When dealing with small medical bills, you may think that covering it yourself rather than submitting it to your workers’ compensation insurer will be easier and less costly.

While this seems logical, choosing to pay a medical bill yourself can create a ripple effect of future problems.

In many states, unless your business is self-insured, paying a claim rather than reporting it to your workers’ compensation insurer may be illegal. It’s could also be a violation of your contract with your insurer because it can artificially lower your experience modification factor (e-mod) and premium.

Other reasons why an employer may not want to pay might also include:

• It could be held as an admission of liability for an injury or admission of an injury
• In most states, an employee cannot waive the statutory right to work comp benefits

Of course, as is the case with most employment laws, they vary by jurisdiction. Here are a few examples.

Minnesota

The Minnesota Department of Labor and Industry explains why employers should not pay medical bills in its training guide for employers .

"If an employer does not report an injury to its insurance company, it could become a more expensive workers’ compensation claim. The workers’ compensation law is complicated. It has many requirements, such as deadlines for payment, forms that must be filed, determining what medical treatment is reasonable and paying bills according to medical fee schedules. Workers’ compensation insurers are required to know how to comply with these requirements. Penalties may be imposed if the claim is handled inappropriately. If the error leading to a penalty was the fault of the employer, the insurer may pass that cost on to the employer. The employer may jeopardize the ability to adequately defend the claim or opportunities to minimize losses if the insurer does not have immediate knowledge of the injury."

However, exceptions may be allowed under a large deductible policy or if it is a self-insured person with approval from the state department of commerce to directly manage and pay work comp claims.

Wisconsin

In Wisconsin, employers can pay work comp bills, but there are limited circumstances when they can pay.

There is also an exception for the self-insured in Wisconsin.

South Dakota

It is not illegal to pay such expenses in South Dakota.

And employers should note that if they do not carry work comp coverage they can be sued civilly.

Again, there is an exception for the self-insured.

Iowa

Likewise, Iowa allows employers to pay medical bills. An employer has the right to choose the medical care/medical provider, meaning an employer would have the right to pay.

There are other factors to consider for the self-insured, and criminal and civil penalties could be levied against employers that violate the mandatory insurance law.

Nebraska

In Nebraska, it is illegal for employers to pay medical bills for injured workers.

Exceptions may be made under a large-deductible policy, but it still requires the insurer to pay with reimbursement to the employer or is self-insured with approval by Nebraska courts.

Kansas

Kansas also allows employers to pay these bills.

If an employer is insured for work comp, by law the insurance carrier is responsible for paying.

In the limited circumstances where an employer does not have to carry workers’ compensation insurance, uninsured employers subject to work comp laws are responsible for the medical bills of covered employees. Also, an employer has the right to choose the treating physician.

In Kansas, an employer can be self-insured for workers’ compensation, but must demonstrate to the state the financial ability to pay any claims that might arise.

Missouri

Missouri allows employers to pay medical bills for their workers. But there are additional rules to note.

If an employee misses no time from work and all medical bills total less than $3,700, the employer may pay the bill. However, employers must notify their insurance carrier and the Missouri Division of Workers’ Compensation and is not included in the e-mod.

Tennessee

Lastly, Tennessee also allows employers to pay medical bills out of pocket.

Reasons not to pay out-of-pocket work comp costs

Beyond the legal obligations in many states, there are other reasons  employers should not make out-of-pocket payments for a workers’ compensation injury, including:

• Additional expenses; carriers often have pre-negotiated rates for care
• Should an injury become worse, and it wasn’t reported in a timely manner, a claim could be denied
• Doing so could impact your experience modification factor
• Potential cancellation of a policy

As noted above, it’s generally better to go through the proper channels when taking care of an injured employee.

Originally posted December 2017; updated February 2024.

This is not intended to serve as legal advice for individual fact-specific legal cases or as a legal basis for your employment practices.