EP 35: What You Need to Know About Worker’s Compensation Claim for Catastrophic Injuries

Welcome to the catastrophic comeback podcast with American Injury Lawyer Clark speaks, helping you find hope, purpose and joy after a catastrophic injury.

Okay, now let's look at a catastrophic case. And then first of all, in terms of a catastrophic case, the way that I would describe a catastrophic case, is going to have permanent, lifelong life altering injuries that are going to make it so that a person is probably not going to be able to do the same thing, or the same sorts of things they were doing before, what I'm thinking of is, you know, paralysis, loss of limbs, you know, death, you know, and, and something really, really, really serious, that's going to impact a person's ability to, to provide for his or her family going forward. Let's, let's look at those cases. And how are those cases different?

Well, you know, in a catastrophic case, it's all hands on deck, right? It's not in the

very beginning, right, from the very beginning, intake investigation the whole day, getting out there seeing

the person and establishing that rapport with them. Because just like any other case, it's kind of like a marriage, you're gonna have a relationship with this person, for an extended period of time, you've got to like one another, and you've got to trust one another, right? So we could go out there and tell somebody that, you know, everything that we can do for them, everything we've done for people in the past. But if there's not that warm fuzzy, then it's not a relationship that's going to work. So getting out there. And being compassionate, and empathetic and explaining what we can do to help them out and what our limitations are. That's real important. I'm a big fan of face to face. And that's a catastrophic injury, it's even more important. Well,

so I remember getting called on a catastrophic case, a few years ago, and before our intake person was off the phone with a daughter of the person that called I had plane tickets to go to the spawn center and in Atlanta, to see them probably that probably the next day, if not that day. So I know, I know what you mean. So let's look at it from the so. So in terms of stage one, the first thing that would be different, I like your description, all hands on deck. And that's my observation, too. If we get a call about a cast, if anybody gets a call about a catastrophic case, that does this, and does this? Well, the first thing I think they would have to do is to go to work immediately to secure to secure evidence to develop a relationship to to find coverage to investigate. And it's just an if I didn't already say it secure evidence, and so that we can use that to develop the claim in the future. Is that where you see it?

Yeah, yeah. And in, in a catastrophic case, to our investigation into whether somebody else is responsible for this happening is even more important.

Now, let me ask you that just explain to me a little bit more about what you what you mean here, because I think this is really, really important than a catastrophic in all comp claims, and all workers compensation claims, but but especially in this constant this in this area. So can you describe a little bit more detail what you mean?

Yeah, you know, in workers comp fault is really not a consideration. But what if somebody else caused the accident to happen? Right? So say your, we can use the example of of the case that you are referring to somebody's on scaffolding or a ladder. And our person, our clients company, didn't assemble it and wasn't responsible for the maintenance, then you want to look to see who was because that just may be another avenue of recovery for our catastrophically injured client.

So just to elaborate, I think it's important for people to understand that there are some things that workers comp does that are beneficial, that that's not available in ordinary liability and third party liability context, for example. In a third party liability context of context, like if you're just injured by somebody else's negligence, do you do you get do they pay your medical bills? Do they pay your lost wages as you go?

In a regular personal you know, you're recovering everything at the end

at the very end right. So you do not have the benefit of weekly checks. And you do not have the belt built the availability of somebody paying your medical bills as you go Uh, and you do not have the the ability to, you know, to have your basic expenses and medical treatment covered. While you're getting better. Instead, you have this sort of situation where you have to, you have to survive until the very end of that process, which is very difficult for people. But the, what's you're talking about, which I think is so so important is that when you have a comp claim, any comp claim, but especially a catastrophic claim, you have to look to see if there's some other source of recovery beyond just workers comp. And the reason for that is, is worker's comp is generally an exclusive remedy. Can you explain what that means?

Well, you can't sue your employer for negligence in the state of North Carolina. So workers comp is all you've got?

Well, unless there's some, like we talked about Woodsen claims, and that's such a tiny, narrow window, it almost seems to never be open. Right? Not never,

but close very, very more and more every time somebody challenged every time. That's

a great point. So in general, what's in claim, whereas a Woodson claim may be may be possible. It seems like it's very unlikely and getting more unlikely with every court ruling, like you say, but so So if if, if ordinary if a person can't sue his employer in ordinary negligence, for negligent conduct in a workers compensation or in a work injury kind of situation, what other options might be available to that person?

Well, if somebody else is responsible for the accident, and the injuries, then we can file a civil claim against that company. And again, it's just another avenue for recovery for our client, whether they're catastrophically injured or just injured, just

the important thing is this analysis has to be done very, very carefully.

Is that right? And we try to do it as early on as possible.

