Injuries At Work: The Complex Intersection of Workers Compensation Law and Personal Injury Law

Most of the time when an individual is injured at work, their sole remedy is to file a claim for workers compensation.  Workers compensation claims are different than ordinary personal injury claims because they do not require the claimant to prove that anyone was negligent in causing their injuries.  In fact, an employee can file a workers compensation claim even if they were at fault for their own accident.

For this reason, workers compensation is often referred to as a “no fault” system.  It sounds great, but of course there’s a catch:  In exchange for being relieved of the need to prove fault, workers compensation claimants are generally precluded from collecting “pain and suffering damages.”  Only actual out-of-pocket damages, such as medical bills and lost wages, are collectable.

Pain and suffering damages are usually the most valuable component of a serious injury claim, so the inability to recover them deals a significant blow to persons injured at work.  Fortunately, not all workplace injuries are confined to the workers compensation system.  If an employee injured at work can demonstrate that the cause of their injury was the negligence of a third party, meaning someone OTHER than an employee or agent of the employer, they can still file a lawsuit for personal injury and collect pain and suffering damages against the negligent third party.

A common example is the employee who, while driving a vehicle “on the clock,” is hit by another motorist.  The injury is a work-related injury and so can be pursued as a workers compensation claim.  However, since the negligence of a third party caused the accident, the employee can also file a lawsuit against the at-fault driver directly.

In circumstances such as these where an accident gives rise to both a workers compensation claim and a personal injury claim, some unique considerations apply.  First, the employee has an unequivocal right to pursue their out of pocket damages through workers compensation.  The workers compensation insurance carrier cannot deny coverage or delay payment merely because there is a possible “third party” recovery.  However, the employee may not recover the same damages twice.  If they are successful in recovering damages from a third party, workers compensation is generally entitled to reimbursement of what they paid.

So, if the workers compensation insurance carrier is entitled to reimbursement of what they pay on a personal injury claimant’s behalf, why bother with a workers compensation claim at all?  There are a couple of good reasons why.  First, since workers compensation doesn’t concern itself with liability, workers compensation claims are generally paid much quick than personal injury claims.  This gets the claimant money now, when they need it.  Secondly, when it does come time to reimburse workers compensation, the insurance carrier will generally accept a reduced sum, since they are benefiting your the work of the claimant’s attorney in obtaining a third party recovery.  Thus, in most cases, workers compensation will accept a one-third “attorney fee reduction.”  In some cases, they will accept even greater reductions.  This enhances the claimant’s overall financial recovery.

These are just some of the important considerations when a worker has been injured on-the-job and the cause of the injury was the negligence of a third party.  Cases such as these are particularly complex, and so it is more important than ever to retain skilled and experienced legal counsel to guide you through the process.