Worker’s Compensation and the Third-Party Personal Injury Claim - MGL c. 152 § 15
If you have been injured on the job you may be, or have been, entitled to Worker’s Compensation benefits. A claim for Worker’s Compensation benefits is filed at the Department of Industrial Accidents against the employer for whom you worked when you were injured. Workers are entitled to benefits regardless of fault. Benefits include a percentage of the employee’s wage and medical bills associated with the injury. Worker’s Compensation does not include payment for pain and suffering. However, in addition to a Worker’s Compensation claim you may also have a claim against a third-party for personal injury, if that third party was also responsible in some way for your injuries.
To illustrate, I will use an example of an injured pizza delivery driver. The driver, who is an employee of a pizza restaurant, is injured in a car accident on his way to drop off a pizza to a customer. As mentioned above, regardless of fault, the pizza delivery driver has a legal right to file a Worker’s Compensation claim against his employer, the pizza restaurant. He or she must only show that they were working at the time of the accident and that they were injured in the accident in order to be entitled to a percentage of their weekly wage and payment of medical bills. However, the employee may also have a third-party claim against the driver of the other vehicle, if the driver of the other vehicle was at fault. A third-party claim for personal injury damages includes lost wages, medical bills, but also includes pain and suffering.
When there exists both Worker’s Compensation claims as wells as third-party personal injury claims, MGL c. 152 § 15, mandates that the employer’s Worker’s Compensation insurer is entitled to reimbursement for, inter alia, lost wages and medical bills paid out on the claim. The insurer is considered a priority lien holder. As such, pursuant to MGL c. 152 § 15, when a third-party personal injury claim settles, a petition for settlement must be filed for approval at either the Department of Industrial Accidents or the Massachusetts Superior Court.
In some respects, the interplay between Worker’s Compensation and personal injury is logical as it prevents a claimant from being awarded a double recovery for medical bills and lost wages. However, in many cases the matter settles for an amount that is insufficient to satisfy the lien amount and, also be reflective of pain and suffering to the client. While the Worker’s Compensation insurer is entitled to reimbursement for lost wage and medical bills, there also exists many different alternatives to negotiate, and otherwise reduce, the lien amount based on Massachusetts case law and a familiarity with the Worker’s Compensation insurance carriers’ policies and procedures.
If you’ve been injured on the job or through no fault of your own, contact a lawyer who specializes in this area of law. Don’t hire someone who is unfamiliar with this area and don’t try to go it alone.