Workers’ Compensation is an accident insurance program paid by your employer where benefits are provided to help you while you prepare to return to work. Workers compensation can often provide you with some help in the form of medical benefits and rehabilitation support.  It can also provide you and your family with some supplemental income.  Additionally, when death results from a job-related injury, dependents may also receive certain plan benefits.

Third-Party Claims may exist when a negligent injury at work is caused by a person or company who is not employed by the same company and falls outside of Georgia’s Workers Compensation Act.  Common third-party claims include car and truck accidents, warehouse, forklift and retail injuries, defective products and machinery, or dangerous premises.

You may have BOTH a worker’s compensation and third-party claim:  Many injured employees are eligible to make both types of claims. For example, if you are hit by a distracted driver while running an errand for your employer, if you are a warehouse employee hurt by a delivery truck, or if you are a factory worker injured by a defective machine, you may be able to recover both workers compensation benefits and insurance money from the outside person or company.

What Workers’ Compensation Covers

Workers’ compensation insurance often (but not always) pays regardless of who was at fault, and benefits sometimes do not cover all of the damages you have suffered in a work-related accident. As with all insurance compensation, there are limitations.

For example, if you were injured while on the job after June 30, 2013, you are entitled to medical treatment for related injury for a maximum period of 400 weeks. However, if your injury is catastrophic or permanent, you may be entitled to lifetime benefits.

If you are not able to return to work right away, you may receive weekly benefits, but they are paid at the rate of 2/3 your average weekly wage, with a maximum of $575.00 per week. (Look here for more complete information on benefits.)

Your benefits may look small and completely out of proportion to what you’ve lost because of your work-related accident. A legal expert may be able to help you locate and take-advantage of additional resources to draw upon.

Some work-related injuries are caused by someone other than your employer. In many cases, other negligent parties can be held liable for your injuries. Don’t imagine that the only recourse you have following an on-the-job accident is workers’ compensation insurance.

Always look beyond your employer’s workers’ compensation insurance; there may be additional avenues for recovery following an accident.

For example, if your work requires you to do refrigeration work in a grocery store owned by another Company and you slip and fall on a cherry tomato in the produce aisle, an investigation should be done to see if you may be able to seek damages from the grocery store for their negligence in failing to keep their aisles safe.  This is known as a “third-party” case or claim.

When you are hurt while working, a good personal injury lawyer will look for all possible third-party claims outside of the Georgia Workers Compensation system.

Personal Injury Claims

When you’re injured because someone else has been careless, as in the case above, you may be able to file a personal injury claim in addition to your workers’ compensation claim, just as you would if you were not working when you were injured. The case then proceeds just like most other personal injury claims, and you may be able to recover both workers compensation benefits and injury damages.

If you decide to file an action against an at-fault third-party, you could be eligible to receive payment for losses not limited by workers’ compensation insurance, including:

  • Medical expenses not covered by workers compensation
  • Property Damages (to your car, for example)
  • Lost Income (at your full usual rate, not the 2/3 limited by Work Comp)
  • Pain and Suffering (personal)
  • Future loss of quality of life
  • Damages for the full value of a Wrongful Death (not limited by the Ga. WCA)

Georgia Workers-Compensation Subrogation Liens

If you do receive compensation from both the workers compensation carrier and the negligent party, you may be faced with a request from the workers’ compensation insurance company to be reimbursed the benefits it paid.  We call this right to recover money from your settlement a Subrogation Lien.

It is important to have any request for repayment from a work comp insurance company reviewed by an attorney.  Many workers compensation liens are not enforceable against your personal injury settlement, but do not expect the insurer to tell you whether “their” payments must be reimbursed. A good injury lawyer will fight to help you keep as much of the settlement as legally possible.

On-The-Job Automobile Accident Claims

If you were hurt in an auto accident while working, you should be able to obtain workers’ compensation benefits that will cover your medical bills and a percentage of your lost wages. However, if a non-employee caused your crash, you may pursue a personal injury claim against that other driver outside of workers compensation.

