When injured colorado workers lose their health insurance following a work injury, the conversion cost of that health insurance can be included in the employees average weekly wage. This way, you are compensated for loss of health insurance – a major and common benefit.
The Administrative Law Judge (ALJ) cannot include it “so long as the employer continues to make payment.”
Motion for AJL Recusal Must Contain a Sworn Affidavit. Learn more about it.
Insurance carriers have tried to avoid including the cost of insurance but it is mandatory even if, for example, the employee was fired or decides not to pay the insurance premium. One employer appealed including the cost of continuing health insurance saying it would have continued to pay their portion of the health insurance.
The Industrial Claims Appeals Panel (ICAO) upheld the inclusion, noting, ” In their brief in support, the respondents contend that because they continued to pay their portion of the claimant’s group health insurance premium, the ALJ erred in adding the costs to continue that insurance coverage to the AWW. Applied to another case, that argument may have merit. In this matter however, the respondents admit the employer “would have paid” a portion of the premium “if” the claimant had elected to continue to pay his portion of the premium pursuant to the COBRA notice. However, the respondents then observe that the “claimant did not elect a COBRA plan.” Accordingly, the respondents did not continue to pay any health insurance premiums. As such, the respondents’ argument does not persuade us that the ALJ erred in increasing the claimant’s AWW by the cost of continuing health insurance coverage.”
As always, how this or any other case we discuss in this blog would apply to your case depends on many more factors. We urge you to call us to see if you are entitled to workers’ compensation benefits. Workers’ Compensation is difficult, confusing, and very complex. Kaplan Morrell has helped thousands of injured workers since 1997 get the benefits they deserve. Contact a Denver Workers’ Compensation Expert attorney now or call us at 303-780-7329 for your FREE CONSULTATION.
Cite: Fortune v. Restauarant Technologis, WC No. 4-915-420 (1/30/2015