Off The Record – SSD & Workers’ Comp

Video Transcript

Hi everybody, Craig Rosasco, Law Firm Turley, Redmond & Rosasco, counsel to the profession for Workers’ Compensation, Social Security Disability, and Veterans’ claims.

We’re going to talk about a different topic today—one that I come across often. Although I don’t directly handle these types of claims, it frequently becomes an issue as part of a Workers’ Compensation or Social Security Disability case.

Here’s an example.

Let’s say Joe Smith injures his back at work and is unable to return to his job. He’s receiving medical treatment and trying to recover, but after three months, his Family and Medical Leave Act (FMLA) protections expire.

At that point, his employer may legally terminate his employment.

Generally speaking, if an employer is covered by FMLA, they’re required to hold the employee’s job for up to 12 weeks. Once that period ends, they may be able to terminate the employee if they still cannot return to work.

Now Joe has another problem—he loses his employer-sponsored health insurance.

What does he do?

Joe, his spouse, and his children were all covered under that health insurance plan, so losing that coverage can create a significant financial burden.

Fortunately, Joe may be eligible for COBRA, which allows him to continue his employer-sponsored health insurance for a limited period, typically up to 18 months.

The challenge is that employer-sponsored plans are often more comprehensive than plans available through the New York Health Insurance Marketplace. If Joe wants to keep the same doctors and the same coverage, COBRA may be significantly more expensive because he’ll likely be responsible for paying the full premium.

After COBRA expires, he’ll need to obtain health insurance through another source.

If Joe’s disability is severe enough and I’m also handling his Social Security Disability claim, he may become eligible for Medicare after the required waiting period following his disability determination.

However, Medicare generally covers Joe only.

What happens to Joe’s spouse and children?

They’ll need to obtain their own health insurance, often through the New York Health Insurance Marketplace or another available plan.

One piece of advice I always give my clients is this:

Before choosing a new insurance plan, check with your current doctors and healthcare providers to make sure they accept that insurance. You don’t want to switch to a plan only to find out that none of your providers participate in it.

While I don’t directly handle health insurance matters, I deal with these issues regularly because they often arise during Workers’ Compensation and Social Security Disability cases.

If you’re facing this situation, give me a call. I’ll be happy to walk you through your options and explain how your Workers’ Compensation or Social Security Disability claim may affect your benefits.

Knowledge is power.

Call me today at 516-745-5666.

I’ll be glad to help.