Worker’s Compensation

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One aspect of personal injury damages is worker’s compensation. If somebody is injured on the job, they typically have a worker’s compensation claim.

Worker’s compensation has a certain way of paying for medical bills and for lost income–people can generate a fair amount of money from pursuing a worker’s compensation claim.

In a personal injury claim, you don’t see any financial result. It might take months or years while a person is not able to work, not being able to make her rent, not being able to make a mortgage. Worker’s compensation provides at least some amount of remedy to prevent a person from completely struggling.

Worker’s Compensation and Personal Injury Overlap

What would happen if somebody is injured at work, or they have a worker’s compensation claim and this is followed by a personal injury claim?

Let’s say somebody was driving a company car and got rear-ended. They have the worker’s compensation claim with the worker’s comp insurance, but they also have a claim against the third party who hit them, the other driver. First, the injured person needs to repay the worker’s compensation insurance what they’re due, which can also is an aspect to negotiate. This is because some worker’s compensation insurance companies expect to be repaid the full amount while some do not.

You can negotiate with them the same way you negotiate with the medical providers and with health insurance companies if claiming interest in their case. You need to look at specific laws as to how much they can claim, and what deductions are they required to accept. Sometimes you can make them agree to accept different reductions, and sometimes you can make them take certain charges off if you can prove that they are not related to this accident.

Health Insurance Negotiation

It is necessary to be very careful with health insurance, because a lot of times they claim every medical expense in a person’s history related to the accident, which is not always accurate.

Review the logs, because sometimes a person goes in and has an accident on September 5th, for example, and then they go in and have an emergency room visit on September 5th. Sure, that’s related. But then they go in and have a flu shot on September 16th, which is not related. Why is it on the ledger? You have to get rid of it.

Sometimes it can be more complicated. What if a person has chronic back pain, and they injured their neck? The insurance company might try to claim all of their medical bills related to any treatment related to back and neck. Some of it is based on what was going on before that, but some of it is based on what is going on after the accident.

This needs to be addressed and watched for in brief, pre-settlement negotiations. Once you take the settlement, you have settled the case and you are bound by the amount you take. You can’t really go back and say, “Well, I need to pay this person, now I need to pay them,” and you’re stuck.

Another situation is when you’d need to notify potential lien holders that they may have a lien, and that they may be entitled to collect something from you. This is because if you settle the case and then you realize that they did not get paid, they can try to come and collect from you or from your client.

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