How is negligence determined in workers comp?

Question

If the claim goes to a lawsuit and the claimant needs to prove that the company they work for was negligent, how does that usually work? Is there some standard definition of negligence that the claimant has to prove existed? Something else?

Answer 1

If you are collecting WC, you cannot sue your employer. WC is your sole remedy.  WC was designed to pay employees for their injuries and wages regardless of fault.  

The only time you can sue your employer is If you are injured because of some reckless or intentional action on the part of your employer.

You can file a claim against a third party who may have caused your injury as a result of their negligence.

Answer 2

Are you suing the employer or the employer's WC insurer?

Answer 3

If you have lied and told them that you know W/C, you are in over your head and they will find you out.

If you are trying to work your way up in the company by showing how determined you are to learn, the best thing you can do is to find a senior adjuster (they are usually outside smoking) and make friends. Adjusters love to vent about claims, and you will learn tons just by listening.

Answer 4

Ask your supervisor.

Answer 5

It isn't.  That's the whole point - negligence gets taken out of the picture.

In exchange for immunity for pain and suffering and other such lawsuits, the employer provides no-fault medical payments and lost wages to the employee.  That's what it is.  

With workers comp, you don't prove negligence.  

If there is a workers comp lawsuit, it's because the claim is being denied.  The claim is usually denied, because 1. the insurer determines it didn't happen in the course of their employment (definition varies by state)  or 2.  the information required wasn't given (usually medical information).   Then you have to prove that the injury happened during the course of work, meets the state definition of an injury, and resulted in medical bills and/or lost wages that need to get paid.  

That's it.

**read your manuals on your breaks, and pick out someone who is a "shining star" there, and listen and watch them very carefully to see what they do.**