Employees who have suffered brain or spinal cord injuries in work-related accidents have many questions concerning the benefits to which they are entitled under the law. Workers’ Compensation statutes were passed in all states requiring employers to provide certain wage and medical benefits for individuals who are injured in work-related accidents. I have answered below the most commonly asked questions concerning workers’ compensation benefits:
1. If I am injured on the job and receiving Workers’ Compensation benefits, am I eligible for Private Funding for brain and spinal cord injuries?
Yes, Private Funding for Brain and Spinal Cord Injuries can pay for rehabilitation, therapies, home modifications, rental and mortgage assistance, assistance with utility/household expenses and other items not paid by your workers’ compensation insurance.
2. What does a Workers’ Compensation insurance company have to pay for?
Workers’ compensation insurance companies must pay all your medical bills for treatments related to your workers’ compensation injury for the rest of your life. In addition, the insurance company must pay a percentage of your wage loss for as long as you are disabled.
3. Does the amount a person receives for Workers’ Compensation wage loss increase each year?
No, unlike Social Security Disability and some private pension benefits, workers’ compensation wage disability benefits for brain and spinal cord injuries do not increase each year. The amount of wage benefits to which you are entitled are determined as of the day you are injured, and remain that way for as long as you are disabled.
4. Does Workers’ Compensation pay for pain and suffering damages?
No, workers’ compensation insurance companies only pay reasonable and necessary medical expenses and a percentage of your wage loss. You need to contact a brain and spinal cord injury attorney if you want to file a lawsuit for compensation for pain and suffering damages related to your spinal cord injury, (paraplegia, quadriplegia or hemiplegia) traumatic brain injury, frontal lobe injury, or fractured skull.
5. Does Workers’ Compensation pay if I have suffered a brain or spinal cord injury and I also have a traumatic amputation from a product liability accident?
Yes, by statute a workers’ compensation carrier must pay if you have had a traumatic amputation, partial amputation, upper extremity amputation, lower extremity amputation or for all practical purposes, you have lost the use of a specific part of your body. These benefits are called “specific loss” benefits and will be paid in addition to the disability benefits that you are entitled to from the workers’ compensation carrier for your brain and spinal cord injuries.
6. If I have been injured in a work-related accident, who can I sue for past pain and suffering, future pain and suffering, scarring, loss of companionship, loss of enjoyment of life, etc.?
Since you are not permitted under the law to sue your co-employees, or employer, in most states, if you are injured in a work-related accident, the only party you can sue for pain and suffering and other damages is a negligent contractor, sub-contractor, manufacturer of a defective product, or other third party who is responsible for your brain or spinal cord injury.
Example: A gas tank that you are cleaning at work explodes, and you suffer a traumatic brain injury, because it has a defective valve which was manufactured by company “X”. You would receive your workers’ compensation benefits, i.e. payment of your medical bills and a percentage of wages from your employer’s workers’ compensation insurance company. You would have to hire a brain or spinal cord injury lawyer to file a lawsuit for compensation against company “X,” the manufacturer of the defective valve.
Note: It is important for you, the workers’ compensation carrier, or your brain and spinal cord injury attorney to secure and preserve the defective valve so there can be a thorough investigation in order to pursue a lawsuit against company “X,” the manufacturer of the defective valve. The defective valve should not be altered, concealed, destroyed, changed, taken apart or modified in any way prior to the inspection. As a preventative measure, my office often reports to the Consumer Product Safety Commission (CPSC) about alleged defective products for their inspection and investigation. The CPSC will issue recalls or warnings if they determine that the particular product is defective or dangerous.
7. How can I prove my work-related injury was caused by someone other than my employer?
It is crucial that there be a prompt and thorough investigation of the circumstances surrounding your work-related brain or spinal cord injury. This investigation should be accomplished by trained attorneys, investigators, experts and engineers whose job it is to determine exactly what caused your accident. Photographs, witness statements and evidence must be secured as quickly as possible after a serious work-related injury occurs.
8. If I can prove that my brain or spinal cord injury was caused by someone other than my employer or co-employees, what can I claim in damages?
Unlike a workers’ compensation case where you can only recover a percentage of your wage loss and your medical bills, in a brain or spinal cord injury compensation lawsuit, you can recover lost wages not reimbursed by workers’ compensation, damages for scarring, past pain and suffering, future pain and suffering, loss of companionship, emotional distress, loss of enjoyment of life, etc.
