Stephen Hasner | Workers' Compensation | September 18, 2019
Getting hurt on the job can leave you with a lot of questions. You could have medical bills to pay and may not be in a position to return to work. In these situations, it can be difficult to know who should be held responsible and what options are available to help compensate you for your injuries.
Generally speaking, when it applies, workers’ compensation is the “exclusive remedy” you have against your employer for any on-the-job injuries. However, in some limited circumstances, you may be able to sue someone else (known as a third party) for your injuries, as well.
Workers’ Compensation Overview
Workers’ compensation is a benefits program created by the state. The program covers medical and rehabilitation costs and provides income to employees injured while working. As you might expect, the amount and type of coverage available to you depend largely on the type of work-related injury and how it was sustained.
Under state law, employers with more than three employees are required to maintain workers’ comp coverage. As an employee, your coverage begins on the first day of employment. It is important to note that if the company you work for has workers’ compensation coverage, this means that in most cases you cannot sue your employer directly. In other words, workers’ comp is typically your only remedy for your injuries.
One of the benefits to workers’ comp is that it offers “no-fault” coverage. This means that benefits will be provided regardless of who is at fault (if anyone). This is an important distinction as you would need to prove that someone was at fault – i.e. negligent – if you were to sue your employer directly. The exception to this rule is if your actions rose to the level of “willful misconduct.”
Overall, pursuing workers’ compensation benefits is typically advantageous for employees. The process is much faster than going to court. However, remember that the trade-off is that you cannot sue your employer.
Limitations to Workers’ Comp
As mentioned above, you cannot collect workers’ compensation benefits in cases of wilful misconduct. Some examples of this behavior include being drunk on the job, fighting, or intentionally hurting yourself.
Further, your injury must occur while working. However, this doesn’t mean that it necessarily must be sustained on your employer’s premises. As long as the injury occurs during employment you eligible for compensation. An example of a covered injury would be if you were a delivery driver and were hurt while making deliveries. But, note that this rule does not apply to your commute to and from work, if you were performing unassigned duties, or if you were injured during breaks.
Keep in mind that workers’ comp only covers medical bills and employment income. You cannot receive cash for pain & suffering or any other “intangible” injuries.
Further, the amount you are awarded for your injury is set by state law and may not reflect how much you actually spent on medical bills. In most cases, even if there is a shortfall, these amounts cannot be recovered against your employer unless one of the recognized exceptions applies.
Third-Party Personal Injury Claims
One exception to the general rule that you are limited to workers’ compensation benefits for work-related injuries is if you were harmed by someone other than your employer. This person is referred to as a “third-party” and you may be able to sue this person directly. Note that the definition of third-party does not include another employee of the company where you work.
An example of potential third-party liability would be if you were hurt by a defective product. In this case, you could bring a products liability case against the manufacturer. Another example would be if you got into a car accident with another vehicle while working. Here, you might be able to sue the other driver.
It might be helpful to think of third-party claims as personal injury lawsuits. In fact, that is exactly what they are. Also note that if you decide to go this route, beware of the possibility of what is called a subrogation lien. This means that if you win your case against the third-party, your employer may be able to recover from your damage award what it paid out to you as workers’ comp benefits.
It may be the case that your employer does not have workers’ comp coverage. This could be because they are not required to (i.e. they do not have more than three employees) or because they neglected to obtain coverage. In this case, you are entitled to sue your employer directly for your injuries.
Another exception would be if your employer intentionally harmed you. This can be complicated, so it is best if you speak to a qualified attorney if you think your injury might qualify for this exception.