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What Employees Can Do If Injured At Work And Workers’ Comp Fails To Cover All Expenses

No one expects to be injured on the job, however, some workplaces are inherently dangerous, such as construction sites and manufacturing plants. Office environments are not immune from workplace injuries either, as employees frequently experience repetitive motion injuries (e.g. carpal tunnel syndrome) or may slip and fall on a slippery floor.

In any case, employees who are injured at work are covered under workers’ compensation insurance. This type of coverage provides benefits such as lost wages and medical coverage, however, injured workers are barred from filing personal injury lawsuits against their employers. Depending on the circumstances, however, it may be possible to hold a negligent employer or third party liable for a serious workplace injury.

How Does Workers’ Compensation Insurance Work?

Most employers are required to obtain workers’ compensation insurance. This type of insurance provides financial and medical benefits to workers who suffer a job-related injury or illness. Because this is a no-fault system, both the employer and employee are protected — neither is considered to be at fault. Therefore, employees essentially forfeit their right to sue their employers in exchange for obtaining workers’ compensation benefits. Such benefits include:

  • Lost Wages — Injured workers are eligible to receive up to two-thirds of their average weekly wages, based on all earnings (e.g. base pay, overtime, bonuses).
  • Medical Benefits — Reasonable and necessary medical expenses are covered at no cost to the injured worker. These expenses include emergency room visits, diagnostic tests (e.g. X-rays, MRIs, lab work), hospital care, doctors’ appointments, prescription medications, assistive devices (e.g. crutches, braces, wheelchairs) physical therapy and rehabilitation.
  •  Permanent Disability Benefits — These benefits are awarded to injured workers who sustain a permanent disability and are unable to perform any type of work as a result. Permanent disability benefits are based on a percentage of the workers’ wages at the time the injury occurred.
  •  Partial Disability Benefits — A worker who suffers a physical impairment that permanently impairs one or more parts of the body, but who is not prevented from performing some type of work, may be awarded partial disability benefits.
  •  Death benefits — If a worker is killed on the job or subsequently dies from complications of a workplace injury or illness, then surviving family members are entitled to death benefits. While the payout is based on a percentage of the deceased workers’ average weekly earnings, death benefits are capped.

It is worth noting that states limit the amount of time injured workers can receive temporary benefits, generally from three to seven years. While permanent disability benefits are not under similar time limits, workers’ compensation also does not provide for intangible losses such as pain and suffering, emotional distress and loss of enjoyment of life — types of damages that can be recovered in a personal injury lawsuit. Ultimately, this means that a seriously injured worker may not receive the necessary benefits to cover all of his or her losses.

Although workers’ compensation is designed to protect businesses from civil liability arising from workplace accidents, there are limited opportunities to file a lawsuit against an employer over a workplace injury. If a workplace injury occurs as a result of a safety violation, for example, it may be possible to hold the employer liable. More often than not, however, such injury claims involve negligent third parties.

Third-Party Claims in Workplace Accidents

While workers’ compensation insurance prohibits employees from filing personal injury lawsuits against their employers, a lawsuit can be filed against a negligent third party that causes an injury. Third-party claims are common in the following work settings:

  • Construction Sites — Despite the fact that construction workers are at a high risk of injury, site owners, general contractors, and subcontractors have a duty to provide workers with a safe environment. If a construction accident occurs, third-party claims can be brought against negligent general contractors, subcontractors, engineers, architects, equipment manufacturers, and their insurers.
  • Factories — If an injury is caused by dangerous or defective equipment or machinery, a  product liability lawsuit can be filed against a manufacturer or distributor.
  • Transportation-Related Work — Truck drivers who are injured in accidents can hold other drivers responsible, while manufacturers and distributors of defective truck and truck parts can be held liable when such defects cause or contribute to a truck accident.

If your work-related injury was caused by the negligence of a third party, it takes a skilled personal injury attorney to determine whether there is a legal basis for a lawsuit.

The Takeaway

If you have been seriously injured at work, you are entitled to workers’ compensation benefits, though obtaining these benefits can be complicated and claims are frequently denied. In addition, these benefits may not cover all of your losses. The best way to obtain the full value of your claim is to consult an attorney who is well-versed in both workers’ compensation insurance and personal injury law.

About The Author
C. Kelvin Adams Attorney C. Kelvin Adams is an experienced trial lawyer who focuses his practice on personal injury cases involving serious to catastrophic injuries and death, as well as a wide array of complex business disputes. Kelvin, who is a native Houstonian, is the principal of Adams Law Firm located in The Woodlands, Texas.