According to a recent report from the Bureau of Labor Statistics, there were a total of 2.7 million nonfatal work-related injuries in 2020. These included everything from repetitive motion injuries, slips and falls, car accidents, and manual materials handling.
The most common occupational hazards reported were falls, most of which resulted in traumatic brain injuries, spinal cord injuries, broken bones, and in some cases, even death.
One of the most frequently asked questions we get with regard to injury at work rights is – Can I sue my employer for a work related injury? Here’s everything you need to know.
What Is Workers Compensation and How Does It Work?
If you end up getting injured at work, in most cases, you cannot sue your employer. The keyword here is – in most cases. There are exceptions.
Workers’ compensation laws are designed to protect employees and employers alike. They address the question of who pays for work related injuries.
If you get injured in your line of duty, your employer is obligated by law to pay for your injuries, regardless of the at-fault party. The catch is, by paying for your injuries, your employer’s liability is limited, meaning they are essentially immune from any potential personal injury lawsuit you may lodge against them.
All states have workers’ compensation laws. These require businesses to take out workers’ comp insurance for their employees. These policies are designed to protect employees who suffer work-related injuries or illnesses by paying for all medical expenses as well as paying out cash benefits regardless of the party at fault.
Work Injury Compensation Eligibility Requirements
While workers’ comp laws vary from state to state, there are specific requirements an employee has to meet to draw these benefits when they need them. Below is an overview of the three main ones.
- Your employer needs to carry workers’ compensation insurance. The criteria may vary depending on the type of business, the type of work the employees do, and the number of employees in the company.
- You need to have been an employee of the company at the time of the injury. The law defines employees as full-time and part-time workers, temporary workers, and seasonal workers. Volunteers, independent contractors, farm laborers, domestic workers, and undocumented workers may not be eligible for workers’ compensation if they get injured while performing their duties.
- You need to have been injured while performing work-related duties. While this sounds straightforward on paper, it’s not always cut-and-dried. If you got injured away from your job site, but in connection with work-related duties, your eligibility for workers’ comp may fall in the gray zone.
Injury at Work Employer Responsibilities
Employers have a general responsibility to provide a safe working environment for their employees as stipulated by federal and state occupational and health safety laws. The Occupational Safety and Health Administration (OSHA) is the federal agency charged with the enforcement of these laws. OSHA is also responsible for promoting workplace training on the prevention of injuries and hazards, in addition to issuing guidelines on safety-related issues.
As soon as a business takes on a new employee, they are required to provide them with a safety manual that details the employer’s safety expectations. Some businesses are required to give new employees specific safety-related training.
In the unfortunate event that you suffer a workplace injury, the first thing your employer needs to do is dial 9-1-1 if the severity of your injuries requires emergency care. If paramedics aren’t required, they need to take the necessary measures to ensure you get first aid. Additionally, if immediate medical attention isn’t necessary at the time of injury, your employer needs to, at the very least, assist you in ensuring you receive some form of medical treatment as soon as possible.
If the workplace injury is severe, such as what would be involved in an industrial accident, employers are required to report the incident to OSHA. If the injury in question results in the employee’s death, the company has to file a work injury report with OSHA within eight hours from the time they learn of the incident.
In the hours or days following your injury, your employer needs to launch an investigation into the incident and gather information about what caused it. Depending on the facts surrounding your case, they may need to talk to other employees who might have witnessed the accident and even take photos of the site to collect evidence. This information comes in handy if the injured employee needs to file a workers’ comp or an injury at work claim.
When Can You Sue for a Work-Related Injury?
As mentioned before, the tradeoff for workers’ compensation is that it limits your employer’s liability. The question then becomes – when can you sue for a work-related injury? There are generally two scenarios in which this could be a viable avenue to pursue:
- If the company you work for wrongfully denies you workers’ comp benefits; or
- If the company does not offer workers’ comp coverage.
These are discussed in detail below:
1. Your Employer Wrongfully Denies You Workers’ Comp
In most cases, before you can sue your employer, you must first file a workers’ compensation claim. If the company you work for pays you the benefits you’re rightfully entitled to, you generally would not have any grounds to sue.
On the other hand, if your employer denies you the benefits you rightfully deserve, that’s when you go to court. Depending on the existing laws in the state you live in, you might have to take additional steps before you can file a work injury lawsuit against your employer.
For instance, some states require that you first file an appeal with your local Workers’ Compensation Board. The outcome of the appeal will advise whether or not you should proceed with your claim to collect the benefits you’re entitled to.
