FAQ: The Difference between Workers Compensation and Civil "third party" cases
California Workers' Compensation laws were written to provide limited benefits to workers who sustain injury or illness which arises out of their employment. The "compensation," if awarded, can be in the nature of money for disability benefits, medical coverage, or, if the work-related injury or illness causes the death of the worker, limited money benefits for those who had been dependent upon the deceased worker for support.
Thousands of California workers are injured on the job every year, so it's likely that most of us will have an on-the-job injury or illness at some point in our lives, or have someone close to us who will. Despite the fact that work injuries occur so commonly, some workers have no idea about their rights, and the limitation of those rights, under the Workers' Compensation laws. Injured workers are usually surprised to learn that California Workers' Compensation benefits are not necessarily intended to fully compensate the injured worker or to make the worker "whole." Simply, Workers' Compensation laws have usually been more protective of the interests of employers than the interests of injured workers, and that is more true than ever today.
With respect to the medical coverage that is provided to the injured worker, the employer's insurer controls, for the most part, how much care the worker will get, as well as where and under what circumstances that medical care will be provided. With respect to disability money, while the injured worker is unable to work and still treating for their injury, they are paid, at most, only 2/3 of what they were earning before their injury, and there are strict limits upon how long this "temporary disability" benefit must be paid to the injured worker. If the worker's disability is permanent, the worker is entitled to additional disability benefits, but they are severely limited under current law.
Regardless of whether the worker's injury is temporary or permanent, Workers' Compensation does not cover neither worker's pain and suffering, past, present, or future, no matter how severe the injury. Workers' Compensation also does not cover the injured worker for mental and emotional distress arising out of the injury or illness, nor loss of enjoyment of life.
The ultimate protection provided to the employer, even if the employer was negligent in causing the worker's injury, is that Workers' Compensation is the only claim, the "exclusive remedy," that the injured worker has against his or her employer. In other words, the injured worker usually cannot sue the employer in civil court for damages.
The justification for this bar on lawsuits against the employer is that the employer must provide Workers' Compensation benefits for all work-related injuries or illnesses, even if the employer was not negligent or otherwise at fault in causing the work-related injury or illness. However, this is cold comfort to a severely injured or ill worker who can receive only these limited Workers' Compensation benefits from the employer.
The strict limits on Workers' Compensation benefits are the primary reason that we look so carefully to determine whether a work-related injury or illness was not only related to the injured worker's employment, but may also have been caused by the negligence or other fault of "third parties." In this sense, "third party" refers to people or companies other than the injured worker, a co-worker, or the worker's employer. While the injured worker is prevented under nearly all circumstances from suing their employer in civil court for the full damages resulting from the workplace injury, the injured worker is allowed under California law to sue in civil court, for whatever damages sustained that are not compensated by the Workers' Compensation system, any such third parties who were negligent or otherwise at fault in causing the workplace injury.
A commonplace example of such a "third-party suit" would be on behalf of a worker who has been severely injured by a machine while on the job. That worker would have a Workers' Compensation claim against his or her employer, but would also have a third-party civil suit against the manufacturer, designer, and/or supplier, of the machine causing the injury, if it can be shown that those third parties were negligent or otherwise at fault in connection with the machine. Another typical example of a third-party case is that of a worker who has been made ill by exposure to asbestos or chemicals in the workplace. Again, that worker would have a Workers' Compensation claim against the employers for whom she or he worked while being exposed to the asbestos or chemicals which caused his or her illness, and that worker would also have a civil third-party lawsuit against the manufacturers and/or suppliers of those chemicals to the workplace. While the worker would not have to prove any negligence on the part of the employer to recover Workers' Compensation benefits, the worker would have to prove negligence or other fault against the chemical manufacturers in this example in order to recover the full measure of civil damages.
There are many other examples of potential third parties who may be responsible when a workplace injury occurs. At Rose, Klein & Marias, we pride ourselves on our experience and ability to uncover the identity of potential third-party defendants who may have caused or contributed to a worker's serious injury or illness.
