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Workers’ compensation to an injured employee excludes some torts

On behalf of of Frederick & Hagle posted in Workplace Injuries on Friday, June 28, 2013.

Each year there are about three million workplace injuries and illnesses that occur in the American workplace. The system everywhere provides that workplace injuries and illnesses are covered by a workers’ compensation system of insurance coverage. In Illinois and all other states there’s a so-called tradeoff that’s been put in place: the injured employee receives payments for wage loss, medical expenses and other costs for a work-related injury or illness, without having to sue the employer.

In this tradeoff concept, the benefits to the worker are presented as virtually automatic, and thus a great benefit in savings of time and expenses. The problem with the model of course is that worker’s compensation insurance carriers, often with the aggressive support of employers, regularly deny legitimate compensation claims. In many cases, they reject the treating physician’s report and demand ‘independent’ medical examinations, which almost always declare the employee fully recovered.

The workers’ compensation appeal procedure that must then be followed to collect on a denied claim is in some ways more protracted and burdensome than the typical tort lawsuit made unnecessary by the tradeoff. That’s why workers’ compensation lawyers are vital. They guard and enforce the workers’ rights to be fairly treated and get the benefits they’ve been promised and are legally entitled to collect.

Workers’ compensation is thus insurance coverage that is paid for by employers and administered by each state. Even if the workplace injury was caused by the negligence of the employer or a co-worker, because of the ‘tradeoff’ mentioned above the law largely prohibits a lawsuit against the employer. That precludes a traditional tort lawsuit for personal injuries, including for pain and suffering. The workers’ compensation benefits pay only a portion of lost wages, all medical bills and some other expenses.

In Illinois and elsewhere, the above system controls the benefits process for an injured employee. Occasionally, where the employer is guilty of reckless or nearly intentional behavior that causes workplace injury or illness, a lawsuit against the employer may be allowed. Additionally, in some instances where a workplace injury is caused by the negligence of a third party, such as an outside contractor, or by a defective and dangerous machine or instrumentality, a lawsuit against the third party is allowed.

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