Is a Worker Limited to Worker's Comp Benefits When Injured On The Job?

Posted on September 11, 2009 by Kristine Meredith

When a worker is injured on-the-job in California, his rights are limited by the workers’ compensation laws. Workers’ compensation is a “no-fault” system.  That means the employee is entitled to compensation from the employer's insurance carrier without having to prove the employer was at fault.   However, the workers compensation benefits are quite limited, and they seldom fully compensate an accident victim for his injuries.     

In an appropriate case, an injured worker can seek compensation for his on-the-job injury from other sources. For example:

  • If a co-worker causes the injury, the injured worker may be permitted to seek compensation from the co-worker, but only (1) when co-worker’s actions are malicious with an intent to cause injury or (2) when co-worker is intoxicated.
  • If someone other than the employer or co-worker (also known as third party) causes the injury, the worker may seek compensation from the third party.  The victim's lawsuit against the third party can proceed at the same time as the workers’ compensation claim against the employer.  In his third party lawsuit, the worker is not restricted to the limited benefits of worker's comp.   However, if the worker recovers against the third party, the employer is entitled to reimbursement for any benefits paid to the injured worker.

In some cases there may be multiple causes of a worker's injury and he should proceed against his employer, a co-worker and a third party.

 

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Repayment of the lien

Posted on July 6, 2009 by Kristine Meredith

After the lawsuit is settled or a judgment is awarded, the liens must be paid. Dealing with the liens is usually the job of the victim’s attorney, but it may differ depending on the agreement between the victim and the attorney.

When our office recovers funds on behalf of our clients, we will negotiate with the insurers the amount of payment on the lien. Because various fees and costs must be factored into the client’s recovery, I will negotiate with the insurer so that it will usually accept only a portion of the bills as full repayment.

Each lien is different. Dealing with them is my job, not the victim.
 

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Health Care Liens

Posted on June 9, 2009 by Kristine Meredith

An accident victim’s health care costs pile up fast. For those who are fortunate enough to have good insurance, a lot of the bills will be paid by an insurance company.  

The victim’s health insurer always expects the victim’s attorney to recover the health care costs from the wrongdoer, and to pay back the insurer. The insurer protects its legal right to repayment by filing a lien against the proceeds of the client’s lawsuit. 

After the lawsuit is settled, the liens must be paid. Frequently the insurer will accept less than full amount of the lien, allowing the client to keep the rest.  But that has to be negotiated, and each lien is different. Negotiating with the lien holders on my client's behalf is an important part of my job.

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