Workers’ Comp vs. Personal Injury: Differences Between Workers’ Compensation and Personal Injury Settlements
Category: Personal Injury
Article by Tuley Law staff
If you are injured as a result of another party’s negligence or mistake, you may be entitled to some form of financial compensation. Depending on the cause or environment of said incident, you may also be eligible for a different form of benefits. Personal injury on the job can be considered an Indiana workers’ compensation case as well as a personal injury case. Contact an Indiana personal injury or workers’ compensation lawyer to see if you have a case.
Things to Know About Workers’ Compensation in Indiana
Under the Indiana Workers’ Compensation Act, most businesses in the state are required to have workers’ compensation insurance. Here are the important things you should know about workers’ comp coverage in Indiana:
- It typically provides coverage to employees from their first day on the job.
- Employees are not required to prove their employer was the cause of their job-related injury; they can receive benefits regardless if their accident took place at work or doing work-related tasks.
- As of 2020, the maximum wage that can be used to determine workers’ comp benefits in Indiana is $1,170; the maximum temporary total disability benefits (awarded with the inability to work) an individual could receive is $780 per week from lost wages.
- Indiana workers’ compensation must pay for all medical care that is “reasonable and necessary” until the injured worker reaches maximum medical improvement; then the employer must pay for care to reduce the workers’ impairment.
- There is no waiting period to receive medical benefits for expenses.
- Employees must report any work-related illness or injury within 30 days of a workplace accident; the employer has seven days after hearing about the injury or illness to report it to the insurance company.
Insurance companies are trying to save as much money as possible by only paying you what’s absolutely necessary. Depending on how your injury occurred, employers or insurance companies might try to argue that you don’t deserve certain benefits, or that you were injured from your own mistake. Even if an injury lawyer cannot help you prove an additional third-party personal injury claim, they will be able to help you get the workers’ compensation benefits you are entitled to.
Workers’ Compensation Benefit Limitations
While workers’ compensation can be extremely helpful for individuals who are injured as a result of their employment, the awarded settlements might not be sufficient for a true financial recovery. A typical workers’ compensation plan will cover medical expenses and two-thirds of lost income from the job you were injured at. While this may cover many of your bills, the difference in lost wages can still cause significant strain on a household.
One example is when an employee has a second job. They will only be compensated by the workers’ comp insurance for the job at which they were hurt. If they make $750 a week from their primary job and an additional $300 a week from their second job, they are usually making around $1,050 each week. If they are injured at the first job, they will only receive $500 a week in lost wages from their employer. No benefits will be awarded to compensate for lost wages from the second job.
Filing a Third-Party Personal Injury Claim
Workers’ compensation benefits are limited to covering quantifiable expenses presented by the inability to work your primary job. Personal injury benefits will not only cover the true lost wages from both jobs, but also provide additional funds for the pain and suffering endured from physical or mental anguish.
It’s important to note that a personal injury settlement is not provided on top of the workers’ compensation settlement, but rather in place of it. If you have already received damages from workers’ compensation then proceed to file a personal injury claim, there will be liens placed on the money you receive from your personal injury settlement. Anything that was originally paid for by the insurance company can be reimbursed from the new settlement.
If your medical expenses total $50,000, the medical insurance company might negotiate down to paying the hospital only $25,000. If you pursue personal injury benefits, the third party will be responsible for paying you the full $50,000. At this point, the medical insurance company will be entitled to the $25,000 they paid. You will end up with the remaining $25,000. Even though the claims do not combine, you can still see how it may be beneficial to file both claims as opposed to one or the other. If you only filed a personal injury claim, $50,000 of your settlement would’ve had to go toward the $50,000 of expenses.
Who Can File a Third-Party Personal Injury Claim?
Not every employee injured on the job can file a personal injury claim along with their workers’ compensation claim. There must be another party—aside from the employer—who is in some way responsible for your injury. Below are some situations in which the victim could file both a personal injury and workers’ compensation claim.
- Delivery drivers: A delivery driver who is required to put themselves in unfamiliar environments to perform their job properly is a perfect example of an employee who is at risk for personal injury. We all know that dogs hate the mailman, but what happens if a dog bites the mailman? If a delivery driver is bit by someone’s dog while dropping off a package, they may be able to recover workers’ compensation and also press charges against the dog’s owner.
- Professional drivers: Beyond delivery drivers, any professional driver is at risk of injury from someone else, including drivers of limos, taxis, buses, trucks, etc. If any of these drivers get into an accident through the fault of someone else, they can press charges. Indiana is an at-fault state for car accidents. Therefore, if the professional driver is a victim, they can receive workers’ compensation from their employer and personal injury damages from the responsible driver.
- Lineworkers: Whenever you’re dealing with manufacturers or large machines that can malfunction, there is an opportunity for third-party claims. If a machine or device which was not made by the employee’s company malfunctions, catches fire, or explodes and injures a line worker, the employee could hold both their employer and the machine manufacturer accountable.
