Workers Compensation Lawsuits

If you are hurt at work, you will wonder how much you can get for a workers’ compensation claim. As part of a typical claim, you are usually entitled to these benefits: 

• Weekly compensation
• Permanent impairment compensation
• Medical bill payments
• Work rehabilitation

First, note that workers’ compensation laws do not provide compensation for your pain and suffering. States have passed these laws to protect workers’ income only. If you have an injury from work and cannot do your job, you will receive weekly compensation, but nothing for pain and suffering. 

Weekly Compensation

You can get weekly compensation for temporary total disability; temporary partial disability; permanent total disability, or permanent partial disability. 

Temporary disability means you are still recovering but you should get better. Permanent disability means your condition is stable but it will not improve. 

Total disability means you cannot work in any type of job. Partial disability means you have some ability to work, perhaps sedentary or light duty jobs. 

Your weekly benefit for total disability usually will be 60% of your pre-injury average weekly salary. But most states cap the weekly benefit at $1000 per week. 

For partial disability, you will receive less because you are still able to perform some type of work. 

If you have a permanent impairment, your payment will be based on how much the injured part of your body is impaired. If your doctor says your hand injury results in a 20% permanent impairment, you would receive 20% of whatever your state law allows for complete loss of a hand. If the full amount is $100,000, you would receive $20,000. Some states also will allow you to receive compensation for scarring from a workplace injury. 

You also are entitled to have all ‘reasonable and necessary’ medical treatments paid for, which can be contentious between you and the workers’ comp insurer. It may be necessary to hire an attorney to represent you here. 

You also can be paid for vocational rehabilitation so you can be retrained for another job. 

Yes. It is possible to collect workers’ compensation after you quit, are fired or laid off. But you may face additional hurdles to prove that you qualify for workers’ compensation. 

There are usually two reasons to file a workers’ comp after you leave a job: 

• You had an injury at work that you thought was minor but has gotten worse and now requires medical treatment. For example, you might have hurt your back at work and thought it was minor. But as the weeks go by, the injury gets worse. 
• You have a chronic health problem, such as a cumulative injury that you got from previous work. For example, your physician may tell you that the pain in your wrist is from a repetitive injury from your old job. It is common for symptoms for repetitive injuries to show up after you leave a job. 

Meeting Deadlines to File Your Claim

Most states have strict time limits to report a work-related injury to the employer and to file a claim. The same limits are in effect whether you still are at the job or left. But some time has probably passed, so there is a chance you could miss the deadline. 

That is why it is important to notify your employer as soon as possible if you are injured at work. You should give notice within 30 days after the event happened. If you did not report the injury until later, your claim will be denied, whether you are still at that job or not. 

For a chronic or cumulative injury, the time period to file does not start until you first learn that your current or old job caused the problem. 

You will need to have strong medical proof that your current medical problem was caused by duties at your previous employer. 

First of all, remember that workers’ compensation cases require approval from the State Board of Workers’ Compensation from the state you live in, which can take time. 

Second, no matter how injured you say you are, you cannot force your company’s workers’ compensation provider to settle your case. They also cannot force you to settle. 

To come to an agreement so you can get paid, you or your lawyer need to negotiate a fair settlement. Before you think about settling, you should ensure you really understand what goes into a settlement. Or, hire an attorney to handle this for you. It can be worth it financially to hire a lawyer so you can obtain the most compensation possible. 

Once you have settled the case and it has been approved by the state board, it is then final. It cannot be changed later. 

If all of this sounds like it could take time, you are right. First, you need to negotiate the settlement and send it to your state board. Assume that the board approves the compensation settlement. From there, it usually takes 30 to 60 days until the insurance company pays the settlement. Some cases do not take that long, and others with more serious injuries could take even longer. 

Major factors that affect the timeline are: 

• The time it takes to prepare the settlement paperwork
• Time it takes to agree on changes to paperwork language
• Time it takes for the state board to review the settlement paperwork
• How long it takes the workers’ comp insurance company to pay you. 

The insurance company has 20 days from settlement to pay you. If they fail to do so, they have to pay you ao 20% late penalty. 

If you are hurt or get sick on the job, you could be eligible for workers’ compensation. The first requirement to get workers’ comp coverage is for the injury to have occurred at work, and this must be proven. Many injuries are straightforward and it is clear the injury occurred on the job, but some injuries are harder to prove. 

