Can I Lose My Health Insurance While on Workers' Comp?

How Workers’ Comp Affects Your Health Insurance

When you're injured on the job, your focus naturally shifts to healing, managing pain, and navigating workers’ comp. But one thing that blindsided me—and many others—is what happens to your health insurance while you're out.

I vividly remember asking HR whether my health insurance would continue while I was on workers’ compensation. The answers were vague, incomplete, and at times contradictory. It made me realize how little guidance there is for employees dealing with this situation. Workers’ compensation typically covers medical bills related to your work injury, but what about your regular health insurance for non-work-related issues, like prescriptions or family doctor visits?

Here's the truth: workers’ comp doesn’t replace your health insurance. It's a separate system. If you get injured and qualify for workers’ comp benefits, that includes wage replacement and medical care for the injury, but it doesn't necessarily cover your existing health insurance premiums. And that's where the confusion—and potential risk—comes in.

Will Your Coverage Continue While on Workers’ Comp?

Whether or not your health insurance continues while you're on workers' comp depends heavily on your employer's policies and your employment status.

If your employer considers you "actively employed" while on leave, your group health coverage may continue—as long as you keep paying your portion of the premiums. Some companies will continue to deduct premiums from your workers' comp payments; others will require you to pay directly.

But here's the catch: there's no federal law requiring employers to maintain your health insurance if you're not actively working—unless you're covered under FMLA (we’ll get into that later). In many cases, if your employer wants to drop your coverage, they can—especially if their policy says benefits are only for active employees.

I learned this the hard way when no one could give me a straight answer. Eventually, I found out that because I wasn’t under FMLA and was on extended leave, my coverage was at risk. The stress this added to an already painful situation was overwhelming.

Making Premium Payments During TTD and TPD

If you're receiving Temporary Total Disability (TTD) or Temporary Partial Disability (TPD) benefits, you’re still technically an employee. But remember: your employer isn’t required to pay your health insurance premiums unless it’s written in a union agreement or contract.

So what happens? Often, it’s up to you to keep the premiums current. Miss a payment, and your coverage can lapse—even if you’re still on the payroll.

This was a wake-up call for me. I assumed that since I was receiving TTD payments, my employer would continue paying my health premiums. They didn’t. I had to send checks directly, and they never told me until it was almost too late.

If you’re unsure how to handle premiums while out, ask your HR department in writing, and request all answers be documented. Trust me—this one step can prevent a nightmare down the line.

When Can an Employer Cancel Your Health Insurance?

The most frequent—and feared—question is: Can my employer cancel my health insurance while I'm on workers' comp? The short answer? Yes, under certain conditions.

Employers can legally cancel your health insurance if:

• You're no longer an active employee.
• You've exhausted FMLA protections.
• You fail to pay your portion of the premiums.
• The company changes its benefits policy.
• Your employment is terminated.

That last one hit hard. I found out some employers will fire or lay off employees while on workers’ comp. It sounds harsh, but it happens. And once that happens, they’re no longer required to continue any benefits.

What they can’t do is fire you because you filed a workers' comp claim—that’s retaliation, and it’s illegal. But proving that can be tough, especially if your company claims it was for “business reasons.”

How FMLA Intersects with Workers’ Comp and Health Benefits

If you’re eligible for the Family and Medical Leave Act (FMLA), it can offer you an extra layer of protection. Under FMLA:

• You get up to 12 weeks of unpaid leave per year.
• Your job is protected during that time.
• Your health insurance must be maintained as if you were still working.

Sounds great, right? But there’s a catch—not everyone qualifies. You must have:

• Worked at least 12 months for the company.
• Logged at least 1,250 hours in the past year.
• Work for a company with 50+ employees.

In my case, I wasn’t eligible. I was just short of the 1,250-hour requirement. That meant no FMLA, and no guarantee of continued health insurance. That gap in protection made me feel incredibly vulnerable.

If you are eligible, FMLA is your best ally in keeping your health coverage intact during recovery.

What to Do If You're Laid Off or Fired During Workers’ Comp

Unfortunately, being on workers’ comp doesn’t make you immune to layoffs or terminations. If your employer decides to cut staff, and you’re part of that reduction—even while recovering—they can legally terminate your employment.

And when that happens, your health insurance usually ends unless you take further action.

What saved me was knowing about COBRA, which allows you to keep your health insurance after leaving your job—but at full cost. We’ll dive into that next.

Important note: if you're terminated, make sure to request the reason in writing. If you suspect retaliation for filing a claim, talk to an attorney immediately.

The COBRA Option: What You Need to Know

COBRA (Consolidated Omnibus Budget Reconciliation Act) allows you to continue your group health insurance for up to 18 months after leaving your job.

Here's how it works:

• You pay the full premium—what you and your employer were both paying, plus a 2% admin fee.
• It can be very expensive, often double what you paid as an employee.
• It kicks in after your employer-sponsored coverage ends.

Despite the cost, COBRA can be a lifesaver. In my case, it was my only option to maintain coverage for medications unrelated to my work injury. I had to budget tightly, but it gave me peace of mind knowing I wasn’t completely unprotected.

Pro tip: Apply for COBRA as soon as you receive the notice. You usually have 60 days to elect coverage, but delaying can lead to gaps in care.

Tips to Protect Your Coverage and Avoid Gaps

Based on my experience and everything I’ve learned, here are my top tips if you're navigating health insurance while on workers’ comp:

1. Get everything in writing – Ask HR about your insurance status and payment responsibilities, and keep all correspondence.
2. Ask if you're eligible for FMLA – If yes, use it. It’s your strongest legal protection.
3. Stay on top of premium payments – Set reminders and double-check if you’re paying directly.
4. Plan for COBRA – Understand the costs and deadlines ahead of time.
5. Consult a workers’ comp attorney – Especially if you're getting mixed messages or fear retaliation.
6. Consider marketplace insurance – If COBRA is too expensive, explore ACA options.

Stay Informed, Stay Protected

Navigating workers’ comp is tough enough without the added stress of losing your health insurance. I learned that the hard way, caught in the middle of HR silence and unclear policies. But once I understood my rights—and my responsibilities—I was able to take control.

You have options. But you also have to be proactive, vigilant, and sometimes a little stubborn to protect what’s rightfully yours.

So if you’re asking yourself, “Can I lose my health insurance while on workers’ comp?”—the answer is: Yes, it can happen. But there are ways to fight it. And now, you’re better equipped to do exactly that.