Employee Benefits While on Leave Due to a Workplace Injury

Sep 21 2022

Josh Goodbaum: Hi Amanda!

Amanda DeMatteis: Hi, Josh. What are we going to talk about today?

Goodbaum: I want to talk about a Connecticut employee who got hurt on the job. They’re getting workers’ compensation benefits. They are temporarily totally disabled, which means they do not have a work capacity, and they’re wondering, “Okay, I’m out of work right now, but do I still have a job there if I get better? And what about my health insurance benefits and my other employee benefits? How long are those going to continue to be provided to me if I’m on workers’ compensation?”

DeMatteis: That’s a great question, and it’s one we see a lot. And it’s one of the classic intersections between workers’ compensation and employment law. So, let’s talk about three specific laws that are really relevant to answering this question.

The first is the FMLA, the Family and Medical Leave Act. We have a Family and Medical Leave Act in Connecticut and also a federal statute. We have the Connecticut Workers’ Compensation Statute, which of course protects employees who are injured at work here in Connecticut. And then we have the Americans with Disabilities Act and our state counterpart to that law, which is the Connecticut Fair Employment Practices Act, both of which protect disabled employees from discrimination, but also entitle them to reasonable accommodations under those various laws. So, three different statutes, three different laws that impact Connecticut employees in answering this kind of tough question, which intersect quite a bit.

Let’s take them one at a time.

Under the FMLA, both state and federal, Connecticut employees are entitled to 12 weeks of continuous leave. What does that mean? That means at the same time you are on TT benefits, you should be applying for FMLA leave so long as you are eligible and your employer is an eligible employer, and you can take that time, but with job protection. So, the FMLA protects and holds your job for that period of 12 weeks. It also requires that your employer return you to the same or substantially the same position at the end of that 12-week period. So, you’ll always want to be thinking about that right off the bat: the best way to protect your job so long as you are eligible.

And don’t forget that we have the Connecticut Paid Leave Act, which just kicked into effect in January of 2022. If you’re receiving TT benefits, you wouldn’t otherwise qualify for that pay because you’re getting it from a different source. If for some reason your workers’ compensation case is being contested and you’re not receiving those benefits, you might be able to get the Connecticut Paid Leave for a period of time. Again, best to talk to an employment lawyer about that, but it is available to you. So that’s number one: FMLA.

Number two is the Connecticut Workers’ Compensation Statute. Now the Connecticut Workers’ Compensation Statute entitles Connecticut employees to a number of different things: TT benefits, medical benefits, and also ensures that you are not retaliated against for either filing a workers’ compensation claim or seeking any benefits to which you are entitled under our workers’ compensation statutes. If you’re out on TT, then you are, of course, receiving benefits under the workers’ compensation statute. If your employer decides to terminate you shortly after suffering that injury or after you seek those benefits under the Act, you may very well have a claim for retaliation. So, keep your thoughts and your mind focused a bit on that Connecticut Workers’ Compensation Statute and what’s going on at work. Going to be very fact-specific there, okay?

Third, we have the ADA and the Connecticut Fair Employment Practices Act. Both entitle you to a reasonable accommodation under the law. So, maybe you’re not entitled to FMLA. Maybe your FMLA has exhausted, you’ve used up your 12 weeks, but you still need a bit of time. You can request from your employer a reasonable accommodation. And that reasonable accommodation may just be a little bit more time to heal from this workplace injury. Now don’t forget that employers do not need to keep your job open indefinitely, so you have to get a doctor’s note that says, “Hey, Employee X needs until September 30th or until December 31st,” or whatever it may be. There needs to be a set period of time when you need to be out of work and when you will be reevaluated again.

These are three employment laws that really intersect when an employee is hurt on the job and out on workers’ compensation. You’ll want to be aware of them, but you do have protections. Of course, with all of the advice we give here, we have to remind you that it’s fact specific. There’s no cookie-cutter case here. Everyone’s different. You’re better off to talk to an employment lawyer and get as much advice as you can on the intersection between all these really important and protective laws that we have.

The next bit of your question was: What about health insurance? Can I keep my health insurance while I’m out on workers’ compensation leave? The answer is that, as long as you’re employed, you are eligible for your employer’s health insurance. If you get terminated, you very well may not be entitled to health benefits through your employer anymore or be able to participate in those plans. But let’s assume for a second that you haven’t been. You’re still an active employee. Well, you may be contributing to your health insurance on a weekly or bi-weekly basis through your employment. It comes right out of your paycheck – maybe that’s $100 a week, maybe it’s $200 a week. If you’re receiving TT benefits, that pay has stopped, right? You’re not being compensated directly from your employer. You’re now getting compensation very likely from an insurance company that administers your employer’s workers’ compensation claims. So, in order to keep your employment-based health insurance, you may have to contribute that amount that was otherwise coming out of your paycheck. So maybe that’s that $100 or $200 per pay period. You’ll now be responsible for sending in a check, making sure there’s no lapse and no interruption with your healthcare benefits.

So again, a little bit fact specific. Here’s what you need to know. You have rights. There are people available that can help you, and we absolutely suggest that you get into the right hands as quickly as you can to make sure that, as a Connecticut employee, you’re receiving every single benefit that you possibly can under the law during a situation, which of course, is not ideal.

Goodbaum: Great advice, Amanda. Thanks so much. Have a great day.

DeMatteis: Take care.

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josh goodbaum discussing employee benefits after a workplace injury

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