Workers’ compensation is no-fault insurance; it pays regardless of who caused the injury. In exchange for workers’ comp coverage, an injured employee is prohibited from suing an employer after an occupational injury, even if the employer may have caused the accident.
However, it is important to understand that there is no prohibition on seeking compensation from parties responsible for your injuries who do not employ you.
- An independent contractor may pursue a personal injury claim against any party whose negligence caused their injury. Independent contractors are not employees; therefore, they do not have workers’ comp coverage, but they are not bound to restrictions imposed by workers’ comp laws, either.
- An employed worker may pursue a personal injury claim against any third party – i.e., other than their employer – whose negligence caused their injury. Third parties may include vendors, other contractors, individuals, etc., as long as they do not employ you.
Such claims may also seek compensation, or “damages,” for pain and suffering, which workers’ compensation does not cover. Punitive damages are not available through workers’ comp but may be awarded in third-party claims if there was egregious conduct that caused a worker’s injury.
On a large highway project, such as resurfacing or widening stretches of Interstate 40 or 95, a work zone may be occupied by a general contractor and several subcontractors and vendors. Smaller projects may be similarly populated. An injured employee with a claim (the first party) may be eligible to obtain workers’ compensation through the second-party (employer) and/or personal injury compensation through another company or individual (third party) responsible for the accident they were in.
- A passing motorist who hits and injures a construction worker in a highway work zone may be held liable in a third-party lawsuit.
- A heavy equipment operator whose negligence caused a back-over accident that injured or killed a construction worker might be held liable (or their employer may be) if he or she or their employer is not the injured or deceased worker’s employer.
- A subcontractor who sets up work zone barriers and signage and employs flaggers may be held liable for injuries caused by a motorist’s crash if the work zone did not provide adequate warning and slow-down room for arriving traffic.
Even if you are receiving workers’ compensation benefits, you may pursue a third-party personal injury lawsuit. However, if you receive compensation through a third-party lawsuit, you will be expected to pay back workers’ compensation benefits you have received.
A workers’ compensation attorney from Younce, Vtipil, Baznik & Banks in Raleigh can help you obtain North Carolina workers’ compensation benefits if you are covered. We can also investigate the circumstances of your accident and determine whether there is opportunity to obtain financial assistance for you through a third-party claim. If we help you pursue a third-party claim, we can reduce the amount of your settlement that goes toward repayment, or “subrogation,” of workers’ compensation payments you have received.
Has Your Work Zone Accident Workers’ Comp Claim Been Denied?
It is not uncommon for a valid workers’ compensation claim to be denied and/or challenged by the employer or the employer’s insurer. However, there is an appeals process and with perseverance, knowledge of the law, and an understanding of the type of evidence needed to support a claim, a denial can be reversed or an objection overcome.
A workers’ compensation attorney from Younce, Vtipil, Baznik & Banks can help if you have received a notice of denial of your claim. We can review the reasons your claim was turned down and begin obtaining evidence required to successfully appeal the denial claim. In some cases, there is a technical problem or omission in your claim that we can correct. In other cases, we need to fight your employer or their insurer on your behalf.
Typical objections we can work to mitigate include but are not limited to:
- Employment status. Increasingly, companies save money by treating workers as independent contractors when legally they meet all criteria of an employee. We can work to show that conditions of your employment meet the legal definition of an employee under North Carolina law.
- Scope of employment. An employer or insurer may claim you were not on the job or not performing assigned job duties when the accident occurred. We will work to gather evidence that establishes they your accident was properly job-related.
- Lack of causation. The claims adjustor may not recognize how your injury or medical condition is related to the worksite accident. We can help you obtain a second medical opinion and submit stronger evidence of your qualifications for benefits.
Denied claims usually involve legal or medical issues, or both, and are litigated first through mediation and, if not settled, through an administrative hearing before an Industrial Commission judge. In some cases, an appeal goes before the full Industrial Commission and into the N.C. Appellate Court System.