“They told me to use my own insurance.”

Why it happens

A claim that never gets filed does not appear on the employer’s loss history, and loss history drives premiums. A visit billed to your health plan looks like an ordinary medical problem.

Sometimes it is genuinely well-meant — a supervisor who thinks it will be faster, or who does not know the rules. The effect is the same.

What it costs you

The record. A treatment note that says “patient reports back pain” without connecting it to work is the document the defense will point to for the next three years. A record that says “injured lifting at work on [date]” is worth more than any argument later.

The clock. The 90-day presumption and the § 5402(c) treatment obligation both run from the date the claim form is filed. If no claim form is ever filed, neither clock starts.

The benefits. Health insurance does not pay temporary disabilityTD / TTD / TPD Temporary Disability, Total or Partial. Wage replacement while recovering. Two-thirds of average weekly earnings; 2026 maximum $1,764.11/week., does not pay permanent disabilityPD Permanent Disability. Compensation for lasting impairment. A different and much lower weekly rate — 2026 maximum $290/week., does not provide a job displacement voucher, and does not keep medical open for life.

And your money. Copays, deductibles, and out-of-network costs — which you should not be paying at all.

What the law actually provides

§ 4600: the employer must provide medical treatment reasonably required to cure or relieve the effects of the injury.

§ 5401: the employer must give you a DWC-1DWC-1 The claim form. Filing it starts the 90-day presumption and the $10,000 treatment obligation. claim form within one working day of learning about the injury.

§ 5402(c): within one working day after you file it, the employer must authorize up to $10,000 in treatment until liability is accepted or rejected — the duty covers the investigation, not the period after a rejection.

§ 5402(b): if liability is not rejected within 90 days, the injury is presumed compensable.

What to do

File the DWC-1 anyway. Get it from the DWCDWC Division of Workers’ Compensation, part of the Department of Industrial Relations. Administers the system. Information Services Center: 1-800-736-7401. if your employer will not provide one, and keep a copy showing the date.

Tell every provider it happened at work, and make sure the note says so. Ask them to correct it if it does not.

Use your health insurance only as a bridge if you must — untreated is the worst outcome, and your health plan may assert a lien against your later recovery, which is a manageable problem. Not being treated is not.

And put the conversation in writing. “Following up on what you told me today about using my own insurance — I’d like a DWC-1 claim form.” Dated, sent, kept.