2. Your Employer Doesn’t Offer Workers’ Comp
If you get injured in your line of duty only to then realize that the company does not provide workers’ compensation coverage, you may be able to sue them. This could be the case if:
- You were working for the company in question as an independent contractor and were, therefore, not covered under the firm’s workers’ comp policy;
- The company is exempt from the state’s workers’ compensation laws (this might be the case if it’s a small business with few employees); or
- The company is in violation of state law by failing to provide workers’ compensation coverage for its employees.
If your case happens to fall into any one of the categories outlined above, you may be able to sue them to receive the monetary compensation required to cover your medical expenses, loss of wages, and any other injury-related losses you incur.
How Personal Injury Claims Work
You’ve now established that you may be able to sue your employer for a work-related injury. Here’s a blow-by-blow breakdown on how to proceed with your claim.
1. Report Your Injury
If you were injured in your line of duty, the first thing you need to do is to formally notify your employer. This is a key requirement for collecting workers’ compensation benefits. It also serves as a crucial piece of documentation when you decide to file a lawsuit against your employer for your work injury.
2. Get Medical Care
Next, you need to seek medical treatment as soon as you suffer the injuries. If you intend to launch a workers’ compensation claim, you may (or may not) need to get treatment from a company-approved healthcare worker. The specifics depend on the laws in your state.
If you intend to file a personal injury lawsuit against your employer, getting medical treatment from an independent doctor of your choice is a critical piece of the puzzle.
3. Take Detailed Notes
If you don’t get workers’ compensation for any of the reasons outlined in the previous sections, the only way you’ll get paid is if you sue. To sue and get the compensation you’re rightfully entitled to will involve proving how and when your injury occurred.
Write down everything that happened while the events are still fresh in your mind. Gather as much evidence as you can in the form of photographs, medical reports, and anything else that might add weight to your claim. It will prove useful in court.
4. Talk to a Lawyer
Consulting a work injury lawyer will help you determine the route you should take to get paid, that is, whether you should sue your employer or file for workers’ compensation. An experienced attorney would be best placed to give you an objective assessment of your legal rights.
5. File a Claim
While you can file a workers’ comp claim yourself, getting an experienced attorney to do it for you would better your chances of getting a full recovery. If their efforts to get the benefits for you hit a dead-end, they can then proceed to sue your employer on your behalf.
Having an injury attorney who’s well-versed in work injury lawsuit settlements actively involved in the entire process will help you with everything from evaluating the settlement offers presented right up to getting the compensation you deserve.
Returning to Work After a Work-Related Injury
You can be forced back to work after injury if you’re deemed ready to return, or else you risk losing your workers’ comp benefits entirely. The question is – who decides when you should go back?
First off, your company’s workers’ comp insurance provider will not continue paying wage replacement disability benefits one day longer than they need to. They want to see you back on your feet and back to work as soon as possible. Only the treating physician has the power to determine your work status. They decide if you’ve recovered enough to resume your normal duties at work.
The doctor’s evaluation of your condition will result in a disability rating. This will determine your ability to resume your role at work and the timing of your return. There are generally four categories of workers’ compensation disability ratings:
- Temporary Total Disability – You’re completely unable to perform any work for a limited period
- Temporary Partial Disability – You’re unable to perform some, but not all, of your work duties for a limited period
- Permanent Total Disability – You’re completely unable to return to work for your current or future employer
- Permanent Partial Disability – You have a permanent injury that partially impairs your ability to perform your work duties
Every time you see your physician, they will make a note in the chart indicating your work status.
Does Health Insurance Cover Work Related Injuries After Settlement?
The short answer is – no. Ideally, you should not be using your health insurance cover for work-related injuries. These should be covered under workers’ comp insurance.
That said, claims settlements often come with a requirement to sign a full and final release of all claims. This means that if your condition gets worse after settling your workers’ compensation case, you might not be able to reopen your claim later down the line. Signing such a release means that you’re giving up the right to bring any future claims related to your work injury.
While some states have laws in place that prohibit injured workers from waiving their rights to future medical treatment, you would have to prove fraud to get them to reopen the claim if you live in a state that doesn’t have such laws in place. It would mean proving that your employer or insurance company misrepresented the settlement terms.
It is, therefore, important to retain the services of an experienced personal injury or work injury attorney to ensure your rights are protected before agreeing to any type of settlement.
Protect Your Rights
The key takeaways are:
- If you suffer a work-related injury, the only way you’ll get compensated is if you assert your legal rights
- If you’re eligible for workers’ comp, ensure that you retain an experienced lawyer to fight for the maximum possible benefits you deserve
- If you’re not eligible for worker’s comp, get a work injury attorney to help you sue your employer for compensation
- Whether or not you’re eligible for workers’ compensation, you can also sue another entity if they are responsible for your accident
Do you need more legal advice on work injury claims? Chat online with an available Laws101 attorney.