When evaluating workers’ comp vs. personal injury claims, there are a lot of similarities.
Both serve to help the injured party deal with the financial burden stemming from their injury or illness, and both may be available to parties who have sustained physical injuries.
If you are not sure what type of claim to file, consider seeking experienced legal counsel.
Workers’ Comp vs. Personal Injury
When evaluating the best legal strategy to receive adequate compensation, you may wonder, If I’m injured at work, do I file a personal injury or workers’ comp claim?
The biggest factors to take into consideration are fault, benefits available, right to sue, and who is eligible to make a claim.
Who Is at Fault?
One significant difference between the two types of claims is the issue of fault. A workers’ compensation claim does not require an analysis of who is at fault for the injury or accident.
In fact, the injured employee could be responsible for the accident and still be able to make a workers’ comp claim.
The determining factor in a workers’ compensation claim is that the injury happened during the course of, and within the scope of the employment.
Personal injury claims require the injured party to prove that another party was legally negligent, resulting in injury.
For example, a construction worker who fell off a ladder while working on a roof would be eligible for workers’ compensation benefits regardless of how the accident occurred.
But to file a personal injury claim, the worker must show that someone besides the employer caused the accident, such as someone intentionally shaking the ladder or the ladder being defective.
The distinction is of vital importance because in a negligence claim, which is what most personal injury cases ultimately are, the injured person is asserting that someone besides the employer was responsible for the harm done.
What Can I recover?
In both workers’ compensation claims and personal injury claims, you are eligible to receive compensation to prevent you from incurring out-of-pocket expenses that you would otherwise not have had.
The legal term is to make sure the injured party is “made whole.”
These expenses generally include the cost of all medical care, such as doctor visits, medical procedures, therapy, medication, in-home care, equipment, and even reimbursement for travel costs for treatment.
Benefits of workers’ compensation and personal injury settlement also usually include payment for lost wages.
Workers’ compensation claims could also include vocational rehabilitation for those who cannot return to their previous position because of their injury.
A significant difference between a workers’ compensation and personal injury settlement is that the injured party cannot recover non-economic damages in a workers’ compensation claim.
But this type of compensation—which includes pain and suffering, mental anguish, anxiety, depression, post-traumatic stress, and other emotional suffering—is available in a traditional personal injury claim.
Do I Have the Right to Sue?
In most cases, if you were injured on the job, you will have to pursue compensation through workers’ comp. In this respect, workers’ compensation is said to be the exclusive remedy for on-the-job injuries.
There are a handful of exceptions. These include:
- If you were injured because of a defective product at work and seek to file against the product manufacturer;
- If you were injured or became ill because of a toxic substance manufactured by a third party;
- If you were intentionally injured;
- If your employer does not carry workers’ compensation insurance; or
- If a third party acted in a way that resulted in your injury.
Litigation can be lengthy but can also be worthwhile for larger settlements. Your North Carolina attorney can help you determine the best course of action according to the facts of your claim.
Am I Eligible to File a Claim?
Outside of the work environment, anyone who is injured because of someone else’s negligence can file a personal injury lawsuit regardless of their employment status.
But when you are injured on the job, it is likely that you have to pursue compensation through workers’ comp. There are limitations, however.
The injured party must be an employee of a company that has workers’ compensation insurance.
In North Carolina, most businesses with three or more employees are required to carry workers’ compensation insurance.
You also have to have been injured during the course and within the scope of your employment.
An experienced employment law attorney can help you determine if you qualify for an award under workers’ comp.
What Is Considered a Workers’ Compensation Injury?
To be eligible for workers’ comp, the injury must have happened during the course of and within the scope of employment.
Common eligible work accidents include falls, machinery accidents, and automobile accidents.
In some cases, occupational conditions like carpal tunnel syndrome or other repeated-use injuries may be compensable.
Your attorney can help you determine what is considered a workers’ compensation injury.
If I’m Injured at Work, Do I File a Personal Injury or Workers’ Comp Claim?
Each situation is unique and deserves its own individual analysis. Generally, if no third party was at fault and you were acting in the normal course of employment, you would file a workers’ comp claim.
If your injury was the result of intentional conduct, a third party’s actions, or a defective product, you might want to pursue compensation through a personal injury claim also.
If you are unsure, it is always best to seek experienced legal counsel.
It is also worth noting that, like other insurance claims, you are not required to accept a settlement that does not meet the full value of your claim. You also do not have to accept the denial of your claim.
The North Carolina workers’ compensation system is governed by the North Carolina Workers’ Compensation Act and adjudicated by the North Carolina Industrial Commission, and a series of safeguards are in place to ensure injured employees are heard.
If you choose to appeal a decision on your workers’ compensation claim, an attorney can help you through the process.
Contact Mehta & McConnell
Any amount of time without a paycheck can be extremely stressful for you and your family.
At Mehta & McConnell, we are dedicated to helping you achieve results that meet your needs so that you can heal and move forward.
Contact us for your free case consultation.