Employer Obligations For Health Laws
After nearly 40 years of representing companies in employment matters, I have noticed that there is a lot of confusion concerning laws that apply to employee health issues. Sometimes even sophisticated employers don’t understand what these various laws are designed to accomplish or how they work. This article is intended to provide a brief overview of these laws to help employers sort out the confusion and understand their obligations.
Workers Compensation Laws
These are the original “no fault” statutes. They are designed to provide a worker who suffers a job-related illness or injury with a basic income while they are out of work and payment for medical expenses. The worker is entitled to benefits even if the injury was caused by his or her own negligence. In return, the employee is prohibited from suing the employer for damages suffered on the job from industrial accident or illness. The workers comp benefit is an “exclusive remedy” for the worker.
These laws provide workers with a basic level of replacement income when they suffer an illness or injury that is not job related. Not all jurisdictions require such coverage, but most do. Benefits generally kick in when an employee is physically unable to pursue his or her usual occupation.
This federal law provides workers with coverage and benefits similar to the disability statutes. There is a critical difference however. In order to get social security disability benefits, the worker must be unable to pursue any type of gainful employment.
The Family and Medical Leave Act
Up until now, we’ve been discussing laws that provide workers with income when they are sick and injured (with the exception of workers compensation which also provides payment for medical treatment). Now we’re going to discuss statutes that provide workers with benefits other than income.
The Family and Medical Leave Act provides eligible employees (those who have worked for an employer for a year and worked at least 1,250 hours for that employer in the past 12 months the right to take up to 12 weeks off in a year in order to:
• Care for their own serious health conditions;
• Participate in the care of a sick or injured family member; or
• Participate in the birth or placement of a child.
Upon completion of the leave, the worker is entitled to return to the same position or a position that is substantially equivalent. Besides holding the job for the employee, the company’s only obligation is to maintain the worker’s health insurance coverage under the same terms and conditions as the worker enjoyed before the leave.
As you can see, the Family and Medical Leave Act does not deal with money; it deals with time.
The Americans With Disabilities Act
The Americans with Disabilities Act does not deal with time or money. Rather, the statute is designed to protect workers with physical or mental challenges who are capable of performing the essential functions of their jobs from discrimination.
After a potential or actual employer becomes aware that an applicant or employee possesses a disability, the company is obliged to engage in an “interactive dialogue” with that person to see if the worker can perform the “essential” parts of the job with or without “reasonable accommodation.”
Generally speaking, a “reasonable accommodation” is one that does not cost a significant amount of money, impose additional obligations on other workers or disrupts the employer’s obligations.
As you can see, the Americans with Disabilities Act does not deal with either time or money; it deals with discrimination.
The Affordable Care Act
The Affordable Care Act is the newest member of the pantheon of health-related laws. It is designed to allow all Americans to obtain health insurance. Parts of the statute impose varying obligations on employers to provide health coverage depending on factors such as size of the workforce and the number of hours worked by individual employees.
The ACA does not deal with time, money or discrimination. It deals with mandatory health care coverage.
Often more than one of these statutes will apply to an individual worker’s situation. A simple example will suffice. Let’s say a worker suffers a non-job related heart attack, spends a brief spell in the hospital and then needs some time to recuperate at home.
The worker will receive some income in the form of disability benefits. That worker will also receive health insurance benefits governed by the Affordable Care Act. The worker will get a leave of absence under the Family and Medical Leave Act and the worker’s ability to return to the job will be gauged by the Americans with Disabilities act.
It is these overlaps that create the confusion about the worker’s rights and the company’s obligations. Once the employer understands what each law is supposed to accomplish, the whole situation becomes much clearer.
A word of caution is in order: this overview of the various statutes is necessarily brief and simplified. The law, regulations and decisions under each statute can (and does) fill up many volumes. Whenever there is the slightest confusion, the employer should consult either a knowledgeable human resources professional or a specialized employment lawyer.
Perry Heidecker is senior counsel for Milman Labuda Law Group PLLC, Lake Success, N.Y. The firm is a full-service Employment Law practice focused on counseling, preventive advice and training, policy and procedure design, representation before administrative agencies, litigation, and appeal.s
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