Being hurt in a work-related injury means you could lose income while you recover. However, Pennsylvania allows various ways for employees to seek benefits and compensation to help them pay bills, replace their wages and seek medical care. The laws around these options can be complicated, as can the process for claiming what you are owed.
WORKER’S COMPENSATION INSURANCE MAY BE YOUR FIRST OPTION
Administered by the Pennsylvania Department of Labor & Industry Bureau of Workers’ Compensation, employer-provided insurance is to provide workers’ compensation benefits. This is meant to pay for your medical bills and partially replace your wages after a job-related injury. Proving fault is not a concern, but it can still be difficult to successfully complete your worker’s compensation claim without pushback from the insurance provider. Some insurance companies may insist injured employees are not as badly hurt as they say.
Managing the details of filing and pursuing a claim can be frustrating when you are also worrying about your health. Any delays in getting the benefits you need could affect your recovery, causing you even more harm. In addition, there are some legal complications that could derail your claim.
Workers’ Compensation Law
PA state law requires all employers with at least one employee must provide workers’ compensation insurance. In addition, there are Federal Laws that protect workers. The U.S. Department of Labor establishes standards enforced by the Occupational Safety and Health Administration (OSHA) that govern workplace safety. If you feel your employer violated those standards and contributed to your injury, you can file a complaint in addition to seeking insurance benefits.
THIRD-PARTY CLAIMS UNDER PENNSYLVANIA LAW
PA’s “Coming and Going” Rule
Employer insurance coverage is not always available to you, depending on the circumstances of your injury. For example, Pennsylvania has a “Coming and Going Rule,” which means that you can’t claim workers’ comp benefits if you were hurt while commuting to and from your workplace unless you were already performing your job duties. This can be challenging to provide, meaning you could lose out on payments you need to take care of your injuries.
When your accident is not covered by workers’ compensation insurance, you may need to work with a personal injury attorney to file a third-party lawsuit. This option can provide you with the ability to recover 100% of your medical treatment costs, including compensation for your pain and suffering. When a third party, such as a vendor, visitor, or contractor, is responsible for your injuries, you can seek payment from them directly through a claim against their insurance or by filing a workplace injury lawsuit.
The statute of limitations for filing a personal injury lawsuit in Pennsylvania is only two years from the date of the incident. This means you must act quickly. Investigating who is at fault and how can take weeks or even months, leaving you with less time to build your case if you delay hiring an attorney. Fortunately, your lawyer can handle all aspects of your claim by using their experience and training.
WHEN YOU MIGHT FILE A THIRD-PARTY LAWSUIT
As mentioned, you have the right to seek compensation from individuals and / or entities other than your employer that cause you harm at work. Some common situations when this might happen include:
- The security company patrolling the worksite fails to check IDs and an unauthorized person enters the building. You are robbed or assaulted.
- A maintenance technician from an outside company does not adequately repair or service heavy equipment, leading to a failure that causes the machinery to explode and injure you.
- A subcontractor doesn’t follow safety protocols for locking out high-voltage equipment, resulting in you suffering an electrical accident.
- A crane operator employed by the equipment rental company is not properly trained and drops materials onto a work crew, injuring you.
- A power tool manufacturer fails to recall a jackhammer that is defectively made, and you are hurt when it malfunctions.
These are just a few examples of instances when you could have a valid workplace injury claim against a third party. Understanding the specifics of your case and identifying all potentially liable parties will be hard if you don’t have any legal or research training. However, a qualified law firm can undertake these tasks for you to help you file a work injury lawsuit against the appropriate defendants.
Building Your Proof of Negligence
To bring a third-party lawsuit against a person or company, you will need to supply what the law terms a “preponderance of the evidence.” This means as much high-quality, compelling documentation as possible to demonstrate that it is more likely than not that the defendant is to blame for your injuries. Your attorney will help you gather these materials from a variety of sources, such as:
- Company injury reports
- Video footage from surveillance and security cameras
- Photos of the accident scene and your injuries
- Medical assessment reports from an on-site doctor
- Follow-up medical records
- Treatment plans
- Witness statements
- Technical expert testimony
- Police reports
- Equipment maintenance records
- Cleaning and repair logs
- Visitor records
If a third-party lawsuit is resolved in your favor, the resulting compensation may be subject to something called subrogation. This refers to a situation where insurance companies attempt to recover part or all of what they have paid from another source in the same claim. It can happen between insurance providers or when the employer’s insurance seeks payment from your third-party settlement or trial award.
Fighting off attempts to subrogate the funds from your third-party resolution can be hard to do without skilled legal representation.
The law generally allows an insurance company to file a lien against a settlement or verdict unless you can convince them to sign a waiver. In any case, the law is generally on the insurance company’s side, which is why it’s vital to carefully consider a decision to seek insurance benefits while also filing a third-party lawsuit.
CAN I FILE A WORKERS’ COMPENSATION CLAIM AND A THIRD-PARTY LAWSUIT?
One frequently asked question we often get is whether a client can seek benefits from employer-provided insurance while also filing a third-party lawsuit. The answer is: sometimes.
Each case is unique, so your attorney will need to review the specifics to determine if this is possible. If so, they can guide you through both processes to secure the full amount of financial compensation available to you.
An example would be if you are harmed on the job by a subcontractor who is not a direct employee of the company. In that case, you may be able to claim insurance benefits to pay for your medical bills and receive partial wages. You could also file a personal injury lawsuit against the subcontractor’s company to receive all potentially available damages which will far exceed what is available under employer-provided workers’ comp.
LEARN MORE ABOUT WORKPLACE INJURY LAWS IN PA WITH SMT LEGAL
If you have more questions about how to deal with a claim regarding injuries you sustained in an on-the-job accident, contact an accomplished work injury lawyer from SMT Legal to schedule a free consultation today.
At SMT Legal, our work injury lawyers understand your concerns and how to manage your case for the best possible result. We can assist you with insurance claims and filing a personal injury lawsuit, depending on your needs. We focus on educating our clients, including how workplace injury laws in Pennsylvania may affect their claims.