How Is a Personal Injury Case Different from a Workers’ Compensation Case?

by | Last updated on Sep 9, 2023 | Published on Apr 9, 2018 | Medical Record Review, Workers Compensation

Personal injury and workers’ compensation cases involve retrieval of medical records and medical record review that is vital to prove the severity of the injuries sustained. These types of cases are distinctive, though there are similarities. A personal injury case is based on fault whereas a workers’ compensation case is not. The plaintiff in a personal injury case has to prove that the person who caused the injury was negligent.

Take the case of a slip and fall injury caused on another person’s property. Just because you fell on that person’s property doesn’t assign fault or negligence to the property owner. To recover the due damages for slipping and falling on someone else’s property you need to prove that the property owner was negligent in maintaining his/her property. If the injury was caused by a car accident, the plaintiff has to prove that the other driver was at fault or negligent.

Workers’ compensation, on the other hand, eliminates the requirement of proving fault. In these cases, negligence is not necessary to be entitled to workers’ compensation benefits. Even if fault is proven, there will be no additional benefits available. The claimant has to prove that the injury occurred while doing his/her work and is related to the work. Even if the claimant was negligent and the negligence caused the injury, he/she is still entitled to receive workers’ compensation benefits.

Let us look at some of the other significant differences.

  • In a workers’ compensation case, you are not entitled to receive benefits for pain and suffering. You are entitled to weekly compensation, permanent impairment benefits, medical bills and vocational rehabilitation.
  • Workers’ compensation laws ensure that all workers injured on the job are given some weekly benefits, and get their medical bills paid. However, injured workers do not have the right to sue their employers or fellow workers for negligence.
  • The claimant is entitled to medical expenses for treatment that is reasonable, necessary, and related to the work injury. He/she is also entitled to lost wages. Wage loss and medical benefits may be payable on an ongoing basis as long as the claimant remains disabled, whereas in negligence cases there is a one-time payment structure.
    • “Total disability” may last for life, whereas “partial disability” signifies that the claimant can work at restricted duties and less pay. Partial disability may be available for up to 500 weeks.
    • Additional benefits or “specific loss” could be available for loss of use of a body part, amputation, or certain disfigurements.
  • In a personal injury case, you are entitled to recover all of the damages you have suffered, which would include lost wages, lost earning capacity, present and future medical expenses, pain and suffering, permanent impairment, loss of enjoyment of life and punitive damages.
  • The settlement or award in a personal injury case may include future injuries or losses, if there is sufficient evidence to prove the same.
    • If a case is settled by the parties, or a judgement is made by the court, plaintiffs cannot seek additional benefits for injuries lasting longer than expected or for consequences that were not anticipated at the time of trial or settlement.

Differences with Regard to Settlements

  • A personal injury case can be settled out of court via forms prepared and signed by the parties concerned, called a release.
  • Workers’ comp settlements called a compromise and release must be approved by a workers’ compensation judge.
    • Out-of-court settlements are not valid.
    • Some or all benefits available can be settled.
    • A judge cannot force either party to settle.
    • Both parties have to agree to the settlement amount, as well as all other conditions.

Differences in Procedures

  • The first step in a personal injury case is the plaintiff filing a complaint with the court, following which the court will issue a case or trial management schedule.
  • The parties involved will have to complete all discovery procedures within the schedule.
  • If the case is not resolved by agreement, the court will hold a single trial. All evidence will be presented and counsel for both sides can make opening and closing arguments.
  • Finally, the Judge or Jury will pronounce a verdict/award.
  • The initial step in a workers’ compensation case is filing a petition by either party (the claimant or the insurer) with the Bureau of Workers’ Compensation.
  • Each judge will have their own rules and deadlines within bureau guidelines, and it is important to know each judge’s rules.
  • There is no jury involved.
  • 2 – 5 hearings may be scheduled, over a period of six to eight months.
  • All evidence is identified and certified following which it is uploaded to the state’s computer system.
  • Each attorney will be asked to write a brief by the judge, usually within 30 – 60 days.
  • The judge will review all evidence and briefs, and then circulate a written decision.

Personal injury claims have the benefit of “immediate award” whereas workers’ compensation cases can take three months or even more after the final hearing to receive the judge’s decision. Personal injury claims involve only a single trial procedure whereas workers’ comp cases could involve serial petitions. Multiple petitions are likely to be filed by both sides to stop, reduce or increase the benefits being paid.

Proving injury is a common factor in both personal injury and workers’ compensation cases, and medical record analysis is required for this purpose. It is important to understand the differences between these two types of cases. In addition to those pointed out above, factors such as social security, short/long-term disability, or other forms of benefits may have an impact on the procedures and benefits payable. Attorneys handling these cases may coordinate their efforts with other attorneys to ensure that their clients receive the best compensation.

DISCLAIMER: The content in this blog is sourced from various reliable internet sources, and is not the opinion or inference of MOS (Managed Outsource Solutions).

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