When Injured Workers Choose Health Insurance Over Workers’ Compensation: What You Need to Know

Getting hurt on the job is stressful enough—but navigating the maze of insurance coverage after an injury can make matters worse. Some employees opt to use their personal health insurance instead of filing a workers’ compensation claim. While this may seem easier in the short term, it can lead to serious legal and financial consequences.

At Nelson, Bryan, and Cross, we regularly assist workers who didn’t know their rights—or thought using health insurance was the better route. Here’s what you need to know if you're facing this decision.

Why Workers Might Avoid Workers’ Comp

There are several reasons injured employees turn to their health insurance:

• Fear of retaliation from employers

• Pressure from supervisors to avoid a formal workers’ comp report

• Belief that their injury is minor or will heal quickly

• Misunderstanding of their legal rights and responsibilities

• Confusion over what qualifies as a workplace injury

In some cases, the employer may actively discourage workers from filing a workers’ comp claim—an illegal and unethical practice.

Risks of Choosing Health Insurance Instead

Opting out of the workers’ compensation system can backfire:

1. Denial of Claims
   Health insurance policies often exclude work-related injuries. If the insurer determines that your injury occurred on the job, they may deny the claim entirely—leaving you with out-of-pocket costs.

2. No Wage Replacement
   Health insurance covers treatment—not lost wages. Workers’ comp, on the other hand, can provide income while you recover. Choosing health insurance alone may mean missing out on crucial financial support.

3. Loss of Legal Protections
   Filing a workers’ comp claim triggers legal protections, including job security and access to approved medical providers. Without that claim, you may not be protected if your employer terminates your position or disputes the injury.

4. Repayment Demands
   If your health insurance pays for a work injury, they may later seek repayment from your workers’ comp claim or settlement—reducing your final compensation.

Your Legal Rights

Under Alabama law, workers injured on the job are entitled to:

• Medical treatment paid by workers’ compensation insurance

• Wage benefits for time missed from work

• Mileage reimbursement for medical travel

• Vocational rehabilitation if you can’t return to your former job

You cannot be legally fired or punished for filing a legitimate workers’ comp claim. If your employer retaliates, you may be entitled to additional legal remedies.

What You Should Do

If you’ve already used your health insurance for a work injury:

• Document everything: dates, treatments, and communications with your employer.

• Notify your employer in writing that your injury was work-related.

• Contact an attorney immediately to help you file a workers’ comp claim and resolve any insurance conflicts.

• Avoid signing waivers or agreements without legal advice.

The sooner you act, the better your chance of receiving the benefits you’re legally entitled to.

Final Thoughts

While it might seem easier or safer to use your health insurance after a work injury, this choice can result in denied claims, unpaid wages, and long-term complications. Workers’ compensation is specifically designed to protect you—and it’s your legal right.

If you’ve been injured at work and aren’t sure what path to take, we’re here to help.

Contact us today to speak with a workers’ compensation attorney. We’ll guide you through your rights, help correct any missteps, and make sure you get the care and compensation you deserve.