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Archive for December, 2017

Who is Held Responsible in a Third-Party Claim?

injured on the job

When an employee is injured on the job, they are entitled to workers’ compensation benefits. These can provide much-needed financial compensation for medical expenses, as well as wage loss benefits in those cases where the worker’s injuries are bad enough to keep them out of work on a temporary basis or permanently. Workers’ compensation is specifically a no-fault form of insurance: the employee does not have to sue their employer for negligence or prove that their employer is to blame for their injury as the benefit is provided regardless of what the cause of the injury was. But there are some instances where a person or entity other than the employer may have contributed to or caused the injury. When this is the case, the injured worker may be able to file a third-party claim and seek additional damages for the injury that they suffered.

Examples of Third-Party Work Injury Claims

There are many ways that a third party outside of your employer’s control can contribute to or cause an injury. Some examples include:

  • Automobile Accidents – If you are driving or a passenger in a company vehicle, or driving or a passenger in another employee’s vehicle or your own car while running a work errand and you are in an accident, the person who caused the accident can be sued as a responsible third party.
  • Defective Products – If you are working and using a piece of equipment or tool that causes an injury as a result of a defect in its design, manufacturing or failure to warn, you can hold the product’s manufacturer, seller, and others in the supply chain responsible as third parties.
  • Co-Worker Assault – One of the most common workplace injuries occurs as a result of co-worker negligence or assault. If somebody that you work with caused your injuries through either an attack or gross negligence, you can pursue a third-party claim against them.
  • Contractor Negligence – When employees of other companies or individual contractors are negligent in their actions and cause your injury, they can be held responsible as third parties.

Suing A Third Party for an On-the-Job Injury

Every work injury is different and needs to be assessed by skilled professionals to determine where liability lies and what actions should be taken. If you’ve been hurt on the job, you may be eligible to file both workers’ compensation and a third-party claim. To make sure you get the compensation that you deserve, contact Vanasse Law to set up an appointment to discuss your case.

How an Employer Can Lower the Risk for Workers’ Compensation Fraud

workers' compensationThere are a lot of benefits of holding a proper Workers’ Compensation insurance policy as a company from having medical bills and at least some lost wages covered when an employee is injured at work. However, with that coverage also comes the risk of abuse by unscrupulous employees looking to rig the system. The first step to working against such abuse is to understand the types of fraud that commonly occur.

Types of Fraud

Fraud can happen at any point in the claim process, from the injury itself to claims made about the severity of the injury. Here are some common forms of fraud to look out for:

  • The alleged accident may not have been an accident at all. In this case, the injury itself is fabricated.
  • Some employees try to pass off old injuries as new injuries. Red flags for this type of scam include no witnesses to the injury, report on a Monday morning yet the injury does not appear new and having medical details that don’t match the narrative presented by the employee.
  • In some cases, medical providers may also be participating in fraud by providing bills for services such as tests that were not performed. This may be done with or without the employee’s knowledge.
  • Exaggeration of severity is likely the most prevalent in fraud cases. The most common is claiming to still be healing despite being able to return to work at full capacity.

Prevention

The first step in preventing fraud in Workers’ Compensation claims is to have a very clearly written company policy on Workers’ Compensation for all employees. This policy will help aboveboard employees understand the process while providing an avenue in which to inform underhanded employees that investigations and legal action will be taken to avoid cases of fraud. In that policy, be sure to let your employees know that there is an immediate need to report injuries and accidents, and that there will be no negative consequence for doing so.

Further, be sure to follow up and conduct investigations into claims. This is to ensure all aspects are accurate and are being handled, which will aid those using the system properly for those with a legitimate injury while making it more difficult for those attempting fraud. If you have been accused of fraud for a legitimate injury, you need legal representation. Contact our team today for more information.