After you suffer workplace injuries, you may think you can only collect workers’ compensation benefits. But what if your accident isn’t that simple?
You may discover that other people or parties caused your accident. In that case, you can file a personal injury, or third-party liability, lawsuit. But how can you determine whether your workers’ compensation case is a personal injury case in disguise?
An experienced workers’ compensation attorney can answer all of your questions and guide you in the right direction when seeking compensation for your injuries.
When you have suffered an injury at the workplace, workers’ compensation benefits should usually be available. Employers must carry workers’ compensation insurance for all employees, even temporary or seasonal workers in many states. This insurance prevents employers from facing lawsuits in what is typically a personal injury case.
For example, if you slipped and fell at an outside establishment, you can sue the property owner for your injuries. But the circumstances change when you work as a waiter and fall during your shift at a restaurant. One case requires a personal injury claim to recover compensation, while the other can lead to workers’ compensation benefits. There can be overlap in some cases, however.
Requirements for workplace accidents
After completing a workers’ compensation claim, you will have access to certain compensation benefits.
Workers’ compensation covers most workplace accidents, and to receive these benefits:
Your accident must have occurred at the workplace or while performing work for your employer
Your injury must have happened due to your work or within the scope of your employment
One requirement not needed for you to receive workers’ compensation benefits is proving that anyone was at fault.
Why does fault not matter in workers’ compensation claims?
Workers’ compensation insurance is a no-fault compensation system. That means you may receive your compensation benefits without determining whether the workplace accident was your fault or someone else’s.
Workers’ compensation insurance is an insurance policy that provides benefits to employees and protects the employer from accident liability. Instead of taking additional legal action for workplace accidents, employees can claim these no-fault benefits.
This waiver of potential legal action in exchange for immediate benefits is supposed to create a balance of rights for workers and employers. However, not all workers obtain their benefits easily.
Exceptions to workers’ compensation benefits
There are some occupations where workers aren’t entitled to workers’ compensation benefits.
These occupations include:
Some agricultural workers
Caregivers and housekeepers
Taxi drivers
Members of the clergy
Independent contractors cannot receive workers’ compensation benefits. Independent contractors are not employees and cannot seek workers’ comp benefits, but they can instead file a personal injury claim for their injuries. This requires them to prove negligence and fault of another party for the accident.
Personal injury cases
A personal injury stems from an accident that occurs due to another person’s negligence. Another person’s negligence can cause significant and costly physical and mental harm, entitling you to compensation.
These types of accidents also cause serious financial consequences for victims. Your accident may have led to expensive medical bills and taking additional time off from work to recover.
You may have to file an insurance claim or lawsuit against the alleged defendant to receive compensation for these personal injuries. Once you have filed this claim, the defendant can respond in different ways. They may offer to settle out of court with you with a mutual settlement agreement, dispute your claim, and decide the matter at trial.
Qualifications for personal injury cases
Even though workplace accidents may also be personal injury accidents, they must meet these requirements:
A duty of care. The defendant (a party other than your employer) must have been responsible for providing you with a certain level of care.
Breach of that duty. The defendant’s actions, or lack of action, must have violated the level of care that they owe you.
Proximate cause. The defendant’s actions must directly lead to your physical or mental harm.
Damages. Substantial evidence must support the damages you’ve experienced from the defendant’s actions.
These four requirements establish the defendant’s negligence towards you. If you do not meet even one of these requirements, you may be unable to receive compensation from the defendant.
Examples of personal injury accidents
Personal injury accidents include:
Car accidents
Nursing home abuse
Motorcycle accidents
Product liability accidents
Dog bites
Slip and fall accidents
Medical malpractice
Exposure to toxic chemicals
If any of these happen at work because of a negligent third party, you can hold them responsible for your personal injury in addition to pursuing your workers’ comp benefits.
The importance of fault in personal injury cases
Unlike workers’ compensation cases, fault is very important in personal injury cases. As a personal injury victim, you need to prove your accident is the defendant’s fault.
For example, you may hold a property owner liable if you suffered an injury while visiting their business while you are working. If another driver is distracted and slams into your work truck, they can be liable.
In some personal injury cases, you may find out that several parties contributed to your injuries, and you can receive compensation from multiple parties. Your attorney can assess all your options.
Workers’ compensation cases vs. personal injury cases
The workers’ compensation claims process should be pretty straightforward, though many people hit obstacles and need legal help. Some insurance companies try to minimize or even deny benefits. You should always consult with a workers’ comp attorney with any concerns.
Personal injury claims can also be challenging, as insurance companies will often try to pay as little as possible. However, with the right legal assistance, you can seek more compensation than you can with workers’ compensation claims.
With personal injury cases, you can include damages like pain and suffering and loss of enjoyment of life in your claim. Workers’ compensation does not cover these damages. Workers’ compensation benefits include damages for medical expenses and lost time from work, but you cannot seek the range of compensation you can with a personal injury claim.