Below are the work-related injuries that usually are eligible for workers’ compensation: 

• Repetitive motion: Overuse or repetitive motion injuries can be very painful and debilitating. They are not caused only  by using a keyboard or mouse all day. Factory workers, office workers, and others can develop repetitive motion injuries such as carpal tunnel syndrome, back pain, tendonitis and more. 
• Occupational illness: These illnesses can range from black lung disease to mesothelioma to AIDS/HIV and many other.s But there needs to be strong evidence that the illness was caused by work. 
• Pre-existing condition: If you have an old back injury aggravated by activity at work, this could be covered. 
• Loss of hearing: Workers in noisy environments can lose their hearing, and this can be covered by workers’ comp. 
• Stress-related injury: Some states allow you to get payment for stress-related injuries, but they can be hard to prove. PTSD can be covered in some states, but the event must have been something immediate and traumatic, such as a teacher dealing with a mass shooting. 
• Stress from work-related physical injury: When a workers suffers a physical injury at work and develops an emotional or mental health problem afterward, this can be covered by workers’ compensation. 

An interesting aspect of workers’ comp is that it is a no-fault system. Even if the employee was partially at fault for his injury, the fact that it occurred at work means it still can be covered 100% by worker’s compensation. 

Most people think of workers’ compensation as one policy, but there are actual two parts, and each has limits. 

Part A is the workers’ compensation part of the program. This provides compensation to the worker who is hurt or made ill as a result of their job. Part B gives liability coverage to the employer. This part provides the company with protection if the worker thinks the employer was negligent or reckless and chooses to file a lawsuit rather than claim workers’ compensation. 

There is no exact limit for Part A coverage. The amount that is paid to the injured worker is determined by the Workers’ Compensation Board in every state. When deciding how much the worker should get in compensation, the Board will consider the worker’s salary each week and how serious the injury is. 

For instance, if the worker in New York earns a salary each week of $500, is hurt and 100% disabled, the benefit would be ⅔ of the average weekly salary, subject to a maximum determined by the state. Workers’ compensation also pays medical bills for disease treatment and injury rehabilitation. 

For Part B coverage, there are set limits. The basic limits are $100,000 per event for bodily injury, $100,000 per employee for a disease, and $500,000 policy limit for bodily injury caused by disease. These limits are in effect for all states, except ND, OH, WA and WY. 

Because one or two large workers’ comp claims can exhaust the limits of the company’s liability, employers should buy more liability coverage. The added premium for boosting limits is quite small when compared to the protection provided. 

Every state has time limits to file a workers’ compensation claim and to report a work-related injury to your employer. If you miss the deadline, you will probably lose your chance to be compensated for your work-related injuries. 

Each state has established time limits, also called Statutes of Limitation, that can vary a great deal. But the bottom line is this: The sooner you file your workers’ compensation claim, the better. 

After you are hurt on the job, or you find out that you have a medical condition that was caused by a workplace accident or condition, you need to report it to your employer as soon as possible. Make it clear to your supervisor or the HR department that you were hurt at work. 

Some state laws say you must give this notice ‘immediately, but most states have a specific time limit between 10 and 90 days. However, in many states, it does not count against you if you fail to make a written workers’ comp report; as long as you tell your employer within the designated time limit, your claim should be eligible under workers’ compensation laws. 

After you tell your company about your illness or injury, you usually need to file a written workers’ compensation claim with the workers’ comp department in your state. Your company may do this for you, but check to make sure either way. Deadlines for filing claims with the state can vary between one and three years in most cases, but some states allow even longer. 

For example, Wisconsin state law is six years within the date of injury. But there is no time limit for very serious injuries, such as brain trauma. If your company provided medical benefits before you filed your claim, the time for filing may not begin until those benefits have stopped. 

Did you experience a traumatic event on the job? You may not think about claiming workers’ compensation for post-traumatic stress disorder (PTSD), but you should understand how the condition is defined. That way you can make sure that you get the compensation you deserve. PTSD is a serious mental health condition that can prevent you from working. It also can prevent you from living your life normally and enjoying daily activities. 

For PTSD to be paid for by your workers’ compensation, it needs to meet the criteria stated in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders. Your PTSD also must be diagnosed by a psychiatrist or psychologist. 

Symptoms of PTSD need to last or begin 30 days or more after the event to be classified as PTSD. Symptoms that last less than 30 days are defined as acute stress disorder, not PTSD. This difference is key because it will change how various states handle your PTSD claim. 

If the work event was a physical event that caused PTSD, most states recognize it as a physical and/or mental injury. Treatment would be covered under workers’ compensation. If the worker was involved in a traumatic episode at work, but there was no actual injury, some states may not recognize it as PTSD. This would be classified as a mental injury and not eligible for compensation under most workers’ compensation plans. 

If you suffer an accident at work and believe you have PTSD, it is important to be diagnosed as soon as possible by your doctor. Early intervention is the best way to guarantee a full recovery. Making a claim as soon as possible after the event also assures you of the best chances to be compensated for your injury. 

