Difference Between Workers Comp and Personal Injury

When a worker is injured on the job in California, they are guaranteed workers’ compensation coverage for their injuries. Depending upon the nature and circumstances of their injury, however, they may also have a separate claim for personal injury. Personal injury and workers’ compensation are two different pathways to compensation after an accident. Below, our experienced California workers’ comp attorney explains the primary differences between the two areas of law.

Workers’ Comp Does Not Require Fault (Negligence)

There are two main differences between workers’ comp and personal injury claims: The standard of proof needed to obtain compensation, and the type of compensation available. Each of these factors benefits one form of recovery over the other.

With regard to the standard of proof, workers’ comp has a clear advantage. Every California worker is guaranteed workers’ comp coverage in the case of a workplace or work-related injury. Every California employer with at least one employee is required to carry workers’ comp insurance, and the insurance company must pay out in the event of a workplace injury.

Injured workers are guaranteed workers’ comp coverage regardless of who was at fault for the accident. The worker only needs to prove that the injury occurred at the workplace or was otherwise incurred during the performance of work-related duties. It does not matter whether the injury was caused by a coworker, a supervisor, a third party, or even the injured worker’s own mistake. Outside of certain limited exceptions (such as intentional injury, intoxication, or criminal activity), so long as the worker can prove the injury was work-related, they are guaranteed coverage.

In a personal injury case, the injured plaintiff must prove that the defendant caused the plaintiff’s injury, typically through some negligent behavior. The defendant must have owed some duty to the plaintiff and breached that duty. The duty might be specific–such as the duty a doctor owes a patient to perform as a proper medical professional–or general, such as the duty every driver owes to everyone else on the road to drive responsibly and follow driver safety laws and regulations.

If the plaintiff cannot prove that the defendant was negligent and that their negligence caused the plaintiff’s injuries, the plaintiff cannot recover.

Additionally of note, an injured worker cannot typically sue their employer for personal injury after a workplace accident. Injured workers are generally limited to workers’ comp coverage from their employer. If the worker was injured by a third party, however, the worker might have both a workers’ comp claim and a personal injury claim against that third party.

Personal Injury Claims Allow for Additional Damages

The other major difference between personal injury claims and workers’ comp is the compensation available. Workers’ comp is limited to specific benefits:

• Compensation for medical costs,
• Two-thirds of the worker’s lost wages while recovering from injury,
• Disability benefits
• Job displacement benefits for retraining

No other damages are available under a workers’ comp claim.

In a personal injury case, the plaintiff can claim a much wider range of damages based on how the defendant’s conduct affected the plaintiff’s life. Personal injury plaintiffs can recover:

• Compensation for their medical costs
• All of their lost wages (unlike the two-thirds rule for workers’ comp)
• Pain and suffering
• Emotional distress
• Compensation for other harm caused by the defendant

Depending upon the circumstances of the incident, the personal injury plaintiff may even be able to recover punitive damages, which are meant to punish a particularly egregious wrongdoer (such as a drunk driver) and are awarded on top of the “compensatory” damages.

Personal injury awards can thus be much larger than the workers’ comp benefits available to an injured party. However, the pathway to obtaining a personal injury award is longer and requires a higher burden of proof.

Workers’ comp benefits can be recovered almost immediately after an accident simply by reporting the injury and demonstrating that it occurred while the worker was on the job. A personal injury plaintiff, on the other hand, will need to collect evidence to prove the accident was the fault of the defendant, file a claim with the defendant’s insurance (where appropriate), and may need to take the at-fault party to court.

Even in a workers’ comp claim, however, the worker may need to negotiate with the workers’ comp insurance provider about the nature of the injury, the severity of the injury, and the appropriate amount of benefits. A seasoned workers’ comp attorney can help you negotiate with workers’ comp insurance to maximize your benefits.

If you’ve been seriously hurt at work, you need experienced, effective legal help to maximize your compensation. The seasoned California workers’ comp legal team at Invictus Law is ready to help. We’re board-certified specialists in workers’ compensation. You don’t have to pay unless we recover on your behalf. Call us today for a consultation.