Workers’ compensation benefits
When you have a work-related injury, you might need medical treatment and have to miss time from work. Many people cannot perform their jobs with their injuries. Fortunately, workers’ compensation coverage should pay for all of your medical bills and a percentage of your lost income.
However, workers’ compensation does not cover intangible losses or 100 percent of your lost income. Personal injury claims can seek full compensation for all of your losses – economic and non-economic. Not every work-related injury qualifies for a personal injury claim, but it’s always worth having a skilled attorney review your options.
Workplace injuries due to third parties
Some workplace accidents may allow you to file a personal injury claim. Let’s say you are a construction worker performing work on a property. The equipment you are using malfunctions, causing you serious injuries.
In this case, you should qualify for workers’ compensation benefits, as you suffered an on-the-job injury. However, the equipment manufacturers can also be liable for your injuries. To hold this party liable, you need to file a personal injury insurance claim or lawsuit against them. Injured workers may file third-party liability claims against additional parties, not affiliated with employers, who contributed to their accidents.
These claims allow you to pursue full compensation for your injuries and losses, including non-economic losses for pain and suffering.
Misconceptions about third-party claims
You may think that you only have one option for compensation—if you obtain workers’ compensation benefits, you cannot file a third-party claim. That’s not the case.
You can still receive workers’ compensation benefits and seek third-party compensation. If the insurance company determines that you have a legitimate third-party claim, you can seek additional compensation.
Another common misconception is that all injured workers may file third-party claims. Not every injured worker may sue someone. Discuss your case with an injury attorney.
Different types of third parties
Some of the common parties named in third-party claims include:
Product manufacturers. Injured victims may sue these parties if a defective product causes a worker’s accident.
Property owners. In some workplace accidents, the property owners may be liable for failing to provide a safe working environment.
Motorists. Car and truck drivers who hurt an employee in the middle of their shift might be liable for their injuries.
A lawyer will know the difference between workers’ compensation and personal injury claims
Knowing whether your case is a workers’ compensation case, a personal injury case, or both can benefit you in many ways. You may be entitled to additional compensation for your injuries if you explore options beyond workers’ comp.
Workers’ compensation benefits may not always cover the costs of your expenses. The insurance company may deny your request for ongoing coverage of your medical bills. They might also cut off your benefits if they believe you should be back at work already.
The reality is that while no-fault workers’ compensation benefits might sometimes be easier to obtain, they are limited in value. Many injured workers experience financial stress while they are out of work, as benefits only cover a portion of their lost income.
Determining whether your workers’ compensation claim is also a personal injury case gives you additional options for compensation. You can hold additional parties liable for their fault in your accident, and insurance policies might have significant coverage. If you discover that your case is also a personal injury case, you can receive different types of compensation.
How far personal injury cases can go
Your personal injury claim can go as far as a settlement or a trial. Many liable parties may try to settle the matter of compensation outside the courts before advancing to a trial. If you and the other party’s legal team can agree to a mutual settlement, you can avoid a trial while receiving your deserved compensation. If both parties cannot reach a mutual agreement during the settlement stage, your claim may progress to a trial.
Speak with an experienced work injury lawyer today
Discussing your case with an experienced attorney can bring some clarity to the situation. You will no longer have to wonder whether you deserve greater compensation for your injuries than workers’ comp can provide.
If you suffered a workplace injury, you need to focus on your recovery. You shouldn’t have to worry about the legal process, no matter what type of claim you have.
Workers’ compensation claims involve dealing with an insurance company. These insurance companies are often quite large, with teams of lawyers and adjusters working for the company’s interests. It is best for you to have the help of an experienced attorney and to let them handle your legal troubles for you. Having legal help becomes even more critical when you have a personal injury claim along with your workers’ comp case.
Contact an experienced work injury attorney to schedule a free consultation about your case. The attorney can provide a clear assessment of the situation and explain whether you can receive workers’ compensation benefits, have to file a personal injury claim, or both.
There are different times you should always seek legal help. First, many workers run into obstacles during a workers’ comp claim, and the insurance company might not offer you the benefits you deserve for your injuries. Reach out to a personal injury lawyer.
Second, if you believe that someone was negligent and responsible for your injury, you should have an injury attorney evaluate your situation. Case evaluations are always free, so you have nothing to lose by seeking legal advice. You have much to gain if you learn you also have a personal injury case.
About the author: Greg Bentley
Co-Founder & Trial Lawyer at Bentley & More LLP
Greg Bentley is Co-Founder of Bentley & More LLP in Newport Beach, California. With 36 years of experience, he represents plaintiffs in personal injury, wrongful death, product liability, insurance bad faith, dangerous road and property conditions, and construction-site failure cases. Admitted to the State Bar of California, Greg earned his J.D. from Western State University College of Law in 1990. He is a member of several invitation-only trial organizations, including the American College of Trial Lawyers and the International Academy of Trial Lawyers, and is active in multiple statewide and regional trial lawyer associations.
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