One of the most common injuries reported in workplace accidents is a back injury. Workers who file claims for back injuries through workers compensation are likely to receive at least some amount of compensation. Recent surveys on this matter found that 74% of workers surveyed got workers compensation. This was done either via a voluntary settlement with the company or through a worker’s compensation hearing. Just 26% of workers who had back injuries did not get an award or settlement.

Surveys show that workers with back injuries who get a settlement in workers compensation receive an average of $23,600. This is slightly higher than the average compensation for workers with all types of injuries – $21,800.

Workplace back injuries can range in severity, so the amount you receive can be much higher or lower than the above figures. Injuries may range from mild strains that only need physical therapy, to herniated discs that need major surgery and months of recovery time.

Surveys also show that 68% of workers with back injuries received $20,000 or less, but the remaining 32% of workers got higher settlements. Six percent got from $20,000 to $40,000, while 17% received between $40,000 to $60,000. Nine percent got more than $60,000.

Workers with back injuries do get more compensation on average compared to other injuries, but their cases take longer to resolve. On average, it takes 18 months for workers with these injuries to resolve their cases. This is approximately two months longer than it takes to resolve cases for those with other injuries. It could be because those with back injuries get medical treatment for a longer time and take longer to reach the point of maximum medical improvement. There is a noted example online where a worker who had a back injury in 2009 did not settle the case until 2014 because of medical treatments that were still ongoing years later.

Your employer is not required to keep your job open while you are getting workers compensation. You can be fired or laid off. This can happen in some cases where work restrictions are preventing you from going back to work for several months. Many employers will try to keep your job available, but at some point, they may need to bring in someone else.

It is helpful for your cause if you communicate regularly with your employer while you are off work. If you do that, it is more likely they will hold your job for you. Make sure you keep the company informed about your health situation and when you can return to work.

Also, if you do come back to work, you are not assured an exact job or pay rate.

But you cannot be fired for claiming workers compensation. This is illegal and you can get more compensation in this case, above and beyond what you are entitled to for workers compensation.

Unfortunately, it is almost impossible to recover pain and suffering compensation through workers comp. It may be possible in limited situations to recover some money for emotional distress. But in almost all state workers compensation laws, the employee may not sue the company for pain and suffering compensation. The only benefits to which you are entitled through workers compensation are wage-loss benefits and medical expenses for your injuries on the job.

However, if a third party was responsible for the injury, you might be able to be compensated for your pain and suffering by suing the third party. A third party is a person or company other than your employer who could be liable for your injuries. This might be a co-worker, contractor or the manufacturer of equipment that caused your injury.

There have been a few workers comp claims where pain and suffering were obtained, however. One possibility is when a claim is filed under the Federal Employee Liability Act. In this case, it is possible to get an award for pain and suffering. Also, some states, such as California, allow claims for emotional distress, but not pain and suffering. But in most states, no recovery for your pain and suffering is possible through workers compensation.

Generally, no, with limited exceptions. When you are hurt on the job, you usually recover compensation only through workers compensation. Employees in all states are covered under workers compensation rules at the federal or state levels. Thus, you usually cannot file a personal injury lawsuit in addition to taking workers compensation. The exceptions to this rule are:

• Your employer tried to intentionally harm you. For instance, if your supervisor punched you in the face, you could theoretically sue for damages in addition to taking workers compensation. But the punch in the face must have been intentional; if it was an accident, it was not intentional harm and does not qualify.
• Fraud: Someone at the job lied to you and you suffered an injury
• Defamation: Someone at work said something untrue about you that caused you harm
• Intentional infliction of emotional distress: You were emotionally traumatized on the job by extremely bad behavior
• Your employer does not have enough workers compensation insurance. If your employer did not carry enough insurance to properly compensate you, it is possible you can file a lawsuit to make up the difference.

Another major exception is if you are injured at your place of employment by a third party. If the injury was caused by defective equipment that the other company produced, you can file a separate lawsuit against that company.

If you are eligible to file a lawsuit, it is important to consult with a personal injury attorney as soon as you can. Your attorney will be able to confirm if you can file a lawsuit in addition to seeking workers compensation. But most cases of workplace injury do not allow for these types of lawsuits.

Work comp lawsuits are generally taken up with the insurance company that’s paid by your employer, not the employer themselves. However, in certain cases of serious negligence, a lawsuit may be filed against the employer directly. Examples of this would be extremely dangerous working conditions that resulted in injuries, or prolonged exposure to toxic chemicals (i.e. asbestos) that caused chronic and/or deadly health conditions.

Depending on the scenario, there may also be a lawsuit filed against a third party – for example, let’s say a vendor was moving a piece of heavy equipment into the office where you work, and it tipped over and fell on your foot, causing major injuries and causing you to have surgery on your foot. You would have a potential personal injury lawsuit against the third party, in this case your vendor, to recoup your losses in for medical bills, loss of income, and pain & suffering.