- Construction workers: Construction sites are a prime example of areas where multiple contractors may all be working together. While workers’ comp insurance handles injuries between employees, it can get more complicated when dealing with contract workers. If the negligence of one worker leads to the injury of another, that victim is eligible for compensation from the construction company as well as personal injury damages from the other individual.
Remember that these recoverable damages do not double up. Personal injury settlements merely help to fill in some of the gaps of workers’ compensation benefits, such as lost wages for extra employment or extra money for pain and suffering.
Personal Accident Insurance vs. Workers’ Compensation
Although both workers’ comp and personal injury settlements help to reimburse you for different expenses, there are multiple differences between the two claim types that matter when filing a claim. Here are some of the things you need to pay attention to when deciding whether to file a personal injury claim, a workers’ comp claim, or both.
The most important difference between these two types of cases is the nature of an accident. If the accident occurs while at work, in the work environment, or performing work-related activities, it will count as workers’ compensation. If you slip and fall on the ground in your own workplace, you may be able to file a workers’ compensation claim.
If you’re at the store picking up office supplies for your children’s school materials and you slip on a wet floor, you might be able to file a personal injury claim. If you’re at the store picking up office supplies for your company and you slip on a wet floor, you may be eligible to file a workers’ compensation claim as well as a personal injury claim.
Burden of Proof
Another difference comes after it has been established which type of claim you are pursuing. When you become an employee of a company, it is assumed that the workers’ comp insurance will cover you if you are injured. You will not be required to provide evidence that your employer or company was responsible for the accident.
As long as you were not under the influence of alcohol or drugs, you did not begin an altercation that lead to the accident, and you were behaving properly within the regulations of your workplace, you should be granted benefits. If the employer or insurance company is not cooperative, hire an experienced Indiana workers’ compensation lawyer to fight for what you deserve.
In a personal injury case, you will need to prove to the insurance company that the guilty party is at fault. You must provide sufficient evidence to prove the other entity’s negligence if you are to receive any benefits.
Role of Insurance Companies
Assuming you were not breaking any rules, the role of insurance companies in a workers’ compensation accident is to negotiate the cost of your expenses. Because the insurance companies are expected to pay for your injuries, the best way for them to save money is to try to minimize the amount they have to pay to the hospital and other providers.
In a personal injury case, insurance companies are expected to perform a full investigation to try to minimize the defendant’s role in causing the accident. They will go back and forth with the claimant’s legal team making lowball offers based on any information that might exempt their client from liability.
Role of Your Lawyers
In a workers’ compensation case, your legal team will ensure that the insurance companies pay you the money you are entitled to. Furthermore, they will make sure you receive a sufficient settlement to pay for additional or future medical expenses.
In a personal injury case, your legal team will perform an investigation and gather evidence to prove the guilty party was indeed at fault. Your lawyers should also negotiate directly with the insurance companies, safeguarding you from low offers and intimidation tactics.
Types of Recoverable Damages
One of the most significant differences between these two types of cases is the scale of benefits you can be awarded. A workers’ compensation case is typically faster and easier, but only covers medical expenses and a fraction of lost wages. These limitations are one reason victims might pursue a personal injury case beyond receiving workers’ comp benefits.
Personal injury cases include benefits called “non-economic damages.” Non-economic damages include costs that don’t come with a receipt. For example, the physical pain caused from an accident, or emotional trauma for years to come. These extra damages allow the victim to recover financially, even after a life-changing accident.
Additionally, personal injury cases allow the victim to recover the full value of their lost income. This includes full wages from the job at which you were hurt AND any other sources of income that you can no longer maintain as a result of your injury.
Workers’ Compensation vs. Personal Injury FAQs
Can you sue your employer for personal injury?
While workers’ compensation insurance protects the employee at face value, its true function is to defend employers from extreme financial losses. By paying for workers’ compensation insurance, employers protect themselves from lawsuits. In Indiana, you cannot sue your employer for personal injury, even if it was caused by their negligence—you must rely on workers’ compensation.
However, there are special situations when it comes to contracting, such as on a construction site. If you were injured on a construction site from your employer’s negligence, reach out to Tuley Law Office for more information to see if you have a personal injury case.
Can you get fired while suing for workers’ compensation benefits?
Whether you can sue your employer or not, workers’ compensation cases still pursue damages from the company. The employer may not be happy about this, especially if they believe the accident was mostly your fault. There are laws protecting you from losing your job because you filed a workers’ compensation case, but that will not always save you.
Indiana is an “at-will employment” state, meaning that the employer reserves the right to fire you whenever they want. The employer can claim the firing is unrelated to the claim and there may not be much you can argue. Luckily, if you are fired while still unable to work and receiving treatment for your injuries, you might be eligible to receive disability benefits.
Hire an Indiana Accident Lawyer for Help Filing Your Injury Claims
Whether you are filing a claim for a workplace accident or personal injury accident, the experienced injury lawyers at Tuley Law Office have an in-depth understanding of how to assist you. We work on a contingency-fee-basis, so we won’t charge you unless you win your case.
Have questions about your case?Contact us