How a Transfer of Care Affects Workers' Compensation Claims

What Is a Transfer of Care?

A transfer of care occurs when a care worker—such as a home health aide, personal care assistant, or nursing aide—moves from one employer to another while an injury or illness claim is pending. The new employer inherits responsibility for the worker's compensation coverage, but the claim's status and benefits must be carefully managed to avoid gaps.

Who Is Covered?

Under most state workers' compensation statutes, coverage is tied to the employer, not the individual. Therefore:

• When a worker transfers to a new employer, the new employer must provide coverage for any existing claim.
• In some states, the new employer may need to notify the state insurance board within a specific window (often 30–60 days).
• Workers who are self‑employed or independent contractors are generally not covered, unless the state's "independent contractor exception" applies.

Key Steps for a Smooth Transfer

1. Notify the State Insurance Department

The new employer must file a notice of transfer and provide proof of coverage. Failure to do so can result in claim denial or penalties.

2. Submit Updated Employer Information

All claim documents—including medical reports, wage statements, and benefit determinations—should be forwarded to the new insurer. This ensures continuity of benefits.

3. Verify Benefit Continuity

Workers should confirm that wage replacement, medical benefits, and rehabilitation services remain active. If there is a pause, they can file a request for "reinstatement."

4. Update Personal Contact Details

Any change in address or phone number should be reported to the insurer to avoid missed communications.

Common Pitfalls

• Delayed Notification: A lag of more than 30 days can lead to claim suspension.
• Incomplete Documentation: Missing medical records or wage statements often trigger a denial.
• Employer Misunderstanding: Some employers incorrectly assume the worker's previous employer remains responsible.

Case Study: A Home Care Aide's Transfer

Maria, a 45‑year‑old home care aide, sustained a back injury while assisting a client. Her original employer, CareFirst, filed a workers' comp claim. After six months, Maria accepted a position at HomeHealth Plus. Within 15 days, HomeHealth Plus notified the state board, provided proof of coverage, and forwarded all medical records. Maria's claim continued without interruption, and she received her scheduled wage replacement payments.

Timeline Overview

What If the New Employer Fails to Provide Coverage?

Workers can file a complaint with the state insurance department. In many states, the new employer faces fines, and the claim may be automatically transferred back to the previous employer if coverage is restored.

Frequently Asked Questions

• Can I keep my original insurer? Typically, the insurer changes with the employer, but some multi‑employer policies allow continuity.
• What about temporary workers? Temporary staff are covered under the temp agency's policy unless the agency is a direct employer.
• Does the injury date affect transfer? No, the injury date remains the same; only the employer changes.