THIRD PARTY CLAIMS IN WORKERS’ COMPENSATION CASES
Workers’ compensation is a state-mandated benefit system that protects employees injured on the job. Under labor & industries workers’ compensation laws, the employer is insured to cover all medical expenses associated with a work-related injury, regardless if the injury is a result of the employee’s negligent or reckless behavior.
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- THIRD PARTY CLAIMS IN WORKERS’ COMPENSATION CASES
- Qualifying Injuries for Workers’ Compensation
- Seattle Attorneys for Third Party Claims With L&I
- Third Party Election Forms
- Repayment of Medical Bills to the Department of Labor and Industries
- Free Consultation for L&I Cases
Workers’ compensation is designed to encourage the speedy recovery of the injured employee, permitting him to return to work as quickly as possible, while preventing any unnecessary difficulties or expenses for the employer.
Qualifying Injuries for Workers’ Compensation
If a person falls or is in an accident while at work and sustains an injury, he or she is eligible for workers’ compensation benefits. Qualifying injuries are not limited to accidents, though. Injuries incurred by participation in normal work activities are also covered. This means that injuries sustained through repetitive activities or repeated exposure to certain conditions are eligible. Mental illness or job-related stress is rarely covered by workers’ compensation benefits because it is difficult to prove that these injuries derive solely from the occupation.
An employee that witnesses a traumatic event while at work would be eligible for workers’ compensation. For example, a bank employee who is working when the bank is robbed at gunpoint could collect workers’ compensation benefits if he experiences unsettling emotions and fears after the event. If an injury occurs while an employee is breaking the law, disobeying company policy, or not working, the injured employee is not eligible for workers’ compensation benefits.
There are also several types of workers specifically excluded from workers’ compensation, including:
- Shop Owners
- Farm Workers
- Independent Contractors
- Government Employees
- Railroad Workers
Seattle Attorneys for Third Party Claims With L&I
In most circumstances, an on the job injury will only result in a legal claim with the Department of Labor and Industries. In some unique circumstances, however, the injured worker can bring two different legal claims for their injuries. The second legal claim would be the “third party” claim and is against another person or entity who is NOT their employer.
The general rule that one cannot sue their employer relating to an on the job injury. But when a third party causes the on the job injury or under very limited circumstances amounting to the employer intentionally causing the injury to the worker, then separate legal claim can be made.
In some circumstances, an injured worker has the right to bring two legal claims relating to his or her on the job injury.
If the injury was caused by someone who was not also an employee of the injured worker’s employer, then the possibility of an additional legal claim, called a third party claim, arises.
A typical example of a third party claim would be a mail carrier who gets into an automobile accident caused by another driver. The postal worker would have a claim for injuries with Federal Workers’ compensation and would also have an independent claim against the other driver. If the other driver were another postal worker then there would be no such third party claim because the worker was an agent of the same employer.
Third Party Election Forms
When working with the Department of Labor and Industries in Washington on your L&I claim, if there is third party involvement, the Department will usually send the injured worker a form that asks whether the injured worker will pursue the third party claim himself or whether he wants for the Department to pursue the claim for him. This choice may not seem important, but it will likely affect the amount of money that the injured worker obtains in their third party claim.
One of the most important things to consider is that the Department of Labor and Industries will have a lien to get repaid what it has paid out to the injured worker for medical care, lost wages, and any permanent disability. In other words, if a third party caused the incident that resulted in these losses, the Department will want to be reimbursed should the injured worker obtain those same monies from the negligent third party. How this all works, however, is the important distinction in whether or not to hire an attorney to pursue the third party claim.
Repayment of Medical Bills to the Department of Labor and Industries
The Department of Labor and Industries is entitled to reimbursement if and when an injured worker collects the same bills and wages that it has paid out to the worker from a negligent third party. Otherwise, the worker would obtain a “double recovery” by having his medical bills paid for him by the State and then collecting the amount of those bills in cash from the negligent third party. While this may seem like a good reason to not pursue the third party claim, that is absolutely not the case.
First, the Department of Labor and Industries is going to only be repaid a percentage of those monies that it paid out on the injured worker and not all of it; the injured worker gets to keep a decent portion of the double recovery – usually around 25%, but cases are fact dependent and unique.
Second, the injured worker can collect more from the third party than he obtained from the Department of Labor and Industries because the worker’s compensation system is not designed to provide fair compensation for all of the effects of all injuries the worker incurred. A third party lawsuit is usually worth quite a bit more than the value of an L&I claim because the third party personal injury attorney can obtain complete compensation for every way in which the injured party was adversely affected by their injuries.
Third, by electing to have the State pursue a third party claim, they only have incentive to obtain those monies that they paid out and not obtain compensation for the rest of the damages as that money goes back to the worker and not back to the State. A personal injury attorney working on the third party claim has incentive to obtain every possible dollar that the third party is legally responsible for. This means more money at the end for the injured worker.
Third Party Injury Claim Scenarios
Most third party claims come about under one of these scenarios:
- Motor vehicle accident involving a third party.
- Defective equipment or product used at work that causes injury
- Construction site injuries where an employee of a subcontractor causes injury to an employee of a general contractor or another subcontractor (or vice versa – a general contractor’s employee causing injury to a subcontractor either directly or via poor oversight – such as an unsafe worksite or exposure).
Free Consultation for L&I Cases
At Wiener and Lambka, PS we offer free consultations regarding third party L&I claims. We’re happy to talk with you free of charge and without any obligation to find out if you have a third party claim and whether or not representation is in your best interest.
Keep in mind that you only have one year to file a claim with the Department of Labor and Industries in Washington for your L&I claim. The statute of limitations for most negligence claims is three years and this applies to your third party claim.
This is a fairly complicated area of personal injury law, but our L&I attorneys in Seattle are equipped to handle even the most difficult third party claims and help people like you get the most from their unfortunate work-related injury. Our consultations are free – start solving your problem today! Call us and let’s discuss your injury!
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Contact your local Wiener & Lambka office today.