WHAT IS THE DIFFERENCE BETWEEN A PERSONAL INJURY AND A WORKERS’ COMPENSATION CLAIM?

Employees in California have substantial legal rights, and anyone injured at work generally has the law on his or her side. Typically, a California employee injured at work will receive workers’ compensation benefits and will not have to file a personal injury lawsuit. Precisely what is the difference between a workers’ compensation claim and a personal injury claim or lawsuit? In California and most other states, the key legal difference is that a personal injury claim is based on “fault,” and a workers’ compensation claim is not. Let our personal injury attorneys explain.

For example, to recover losses and damages for injuries sustained in a traffic collision or any other type of accident unrelated to work, the injured person must show that another person was negligent and therefore at fault for the injuries. However, if a person is injured at work and while working, all that a personal injury lawyer needs to be proven is that an injury genuinely occurred, and workers’ compensation benefits will be paid.

HOW IS “FAULT” DEFINED UNDER THE LAW?

A “trip-and-fall” incident is a good example of fault in personal injury law. Just because someone trips, falls, and gets injured on someone else’s property, it doesn’t necessarily follow that the property owner was negligent. Accidents sometimes happen for no reason at all, so if an injury victim wants to be compensated for damages after tripping on someone else’s property, that victim must prove that the property owner maintained the property negligently. Likewise, in a traffic crash with injuries, damages can only be recovered from a driver if there’s proof that the driver was negligent and therefore legally at fault.

A workers’ compensation case is entirely different. With very few exceptions, employees who are injured at work are entitled by law to workers’ compensation benefit payments. Workers’ comp insurance is a no-fault system. To receive workers’ compensation benefits, employees are not required to prove that employers or co-workers are at fault for their injuries – they’re required only to prove that the injury actually happened at work and while working. Even an employee who is negligent at work and causes his or her own injury is usually entitled to workers’ compensation benefits, within reasonable limits.

Fault is the key legal difference between workers’ compensation and personal injury, but when it comes to payments, the main difference is the “pain and suffering” damages available to plaintiffs in personal injury claims but not to employees injured on the job. In most personal injury cases, victims are entitled to monetary compensation for non-monetary damages – pain and suffering – as well as monetary damages such as medical bills, future medical expenses, lost wages, and lost earning capacity. Worker’s compensation pays for permanent impairment benefits, weekly compensation, medical bills, and vocational retraining – and nothing more.

WHY IS WORKERS’ COMPENSATION SO LIMITED?

No one can receive pain and suffering benefits through a workers’ compensation claim. The workers’ comp system today is basically a political compromise that has emerged over decades among labor, business, insurance companies, and other interest groups. Before the states adopted workers’ compensation laws, the only solution for workers injured by employer negligence was a personal injury lawsuit. If the employer was not directly negligent, or if the employee did not bring a claim or could not prove an employer’s negligence, the employee received nothing.

In the late 19th and early 20th centuries, the states developed workers’ compensation systems to ensure that all workers injured on the job would receive at least some kind of minimum weekly benefits and have their medical expenses covered. In reciprocation, injured employees gave up the right to sue their employers and co-workers for negligence, and they additionally gave up any right to monetary compensation for pain and suffering.

ARE WORKERS EVER PERMITTED TO SUE EMPLOYERS?

Two groups of workers are not covered at all by any workers’ compensation system: the crew members of vessels and interstate railroad workers. A crew member – whether on a cruise ship or on the smallest commercial fishing vessel – is not covered by workers’ compensation. A federal statute, the Jones Act, lets crew members sue employers for damages, including pain and suffering, if they are injured on the job. Interstate railroad workers are allowed by the Federal Employers Liability Act to sue employers for damages if they are injured while on the job.

Other workers are allowed to sue their employers for compensation related to injuries only in very strictly defined circumstances. If an injured worker’s employer does not carry workers’ compensation insurance, for instance, or if an employee is injured because of an employer’s intentionally hostile, negligent, or illegal conduct, then a personal injury claim can probably be filed and pursued. In California, if a third party’s negligence, oversight, or malice causes a workplace injury, there may be grounds for a third-party personal injury lawsuit, but an injury victim should seek the advice of a California personal injury attorney.

The fact is that third parties rather than employers are responsible for a large percentage of today’s workplace injuries. Injuries can happen, for example, when work equipment fails or is defective because of a design, engineering, or production flaw. Workers injured by faulty equipment may choose to pursue a product liability claim against the equipment manufacturer. When a worker who drives as part of his or her job is injured by another driver, if that other driver was negligent, the injured worker may file a personal injury lawsuit.

WHAT OTHER RECOURSE DO INJURED WORKERS HAVE?

Injured California workers have a legal right to pursue damages apart from the workers’ compensation system. Frankly, while workers may receive basic benefits through workers’ compensation, in most cases those payments are barely adequate. Moreover, workers’ compensation does not provide for punitive damages to penalize employers who allow dangerous workplace conditions, and those employers need to be held accountable.

Workers injured in California need to report their injuries and obtain medical treatment immediately. A consultation with a California personal injury attorney can help an injury victim to understand fully his or her legal options and alternatives. Injured workers in California have rights that are enforceable under the law, and they may have several legal alternatives beyond workers’ compensation. Californians injured at work should make certain that they understand their rights thoroughly and that they receive the full benefits and compensation they need and deserve.