During a planned 4 month termination period the employee injured themself on the job. What benefits does the employer have to continue, if any?

[TheNavigator]

California -

In November 2019 an employee was given 120 days notice that their employment would end 3/31/2020. On 12/22/2019 the employee injured themself on the job but did not notify the employer. Approximately 60 days after being injured (30 days before end of employment) the employee has hired a lawyer and filed for worker's compensation and is also considering filing for disability.

Is the employer obligated to continue paying employee benefits namely Health Insurance after 3/31/2020?

 

[PayrollHRGuy]

How many employees work for the employer?

 

[TheNavigator]

How many employees work for the employer?

Eight paid employees. Four are full-time with health insurance benefits including the subject employee.

 

[quincy]

California -

In November 2019 an employee was given 120 days notice that their employment would end 3/31/2020. On 12/22/2019 the employee injured themself on the job but did not notify the employer. Approximately 60 days after being injured (30 days before end of employment) the employee has hired a lawyer and filed for worker's compensation and is also considering filing for disability.

Is the employer obligated to continue paying employee benefits namely Health Insurance after 3/31/2020?

The employer will be obligated under worker’s compensation laws in California to continue medical care, this if the worker’s compensation claim is approved by your claims adjuster. You should let your insurer handle the claim.

Here are three links to information that you should read:
https://www.dir.ca.gov/dwc/FAQs.html

https://www.dir.ca.gov/InjuredWorkerGuidebook/Chapter1.pdf

https://www.dir.ca.gov/InjuredWorkerGuidebook/Chapter3.pdf

 

[PayrollHRGuy]

Good, so FMLA doesn't come into play. I am not a California HR specialist but I can't find anything in CA that would require it to be continued.

@quincy I think the OP is asking about continued health insurance not work comp. I could be wrong.

 

[LdiJ]

California -

In November 2019 an employee was given 120 days notice that their employment would end 3/31/2020. On 12/22/2019 the employee injured themself on the job but did not notify the employer. Approximately 60 days after being injured (30 days before end of employment) the employee has hired a lawyer and filed for worker's compensation and is also considering filing for disability.

Is the employer obligated to continue paying employee benefits namely Health Insurance after 3/31/2020?

The employer needs to be talking to an attorney of their own about this. I am guessing that the employer will at least need to make sure that he has coverage until the injury is fully taken car of, although workman's comp should take care of that. If he qualifies for disability the company probably doesn't want to be cancelling that insurance.

Again though, the company needs a consult with their own attorney on this matter.

 

[NeilTheCop]

"On 12/22/2019 the employee injured themself on the job but did not notify the employer. "
Would not having any record of the injury be problematic. After all, if it wasn't reported to the employer how can the injured person prove that it happened while on the job?

 

[Zigner]

"On 12/22/2019 the employee injured themself on the job but did not notify the employer. "
Would not having any record of the injury be problematic. After all, if it wasn't reported to the employer how can the injured person prove that it happened while on the job?

Neil - it's California. They don't need no stinkin' proof.

 

[quincy]

"On 12/22/2019 the employee injured themself on the job but did not notify the employer. "
Would not having any record of the injury be problematic. After all, if it wasn't reported to the employer how can the injured person prove that it happened while on the job?

An injury should be reported to the employer as soon as the employee is aware of it, which might not be at the same time the injury occurs. But from the information in the links I provided earlier, the longer the employee waits to report an injury, the greater the chance his worker’s compensation claim will be denied.

 

[PayrollHRGuy]

"On 12/22/2019 the employee injured themself on the job but did not notify the employer. "
Would not having any record of the injury be problematic. After all, if it wasn't reported to the employer how can the injured person prove that it happened while on the job?

It will certainly be something the WC carrier can argue. Especially if the nature of the injury isn't consistent with the work the employee does. But in most states (including my very red state) the WC Commission usually puts the burden of proof on the employer unless it is something like an office assistant that fell off a ladder and there are no ladders in the office.

 

[quincy]

It will certainly be something the WC carrier can argue. Especially if the nature of the injury isn't consistent with the work the employee does. But in most states (including my very red state) the WC Commission usually puts the burden of proof on the employer unless it is something like an office assistant that fell off a ladder and there are no ladders in the office.

The employer just hands everything over to his insurance company’s claims adjuster. If fraud is suspected, it will be investigated.

 

[PayrollHRGuy]

The employer just hands everything over to his insurance company’s claims adjuster. If fraud is suspected, it will be investigated.

Way more than well aware. But the employer needs to make sure that the carrier knows the whole story. They don't read minds.

 

[quincy]

Way more than well aware. But the employer needs to make sure that the carrier knows the whole story. They don't read minds.

Oh. I agree with that. I hope my post didn’t imply otherwise.

 

[cbg]

I don't think anyone has addressed what I see the OP's basic question.

No. The employee has no legal expectation for the employer to continue things like health insurance, life insurance, retirement plans and so on. IF the claim is accepted by the workers comp carrier, then ongoing medical treatment FOR THAT CONDITION ONLY will continue. But there is NO obligation for the employer to violate the plan rules for ending benefits in general.

The employee cannot collect disability benefits and workers comp both.

 

[PayrollHRGuy]

I don't think anyone has addressed what I see the OP's basic question.

No. The employee has no legal expectation for the employer to continue things like health insurance, life insurance, retirement plans and so on. IF the claim is accepted by the workers comp carrier, then ongoing medical treatment FOR THAT CONDITION ONLY will continue. But there is NO obligation for the employer to violate the plan rules for ending benefits in general.

The employee cannot collect disability benefits and workers comp both.

I think I did in post #5. At least I meant to.