Workers’ Compensation and Personal Injury Claims
If you suffered a work-related injury or illness, you may be eligible to file for a Workers’ Compensation (WC) claim and in some cases you may also be eligible to file a Personal Injury (PI) claim in addition to your WC claim.
In this article, we will break down the difference between WC and PI claims and discuss your options if you live in the state of California and have become injured on the job.
Workers’ Compensation
Workers’ Compensation is a type of private insurance that most U.S. companies must carry for work-related incidents. In California, state law requires all employers to have WC insurance. WC covers medical expenses and partial wages while employees recover from injuries or illnesses that result from workplace incidents.
Workers’ Compensation claims operate on a no-fault system, meaning benefits are available regardless of who caused the incident—the employee, employer, or another party. The burden of proof is lower in WC claims, using a “more likely than not” standard. In exchange for this lower threshold, employers are only responsible for specific, pre-set benefits.
WC law evaluates whether an employee sustained an injury while performing job duties or if the work caused or aggravated the condition.
Personal Injury Claim
Personal Injury claims cover a wide range of injuries that someone can file if they were harmed and another party is at fault. Car accidents, slip and falls, and medical malpractice are common examples. To prevail, there must be proof of negligence.
A PI claim requires showing that negligence or intentional misconduct caused the injury. It must be established that another party was responsible. PI claims do not have to be work-related injuries.
PI claims cover a broad scope of damages and can include medical expenses, lost wages, future income capacity, and physical and emotional “pain and suffering”.
However, there is no precise formula for calculating potential damages in a PI case as they are awarded by a jury, absent a settlement of the claim.
It is important to note that the amount of compensation you receive for a PI claim differs on a case-by-case basis and is circumstantial.
Overlap in Workers’ Compensation and Personal Injury claims
If a third party—someone not employed by your work—is involved in the incident that caused your work-related injury, you may be eligible for both a WC and PI claim.
For example, a construction worker injures themselves using a faulty or damaged jackhammer. In this case, the employee could have a WC claim and a PI claim because the injury arose on the job, and a third party was at fault.
A WC claim is filed through the employer, while a PI claim could involve suing the manufacturer of the defective tool that caused the injury on the job.
Differences Between PI and WC claims
WC claims do not recognize “pain and suffering” under WC law. WC insurance mainly covers medical expenses and lost wages. However, certain mental health conditions like anxiety, depression, or post-traumatic stress disorder (PTSD) can be covered by WC if the condition is related to the work-related injury.
PI claims do not have to be for work-related injuries and cover a broader scope of damages.
In PI, instead of benefits, there are damages, many of which go above and beyond the benefits available in WC, including but not limited to reimbursement for medical expenses, lost wages past, present and future, physical and emotional “pain and suffering” damages, and damage multipliers in the event of misconduct by the negligent third party. When there is overlap and an injured worker has both a PI and WC case, there are potential damages available above and beyond the benefits provided by WC, which is why it is important to file both WC and PI claims when available. However, often times there may be a dollar-for-dollar credit between the two cases, for WC benefits or PI damages received, in order to prevent duplicity, multiple recoveries or unjust enrichment by the injured worker.
The key difference between WC claims and PI claims lies in who is at fault and the burden of proof for the injured party to establish liability. WC claims provide benefits regardless of who is at fault, while PI claims require proving that another party’s negligence caused the injury.
Why do I need a lawyer for my personal injury case?
This is a challenging time as you focus on healing and getting back on your feet. As mentioned previously, there are damages and remedies available in PI above and beyond the benefits provided by WC, so it is important for an injured worker who was injured by a negligent third party to file both claims to ensure they receive the maximum amount of damages and benefits they are entitled to under CA law. The claims process can be complex, and if you are pursuing both WC and PI claims, it’s important to ensure you are following the rules, meeting all requirements, and ensure you have the best chance of receiving fair compensation.
An experienced attorney is highly recommended to have when filing a PI claim and/or a WC claim, and many law firms that represent individuals for WC claims also specialize in PI cases.
Fierce Advocacy
At Nyman Turkish, our team of Workers’ Compensation attorneys are among the best in the field. Backed by a skilled staff of legal assistants and case managers, we bring unmatched expertise and dedication to every case. What sets us apart is not only our deep knowledge of the law and claims process, but also the care and compassion we show each client. Our attorneys will guide you through your rights, advocate on your behalf, and work tirelessly to ensure you receive the compensation and benefits you deserve.
While we do not undertake representation in PI cases, we partner with trusted firms and in most instances we will be able to provide a referral for a free consultation with a knowledgeable PI attorney who can evaluate whether there is a potential PI case in addition to your WC claim.
Our team is ready to speak with you about your claim and will review your case for FREE. Please call us at 877-529-4773 or visit our website today!
