Q: Using private insurance during workers comp claim.
Hello, can my private insurance demand I repay them for any treatment or diagnostics they've paid for once I file for workers compensation? Also could my current private doctor refuse to further certify me for disability if I file? She says she would continue certifying me for short term state disability (without knowing my desire to file WC). I'm worried filing might affect her willingness to treat me, but I can't currently work so I don't know where that would put me in terms of my disability pay. Lastly, if I file, can my employer demand I return to work? I feel if I have to go through their doctors it would be in their best interest to make me return to work and not re-certify my disability.
A:
In California, if you use your private health insurance for treatment related to a workplace injury and later file a workers' compensation claim, your health insurance company may seek reimbursement for the expenses from the workers' compensation insurance. This is because workers' compensation is primarily responsible for covering medical expenses and lost wages due to work-related injuries. Your private health insurance might cover the costs initially but can pursue repayment once workers' compensation benefits are approved.
Regarding your doctor's willingness to certify you for disability, it's important to communicate openly with your healthcare provider about your intention to file a workers' compensation claim. While your doctor can continue certifying you for short-term state disability, their approach to your case might not change just because you file for workers' compensation. However, each doctor's response can vary, and it's best to discuss your concerns directly with your physician to understand how filing for workers' compensation might influence your treatment and certification for disability.
Lastly, your employer cannot demand you return to work until you are medically cleared to do so. If you file a workers' compensation claim, you will be evaluated by a doctor who determines your work status. If the doctor provided by your employer's workers' compensation insurance deems you fit to return to work but you disagree, you have the right to seek a second opinion from another doctor within the workers' compensation system. Your health and ability to perform your job duties safely should always be the priority.
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