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The government could face a judicial review after excluding some health workers from a one-off bonus.
The sum was part of a pay deal for more than a million NHS staff in England this year and was partly to recognise their work since the pandemic.
But thousands of outsourced staff, such as community nurses and physiotherapists, will not receive it - a decision described as an "injustice".
The government said it was considering its position.
The workers were told they did not qualify for the payments of between £1,655 and £3,789 because they were not directly employed by the NHS. Instead, they work for not-for-profit organisations, such as social enterprises, which together provide a third of community health services for the NHS.
About 20,000 health staff are thought to work in those services in England, the Department of Health and Social Care said.
Social Enterprise UK, an industry body which represents more than 10,000 of those workers, told the BBC it had started the process of applying for a judicial review, as it believed the arrangement was "completely unfair".
Chief executive Peter Holbrook said social enterprises were a "crucial part of the NHS family", employing thousands of staff and reinvesting profits in communities.
'Slap in the face'
Many of the healthcare workers Mr Holbrook represents were previously employed by the NHS before being transferred to independent providers as part of a move to outsource some services.
Among those is Julie Tollit, a physiotherapist working for a community provider in homes, clinics, hospitals and schools.
"I am employed by Central Surrey Health to work for the NHS - all my patients are NHS and consider me NHS," she said.
Ms Tollit is employed under the same terms and conditions as her NHS counterparts.
She said: "I feel completely demoralised. Our team worked throughout the pandemic, we worked incredibly hard, we were treating patients in the community trying to keep them out of hospital to help prevent more admissions for those hospitals which were overwhelmed. We worked tirelessly. Apparently, my work doesn't count. Frankly it's a slap in the face."
The government announced a 5% pay rise for more than a million NHS staff in England earlier this year. It said it was agreed during negotiations that outsourced staff would not get the additional bonus.
A spokesperson said: "We hugely value the work of all our healthcare staff" and added that the government was "considering its position" relating to non-NHS staff payments.
Some "bank" staff - health staff at other organisations, deemed "non statutory" - including those working in nursing homes and GP services, have also missed out on the lump sums.
Separate pay deals were made for staff working in the NHS in Wales and Scotland.
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