Note: Jake and Cecilia’s stories are fictional scenarios presented to help illustrate the difference between a workers’ compensation case and a personal injury case.
Introduction
Workers’ compensation and personal injury cases have something in common. They both provide reparations for injuries. There are, however, some key differences. These include the cause of the injury, legal basis, compensation structure, legal process, and the role fault plays in determining eligibility for benefits. Below, we will define workers’ compensation and personal injury and explain their key differences.
Workers’ Compensation
Workers’ compensation is a form of insurance employers may be required to have in case one of their employees is injured on the job or contracts an occupational illness. It provides coverage for the employee’s medical expenses and lost wages. In exchange, the employees can not sue the employer for negligence.
Personal Injury
Personal injury is a legal term for an injury to the body, mind, or emotions. It is a specific type of tort lawsuit in which the person suing has suffered harm at the hands of someone else’ abuse or neglect. A tort lawsuit is a civil wrong involving an act or failure to act that results in harm to another person. The purpose of a tort lawsuit is to compensate the victim. There may also be punitive damages, or exemplary damages, assessed to punish the defendant for past behavior (or keep it from happening in the future). Tort lawsuits almost always involve the injured person, or plaintiff, seeking reimbursement from the defendant for personal damages. The money can be used for medical expenses, loss of income, or “pain and suffering”. Pain and suffering is the physical or psychological distress a victim experiences after an event, and the effects can last days or a lifetime.
Can You Have Both Cases At Once?
Although rare, it is possible for someone to pursue both types of cases at the same time. This may happen if someone is injured while at work, but the injury was caused by someone other than the employer. This is known as a “third party liability claim”.
Cause of Injury
Personal injury cases involve harm caused by negligent or intentional actions of another party. Workers’ compensation cases, on the other hand, involve harm that is specific to an employee’s job duties, even if the employer wasn’t at fault.
Legal Basis
Personal injury is governed by tort law, and it involves filing a lawsuit against the party who is at fault. Workers’ compensation, however, is governed by state law. 49 of 50 states are required to carry workers’ compensation insurance. Despite some exceptions, most employers’ insurance companies are obligated to cover their employees’ injuries.
Compensation Structure
Personal injury settlements may cover non-economic damages such as pain and suffering, whereas workers’ compensation settlements do not.
Legal Process
Personal injury lawsuits, once filed, may lead to negotiations, settlement discussions, or a trial. Workers’ compensation claims, on the other hand, are typically resolved outside of court.
Fault
In personal injury lawsuits, the victim must prove that the liable party was negligent or intended to harm them. In workers’ compensation cases, fault is not typically a factor in deciding whether or not the injured person is eligible for benefits.
Jake’s Story
Jake is a professional player for the Major League Soccer team. During one of the games last season, he and another player went in for a head ball at the same time. After colliding into one another, Jake fell to the ground with a head injury. In the weeks and months following the incident, Jake had symptoms of a mild concussion. His care team confirmed the diagnosis. Because the injury was no one’s fault and ruled an accident, Jake filed a workers’ compensation claim because the injury was related to his job duties. The concussion kept him out of the game and in recovery, so he sought reimbursement for lost wages and medical bills.
In the legal world, workers’ compensation cases are typically considered no-fault. This means that employees receive benefits regardless of who was responsible for the accident. Even if Jake made the mistake of jumping too closely to his opponent, that wouldn’t affect his eligibility for compensation.
Cecilia’s Story
Cecilia is a professional soccer player for the U.S. Women’s National Team. During one of the games last season, Cecilia’s opponent violated one of the rules of the game by intentionally elbowing Cecilia in the jaw. Cecilia left the game immediately and went to the emergency room to seek pain relief. She sought medical care for months following the incident. She started seeing a TMJ (temporomandibular joint) disorder specialist. She did not have a pre-existing condition before the injury, so her doctor determined her jaw issues were a direct result of the other player’s behavior. Because her opponent had violated the safety rules of the game and there were witnesses who confirmed this (including the referee), Cecilia sued the other player for personal injury.
Her opponent’s behavior on the field was a breach of the reasonable person standard. This is a legal term describing the standard level of care and caution that an ordinary person would use in a given situation. It is applied to defendants in these types of cases to determine their liability. In other words, Cecilia’s opponent did not meet the reasonable person standard because she failed to fulfill her duty as a fellow athlete.
Cecilia could have also filed a workers’ compensation claim because the incident happened at work.
Conclusion
It is possible for an injury to result in both a personal injury lawsuit and a workers’ compensation claim. However, most people’s cases fall under one category or the other. If you have been injured and need advice on which to pursue, you can book a free consultation with us at the Law Offices of Craig L. Cook, and one of our attorneys will guide you through the journey of getting the compensation you deserve.
