With this website article, Scholle Law Firm attorneys discuss the difference between workers’ compensation claims and third-party claims. Many people often fail to realize that a work injury may offer them multiple opportunities to gain compensation after being hurt on the job. The Atlanta work injury lawyers at Scholle Law discuss work injury benefits from workers’ compensation insurance and claims again negligent parties (third-party claims). This topic is very important but complex. If you have any questions about a work injury or this specific content, please contact us.
Georgia work injuries often involve two types of claims. An injured employee may have a claim that falls under their employer’s workers’ compensation plan, or they may also have a negligence case against a party or other entity (company, subcontractor, etc.) that caused them to become injured while they were engaged in their work. The negligence claim is what we refer to as a “third-party” claim and it is separate from a workers’ compensation claim. Injured workers should speak to an attorney to determine if they have both claims because it could result in a more favorable case resolution than if they only pursued the workers’ compensation claim.
Most employers are required to provide workers compensation accident insurance for their business / employees. Under this type of insurance, benefits may be paid to help an injured worker while they are not able to work because of their getting hurt on the job. These benefits include coverage for medical bills. Additionally, some cases may involve an injured worker being able to recover a portion of their lost wages. In the case of loss of life from a workplace accident, the deceased person’s relatives or dependents may be able to recover some benefits as well.
A third-party claim is something completely different. Third-party claims arise when a worker is injured by the negligence of another party that is not their employer. These separate claims are not part of the workers compensation insurance program that was previously mentioned. These claims are completely separate from workers’ compensation. Additionally, there is not one type of specific injury or accident required to bring a third-party claim. Third party claims include truck and car accidents as well as injuries that could be caused by defective products or work equipment. Warehouses and stores are common places where 3rd party claims occur because they are places where employees and many other third parties come into contact with one another.
It is possible to maintain a workers compensation action and a third-party insurance claim. You are not required to bring one or the other but depending on the situation it is often advisable to recommend a work injury victim to consider pursuing both claims. Injured workers should not assume that they are covered by workers comp or by a third-party claim. After a work injury it is a great idea to meet with an experienced work injury lawyer that can analyze the specific claims that are relevant to your individual situation.
Workers’ compensation claims are generally not dependent on liability. That means that an injured worker that causes their own injury will generally (there are exceptions) still be able to receive their workers’ compensation benefits. Fault and liability do not usually matter under workers’ compensation. As far as benefits, one of the most significant benefits from workers compensation is the medical coverage it provides.
That being said, there are limitations on that, and it is not uncommon for injured workers to have complaints about the medical care they receive from their workers compensation claim. However, someone with a very serious work injury case that may not have health insurance would be able to get medical care and have their medical bills paid for by their workers’ compensation insurance carrier. This is very significant due to the significant costs associated with serious accident and injury cases.
Additionally, there can be issues with future care depending on whether or not the injury results in a permanent disability. The worst cases may result in lifetime future benefits from workers’ compensation. Lastly, there are weekly benefits to make up for salary and wages lost because of being unable to work. Unfortunately, the amount of money able to be recovered is never the total weekly lost wages, but rather a fraction of them, 2/3 as of the time of this writing. An experienced work injury lawyer can provide you more information on what your lost wages may look like. Again, every case is different!
Third-Party Work-Related Injury Claims
When you think of a work injury you may think of pulling something or having a strain injury from heavy lifting. You also may think about injuries caused by dangerous work equipment. Slip and fall injuries at work or work premises type injuries are also common types of work injuries. None of those examples are third-party work injury claims because there was no 3rd party involved of course… Work accidents and injuries caused by parties other than your employer / co-workers will fall into this category.
The most common examples of third-party injury work claims are car and truck wrecks caused by third parties. Again, work-related injuries caused by someone other than your employer are the basis for all third-party work injury claims. Unlike workers’ compensation claims, these cases are liability dependent. In most cases, other negligent parties (in Georgia a party that is 51% at fault or more) that hurt you while you are on the job can be held liable for your work-related injuries. The recourse you have following an on-the-job accident may not be limited to only workers’ compensation!
