There’s a lot of confusion that happens when someone is injured on the job. Yes, the injury is supposed to be covered by workers’ compensation insurance, but the questions don’t end there.
More than 50,000 injuries occur annually in the workplace in California alone. When workers’ comp insurance is involved, there are strict protocols that must be followed. An injured party must follow the system, which means that most of the time they can’t make a personal injury claim.
But there are exclusions to this stipulation that a knowledgeable personal injury attorney would know. That’s why it is important for you to talk to a lawyer at Hershey Law before you decide you don’t have a case.
To help you understand a little more about the overlap that occurs in workers’ comp and personal injury claims, we’ve broken down the basic FAQs we hear most frequently.
What Are the Workers’ Compensation Laws in California?
With the predominance of work-related injuries, it is crucial that employers have a strict set of guidelines to follow. These laws and regulations ensure their employees are taken care of in the event of an injury.
In general, if you’re hurt on the job, your workers’ compensation insurance will cover the costs of your medical care. If you have problems getting your care covered or your injuries are permanent, a workers’ compensation attorney can help you.
Each state has its own regulations on workers’ compensation coverage, but in California, there are no exceptions. Every employer, even if they only have one person working for them, must carry workers’ compensation insurance.
It doesn’t matter if the employees are full- or part-time, they need to have the blanket of safety that workers’ comp insurance provides.
Any employer who is found violating this requirement can be prosecuted at the criminal level. California imposes penalties that include, but are not limited to, consequences such as:
- A financial penalty up to double the total amount of premiums for the time the employer did not have coverage or $1500 per employee
- A forced closure of the business, either temporarily or permanently, with a steep fine of over $10,000 and a jail sentence for continued violations
- A lien against any property held by the employer to pay the injured employee’s benefits
With the imposing fines and other penalties that hang over an employer’s head, it just makes sense that they carry workers’ compensation insurance. The odds are that if you’re injured on the job, your employer has coverage for you.
What Does Workers’ Compensation Cover?
Workers’ comp injuries and personal injuries often look the same.
Almost three million non-fatal work-related injuries happen annually across the country. Like a typical personal injury, these accidents result in physical damages like:
- Neck and back strain and sprain
- Broken bones
- Traumatic brain injuries
- Long-term chronic illnesses
- Loss of extremities
- And more
Your insurance coverage for an on-the-job injury will cover your medical care, temporary or permanent financial and insurance benefits, and other treatment necessary to attempt to return you to your pre-injury status.
Isn’t My On-the-Job Injury a Personal Injury, Too?
There are some subtle nuances that must exist in order for a workers’ comp injury to fall into the realm of a personal injury.
First of all, in a workers’ compensation injury, fault is not an issue. Whether you were injured because of your own mistake or someone else’s negligence, you’re still covered under the insurance. You can also still file a claim against the workers’ comp coverage for injuries that are long-term or permanent.
However, in a personal injury case, recovery of damages depends on your attorney’s ability to prove negligence against the defendant. You have got to provide sufficient evidence that directly points the arrow from your accident and injury to the fault of the person you are blaming.
Another difference is in the damages you can receive in workers’ comp cases as opposed to a personal injury claim.
Damages due to an injury on the job have a specific formula. You can expect to receive financial compensation for any lost earnings you missed out on while recovering. You’ll also likely receive financial benefits for any permanent physical injury and for your medical bills.
If you can no longer work in your previous capacity, you’ll also be entitled to vocational rehabilitation. This service is intended to either help you get back to doing what you once did or train you to be able to work in a new career.
But personal injury damages are different. What you receive in compensation can depend on the evidence that you submit to the jury.
A solid personal injury case with an expert attorney can mean that you not only get lost wages and medical bill coverage, but that you also are awarded damages for pain and suffering.
This extra compensation exists because in a personal injury, another party was negligent. If their negligence hadn’t happened, you wouldn’t have been suffering. Because workers’ comp cases are not contingent on fault, this is not a damage awarded in those types of claims.
If the personal injury case is severe enough that the jury feels the negligent party should be taught a lesson, punitive damages might also be awarded.
One more important distinction between the two types of claims is in the way they are handled. Workers’ comp claims start at the job by notifying your employer of the injury. From there, the doctors you see and the treatment you get is determined in large part by the workers’ comp carrier.
In a personal injury case, you can seek treatment with any provider who is willing to accept your insurance coverage. You are in charge of your care and the way the case heads. Your attorney serves the at-fault party with the lawsuit, and you and your attorney have a right to all records, depositions, and information on the case to prepare your evidence.
You can choose to settle out of court or request a trial in front of a jury. In short, you and your attorney lead the way as long as the evidence of negligence is sufficient.
What Happens When Workers’ Comp and Personal Injury Cases Overlap?
In rare situations, a workers’ comp case has elements of a personal injury lawsuit. For the most part, once you enter the workers’ comp arena, which starts the second you file a claim, you can’t switch over to personal injury.
And you can’t choose to ignore the workers’ comp aspect just because you would prefer a personal injury claim to be filed.
But if your injury stems from a third party’s negligence, you may still be able to file a claim against that third party. You can’t file a lawsuit against your employer. That’s the workers’ comp arena.
However, if your injury happened at work because of the actions of a customer or someone else, then a personal injury lawsuit might be possible.
Hershey Law attorneys will be able to navigate these muddy waters with you. Questions may arise that need to be answered before a personal injury claim is verified.
The accident in question will be addressed, of course, as well as the events leading up to and after it. In some instances, the aspect of the third-party person will be under investigation. If the at-fault party is a coworker or your employer, you may be reverted back to the workers’ compensation attorney.
But if the person whose negligence caused your accident is, indeed, a third-party, then you’ll want a knowledgeable personal injury attorney on your side to file your lawsuit and fight any accusations of a workers’ comp only claim.
Other circumstances may apply that bring in the need for a personal injury lawyer. If you were fired or otherwise sanctioned because of your injury and claim, you may also have a workplace wrongful lawsuit.
OSHA, or the Occupational Safety and Health Administration, might need to become involved. Your personal injury attorney can advise you if this is necessary. OSHA generally steps in if your accident occurred because of hazards on the job causing unsafe work conditions.
Always Err on the Side of Your Best Interests
When you are injured on the job, your employer and all the paperwork you are given is going to make it clear that you have no rights to a lawsuit beyond your workers’ compensation claim. To a degree, they’d be right.
But there are extenuating circumstances that may fit in your situation. Before you decide that you have to settle for what the workers’ comp attorneys say you are worth, schedule a free consultation with an attorney at Hershey Law.
The workers’ comp investigators and attorneys are looking out for the best interests of the associated insurance company. They want to give you just enough to satisfy the letter of the law, nothing more.
Our expert personal injury lawyers will evaluate your case and work with you to determine your next steps and see if you qualify for further damages. We are on your side, looking out for your best interests.