Workers’ Compensation or Civil Action – Pick One!
Workers’ compensation is insurance paid by an employer to cover an injured worker. If an employee gets hurt, he or she reports the injury to a supervisor, who in turn refers the worker to an approved medical practitioner. If the injury is severe enough for the employee to go directly to the emergency room, the worker needs to notify the staff at the hospital that he or she has been hurt at work.
Once a claim is reported, workers’ compensation will cover all the medical expenses and treatment relating to the injury. The caveat to this insurance is the employee must visit a workers’ comp approved doctor and the provider must approve the treatment.
Workers’ compensation allows injured employees to seek immediate treatment, regardless if they can pay or not. The catch to workers’ compensation, however, is that the employee gives up his or her right to pursue a civil lawsuit against the employer.
Wal-Mart of Kentucky Appeals Workers’ Compensation Case
In a Kentucky case reported through PRNewswire, Wal-Mart recently won an appeal for a case involving an employee named Donald Wells who sued additional responsible parties outside of his workers’ compensation agreement. Wells was exposed to carbon monoxide in 2005 at a Wal-Mart Distribution Center during renovations made by two different contractors.
Wells made a claim through workers’ compensation and at the same time commenced litigation against the outside parties in a third-party liability lawsuit. The awards in the civil actions amounted to almost $1 million while the workers’ compensation claim was almost $450,000. Wal-Mart appealed the case citing that Wells should have either filed a workers’ compensation claim or pursued the civil lawsuit, but not both.
The Court of Appeals of Kentucky found that the Administrative Law Judge in the workers’ compensation was correct in awarding Mr. Wells the workers’ compensation settlement. However, when a recovery is made in a third party liability lawsuit that arises out of the injury incident, the workers’ compensation carrier or self-insured employer is entitled to a subrogation credit for some or all of the workers’ compensation award. In this particular case, the subrogation credit was $126,811.60.
Michael Monheit is the managing lawyer at Monheit Law, outside Philadelphia, Pennsylvania. He has practiced law since 1989. Michael Monheit was the managing attorney of the law offices of Herbert Monheit — now Silverman and Fodera — a firm... Michael Monheit→