Understanding Workers’ Compensation Claims & Personal Injury Claims
When you’re seriously injured due to the intentional or negligent act of another party or entity, you can generally pursue a Personal Injury claim. When this happens at work, though, you must place a claim for Workers’ Compensation benefits either instead or in addition to a personal injury claim depending on the situation. It’s important to know the differences between a Workers’ Compensation claim and a Personal Injury claim in order for you to understand what you’re entitled to and from what parties you may receive certain types of compensation for damages such as lost wages, medical bills, pain and suffering, etc.
Workers’ Compensation Claims
Note that you are generally barred from bringing a Personal Injury claim against your employer or coworkers for any injury you incur on the job. However, you can receive compensation for lost wages and medical bills through a Workers’ Compensation claim no matter who is at fault for your incident, so long as it happened while you were on the job.
Under Workers’ Compensation law, all of your medical bills and pharmaceutical needs that aid in your recovery are covered so long as you meet the requirements set forth by the New York State Workers’ Compensation Board. These may include multiple diagnostic tests, x-ray examinations, MRIs, and other radiological examinations that prove your disability to work. Note that you may be required to undergo periodic independent medical examinations by medical providers affiliated with your employer’s Workers’ Compensation insurance carrier. Since these medical providers are being paid by your employers’ Workers’ Compensation insurance carrier, there may exist an incentive for them to mitigate your injuries in their reports. By doing so, they’ll likely see further employment from these insurance carriers since they are giving them reason to abate what you’re entitled to or deny your claim. This is why having a Workers’ Compensation attorney (not to be confused with a Personal Injury attorney) is a prudent choice. If you are denied your claim or not afforded the compensation you are entitled to, you’ll need a Workers’ Compensation attorney to represent you.
The medical exams discussed above will determine your percentage of disability, which factors into how much you receive in lost wages. What you receive in terms of lost wages is based on a simple equation. You’ll receive a weekly benefit that’s determined by an equation that takes into account both your average weekly wage prior to your incident as well as your percentage of disability. The equation is as follows:
2/3 of your average weekly wage multiplied by your percentage of disability
So, if you make $400 on a weekly basis, and you are found to be 100% (totally) disabled, you would receive an amount of $266.67 per week through your Workers’ Compensation benefits. If you were found to be 50% (partially) disabled, you would receive $133.34 a week through Workers’ Compensation benefits.
*Note that Workers’ Compensation will not pay damages for pain and suffering.
Personal Injury Claims
Since you are generally barred from suing your employer, there needs to be a third party’s negligence involved for you to pursue a personal injury claim. That claim would be placed against said third party. For instance, if you are a truck driver, and another car strikes your truck due to their negligent actions and you become seriously injured, you can place a Personal Injury claim against said negligent party (as well as a Workers’ Compensation claim against your employer). You may be entitled to compensation with a Personal Injury claim that your Workers’ Compensation benefits won’t cover (such as pain and suffering, additional compensation for lost wages, out-of-pocket expenses, etc.). Note that this is a rudimentary example of how a Personal Injury claim and a Workers’ Compensation claim may work in conjunction with one another if your injury took place while you were on the job.