This is known as a third-party claim and could pay you additional compensation.  This includes your deductible and other general damages such as physical pain and suffering, mental distress, disfigurement, and the loss of intimacy and companionship that are not available from workers compensation.

How Workers’ Compensation Works If you Recover Money in a Lawsuit

Know your Georgia personal injury rights: If you were injured while working, and your employer’s workers’ compensation carrier has provided medical and lost income benefits, then the carrier would have a limited right to seek reimbursement from any verdict or settlement recovered in your case. This is often referred to as a “workers’ compensation subrogation lien.”

Limitations of a Subrogation Lien

A health insurer can seek reimbursement from a victim of a slip and fall incident, car accident, or other personal injury case, who recovers money from a third-person or company.  However, unless a workers comp insurance carrier can prove that you were fully compensated, or “made-whole” the insurer may not be entitled to be reimbursed, and the lien may not be enforced.

Knowledge is Your Best Resource

Insurance reimbursement or subrogation are important reasons to consult with the experienced personal injury attorneys at The Millar Law Firm before you speak with an insurance company representative or try to settle any personal injury claim on your own.

You may also want to check out Georgia’s Bill of Rights for employees injured on the job: O.C.G.A. 34-9-81.1, which is available in this great Atlanta, Georgia, legal resource here.

A worker’s injury claim is very similar to other injury claims caused by the negligence of somebody else. Some of the more common cases involve injuries caused by the following:

  • Car accidents
  • Slip or Trip and Fall
  • Faulty/defective equipment
  • Faulty design/supervision
  • Property hazards
  • Delivery car or truck accidents
  • Forklift accidents and crashes
  • Negligent security
  • Warehouse injuries
  • Products Liability
  • Construction defects
  • Defective machinery or equipment
  • Construction site accidents
  • Failure to repair
  • Many other on the job injuries

Motor vehicle incidents are among the leading causes of job-related injuries in the U.S. If your job duties included driving a car and you were injured in a wreck, you may have a claim or lawsuit against the driver of the other vehicle (the third party in the liability claim) even if you were on the job when the accident happened.

Third-party claims can, and often do, lead to a much larger financial recovery than Workers’ Compensation alone. The attorneys at The Millar Law Firm know what claims—and how—to file for you.

Malfunctioning machinery or equipment can cause injury or death at a jobsite. If you are a worker harmed by such equipment, there may be a case against the manufacturer and/or distributor of the equipment or machinery. There may also be a claim against an outside company for failing to properly maintain or repair your company’s equipment.

Such a claim should be investigated if there were recalls, warnings, or similar incidents pertaining to the equipment/machinery involved in your injury. You want a law firm with the resources and experience to investigate all avenues of possible negligence in order to obtain the most possible recourse for you and your family.

In some cases, a jobsite where an accident occurs itself is dangerous. For example, if you are injured in a construction accident, the general contractor, architect, or engineer in charge of the construction project may have been negligent. This is often the case when a wall, stairway, or even an entire building collapses.

The owner of any property has a legal responsibility to ensure that the property is safe for visitors. If you are an employee sent to work on a property owned by a company or an individual and you are hurt there, you may have a worker injury claim if a dangerous condition on the property contributed to the accident. A property owner might be held accountable for the hazardous property conditions that caused your injury or illness.

When our work-injury attorneys examine injuries caused in these kinds of situations, we often find that the injury could and should have been prevented.

Suzanne’s Story* — A Worker’s Injury Example

Suzanne is a pharmaceuticals sales representative. She represents her drug company at the local level, introducing physicians and hospitals to the products her employer makes.

When Suzanne was thirty-two years old, she had been married eighteen months. She and her husband were looking forward to starting a family. For Suzanne and her husband Troy, life was full of potential for growth and success.

