• FreeAdvice has a new Terms of Service and Privacy Policy, effective May 25, 2018.
    By continuing to use this site, you are consenting to our Terms of Service and use of cookies.

Work comp employee's benefits cancelled

Accident - Bankruptcy - Criminal Law / DUI - Business - Consumer - Employment - Family - Immigration - Real Estate - Tax - Traffic - Wills   Please click a topic or scroll down for more.

shartla1

Junior Member
What is the name of your state? Florida
I have not been able to work for six months due to an injury caused by negligence of my employer. I am receiving medical treatment paid by work comp, but I have received no wage loss indemnity benefits and a mediation hearing is scheduled in Oct.
I received a notice from Blue Cross on Sept 12th stating my health insurance had been cancelled by my employer and the coverage ended on Aug 1st. I did not receive any notice from my employer offering continuation under Cobra. I have not received any notice of termination of employment.
Can my employer cancel my health insurance benefits while still considering me an employee?
Aren't they required by law to notify me in writing sooner than 6 weeks that my insurance has been cancelled?
What legal action if any should I take regarding this issue, and what are my rights as an injured worker?
Thanks!
 


cbg

I'm a Northern Girl
If you no longer qualify for benefits under the company's policies, then yes, they can terminate your coverage even while still considering you an employee. It is neither uncommon nor illegal for an employee who has been unable to work for an extended period of time, or who has had their hour reduced, to have their benefits termed although still an employee.

The employer has 44 days from the last day of coverage, whatever that is, to notify you of your right to COBRA. If your coverage ended on August 1 and you received the notice on September 12, your employer IS in compliance with notification laws.
 

shartla1

Junior Member
Health benefits cancelled

The notice I received was from Blue Cross and did not offer continuation of the policy, it was only a certifiation of creditable coverage for use when applying to a future group policy. Aren't they required to notify me in writing specifically regarding Cobra?
 

cbg

I'm a Northern Girl
Yes, they are. Sorry, I misread your post the first time.

That's assuming that your company has more than 20 employees. If there are less than 20 employees, COBRA does not apply, although a state continuation (if any) may.
 

shartla1

Junior Member
Should I take legal action to get my insurance reinstated? If my employer has not provided notice and information required by law, are they liable for any costs regarding continuation of the policy, at least for the period that passes between cancellation and proper notification?
Thanks for your help!
 

cbg

I'm a Northern Girl
It would probably make more sense for you to file a complaint with the US DOL if you have not received notification of your right to COBRA by tomorrow or the next day - based on the info you provided, today is their last day to notify you and still be in compliance, but I believe that as long as it's postmarked today they're legal. Unlike the discrimination laws, it is not mandatory that you go through the regulatory agency, but hey, that's what it's there for, and you don't have to pay them the way you would a lawyer. You can always take legal action later if you don't like the way it turns out, but why not go with the freebie? Trust me, a notification from the US DOL is extremely impressive.

As to what they would be required to do, I haven't read the compliance regs recently, but as I recall they would be required to reinstate your coverage until the date of the notification. Beth?

Keep in mind that you have 60 days from the date of notification or the last day of coverage, whichever is later, to notify them that you want the coverage and 45 days from the day you notify them to send your first check. But they are NOT required to keep your coverage in effect until 105 days later - they may LEGALLY term your coverage and reinstate it when they have your check in their hand.

Also, I suspect you'd have mentioned it if this were the case but just to be thorough - they are only responsible for sending the info, not for ensuring that you receive it. If they have sent and can prove they have sent the information to your last known address, they are off the hook legally even if you never receive it. You haven't moved lately or anything, have you?
 

BlondiePB

Senior Member
In regards to your wage loss, lack of indemnity benefits, and upcoming mediation, immediately call some w/c attorneys (no TV ones) and acquire free consultations. You should have received wage benefits by now. Going to this mediation without seeking council is not a wise thing to do, especially if you haven't reached MMI(maximum medical improvement).
 

shartla1

Junior Member
Thanks for all the information and quick replies to my questions. At this point I am waiting for my request for accrued vacation pay and do not want to push anything until I have that check in hand. If I do not recieve that pay and my notice to continue health insurance this week, I will file with DOL. If they mailed my notice to continue health insurance, I would have recieved it. I have not moved and it is rare that mail gets lost. I'm not sure what proof they would have that it was sent other than receipt for postage, unless it is coming registered or certified mail. Probably a moot point and I am pretty much out of luck as I suspected.
I do have an attorney who filed for the mediation which is scheduled for Oct. As his payment is based on a settlement being reached, he has not offered me much in the way of time/counsel prior to the hearing, which may be reasonable. Hopefully the mediation will result in an offer for past due indemnity benefits as well as future medical treatment and expenses as this injury will leave me with a permanent disability.
Thanks again for your help.
 

BlondiePB

Senior Member
Your attorney has not applied for wage benefits and mileage for SIX MONTHS and is ONLY filing for the mediation to settle??!! I'd certainly be looking for another attorney.This one sounds way too lazy. Have you reached MMI?
 

cbg

I'm a Northern Girl
Shartla, just as an FYI, no Federal law and no law in FL requires your employer to pay out unused vacation time. If your company has a policy of consistantly paying it, then they would be obligated to pay it in your case. But barring such a policy, it's not required by law.
 

shartla1

Junior Member
They paid it a couple of months ago when I requested 2/3 of the 180 hours I had accumulated over the past two years, but as of yet I have not heard anything from them about the balance since my written request last week. Obviously I worked an enormous amount of hours for them when they needed me, but it would not surprise me if they now change their policy. Maybe I should ask for it again at the mediation.
 

shartla1

Junior Member
I did not contact an attorney until a couple of months ago up until which time I was filling out the necessary earnings reports and mileage claims myself hoping an attorney wasn't going to be necessary. My claim kept being transferred to different reps all of whom said my indemnity benefits were delayed due to the transfers, but I could expect a check in a couple of weeks. The current rep told me in June that she was waiting on a response to a letter she sent to my doctor asking if my current condition was a direct result of my accident in 2002, and not a result of a prior injury in 1990 at another company. She said once she received a response it would take two weeks to process my benefits. After discussing the letter with my doctor who sent his reply stating that my current condition was a result of the accident at this company, that I had not reached MMI and my TTD status was still in effect, I waited several weeks giving here the time she said was necessary. When she stopped returning my calls I then contacted this attorney who filed a petition for benefits. It took several weeks to get a confirmation that the wc carrer had received the petition and the mediation was scheduled. Given all that I don't think another attorney would have done things any faster.
 

BlondiePB

Senior Member
Thanks for clearing that up. This is what I do know about FL w/c statutes. Once you reach MMI, then indemity benefits can begin. You can receive TDD payments for approx. 104 weeks. Indemity benefits are 1/2 of TDD. However, you can still receive the TDD payments up to the time allowed rather than the indemity benefits. Obviously, that's more $$. Once the allowed time for receiving TDD payments has passed and if you are still out of work and have an impairment, supplemental benefits can be acquired. If you take a lump sum settlement, that's it. Keeping your cobra is very, very important. Good luck at mediation.
 

shartla1

Junior Member
I guess indemnity is the wrong term, I haven't received any wage loss of any kind and haven't reached MMI. I thought indemnity was the correct term for any payments while on TTD or after MMI.
Thanks for your help!
 

Find the Right Lawyer for Your Legal Issue!

Fast, Free, and Confidential
data-ad-format="auto">
Top