What to Know About Third-Party Workers' Comp Claims

construction worker lifting box with equipment

Generally speaking, an injured worker who receives workers’ compensation benefits in North Carolina cannot sue his or her employer for causing a workplace accident. However, there are situations in which an injured worker may file a lawsuit and seek compensation from another party that was liable for the accident that caused the injury. These are known as third-party claims or lawsuits. By filing a third-party claim or lawsuit, an injured worker may pursue additional compensation besides the amount available from workers’ compensation benefits.

Here’s an example: ACME Construction is serving as a general contractor at a construction site in Raleigh, constructing an office building. ACME Construction hires multiple companies from throughout the Triangle as subcontractors to perform specialized tasks related to the project such as site excavation, installation of utilities and roofing. If one of the subcontractor companies working at the job site creates hazardous conditions that cause another company’s employees to be injured, then an injured worker may be entitled to file a third-party claim against the company that acted negligently and caused the injury.

The point to emphasize here is that a third-party lawsuit must be filed against a negligent party that is not your employer or a co-worker at your company.

Why is a Third-Party Claim Important?

The North Carolina Workers’ Compensation Act provides certain benefits to employees who have been injured in workplace accidents such as paid medical care and partial replacement of lost income. The law governs the amount of money an employee can receive if he or she is injured or a loved one dies in a workplace accident.

By filing a third-party claim, an injured worker may pursue additional compensation beyond the expenses that standard workers’ compensation covers, such as:

  • Pain and sufferingWorkers’ comp does not provide compensation for the pain and suffering or emotional distress that a serious injury can cause. However, compensation for pain and suffering can be sought in a third-party claim.
  • Medical costs – With workers’ comp medical coverage, you have to go to a doctor selected by your employer. When you file a third-party lawsuit, you can seek compensation for both present and future medical expenses related to your injury.
  • Lost income – Workers’ compensation benefits only pay two-thirds of your average weekly wages should you become disabled. The benefits also are subject to maximum state caps. If you file a third-party claim, you can pursue a settlement that reflects the full extent of your lost income and future lost earning capacity related to your injury.
  • Wrongful death – The compensation available through a wrongful death lawsuit may be more than standard worker’s comp death benefits. Surviving family members of a victim may be compensated for financial support and companionship that would have been provided if the loved one had survived.
  • Punitive damages – Punitive damages are not awarded under workers’ compensation benefits. In some instances, punitive damages may be awarded in third-party claims if there was egregious conduct that caused the employee’s injury. Bottom of Form

You can collect workers’ compensation payments at the same time you are pursuing a third-party claim. However, if you receive compensation through a third-party lawsuit, you will be expected to pay back your workers’ compensation benefits from the settlement. An experienced attorney can help you reduce what you have to pay back workers’ compensation out of the settlement.

Under What Circumstances Are Third-Party Claims Brought?

The difference between workers’ compensation and a third-party claim is that workers’ compensation is considered “no-fault” insurance. Most employers in North Carolina are required to provide workers’ compensation insurance. Injured workers do not have to prove someone was at fault to collect benefits. The only proof required is that the worker is an employee and was injured while performing his or her job.

However, for a third-party claim, you need to establish that the other party acted negligently and is responsible for your injuries. When filing a third-party claim, your accident and injuries must be due in whole or in part to the negligence of another person or business that is not your employer or co-worker.

Through evidence and testimony, you must prove that these circumstances occurred:

  • An accident was caused by a third party that is not an employer or co-worker
  • The other party caused the accident by failing to take an action that was reasonable
  • You sustained injuries
  • Your injuries were directly caused by the accident
  • Your injuries were foreseeable and could have been prevented

Who is Considered a Third Party in a Worker’s Compensation Claim?

  • Drivers –Truck, delivery, or rideshare drivers, salespeople, and construction workers are employees that regularly drive for their jobs. If they are involved in a car accident, the other party who caused the accident may be held liable for their injuries through a third-party claim.
  • Non-employee supervisors. A non-employee engineer or developer might oversee the activities on a construction project. In many cases, a non-employee supervisor would be considered a third party.
  • Workers often use heavy machinery, equipment, and tools to do their jobs. If a worker suffers injuries because a piece of equipment or machinery has an unsafe design or was defective, the equipment manufacturer may be liable for the worker’s injuries.
  • Property or business owners. Employees can become injured when performing tasks at a business maintained by a property owner or business owner that is not the employer.

Common Types of Third-Party Workers’ Compensation Claims

Several circumstances can cause a work-related accident. Many accidents that involve liability by a third party may fall into one of these categories:

  • Auto Accidents — If you are in a car or truck accident on the job and are injured in a crash caused by someone else, you may have a third-party claim.
  • Construction Site Accidents — Construction sites often use contractors from various companies because contractors or subcontractors handle separate aspects of construction. When a construction accident is caused by a contractor that is not employed by your company, you may have a third-party personal injury claim.
  • Premises Liability — If while attending a business conference, you were injured on someone else’s premises, such as slipping and falling in the lobby of a hotel where the business meeting was taking place, you may have a personal injury claim against the property owners.
  • Defective Products or Machinery – A worker that loses a limb in a work accident caused by a piece of machinery with a dangerous design may have a third-party defective product claim against the machinery manufacturer. The worker may collect worker’s compensation benefits and have a right to file a third-party claim against the manufacturer of the defective machinery.
  • Dangerous Designs – An employee could be injured because of the actions of a project manager, architect or other non-employer third party. For example, if an engineer or an architect made mistakes on the job (a construction beam collapses due to an architect creating a hazardous design), the worker could sue the non-employer.
  • Toxic Substances – You can file a third-party lawsuit against the manufacturer of a toxic substance that causes your injury or illness. Toxic substances include lead-based paint, asbestos, poisonous fumes, or other substances that directly or indirectly cause serious health problems.

Filing a Third-Party Claim

Before filing a third-party claim, you should do the following:

  1. Visit a doctor immediately after being injured for an examination. The doctor can determine your condition and the seriousness of your injuries. Medical records can offer proof of your condition that the insurance companies can use to evaluate your claim.
  2. If your injuries are severe or catastrophic, you should seek the advice of an experienced personal injury attorney. An attorney can determine whether you have a valid third-party claim, gather evidence to support your claim, and negotiate for a fair settlement to ensure you receive proper compensation.
  3. The negligent party or their insurance company may contact you soon after an accident and offer a quick settlement. Do not sign anything or accept a settlement without having an attorney review it and advise you whether it is fair.

How Our Workplace Injury Attorneys Can Help

Being injured in the workplace is probably one of the most stressful things you can experience. You may feel overwhelmed when dealing with insurance companies and medical bills while trying to recover from the injury.

When you work with the North Carolina workers’ compensation attorneys at Younce, Vtipil, & Baznik, P.A., you will be represented by experienced attorneys who are Board Certified in North Carolina workers’ compensation law, a distinction that only a small portion of attorneys have. Our workers’ compensation attorneys can advise you whether a third-party lawsuit is appropriate in your situation.

If you have questions about filing a third-party claim, the lawyers at Younce, Vtipil, & Baznik, P.A., are ready to answer your questions and assist you. We will fight to get you the compensation you need to rebuild your life after a workplace accident. Contact us at (877) 762-9071 for a free consultation.