You are currently viewing What are my options after a catastrophic work injury?

What are my options after a catastrophic work injury?

What kind of injuries occur at work?

For many individuals, work takes up a significant portion of their time, second only to sleeping. Unfortunately, work-related injuries are all too common and can be much more serious than injuries sustained during leisure time.

Work-related injuries can be caused by the physical demands of the job or accidents like falls and car crashes. Heavy lifting can cause injury, while office work can lead to repetitive stress injuries. Retail workers may also suffer from spinal injuries from standing in one place for extended periods. The severity of work-related injuries can range from minor cuts and bruises to limb loss, paralysis, or even death.

In the event of a catastrophic injury, it is important to explore all possible avenues for compensation, including workers’ compensation, disability benefits, and personal injury claims, also known as third-party claims.

How do workers’ compensation benefits work?

In Florida, all but the smallest employers must provide workers’ compensation benefits to employees. Employers do that by purchasing insurance from a workers’ compensation insurance carrier. This is similar to car insurance but pertains to injuries sustained on the job.

Workers’ compensation insurance covers medical benefits, lost wages, and vocational rehab for job-related injuries. The system aims to get you back to work…and fast. Florida also has a specific death benefit of up to $150,000.

Workers’ compensation is a no-fault system, meaning you do not have to prove that your employer is at fault to get benefits. In exchange for these benefits, you forfeit the right to sue your employer for negligence. Workers should receive immediate benefits for giving up the right to sue employers, except for extreme circumstances.

Workers’ compensation benefits often work with disability benefits and personal injury claims discussed below.

What are the limitations for workers’ compensation benefits?

As previously stated, once you inform your employer about your injury, they should promptly provide you with benefits. If fully satisfied with your workers’ compensation benefits, you may want to talk to a lawyer to explore your rights but may not need to pursue a claim. Lawyers typically see people complaining about workers’ compensation benefits. For example, some workers feel the insurance carrier may not take their claims seriously or give them substandard medical care.

Workers’ compensation benefits may be available without proving employer fault, but insurance carriers may deny coverage by claiming pre-existing injuries.

  • Injury was pre-existing;
  • Injury did not occur on the job or not while employee did work-related duties;
  • Injury was due to employee’s use of drugs or alcohol.

In addition to these defenses, workers’ compensation does not provide non-economic damages or pain and suffering. That is a huge difference between a personal injury claim, where pain and suffering may be a huge component of the claim, and workers’ compensation.

Why might you want to claim workers’ compensation benefits?

Receiving some workers’ compensation benefits may not fulfill all of your needs, but it’s still better than receiving nothing. After a serious injury, it may be necessary to receive workers’ compensation benefits before pursuing other benefits. If you or someone you love has a severe injury and a personal injury claim, prompt medical care may still be necessary.

A lawyer knowledgeable about your options can discuss when it is wise to pursue or not pursue workers’ compensation benefits, also called the “election of remedies.”

Seeking workers’ compensation benefits may be a temporary solution while you pursue more valuable claims in a personal injury lawsuit. Lawyers experienced in both the workers’ compensation process and other legal avenues for recovery can help you navigate the situation.

Can I claim other benefits along with workers’ compensation?

Yes.

For catastrophic injuries, you or your loved ones will want to seek every possible avenue for recovery. These include workers’ compensation benefits, personal injury claims for any third party involved, and the possible pursuit of private and government disability benefits.

Example 1:

You are rear-ended while working. In addition to seeking workers’ compensation benefits, you may also be able to pursue benefits from the car insurance of the vehicle that hit you, as a third party. If companies like Uber or DoorDash employed the individual during the incident, you may also be able to file a lawsuit against those companies.

You can pursue your benefits as an uninsured motorist or first-party. It can be complicated, but submitting multiple claims can improve your chances of getting benefits.

A knowledgeable lawyer will try to help you try to maximize your recovery. It’s important to remember that most lawyers receive payment on a contingency fee basis, which means they only get paid if you receive a recovery. A dedicated lawyer committed to your case increases both parties’ earnings. It’s reassuring that your lawyer is invested in your best interests and committed to maximizing your financial compensation.

Example 2:

While carrying out your job responsibilities at a commercial property, you suffer a serious injury due to a hidden hazard, such as a hole, that causes you to fall. You may be eligible to receive benefits from workers’ compensation. Additionally, you can file a lawsuit against the commercial property owner for neglecting to maintain a safe environment or failing to notify you about the hidden danger.

Example 3:

If you were injured in a bridge collapse, such as the one that occurred at Florida International University, where a pedestrian bridge collapsed onto a busy road filled with cars, resulting in a tragic loss of life in 2018, there might be options for compensation. This incident left one worker and five motorists dead and six people with serious injuries, including one employee who was permanently disabled. Those injured in the collapse, including workers, may be able to pursue workers’ compensation claims and other legal claims like those not employed at the site.

Exception:

Under Florida law, the exception is that an employee cannot sue an employer unless the employer engaged in “gross negligence.” To sue an employer, it is necessary to prove that they acted with extreme negligence, to the point where it was highly likely that the employee would experience severe injury or even death. Meeting this high standard may seem daunting, but it is not impossible. Unfortunately, some employers prioritize saving money over their employees’ safety, disregarding simple and logical safety measures. This borderline criminal behavior puts employees at risk of injury or worse.