9. Can my spouse bring a lawsuit for compensation if I suffer a brain or spinal cord injury in a work-related accident?
A spouse is not permitted under the law in most states to sue your co-employees or your employer, but your spouse can sue for damages if a negligent contractor, sub-contractor, manufacturer of a defective product, or other third party is responsible for your brain or spinal cord injury. For example, your spouse can bring a claim against the manufacturer of the defective valve, but your spouse cannot bring a claim against the workers’ compensation insurance company, his co-employees, or his employer.
10. Does my employer have a right to be reimbursed for the wages and medicals they paid if I prove a negligent contractor, sub-contractor, manufacturer of a defective product, or other third party caused my accident?
By statute in most states, an employer, if self-insured, or a workers’ compensation insurance company has the right to be reimbursed a certain percentage of the money expended if you and your attorneys prove that a third party caused your injury. The rationale for reimbursing the employer or workers’ compensation insurance company is that you receive your workers’ compensation benefits even if the employer is not at fault, i.e. a third party, it is only fair to reimburse the insurance company or your employer for the benefits they have paid. It is important to remember that your employer or the workers’ compensation carrier is very interested in determining whether a third party is responsible, since their rights to be reimbursed (subrogation rights) would be protected if you succeed with your lawsuit for compensation against a responsible party.
11. If I am receiving Workers’ Compensation benefits, can I also receive Social Security Disability?
Yes, you can collect both, but Social Security Disability will receive some type of credit for the amount of workers’ compensation benefits you are collecting. If you are injured and are unable to be gainfully employed for a year, you should apply for Social Security Disability Benefits.
SUCCESSFULLY LITIGATED BRAIN AND SPINAL CORD INJURY WORKERS’ COMPENSATION CASES
1. Workplace/Construction Accident – Ladder – Spinal Cord Injury/Traumatic Brain Injury
A workman suffered a spinal cord injury and a traumatic brain injury as the result of a fall that occurred when he was working on a ladder at a job site. I filed a lawsuit for compensation that was successful based on the theory that another workman, not his co-employee, improperly secured the ladder, and this led to the fall and resulting paraplegia. SUGGESTION: All construction site accidents involving brain and spinal cord injuries should be thoroughly investigated to determine whether or not there is a contractor, subcontractor, or third party company, other than workers’ compensation, against whom a claim can be made for damages.
2. Workplace Accident – Fork Lift – Spinal Cord Injury
An employee suffered a spinal cord injury when he was struck by a fork lift at his employer’s place of business. The lawsuit for compensation I filed was successful against the manufacturer of the fork lift, since it was defectively designed and did not allow the operator of the fork lift to see the worker who was walking at the plant.
SUGGESTION:
Any time a product is involved in a brain or spinal cord injury at work, the brain or spinal cord injury lawyer should hire an outside expert to examine the product and determine whether the product was defective and unsafe for its intended use. If the product was defective, a lawsuit can be filed seeking compensation for your brain and spinal cord injury.
3. Scaffold/Construction Accident – Traumatic Brain Injury
An employee of an electrical company suffered a traumatic brain injury as a result of a fall that occurred while he was working on a scaffold at the job site. My investigation revealed that the scaffold was defectively designed, and this led to the fall and the employee’s resulting traumatic brain injuries. The injured employee received his workers’ compensation benefits from his employer, the electrical company. I filed a lawsuit for compensation against the manufacturer and seller of the defective scaffold and recovered a settlement for the client’s traumatic brain injury. The settlement funds amounted to millions of dollars to supplement my client’s workers compensation benefits.
SUGGESTION: All construction site accidents should be fully investigated to determine whether or not there is a contractor, subcontractor, engineer, architect, or other third party company, other than the workers’ compensation carrier, against whom a claim can be made for damages.
4. Slip and Fall – Investigation – Spinal Cord Injury
An employee worked as a delivery man for a company. He was delivering a product manufactured by his employer to a customer located in a commercial office building. The employee fell down the steps of the commercial office building and he suffered a severe spinal cord injury (paraplegia). My investigation revealed that the stairway violated the local building code. Luckily, I was able to obtain photographs of the stairway before the apartment owner renovated the stairway shortly after my client’s fall. After investigating this matter, I filed a lawsuit for compensation against the owner of the commercial building and recovered settlement funds that amounted to millions of dollars to pay for the client’s needs. The money was used to pay for nursing care, transportation (new accessible van), home modifications, therapies, and household expenses.
SUGGESTION: Slip and fall accidents that result in brain or spinal cord injuries should always be investigated. Many homes, apartments, restaurants, and office buildings do not meet the architectural and other safety standards that apply. When the brain or spinal cord injury occurs, the structure in question should be carefully examined by an expert to be sure that all safety standards and building codes have been met.