Workers’ Compensation Claims vs. Personal Injury Lawsuits: What’s the Difference?

If you’ve been injured at work or due to someone else’s negligence, you may be wondering what legal options you have for obtaining compensation. In most cases, you’ll either file a workers’ compensation claim or a personal injury lawsuit.

While both provide money for medical expenses and lost wages, there are key differences between these two types of claims. Understanding which one applies to your situation is crucial for protecting your rights and maximizing your financial recovery.

What is a Workers’ Compensation Claim?

Workers’ compensation is a state-mandated insurance program that provides benefits to employees who suffer job-related injuries or illnesses. Most employers are required to carry workers’ comp coverage. If you get hurt at work, you can file a claim to receive:

• Medical treatment for your work-related injury or illness
• Partial wage replacement while you’re unable to work
• Vocational rehabilitation if you need to change jobs due to your condition
• Permanent disability benefits if you suffer lasting impairments
• Death benefits for surviving family members if a worker dies from their injuries

The workers’ comp system is considered “no-fault.” That means you don’t have to prove your employer did anything wrong to cause your injury. As long as your injury happened during the course and scope of your employment, you are entitled to benefits.

However, in exchange for this no-fault coverage, you generally can’t sue your employer for additional damages like pain and suffering in court. Workers’ comp is considered an “exclusive remedy” against your employer in most cases.

There are a few exceptions that allow work injury lawsuits, such as when:

• Your employer doesn’t have workers’ comp insurance
• Your employer intentionally causes your injury
• A third party (someone other than your employer) causes your injury
• Your employer retaliates against you for filing a workers’ comp claim

Navigating the workers’ comp claims process and appeals can be challenging. There are strict deadlines, complex forms, and medical evaluations. Insurance companies often look for ways to deny or limit benefits. An experienced workers’ compensation attorney can help you file your initial claim, gather necessary evidence, and fight for the full benefits you deserve.

What is a Personal Injury Lawsuit?

Personal injury law allows you to sue someone whose negligence caused you harm. “Negligence” means the failure to exercise reasonable care to prevent injury to others. Common examples of personal injury cases include:

• Car accidents caused by distracted, drunk, or reckless drivers
• Slip and falls due to dangerous property conditions
• Medical malpractice by doctors and healthcare providers
• Defective products that malfunction and cause injuries
• Dog bites and animal attacks
• Assaults due to negligent security

Unlike workers’ comp, personal injury claims are fault-based. You must prove the other party acted negligently and caused your injuries. You’ll need strong evidence of:

• The at-fault party’s duty of care
• How they breached that duty
• Causation between the breach and your injuries
• Damages you suffered as a result

Personal injury damages are more expansive than workers’ comp benefits. They cover all medical expenses, past and future lost income, pain and suffering, emotional distress, and other losses. Your spouse may also have a claim for loss of consortium.

However, recovering personal injury compensation is often challenging. At-fault parties and their insurance companies vigorously defend cases to avoid liability. You may need to file a lawsuit and prove your case in civil court to get the money you need and deserve. A knowledgeable personal injury lawyer can investigate your case, build compelling evidence, negotiate with insurance adjusters, and advocate for your rights in court.

Key Differences Between Workers’ Comp and Personal Injury Claims

To summarize, the main differences between workers’ compensation and personal injury claims include:

• Fault: Workers’ comp is no-fault while personal injury is fault-based.
• Types of Incidents: Workers’ comp covers on-the-job injuries while personal injury applies to many types of accidents and intentional torts.
• Compensation: Workers’ comp provides limited benefits for medical bills, partial lost wages, and disability; personal injury allows recovery for fuller economic and non-economic damages.
• Lawsuit rights: In most cases, you can’t sue your employer under workers’ comp but you can file lawsuits against at-fault parties in personal injury.
• Proof: Workers’ comp requires proof your injury occurred during the course and scope of work; personal injury requires proving duty, breach, causation, and damages.

What if My Injury is Covered by Both Workers’ Comp and Personal Injury?

Sometimes a work-related injury may give rise to both a workers’ compensation claim and a personal injury lawsuit. This is known as a “third party claim.”

For example, if you’re driving for work and get hit by a negligent driver, you may have a workers’ comp claim because your injuries occurred on the job. But you may also have a personal injury claim against the at-fault driver.

In these situations, you may be able to pursue both types of claims to maximize your overall recovery. A personal injury attorney can coordinate your claims to ensure you receive all the benefits and compensation you’re entitled to.

Get Help with Your Work Injury or Personal Injury Claim

Knowing your legal rights after an injury can be confusing. At the Benjamin Durham Law Firm, we help injured workers and accident victims pursue all avenues of compensation. Our attorneys have decades of experience handling both workers’ compensation claims and personal injury lawsuits.

We offer free consultations to review your situation and explain your legal options. And you pay no fees unless we win your case. Don’t hesitate to get the legal advocacy you need during this difficult time. Contact us today to see how we can assist with your claim.