One summer afternoon, Suzanne was about to visit a local hospital’s Chief of Surgery to deliver samples of a revolutionary new surgical soap that helps eliminate the chapped raw skin from which many surgeons suffer. She was waiting at the intersection that leads into the hospital parking lot. Intending to make a right-hand turn, she was in the appropriate lane.

In the lane to her left, the driver of an approaching hospital linen delivery truck realized late that he was also supposed to turn at this intersection. He was new, nervous, and this was his first delivery to this hospital. The truck crossed Suzanne’s lane and crashed into the driver’s side of her vehicle, smashing in the driver’s door and leaving Suzanne injured from the impact, with her left side badly cut and torn by jagged edges of the door.

The trauma physician in the emergency room saw that Suzanne’s left leg had been nearly amputated in the wreck and worked to stop the bleeding. In emergency surgery, the orthopedic surgeon determined that Suzanne’s leg could not be saved so he completed the amputation. Her other lacerations were stitched up and her left arm and shoulder were immobilized with a cast.

Suzanne’s hospital bills and her lost wages would be covered by her employer’s workers’ compensation insurance, but who would compensate this young woman for her grief over her sudden disfigurement? How would she do her job without a leg? Suzanne and her husband were understandably devastated by the horrible consequences they faced even though Suzanne did nothing wrong.

After a few days, Troy called an experienced Georgia personal injury law firm and spoke with an lawyer who agreed to meet with the couple at the hospital.

It was determined that Suzanne would claim pain and suffering for her damages and her loss as well as costs for medical care. Workers’ compensation would cover some of this. She would be compensated by the workers’ compensation insurance for the loss of her leg according to a schedule or list of values given to various body parts by the insurance industry. The value was a conservative one, adjusted to reflect Suzanne’s young age.

Suzanne and Troy agreed with their attorney that their losses were greater than what workers’ compensation insurance was likely to offer them. They decided to sue the negligent truck driver and his company in an additional action. They understood that the workers’ compensation insurance company might attempt to assert a claim to a portion of their settlement (a subrogation lien).

Proving Who Was at Fault

Suzanne’s claim would proceed separately from the original workers’ compensation claim.

The first job in the third-party liability case was to prove that the driver of the linen delivery truck was at fault. The insurance company alleged that Suzanne was at fault for her own injuries since she did not see the truck coming.  However, the police cited the driver for several offenses including improper turning and failure to yield and an accident re-construction expert was hired by Suzanne’s lawyer to further investigate.

The expert concluded that Suzanne couldn’t have reasonably known when she saw the truck that the driver planned to turn since the truck was in the wrong lane and moving forward.

Other witnesses to the accident testified that the driver didn’t slow down before making the illegal right-hand turn in front of Suzanne. Suzanne’s lawyers alleged that the driver of the truck did not know where he was going and furthermore, he was not properly trained to do his job.

How Suzanne’s Settlement Was Reached

Once all the facts and evidence had been gathered, the attorneys began the process of coming to a settlement amount. The hard costs to Suzanne and Troy were calculated.

A copy of the hospital bills was obtained and the projected costs for future treatment were obtained from doctors and health care cost consultants.  In addition, the cost for the purchase of and replacement and/or repair of prosthetic legs in the future were determined, as well as the cost to replace Suzanne’s car which was totaled. Suzanne’s lawyers had a solid total claim amount.

A settlement was reached based upon other, similar cases that had already been settled or trial verdicts reached, as well as the unique effects of on Suzanne’s quality of life.

*Suzanne is a fictitious client and is not intended to represent or resemble an actual past client of The Millar Law Firm.  Her story is intended to give an example of our injury law firm might evaluate, prove and settle an injury case.

Free Case Evaluation

The Millar Law Firm evaluates all potential injury cases, including work injuries and all other Georgia tort (injury) claims free of charge.  Contact us today at 770-400-0000 (“770-Four-Million”) and speak with a friendly and compassionate lawyer today.