The basis for personal injury law is fairly straightforward:
If you’re injured because of someone’s negligence, then you’re entitled to recover for your financial losses related to the injury.
The premise for the workers’ compensation system is similar:
Your employer is required to have specific insurance that provides benefits if you’re injured at work.
Both are intended to provide benefits to an injured person so they are in a comparable financial condition as if the injury hadn’t happened. In other words, you shouldn’t have to pay for injury-related expenses out of your own pocket.
But there are several important ways in which these 2 systems are different.
Is your injury someone’s fault?
If your injury happened at work or while performing work-related duties, then you’re eligible for workers’ compensation.
Your injury might be directly related to your job, like falling off a scaffold or a repetitive motion injury like carpal tunnel. It could also be the result of a condition in your workplace that isn’t directly related to your job function, like tripping over an electrical cord or obstacle in a walkway.
The biggest difference between a personal injury lawsuit and a workers’ compensation claim is that no determination of fault is necessary to receive workers’ compensation benefits.
If the injury happened at work, it’s covered under workers’ compensation whether there was negligence or not. Period. In other words, if it happened at work, it doesn’t matter who (if anyone) was at fault. Some accidents are just… accidents.
For example, if a coworker left a box in the hallway and you tripped over it and got hurt, it’s possible that the person was negligent. But when you file a workers’ compensation claim, that doesn’t matter.
Whether the injury was someone’s fault, your own fault, or no one’s fault isn’t an issue in the workers’ compensation system. As long as you can prove that your injury is related to your work or happened at work, you won’t be asked to show who was at fault in order to receive benefits.
This system benefits both the employer and the injured employee:
- The employer benefits from the workers’ compensation system because injured workers aren’t able to sue, meaning the company doesn’t have to defend against costly and time-consuming legal battles waged by injured employees.
- The employee can receive benefits quickly in order to pay for their related medical expenses and wages for time off from work, without having to undergo the hassle of providing fault.
Can I ever sue someone for a workplace injury?
There are certain limited situations when a personal injury claim is appropriate when the injury happened at work. Although the workers’ compensation system isn’t based on fault, there are cases in which there is liability — such as when a third party (not your employer) is involved.
For example, let’s say you fell from a scaffold while working on a construction site. Here are your best options for recovery:
- Workers’ compensation: You fell because your foot slipped. Perhaps the scaffold or your shoe was wet, or maybe you just lost your footing. This would most likely be a workers’ compensation claim.
- Personal injury claim: Instead, what if you fell because the scaffold broke? The manufacturer indicated that the scaffold can hold 1,000 pounds of weight when used properly. You and the equipment being supported by the scaffold weigh far less than 1,000 pounds, yet it buckled under your weight because of faulty construction. In this instance, you might be able to file a personal injury lawsuit against the manufacturer of the scaffold because the manufacturer was negligent in constructing the item properly for its intended purpose and caused your injury.
You are generally prohibited from suing your employer or a coworker for a work-related injury. You may bring a lawsuit against a third party if that person’s or entity’s negligence caused your injury. The exception that might allow you to bring your employer into the lawsuit would be if the employer knew or should’ve known about the product’s defective condition.
What can you recover from a workplace injury?
The following benefits are included under workers’ compensation:
- Lost wages for time off from work during recovery
- Medical treatment
- Compensation for permanent disability as a result of the injury
- Vocational retraining if you’re unable to return to your job
- Death benefits for survivors of a worker who died as a result of a workplace injury or illness
Each state has a maximum weekly payment that workers’ compensation can offer as benefits for lost wages. As an injured worker, you can usually choose whether you prefer a workers’ compensation settlement in the form of a single lump sum or you want ongoing weekly benefits for a set period of time.
A personal injury lawsuit allows recovery of certain damages that aren’t included in workers’ compensation benefits.
There are 3 categories of personal injury damages:
1. Economic damages
- Costs of medical treatment, current and future
- Lost earnings and earning capacity
- Costs for assistive devices or other modifications necessary to aid in your recovery
- Other out-of-pocket expenses related to the injury
2. Non-economic damages
3. Punitive damages
- Intended to punish a defendant for especially malicious or egregious acts that caused the injury
Workers’ compensation insurance doesn’t provide for punitive damages, non-economic damages like emotional distress, or other economic damages aside from medical expenses and a portion of your lost wages.
Pros and cons of seeking recovery from a work-related injury
There are advantages and disadvantages to both the workers’ compensation system and personal injury lawsuits.
|Personal injury lawsuit|
|You can recover damages that are more comprehensive compared to workers’ compensation benefits. This might include full compensation for lost wages, damages for emotional distress, and pain and suffering.||The personal injury litigation process can take months or years. You won’t have immediate funds to cover the medical bills or other expenses you already owe from the injury, or coverage of your regular expenses if you’re not earning a salary.|
|You can potentially recover a larger settlement or award than is available for a workers’ compensation claim.||You must prove that the defendant was negligent and that the negligence caused your injury.|
|Workers’ compensation claim|
|Your benefits begin as soon as your claim is approved.||You cannot recover for non-economic losses like pain and suffering.|
|If your claim is denied, there’s an administrative appeals process.||A verdict can be appealed, but it will take a very long time and can be expensive.|
|You don’t have to prove fault in order to receive benefits. The system covers your injuries even if they were caused by your own negligence.||The injury has to have taken place during the course of your employment. An injury during your commute to and from work, for example, is not included under workers’ compensation benefits.|
Again, there are certain instances where you might have the opportunity to select whether a personal injury lawsuit or workers’ compensation claim is right for you. But in many instances, you’re going to be limited to a workers’ compensation claim for a work-related injury.
Workers’ compensation is insurance for both you and your employer. You have the benefit of being able to recover weekly benefits and reimbursement of medical bills regardless of fault, and the employer receives protection from lawsuits on the basis of negligence for personal injuries.
One thing that both workers’ compensation claims and personal injury lawsuits have in common is that either one is a complicated process. If your injuries were fairly minor and you’ve completed treatment and returned to work, you might be able to settle swiftly with the insurance company if it offers you the full amount of your expenses.
But if you still require medical treatment or might have surgeries or additional treatments in the future, a knowledgeable workers’ compensation lawyer is likely best-suited to provide you with the guidance and advice you need to have your expenses covered.