Save Yourself from Having to Wade through the Bureaucratic Red Tape and/or the Complexities Surrounding Workers’ Compensation Claim

There are many different causes of injuries in the workplace, most of which result not only to physical pain suffered by injured workers, but also to financial sufferings, especially if these injuries are serious as this would mean costly medical treatment, the need to purchase the needed medication, and days or weeks off from work, which means no salary to expect.

Providing employees a financial safety net (though lower in amount compared to their regular pay) until they are able to return to work and earn their keep is the Workers’ Compensation, a state-administered insurance program. This Workers’ Comp is designed to provide benefits to workers whose injury, disability or illness is work-related. Though cash benefits is only about two/thirds of an injured worker’s average wage, (injured workers) greatly rely on it so as not to totally suffer disabling financial conditions.

Workers’ Comp pays benefits regardless of whose fault the accident is. However, there are limits as to the types of injuries that may be paid. As a rule, benefits will never be paid to workers:

  • Whose injury were self-inflicted;
  • Who were intoxicated at the time of the injury; or
  • Whose injury was a result of actions in violation of a law or company policy on work safety.

Because Workers’ Comp is financed by employers, it serves as some sort of an exchange or deal wherein injured employees, by choosing to receive its offered benefits (which usually include cost of medical treatment, lost wages, disability, rehabilitation and death), automatically waive their right to sue their employer for additional compensation.

Before applying for Workers’ Comp benefits, however, there are three very important legal aspects about this insurance benefits that injured workers need to understand:

First is the fact that they have the right to claim it (which means they cannot sue their employer);

Second, they can waive their right to receive Workers’ Comp benefits for the right to sue their employer to seek higher compensation. This legal pursuit is legally permissible, especially if this benefits program: is not actually offered by the employer; there is clear proof that the accident was intended by the employer; or the injury was very serious or leads to death. By suing their employer, injured workers may be able to receive damages that will also cover pain and suffering, mental anguish, and punitive damages in addition to all those that Workers’ Comp would have provided; and,

Third, aside from the right to sue their employer, injured workers can also pursue legal action against third parties, such as suppliers or manufacturers of the defective products or toxic substances that they used at work, or any other outside contractor who may have caused the injury. While suing an outside contractor does not require waiving their right to Workers’ Comp, paying a portion of the Workers’ Comp insurance benefit already received may be necessary. The employer and insurance provider may otherwise be allowed to join injured workers’ side in the lawsuit in order for them to recover the value of the benefits that they already paid.

According to one Georgetown personal injury attorney, though hard and loyal workers have every right to expect their employer to support them if they get hurt on the job, many employers and insurance companies attempt to sidestep their workers’ compensation responsibilities by arguing that the employee’s injury or disability was not work-related – this is a move by many employers so as to avoid increasing their premiums (employees making claims too often or employees making expensive claims due to severe injuries would mean higher premiums for employers).

Applying for Workers’ Comp benefits can be a complex process; more so if an injured worker decides to sue his/her employer instead. After being seriously injured, however, the last thing a worker needs to worry about is wading through the bureaucratic red tape and/or the complexities surrounding Workers’ Compensation claim. To save himself/herself from all these trouble, having a legal representative (a Workers’ Comp claims lawyer) may just be a necessity.

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