Introduction to the (Important) Differences Between a Personal Injury Case and a Worker’s Compensation Case
Personal injuries do not just happen when you are out and about on personal errands or tending to your personal affairs. Other people do not wait until you have clocked out from your job and started to make your way home before deciding to commit negligent or reckless acts. As any person who has been injured at work can attest, accidents caused by the negligent and careless acts of others can happen at any time and at any place. You are at risk of suffering a personal injury even in your own workspace. For example:
- You may fall down a flight of stairs while carrying a heavy load, or you may trip and fall over a misplaced rug or runner.
- You can injure your back by attempting to pick up a heavy load or injure your wrists or back through excessive and repetitive movements.
- You can be injured by dangerous office equipment like large paper shredders, industrial trash compactors, and dangerous chemicals.
- You may be struck by heavy equipment like dump trucks, forklifts, and/or cranes.
There are (simply put) myriads of ways in which you can be injured at work.
Injuries at work and injuries away from your workplace have some similarities in that you may be entitled to compensation for your injuries and/or losses. Aside from this, however, there are very few similarities: In fact, personal injury lawsuits and worker’s compensation claims have more differences than similarities. Knowing these differences is key to knowing when you need to file a worker’s compensation claim and when a personal injury lawsuit is in order, as well as knowing how to prevail in either situation.
Statutory Scheme vs. Common Law Creatures
The first difference between the two types of claims or lawsuits centers on how the right to pursue compensation in each situation is created. The ability to pursue compensation against a negligent person in a personal injury case has existed for hundreds of years and is a product of common law. In other words, the right to obtain compensation from a negligent person whose careless actions caused you harm has been recognized by the court system long before there were statutes and codes.
Conversely, the ability to file a worker’s compensation claim is purely a creation of statute. Legislators in each state determined to provide compensation to injured workers and did so by passing various laws that created the framework whereby injured employees can obtain recompense for their work-related injuries. This means that an injured worker must comply with all relevant statutes and regulations to be able to bring a worker’s compensation claim: Failing to comply with even one portion of a state’s worker’s compensation law is grounds for denying the entire claim. For example, most worker’s compensation schemes require the injured worker to provide notice to his or her employer about the injury within a reasonable time. In some states, failing to provide this notification can be fatal to the worker’s claim, even if the worker met all of the other requirements to be entitled to benefits. This also means that if a state does not have a worker’s compensation scheme, then no worker’s compensation claim can be filed. For more information on differences between workers comp and PI visit Alllaw’s article on the subject.
Broad Scope vs. Limited Scope
The next difference between these two types of claims has to do with the situation under which each is applicable. A worker’s compensation claim is appropriate only in a very limited situation – when a worker sustains an injury while he or she is “at work.” An injury occurring at any other time other than when the worker is engaged in the performance of his or her duties or otherwise on “company time” is not able to file a worker’s compensation claim. For instance, a worker who is driving home from work and gets into an automobile accident is not able to file a worker’s compensation claim.
The worker who is injured on the way home may be entitled to file a personal injury lawsuit, however. This is because personal injury lawsuits are appropriate in a wide variety of situations and circumstances. Unless the legislature of a state has “carved out” a specific injury situation and provided a means of compensation for that particular situation (such as worker’s compensation laws covering injuries in the workplace), a personal injury lawsuit is appropriate. Personal injury lawsuits cover the following situations and more:
- Trips and falls or slips and falls on public or private property;
- Dog bite injuries;
- Nursing home abuse and neglect cases;
- Car, motorcycle, and/or trucking accidents;
- Defective products;
and many other types of situations.
What does all this mean for you, the injury victim? If you were injured in the workplace while on the job, it is very likely that you will need to file a worker’s compensation claim. If you were injured under any other circumstances, a personal injury case would be appropriate.
(Note, too, that in some states a workplace injury is only compensable through a worker’s compensation claim. In other words, in these states, you cannot bring a worker’s compensation suit against your employer for any negligent acts your employer or an employee of your employer committed. In other states, you as a workplace injury victim can elect between filing a worker’s compensation claim or a personal injury lawsuit against your employer.)
