Workers Comp Vs. Personal Injury – All You Need to Know

According to the U.S. Bureau of Labor Statistics, there were 2,654,700 total non-fatal injury or illness cases in the workplace in 2020. Out of those cases, there were 211,640 involving slips, falls, or trips. There were also 4,764 fatalities that occurred on the job. Individuals injured in or at a place of work often wonder if they should pursue compensation for injuries through a workers’ compensation vs. personal injury claim and if a Personal Injury lawsuit is the better option. Although both require an injury, they have one distinct provision separating the two claims. Personal injury lawsuits require fault, whereas workers’ compensation does not. However, workers’ comp claims for damages are limited to specific areas.

No-fault worker’s compensation claims

All states have their own laws for workers’ compensation claims. The specific laws are contained in state statutes and vary amongst states. There are also laws specific to federal government employees and other laws for those that work in certain industries, such as the railroad industry. Employees injured at their place of employment are automatically entitled to some form of workers’ compensation benefits. It doesn’t matter if the injury or illness was caused by an individual’s carelessness or a hazardous work environment.

It’s important to note that not all employers have workers’ compensation insurance. If they have less than four employees, it isn’t a requirement. If injured on the job and the employer doesn’t have insurance, employees may want to file a personal injury lawsuit if the conditions of fault are met.

The most common workers’ compensation claims

According to the National Safety Council, the most common workers’ compensation claims are:

●        Strains account for 30.06% of workers’ compensation claims

●        Contusions account for 20.83% of claims

●        Lacerations account for 11.79% of claims

●        Sprains account for 8.85% of claims

●        Punctures account for 5.50% of claims  

How much is workers’ compensation?

In most states, workers’ compensation pays employees around two-thirds of their weekly wages, with specified minimum and maximum limits. The benefits typically last the duration of the disability, but some states limit the total amount employees can receive. Workers’ compensation also covers medical care expenses for work-related injuries and illnesses.

How does workers’ compensation settlement work?

The employer is usually responsible for filing the workers’ comp claim with the insurance company.  They’ll send the employee’s claim form and any documentation to the state’s workers’ compensation board. Even if the employee isn’t filing a claim, employers are required to report workplace injuries.

If the insurance provider approves, the employee can either accept the payment offered or attempt to negotiate a larger structured settlement or lump sum. In most states, the first seven days after an injury are not payable unless the injury lasts more than 21 days.

No lawsuit is typically needed for a workers’ compensation vs. personal injury claim. Most workers receive between $2,000 to $40,000 for workers’ compensation claims, but the average is about $20,000.

Fault established in personal injury cases

To recover damages for a personal injury, the victim needs to prove that someone’s negligence caused the injury. The victim’s attorney must prove injuries occurred due to another party’s negligence, whether it was an automobile accident or a slip and fall in a store. Personal Injury cases are sometimes complex because they can involve multiple responsible parties, and compensation takes various factors into consideration. In addition to proving fault, you’ll need to prove the injuries were the direct result of the accident or incident that occurred.

Personal injury claims are often lengthy. Although most are settled outside of court, a suit must still be filed. It can take months to years for these cases to settle. While people can technically file their own lawsuits pro se without an attorney, the process is complex and likely will not result in a high payout. According to Nolo, people who hired a lawyer received an average of $77,600 in compensation, compared to $17,600 for people who handled their own cases.

Differences In Personal Accident Insurance Vs. Workers Compensation

Workers’ compensation benefits exclude benefits for pain and suffering[RC15] [MA16] . Employees will receive prompt weekly compensation while away from work. The compensations will cover their medical bills, vocational rehabilitation, and even permanent impairment benefits if needed. 

Personal injury claims allow victims to recover all damages suffered, including lost wages, medical expenses (past and future), lost earning capacity, pain and suffering, permanent impairment, loss of enjoyment of life, etc.

Suing the employer for the accident at work claim

Generally, employees are barred from suing employees for workplace injuries, even if they do not want to file a claim through workers’ compensation. Employees cannot opt to sue instead of accepting benefits. When an employer provides workers’ compensation benefits through an insurance company, they are protected from personal injury claims. The system was established to act as a trade-off or an alternative to suing employers, regardless of who is at fault. However, there are exceptions to this.

If an employee believes the employer intentionally caused them harm, a lawyer can file an intentional tort suit in civil court. A tort injury includes physical injuries and emotional distress. Some common intentional torts include battery, assault, false imprisonment, intentional infliction of emotional distress, defamation, fraud, and invasion of privacy.

Suits for injuries caused by third parties on the job

If an employee was harmed at work and believes someone other than the employer was responsible, they have the option to sue that party. For example, if your client was injured by what is believed to be defective equipment, a suit can be filed against the equipment manufacturer. If awarded damages, the client may have to pay a portion to the employer or employer’s insurance company to repay the workers’ compensation insurance benefits. However, the employer and its insurance company can become parties in the lawsuit to recover their portion of paid workers’ compensation benefits. 

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