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The difference between workers’ comp and third-party claims

On Behalf of | Apr 18, 2024 | Workplace Injuries

When employees suffer injuries on the job, they typically have two avenues for seeking compensation. The most commonly-known route is to file for workers’ compensation.

However, some injuries might call for a third-party claim instead. Both options offer financial support, but they differ significantly in their scope and eligibility criteria.

Workers’ compensation

Workers’ compensation is a system that provides benefits to employees who sustain work-related injuries or illnesses. It is a program funded directly by employers. These benefits offer coverage for medical expenses, lost wages and rehabilitation services. Unlike traditional lawsuits, workers’ comp does not require employees to prove fault or negligence on the part of their employers. Instead, it operates on a no-fault basis, ensuring that injured workers receive benefits regardless of who caused the accident.

Third-party claims

Workers’ compensation may not always cover the full extent of an employee’s losses, especially in cases involving severe injuries or long-term disabilities. In such instances, injured workers may pursue third-party claims against parties other than their employers who may be liable for their injuries. These parties could include equipment manufacturers, subcontractors or negligent drivers.

The matter of fault

Unlike workers’ comp claims, third-party claims are fault-based. This means that the injured party must demonstrate that someone else’s negligence or wrongdoing caused their injuries. This requires gathering evidence and presenting a compelling case to establish liability.

One significant advantage of third-party claims is the potential for higher compensation. Unlike workers’ comp benefits, which are typically limited to medical expenses and lost wages, third-party claims can include damages for pain and suffering, loss of consortium and punitive damages in cases of gross negligence.

The National Safety Council reports that there were 4.53 million medically-consulted work injuries in 2022 alone. For each of these injuries, the affected workers must determine if their claim falls under workers’ compensation or if it is a third-party claim. Knowing how to find the answer will make the process much easier to navigate.