I believe that only when employees pursue gross negligence claims will employers start taking the safety of their workers seriously.

Can I get in trouble for claiming workers’ compensation benefits?

In Florida, a law safeguards individuals who file for workers’ compensation from facing any negative consequences in their employment. Such discrimination is prohibited by law, much like being terminated from a job based on your race, age, or gender. If you are fired for pursuing workers’ compensation benefits, you can take legal action against your employer for wrongful termination if you have made a good-faith effort to seek benefits. This applies even if you ultimately do not receive any benefits, as long as you pursue them in good faith.

Any employer should readily help you get treatment under their workers’ compensation policy. After all, they paid for the insurance to help you. That is the goal of the law: you cannot sue your employer, but you are entitled to swift benefits. If denied, you can immediately pursue a claim with an administrative law judge.

Employers may discourage workers from filing compensation claims to avoid higher insurance premiums in the future. This is more common among smaller businesses, where a single claim could impact their impeccable record. In contrast, larger corporations are less affected by such claims. However, it is important to note that it is illegal to discourage employees from seeking benefits. Additionally, failing to provide workers’ compensation benefits or falsely claiming to offer them without paying for them is considered a criminal offense.

Why should I contact a lawyer after being hurt at work?

It is common for injured individuals to seek legal counsel after their employer denies or restricts their benefits, often long after the injury has occurred. This is not ideal. Just like with any case, you should seek a lawyer quickly who can move to find evidence and pursue the case. Delaying your claim could make it harder to take legal action against your employer or third-party cases. For instance, if you were injured due to equipment failure, there may be a product liability claim to consider. Additionally, a class action claim may be possible if your injury is not severe but commonly occurs due to a defective or poorly designed product. Taking action as soon as possible is important to protect your rights.

If you are rejected for benefits and your employer has fired you, pursuing workers’ compensation benefits poses no risk. After all, you cannot get fired for seeking benefits if you were already terminated. Do not forget that a statute of limitations can bar any claims related to your injury if you wait. There is no time like the present to call a lawyer; the greater the injury, the greater the urgency.

Note:

Most workers’ compensation carriers require you to resign when you settle any workers’ compensation case. To get a settlement from most insurance carriers, in exchange, you agree not to sue them for anything else and, thus, never work for the employer ever again.

Some large employers do not require resignation, but it is common to resign to receive a lump sum workers’ compensation settlement; the result people most often want out of workers’ compensation: you give up future benefits, and they give you a lump sum, and you move on to handle your medical care outside of the workers’ compensation system.

On the other hand, if you are happy enough at your job, can still work or get proper accommodation, and do not want to risk resigning and looking for another job, maybe you only want to pursue a third-party claim.

Your employers should have no problem with you suing a driver who rear-ended or the commercial business you got hurt while visiting. Your employer’s insurance will be happier if you can settle a third-party claim against that driver or property owner since your settlement will reduce their obligation for your injuries.

Why?

When a personal injury lawyer gets a settlement from the driver or commercial property owner (we call these a tortfeasor or a civil wrongdoer), that caused your injury, harm, or loss, this settlement comes by citing the damages from these injuries, including damages paid by workers’ compensation carrier. When your employer’s insurance carrier pays these damages, that insurance company has a claim known as a subrogation lien. This lien is against future personal injury claims related to this same injury that the workers’ compensation carrier paid benefits.

When you collect money from a tortfeasor, you get this money based on damages the workers’ compensation carrier paid. Using a formula called the Manfredo Formula (Manfredo vs Employer’s Cas. Ins. Co.), you then use some settlement money to pay back what your workers’ compensation carrier paid.

If you recover from a work injury, your employer’s insurance company will be happy. But remember, in Florida, if you wait over a year to take legal action, your employer can sue a third party to recover the benefits they paid on your behalf. You must cooperate with your employer during this process. Some people prefer to hire their own legal counsel to navigate this situation.

Before you let an employer bring a case on your behalf, you may want to interview lawyers to represent you. When you sue, you may seek additional benefits, such as for pain and suffering. You have the right to choose your own lawyer instead of allowing your employer to sue to recoup their expenses. After all, you must participate in either suit; why not get a lawyer of your choice?

How do I know what sort of claim I might have based on my work injury?

Determining the best type of claim can be difficult as it varies depending on the circumstances. In certain cases, an individual who has been injured at work may only be eligible for workers’ compensation. This is because there may not be any third parties at fault, or the injury may be too severe to be litigated. It’s important to note that you can’t sue an employer for negligence unless it is gross. Proving negligence is easier if you’re injured as a guest at work than if you’re injured on the job.

Navigating the intersection of workers’ compensation, personal injury, employment law, and disability law can be a daunting task. In case of a catastrophic injury to you or your loved one, seeking legal representation from a knowledgeable lawyer in this field is crucial. It is important to connect with lawyers specializing in work injury cases, as each case presents unique challenges requiring extensive knowledge to maximize potential recovery.

Authored by Aaron Clemens, Esq.

Attorney Aaron Clemens