Certain but Limited Compensation vs. Uncertain but Open-Ended Compensation
When you file a worker’s compensation claim, in most states, the law provides that your claim is to be approved regardless of whether your employer’s negligence, your own negligence, or another employee’s negligence (or all three) contributed to your injuries. However, the compensation you receive is specific and limited: You can usually only recover the costs of your medical care and treatment, a portion of your lost wages (if you miss a sufficient amount of time from work), and perhaps some compensation if you suffer scarring or disfiguring injuries. If you (the worker) die from your injuries, your surviving family members are usually able to recover a death benefit as well as have funeral and burial costs covered up to a certain amount. You are typically not able to recover compensation for mental pain and anguish, noneconomic losses, and/or punitive damages through a worker’s compensation claim.
A personal injury lawsuit allows you to recover compensation for both economic and noneconomic losses (including punitive damages in some cases), but your ability to actually recover these damages is much less certain. This is because a judge or jury needs to find that the defendant is in fact negligent and that the damages you claim you suffered are connected to the negligent behavior. For instance, suppose you are involved in a car accident and suffer a minor back injury. While you are at home but before you file a personal injury lawsuit, you slip and fall and seriously hurt your back. You thereafter file a personal injury lawsuit over the car accident and seek compensation for the damage to your back. The judge or jury may find that the harm caused to your back was predominately (or even exclusively) caused by your injury at home, not the car crash. If the judge or jury made this finding, you might not receive any compensation at all for your back injury.
When a Worker’s Compensation Claim May Not Be Appropriate
As noted above, because worker’s compensation claims are “creations of statute,” they are only available in certain limited circumstances. You may not be entitled to file – or even want to file – a worker’s compensation lawsuit in the following situations:
- Your employer has engaged in intentional or grossly reckless conduct that caused you injury. This can include directing other employees to purposefully injure you or ignoring repeated safety warnings by workplace inspectors;
- The person who injured you on the job was not an employee of your employer but was rather an independent contractor or the employee of another company. In the case of an independent contractor, the contractor him- or herself would be responsible for your injuries. In the case of an employee from another company, that other company would be responsible for your injuries.
In either case, though, a personal injury lawsuit (perhaps coupled with a worker’s compensation claim) is appropriate. Any compensation you would receive through your personal injury case would be paid to the worker’s compensation insurer first, up to the amount the insurer paid to you. For example, if you received $25,000 from your employer’s worker’s compensation insurer and thereafter recovered $100,000 through a personal injury lawsuit, you would receive a net damages award of $75,000.
- Your injury or illness is not connected to your employment or sustained while you were “on the job.” It can sometimes be difficult to determine whether your injury occurred “on the job,” making it difficult to determine whether you should file a worker’s compensation claim or a personal injury lawsuit. Take a delivery truck driver, for example: Suppose that while he or she is on his or her delivery route he or she takes a quick detour to drop his or her child’s backpack off at his or her child’s school. Suppose further that while on this “detour” the driver is involved in a car accident caused by another person. Was the delivery driver truly “at work” when the accident happened? Courts and commissions can view this situation differently.
When in doubt about whether to file a personal injury lawsuit or a worker’s compensation lawsuit, it may be advisable to file both types of claims to cover yourself. You should know in doing so, however, that one claim or the other is likely to be dismissed if a court or a worker’s compensation commission determines that one of the claims is not appropriate for your set of circumstances.
Conclusion to the (Important) Differences Between a Personal Injury Case and a Worker’s Compensation Case
Worker’s compensation claims are meant to provide some compensation to injured workers so they can address their economic losses. While they are similar to personal injury cases in that both attempt to give an injured person compensation for his or her injuries, worker’s compensation cases and personal injury cases have many significant differences. Understanding these differences can help you determine whether you should file one type of claim or the other under your specific circumstances. While personal injury cases offer the opportunity to recover more compensation than a worker’s compensation claim, personal injury cases are uncertain in that a judge or jury must find the other party acted negligently and that the damages you claim to have suffered are connected to the negligent behavior. Worker’s compensation claims, on the other hand, do not provide any compensation for a worker’s noneconomic losses (like pain and suffering), but compensation is available regardless of whose negligence caused the injury to occur. When in doubt about whether one should file a worker’s compensation claim or a personal injury claim, it may be beneficial to file both types of claims.