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Personal Injury or Workers’ Compensation Claim-Why Not Both?

by | Jun 5, 2024 | Workers Compensation


An injured employee availing for both workers’ compensation claim and personal injury claim arising from the same incident is possible. Let’s take an example of a driver getting injured in a motor vehicle accident during his work.

In this case, the worker can claim workers’ compensation from the employer as well as personal injury claim against the person who hit him. This would be a very complicated lawsuit that demand attorneys experienced in both personal injury and workers’ compensation litigations.

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The laws governing workers’ compensation cases in the US vary from one jurisdiction to the next. In some states of the US like Georgia, an injured worker is prohibited from pursuing any other claim from the employer other than the workers’ compensation claim.

In a workers’ compensation lawsuit, the employee can seek compensation only if he is injured during the working time. In such cases, compensation can be claimed only for financial losses like wage loss, medical expenses, disability claims, etc. Personal damages like pain and suffering are not taken into consideration in a workers’ compensation lawsuit.

While in a personal injury claim, benefits are also made available for the pain and suffering incurred by the injury. However, there are exceptions to these laws for the benefit of the employees. To have a clear insight into this subject, keep reading further.

Claim for Workers’ Compensation Claim Benefits

In a workers’ compensation lawsuit, you should not have to argue that someone involved was at fault for the accident. Medical coverage for injured workers is often capped by state rules i.e. only two years’ worth of medical coverage will be entitled. If the injury is found to be a minor one, then cap over medical benefits is not considered to be an issue.

It is important to notice that not all workers are eligible for workers’ compensation claim even if the injury occurs during the scope of employment. Some of the reasons are,

  • When the claimant is designated as an independent contractor rather than an employee.
  • When the company is excluded from the workers’ compensation laws of the jurisdiction and the employer has chosen to opt-out of workers’ compensation.

Even if the above-mentioned complications are made, a proper analysis of the situation must be done with the help of an experienced job injury attorney.

Claim for Personal Injury Damages at Workplaces

When a worker gets injured within the scope of his work, he is entitled to receive workers’ compensation. But it is important to know that if the options are not only limited to the workers’ compensation claim.

In such situations, the claimant should consult an attorney to get a clear idea about submitting a personal injury lawsuit on for workplace injuries. The below are few examples of workplace injuries that result in personal injury lawsuits.

1. Injury involving a co-worker:

If the injury is caused by the co-worker, personal injury claim can be filed against him.

2. Injury involving a third party:

Personal injury litigation can also be filed against a third party who is responsible for the cause of personal damage. A third party is one who is not associated with the company.

He can be an individual employee, building owner, contractor, property manager, reckless and distracted vehicle driver, product manufacturer, wholesaler, and retailer, etc.

Third-party personal injury litigation can provide compensation for the medical loss, both financial loss and non-financial loss, lost wages, and damages for pain and suffering.

3. Injury involving a defective product/tool:

If you are working at a construction site and suffer an injury due to the defective tool, then a separate product liability case can be filed against the tool manufacturer in addition to a workers’ compensation claim.

4. Injury involving unsafe work conditions:

If you are injured because of unsafe property conditions while doing renovations in someone’s house, then you can file a personal injury claim against the property owner on top of the workers’ compensation claim.

5. Injury involving intentional conduct of the employer:

In certain cases, the injury may be caused intentionally by the employer due to differences in views or personal reasons. If so, the worker may be entitled to file a personal injury claim against the employer.

6. Lack of appropriate workers’ compensation benefits in the workplace:

You can also make a personal injury lawsuit if the employer does not have appropriate workers’ compensation benefits or none at all.

Is Claiming Both Worker’s Compensation and Personal Injury a Double Recovery?

Seeking both personal injury claim and workers’ compensation claim is never considered to be a double recovery case for the following reasons.

1. The difference in damages:

Workers’ compensation claim doesn’t cover the pain and suffering incurred by the injury. If you are hurt during the scope of work and if there is no third-party responsible for the injury caused, then you are not entitled to any compensation.

This acts as an economic burden to the family and friends of the injured worker which would impose an emotional strain for the rest of their life.

2. Subrogation:

When you have both a worker’s compensation claim and a personal injury lawsuit, the worker’s compensation provider has the legitimate right to demand that you repay them for the medical assistance you received. This is termed Subrogation.

In such a scenario, a personal injury lawyer is contacted to negotiate the claim made with the worker compensation insurer.

3. Relationship Issues with the employer:

Another important factor to be considered while opting for combination claims is that your employer can fire for filing both workers’ compensation claim and personal injury claim against them. This may end up affecting the relationship with the employer.

Whether in personal injury claim or in workers compensation claim, your medical records form a strong base on which your claim can be built. Get the aid of top notch medical record review comapnies to handle your medical record review.

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Final Thoughts

Both the worker’s compensation claim and personal injury claim intersection is found to be a complex one. Receiving workers’ compensation doesn’t mean that the worker is ineligible to file a personal injury claim against the employer or the institution they work for.

The injured party’s available damages are the primary reason that those who are entitled to file both workers’ compensation and personal injury claims are allowed to do so. The challenge is arguing that a third party was at fault or behaved negligently in a manner that caused the injury. In such combination cases, the claimant should seek the service of an experienced attorney for getting a better settlement.

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