Workers’ Compensation vs. FMLA

While workers’ compensation and the Family & Medical Leave Act (FMLA) serve different purposes, they sometimes overlap. It’s crucial to understand how they can apply to you and your family when you are dealing with a serious illness so that you can maximize your benefits and coverage under these important protections.

Workers Compensation Coverage

Workers’ compensation is a type of insurance for workers who are injured on the job. If your employer carries workers’ compensation insurance, it should cover your injury-related health care costs and income replacement – typically a percentage of your full pay rate. Benefits vary from state to state, but in Texas workers’ compensation pays an injured employee 70 percent of his or her full pay rate, and coverage can last as long as 104 weeks – or two years.

Family & Medical Leave Act Protection

The FMLA requires employers to permit employees up to 12-weeks off during any 12-month period to deal with a serious medical condition – whether it’s job-related or not – or to care for a close family member who is dealing with a serious medical condition. Your employer does not have to pay you for this time off, but you can’t be fired or demoted as retribution for taking medical leave. And, any health insurance benefits you had before taking leave must be maintained.

Concurrent Workers’ Comp and FMLA Coverage

So, what if you need to take time off to deal with a serious medical issue? If it’s a work-related injury, it may be covered under workers’ compensation and the FMLA. Through worker’s comp, your injury-related medical expenses would be paid, and you would receive workers’ compensation pay for the time off you needed to recover. But the time you take off under workers’ compensation may be counted toward the 12-week maximum you receive through the FMLA.

However, your employer must notify you at the beginning of your leave that they are counting it as workers’ compensation leave and FMLA leave concurrently. For example, you might take time off to recover from a work injury under a workers’ compensation claim and then a few months later need to take time off under the FMLA. Unless your employer told you when you took workers’ comp leave that it was also being counted as FMLA leave, you are entitled to your full 12-weeks off under the FMLA.

Illnesses and Injuries Are a Fact of Life

Nearly everyone experiences serious medical issues at some point in their work lives – whether it’s a work-related injury or a health crisis suffered by a loved one. If you don’t know your rights, you may miss out on valuable workplace benefits designed to help you during those tough times.

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