turned to the Wisconsin Health Insurance Risk-Sharing Plan.  If these workers were not eligible for Medicaid or Badger Care, then “HIRSP” was a potential safety net that allowed for health insurance coverage.  With some coverage, the injured worker could at least pursue some medical care.  For me, seeing that beneficial program fade away hurts.

The bright side is the hope of ObamaCare and increased access to health insurance.  Now, our governor’s short-sighted (or politically-calculated) decision to reject the expansion of Medicaid coverage may hinder this expansion–and cause some further confusion.   The key, however, is further hope.  If an injured individual is without insurance, a downward spiral can happen fast. Regardless of whether someone’s disability is work-related or not, if they are hurting, access to medical care should be a right.