Workers’ compensation exists to provide injured employees with a structured path to medical coverage and lost wage benefits after a workplace injury. It is not, however, the only legal remedy available in every situation. Depending on how an injury occurred and who was involved, a separate personal injury claim may also be possible, and the two processes can run simultaneously.
The Distinction Is Worth Understanding Early
Our friends at Mishkind Kulwicki Law Co., L.P.A. discuss this with clients who come in after a workplace injury assuming their only option is a workers’ compensation claim: the circumstances of how an injury occurred determine what legal avenues are available, and many clients are surprised to learn that the involvement of a third party, someone other than the employer, can give rise to a civil personal injury claim entirely separate from the workers’ comp process. A car accident lawyer may be able to help you pursue compensation for medical costs, lost income, and the full impact of your injury in ways that workers’ compensation, by design, does not reach.
The two claims are governed by different legal frameworks and produce different categories of recovery.
What Workers’ Compensation Does and Does Not Cover
Workers’ compensation is a no-fault system. An injured employee generally does not need to prove their employer was negligent to receive benefits. In exchange for that accessibility, workers’ compensation provides a defined and limited set of benefits, typically covering medical treatment and a portion of lost wages, but not pain and suffering, full wage replacement, or other non-economic losses.
And in most states, accepting workers’ compensation benefits from an employer means giving up the right to sue that employer directly for negligence. This is the trade-off built into the system.
But the limitation on suing your employer does not extend to third parties whose negligence contributed to your injury. That is where the personal injury claim enters.
When a Third-Party Claim Is Available
A third-party personal injury claim arises when someone other than your employer bears responsibility for the conditions that caused your workplace injury. Common scenarios include:
- A contractor or subcontractor whose work created a hazardous condition at your worksite
- A driver who caused a vehicle accident while you were working, such as during a delivery or service call
- A manufacturer of defective equipment or machinery that malfunctioned and caused your injury
- A property owner, separate from your employer, whose negligent maintenance of a premises contributed to your injury
- A vendor or outside service provider whose employees created an unsafe condition at your workplace
In each of these situations, the responsible third party may be liable in a civil personal injury claim regardless of what workers’ compensation covers.
Why Third-Party Claims Produce Different Recovery
This matters practically because the categories of compensation available through a personal injury claim are significantly broader than those available through workers’ compensation alone.
A successful third-party personal injury claim can recover damages for pain and suffering, the full extent of lost earning capacity rather than the partial wage replacement workers’ comp provides, the non-economic impact of the injury on your daily life and personal relationships, and future medical costs not covered by the workers’ compensation system. In some cases, punitive damages may also be at issue depending on the nature of the third party’s conduct.
The combination of workers’ compensation benefits and a third-party personal injury recovery, when both are available, produces a more complete financial outcome than either alone.
The Lien Issue in Combined Claims
When a workplace injury supports both a workers’ compensation claim and a third-party personal injury action, the workers’ compensation carrier typically has a right to recover some portion of what it paid from any personal injury settlement or verdict. This is called a workers’ compensation lien, and resolving it is a required part of closing the personal injury matter.
Your attorney will identify any applicable lien early in the representation and work to negotiate it where possible. The existence of a lien does not undermine the value of pursuing a third-party claim. In most cases, the additional recovery available through the civil claim still produces a meaningfully better outcome for the client even after the lien is resolved.
Steps to Take After a Workplace Injury
If you’ve been injured on the job, the immediate priority is medical care and reporting the injury to your employer through the appropriate channels. Beyond that, preserving evidence about how the injury occurred and who may have been responsible, including any third parties present at the scene, is something worth doing as early as possible.
Speak with a personal injury attorney before making any decisions about what claims to pursue or what settlements to accept. Accepting a workers’ compensation settlement without understanding its effect on a potential third-party claim can limit your options in ways that are difficult to undo.
Find Out What Claims May Be Available to You
If you’ve been injured at work and want to understand whether a personal injury claim against a third party may be available alongside your workers’ compensation case, speaking with an attorney is the right and well-considered starting point. Contact our office to schedule a time to discuss the circumstances of your injury and what your full range of legal options may involve.