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Workers Comp Versus Blue Cross And The Solution In The Middle

September 29, 2023

By Thomas McCutcheon

Worker’s compensation insurance is there to provide coverage for on the job injuries.  Blue Cross Blue Shield provides insurance coverage for non-work related injuries or conditions.  That said, Blue Cross won’t pay for on the job injuries and worker’s comp won’t pay for non-work related injuries.  Reach out to a workers compensation lawyer.

Sometimes people have conditions such as repetitive motion injuries like carpal tunnel syndrome that are probably work related.  Sometimes people have problems that are work related that they failed to initially report as a work related condition.  Often, at the suggestion of the employer a worker will try and have something work related covered on their personal or family Blue Cross Blue Shield coverage.  

When a person gets treatment, they are asked how the injury or condition was caused.  If a person does not know or is “wishy washy” about how they came to be at the doctor’s office, they probably are not going to win a worker’s compensation case.  If they misrepresent that it was not work related and it was, they will still probably lose their worker’s compensation case because judges have a professional dislike for that kind of behavior.  

Now, sometimes people will try and put something on their Blue Cross Blue Shield that is work related just to avoid the delay and fight that often goes with an on the job injury claim.  Some employers deduct worker compensation claims from annual bonuses from all employees thus making those who claim workers comp cost everyone some bonus money.  

mccutcheon & hamner

The solution in the middle is that Blue Cross Blue Shield will pull their money back if they learn or believe that the injury is work related, but the misrepresentation may have the effect of leaving workers comp not responsible.  That means the person who received the medical treatment has to pay for the medical treatment they received themselves.  Most folks can’t afford that.  So, take care to avoid being the solution in the middle.  Reach out to a personal injury lawyer.

Buckle up, drive safely, and as always, your referrals are appreciated!  256-764-0112

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