Navigating Workers’ Compensation Claims and Third Party Settlement
You have the right to be safe from harm at work. When an injury occurs, certain rights are in place to support your recovery, protect your job and provide for a portion of your wages while you are out of work due to the injury.
Being catastrophically injured or caring for someone who has been impacted by a life-altering workplace injury presents numerous challenges, not only in recovering from the injury but managing the financial constraints due to loss of work and loss of ability to work. Workers’ comp laws vary from state to state. In many instances, workers’ compensation benefits for your injury are clearly laid out within the law. Your case will be presented to the Workers’ Compensation Commission in your state before an administrative judge, who will determine the extent of your benefits and whether your medical claims are properly applied.
Here are the top things to know about the rights that protect workers when they are severely injured at work.
- You have the right to file a claim for workers’ compensation benefits.
As long as you can show that your injury occurred at work while reasonably performing a job task or work duty, you are eligible for workers’ compensation benefits. These benefits cover the cost of medical expenses to treat the injury and approximately two-thirds of your regular pay, or Average Weekly Wage (AWW).
- You have the right to appeal your case if your workers’ compensation claim is denied.
If your workers’ compensation claim is denied, you have the right to appeal the decision of the administrative judge. Hiring a workers’ compensation lawyer to help gather all the necessary documentation and paperwork would likely be to your advantage.
- You have the right to receive medical treatment for your injuries.
Regardless whether the fault of the employee, employer or a third party, the Workers’ Compensation System provides for injured workers to receive compensation for “reasonably necessary medical care” due to an injury on the job or occupational illness. This includes rehabilitation services such as occupational therapy or physical therapy.
- You have the right to hire a workers’ compensation lawyer.
In cases in which your injuries are not clearly work-related, require extensive medical treatment or result in permanent or partial disability and/or long periods of time off work, hiring a workers’ compensation lawyer is recommended. They can help navigate these more complicated claims to argue your case effectively and help get the benefits you deserve.
- You have the right to return to work once your doctor has released you.
You have the right to return to your job as long as you can continue to perform the duties that were a condition of your employment and have maintained accurate documentation of your diminished capacity while you were recovering from your injury. Your employer does not have a legal right to retaliate against you for filing a workers’ compensation claim, such as by reducing your hours, demoting you or terminating your employment. If that is found to be the case, in addition to workers’ compensation benefits, your employer could be required to pay punitive damages. The Worker’s Compensation Act provides incentives to the employer and employee to return to work as soon as possible, and light duty may be an option depending on your position.
- You have the right to file a separate personal injury lawsuit against a liable third party.
You have the right to pursue a personal injury claim against a responsible third party even if you also have filed for or are receiving workers’ compensation benefits. Victims of severe injuries on the job often face long-term loss of work and other challenges, and in many cases, workers comp may not be enough. Should your settlement or verdict be successful, your employer will be eligible to recover all or part of the amount of the workers’ comp. benefits you receive.
- You have the right to sue your employer (in Rare Instances)
In most instances, workers’ compensation prohibits you from being able to sue your employer. Likewise, contractors who are hired to undertake work on behalf of your employer are considered “statutory employees” in most states under the law and therefore cannot be sued as a third party.
However, there are some exceptions when a civil lawsuit can be filed against your employer:
- You can sue your employer for a workplace injury if the injury is caused by intentional acts of a co-employee when the employee’s conduct is closely connected to the time, place and performance of the workplace duties you were performing. The injured employee must prove the employer was aware of the third party’s history or predisposition to violence and took no action to remove the employee or otherwise protect workers from his or her reckless behavior. Employers are not liable when a co-worker-caused injury is the result of a personal dispute.
- Because workers’ compensation insurance is mandatory for employers with the exception of Texas, if your employer fails to carry state-mandated workers’ comp insurance you may file a lawsuit for your injuries and resulting damages.
- You also may file a lawsuit against your employer if you are able to prove your work-related injury was caused by your employer’s willful, wanton, gross or reckless negligence. For example, if an employer was aware of the dangers of hazardous or toxic substances in the workplace and failed to provide protective clothing, respirators, or otherwise failed to protect workers, the employer can be found to be negligent and liable for damages in a separate civil lawsuit.
Trammell Piazza’s experienced personal injury trial lawyers fight to achieve fair and reasonable compensation for financial and personal impact caused by a life-altering injury so that you can focus on getting the care you need to achieve your best outcome and quality of life.
We have handled complex third party settlements for catastrophic workplace injuries, construction accidents and injuries due to defective or faulty equipment or machinery, inadequate safety measures, and workplace negligence.
Contact us for a free consultation to review the details of your case and determine the best course of action.