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Regardless of whether an at-fault party was involved or not, workers' compensation will usually be recoverable in situations where there is an injury sustained while job duties are being performed.
What people may not realize is that there will sometimes be multiple avenues of redress. For example, if a negligent third party, such as a delivery driver, injured an employee during a drop-off, a workers' compensation claim may be possible, alongside a lawsuit against whichever external entity is responsible.
What Is Subrogation in Workers' Compensation?
Subrogation is a process used by insurance companies to recover money paid on workers’ compensation claims. It allows them to get some or all of the funds they paid to the victim from a third-party claim.
This can understandably be a confusing part of the workers’ compensation process, but grasping it can help victims navigate the system. Essentially, if an injured party receives workers’ compensation benefits, they may be subject to subrogation if they also file a lawsuit against a third party.
Therefore, an injured employee may be left to wonder if filing a personal injury claim against the liable third party is even worth it.
Why Does This Work?
When a victim receives workers’ compensation benefits, it may mean that they get money for expenses, such as wage replacement and medical benefits. This may represent the full suite of coverage for all damages.
However, if someone else was at fault for the work injury, that entity should be responsible for addressing the losses that were experienced.
Subrogation, therefore, exists to allow "fair" recovery of the amount of the claim paid by the worker’s compensation insurance carrier since the damages would have already been covered by the responsible party.
The insurance company will file a workers’ compensation lien in the third-party case, setting out how much they have paid in benefits as of the date of the lien.
Why Doesn't the Insurance Company Go after the Employer?
If an insurance company could recoup the third-party recovery funds from the employer for workers' comp, it probably would. However, remember the whole point of this kind of insurance is to ensure that the employer is protected from liability whenever an injured worker chooses to file a workers' comp claim.
Once the coverage is provided, the employer has already fulfilled the designated duty to the employee. Furthermore, legally, a fellow worker is considered a part of the employment relationship, which means that it is not possible for the insurance company to have them reimburse it via subrogation.
Employer’s Role in Subrogation
It is expected that the employer will work with the insurer as it tries to get third-party compensation.
Since the insurance company is an external firm, it will typically need to get information from the business that will assist with the subrogation claim.
This means that the employer has a responsibility to preserve any evidence that is related to the claim, so that it can easily be turned over to the insurance provider upon request.
Note that the right of the insurance company/employer to pursue compensation in this way is known as a subrogation interest.
Waiver of Subrogation in Workers Compensation Claims
A waiver of subrogation can be agreed upon by the company and the employee, which means the employer will not pursue the recovery process. Waivers of these claims can be very confusing, and they do not always work.
It gets even more confusing since such an agreement in a workers’ compensation case can have a couple of different meanings.
Employees and their attorneys may request a waiver of subrogation for a workers’ compensation claim, and the insurance company may also agree to forego all or part of their subrogation lien. Our experts can also explain the vocational rehabilitation definition.
Preserving Evidence for Subrogation
As indicated before, the business is required by law to maintain any relevant evidence.
There may be significant consequences for an employer if it fails to do so, including the employee suing the firm for spoliation of evidence. Therefore, this is also a matter of the employer reasonably protecting its own interest.
Additionally, workers’ compensation applications do not represent the limits of the obligations that a business may have, which means that there is even more of a need to tread carefully.
Such concerns will usually be most apparent when an employee decides to sue a product manufacturer for damages.
Seeking Legal Help for Subrogation Claims
Workers’ compensation cases are confusing, and when the extra layer of a potential third-party claim and subrogation are added, it can get much more complicated.
There's no need for an injured party to face these issues alone. An Ohio workers’ compensation attorney can help victims navigate the process and increase the likelihood of getting enough funds to address any sustained work injury adequately.
Typically, working with a qualified lawyer will usually result in the best possible outcome, even if it is not always the desirable one. For more information, a workers comp attorney in Columbus OH may be able to help.
Key Takeaways
The important things to remember about this process are as follows:
Subrogation can affect the amount of money that a victim will ultimately receive from a workers’ compensation claim.
If an injured party was fully compensated for all accident-related economic and non-economic losses, the employer/insurer may be entitled to recover money on their subrogation claim.
A skilled attorney will usually be the best option to maximize recovery and ensure the deserved compensation is what is received.
Schedule a Free Consultation with a Seasoned Ohio Workers' Compensation Attorney Today!
Many people are under the impression that they can freely file a personal injury lawsuit alongside a workers' compensation claim to "double their settlement." While there are scenarios in which both forms of claims will be accessible, in some cases, subrogation will be a concern.
It is highly recommended that you discuss your situation with a qualified workers' compensation attorney in Ohio, so the best way forward can be determined.
Larrimer & Larrimer has the qualifications and expertise required to ensure that you receive the maximum amount possible. Schedule a free consultation with us today!