3rd Party Work Injury Claims Are Personal Injury Claims
When you are injured by someone else’s negligence while working you may be able to file a personal injury claim on top of your workers’ compensation claim. Essentially a third-party work injury claim is the same thing as a personal injury claim. It is the same process as what you would do to pursue a case for damages if you were hit by another car while driving on your own time. Workers’ compensation and third-party injury claims do not provide the same benefits!
A claim for personal injury / third-party work injury claim can pay for your medical bills. If you were in your personal car during the accident, the 3rd party claim would also pay for your property damage. Under these types of claims you are also eligible to recover lost wages, pain and suffering and other economic and non-economic damages.
Double Recovery and Subrogation
If you decide to pursue both the workers’ compensation claim and the third party claim you may wonder if it is fair to pursue both. Some people ask if this scenario is the same thing as a double recovery. The simple answer is no. Having a successful workers’ compensation claim and a 3rd party claim is not the same thing as being compensated twice. The benefits are different, and both involve two very different types of law: workers’ compensation and personal injury / tort law.
These types of claims can be confusing, especially in situations where the medical coverage and treatment overlaps. For instance, a situation where a delivery driver in a car accident treats with a workers’ compensation doctor and also with a chiropractor. Who pays for what? All medical care for a work injury will be analyzed by your lawyers and it is their responsibility to help you resolve any medical bills (if there are any).
In doing so, your lawyers may discuss an issue called subrogation. If you do receive benefits or money from the workers’ compensation insurance company and the negligent party’s insurance company, you may be asked by the workers’ compensation insurance company to reimburse them for the medical bills that were paid by workers’ compensation. That is called subrogation and they may try to argue a legal interest in the 3rd party personal injury work claim through a lien.
An experienced work injury lawyer can explain what that means to your settlement. Many workers compensation subrogation liens cannot be used to recover against your personal injury settlement. If you get a call or letter from a workers’ compensation adjuster telling you that you have to pay them back, do not worry. That is their job to try to recover money. That is how all insurance companies work. It is your lawyer’s job to do everything they can to make sure your case is resolved in the manner that is most favorable to your position. That may include preventing them from successfully making their claim for subrogation.
Additionally, your health insurance company can attempt to seek similar reimbursement from your third-party work injury claim (personal injury and not workers’ compensation). The law on this issue is very favorable to injury victims. Unless a workers’ compensation insurance company can prove that you were “made-whole” (you were fully compensated) the insurer may not be entitled to be reimbursed, and the lien may not be enforced. Proving that an injury victim has been made-whole is a very high standard for an insurance company to meet. This is why most personal injury lawyers will advise their clients that it is unlikely that they will have to repay all or maybe even any of their medical bills that were paid by their health insurance company.
The main take away from this article should be that injured workers need to think about their options before assuming that workers’ compensation is their only path. Not every work injury case will have an option for pursuing a 3rd party work injury claim. However, the cases that do will potentially mean a better recovery for the injured work accident victim. After a work accident, speak to our experienced Atlanta work injury lawyers for a free consultation and an opportunity to discuss your options.
Contact Our Atlanta Work Injury Lawyers Today!
Contact Scholle Law to discuss your work accident case. Our Atlanta work injury lawyers handle 3rd party work injury claims relating to many different types of work injuries. Our cases have included injuries sustained in car and truck accidents as well as injuries caused by dangerous premises and defective equipment. Many of our previous clients did not even know they had potential third-party claims until we spoke to them. Our Atlanta work injury lawyers have the knowledge and expertise to investigate your case and to help you get the compensation you deserve. Find out what your options are, contact Scholle Law today for a free case evaluation.
To set up a meeting, call us today at (678) 921-3320 or contact us online.