And as early as possible, let me for investigative purposes and other purposes. So so so let's look at another example, let's say there is a person who's working at a plant, who is terribly injured. And that person is working for company A. And there are other companies work Company B and Company C, are working in that plant to if if a person is injured by company, a, his employer, and or another co worker, or, or, or a supervisor or something like that, and it's all that supervisors fault, and no one else's fault, then how does the exclusive remedy apply in that situation, that

is a workers compensation case and won't ever be anything else. Okay. An example where there might be a third party case is this guy who's in the factory, and he's working on complicated equipment. And the company that he works for, all they do is they run the equipment, but they have an outside firm come in, and do the maintenance and the repairs on the equipment. And maybe they didn't do something properly, or maybe they forgot to do something at all and the person gets injured, then that's a possible third party case against that other company,

or maybe they're operating a piece of equipment in a negligent way. And it causes in the person from Company B, or Company C is operating a piece of equipment in a negligent way, or secure or something and in the negative, negligent way doesn't secure it properly violates protocol. And then as a result, that guy employed for company A, whereas he can't sue his own employer, company A, he may be able to sue Company B or C. We've

had a lot of calls recently about people getting injured on forklifts, where their co workers are either messing around or not paying attention and forklifts collide. That's really just a worker's comp case. But say there were other companies working in the same area. And somebody from Company A is driving a forklift and runs into the person from Company B, then that person from Company B not only has a worker's comp case, but they may have a claim against the company a also

so so just so we're clear, you know, we're not giving legal advice to you or to anyone else we're trying to get illustrate to you how this works and how important it is to look at this to see if there is a third party liability claim because if they could be overlooked and if they're overlooked what happens then,

you know, the time to file a claim against that company could just run and then there's no claim to be made there. You never

know what you mean if you if you just never know that you had this claim. And you did we talked about some of the ways where workers compensation claims are good, you know, having a workers compensation case, you wouldn't ever want to be injured. But if you had to be injured, and you had workers comp and compensation insurance available to you, that could be good, right? They're gonna pay your weekly wage, your average weekly wage, they're gonna pay for your medical treatment going forward don't have to wait to the end. That's good. There are some ways where it's not as good as third party liability coverage. Give me some examples of what Where's not as good? Um, well, I, what I'm thinking of specifically is pain and suffering, for example.

Okay, so when workers compensation and City, North Carolina, pain and suffering is not taken into consideration at all, okay? You are, workers comp is going to pay for your wages, they're gonna pay for your medical treatment, and they're going to pay for a disability rating that your treating doctor is going to give you at the end of your treatment, but they don't have to consider pain and suffering, you know, they don't have to consider, hey, you know, I can't pick up my kids or I can't throw the ball around the yard with them anymore. I can't coach their basketball team anymore. There's no other way to say it. But the carriers don't care about any of that stuff. And they don't have to,

they're not legally required to do that. Even if they may personally be sympathetic or empathetic towards this. Right? They are legally not required to pay that that is not how those insurance contracts are drawn how they work. And that's not coverage that's provided. So So and and it's important to recognize that that I think that the reason for that right? The reason for that is something that you raised earlier, which is fault is not an issue and workers compensation. People don't seem to understand that people call us all the time about workers compensation, and they go, hey, I want you to know, I was doing what I was supposed to be doing. And this other guy was not doing what he was supposed or she was supposed to be doing. And it was their fault. And And do you find that that's a common misconception is people people tend to want to think that fault is somehow a component of Workers Compensation.

Yeah, they you know, the thing that people are most familiar with is a car wreck. Right? And the most important thing in a car wreck is who's at fault for it? So they take that knowledge and they say, Okay, well, was I at fault for my accident, or No, I wasn't at fault for my, for my accident. So I must have a worker's comp case. But the thing is, if you're a roofer, for example, and you lean your ladder up against the roof, and it's not on solid ground, and you're climbing up there, and your ladder falls over and you break your arm, you're probably covered.

Regardless of the fact that in a third party liability case, you would be looked at as being negligent on your entry within yourself, which would give entitle you to zero recover.

That's correct. Right.

So let me ask you this. With that in mind, what are some of the mistakes that you see people make in claims that are harmful to their cases,

um, there's, there's a couple of common ones, you know, if it's a smaller company, or kind of a mom and pop kind of thing, or the injured worker has, what they consider a friendly relationship with their employer. When they go and get medical treatment, they may not say, I got her to work, they'll say something else in their boss, their friend or boss a solid. That's right. And all they're doing is they're hurting themselves in the in the long run, because it's all about what's in your medical records. It's a paper trail. And if it starts off poorly, then it's usually going to continue to go on poorly. So that's something difficult to overcome, cannot be overcome. Absolutely, if, if an ambulance shows up and pick somebody up, we're going to know where they pick them up from, and we can get that report and show where it actually happened. But that's a I hate to use the word mistake, but it's just, it's something that people do, and not because they're trying to be deceptive. But like you said, they're trying to just do the right thing for these folks as they work for and, you know, people are afraid of losing their jobs.

Here's another one quitting their job. How's that harmful to people in this situation?

I don't know that in all the years that I've done this, that we've told somebody to quit a job. You know, when somebody comes to to us and says, Hey, listen, you know, these guys are just doing all this terrible stuff to me. I'm gonna quit my job and I'm gonna find something else. And you know what? It's not my family that is there taken care of. It's not my finances. You got to do what you got to do, but it is going to change the way we do things in the long run. But you got to do what you got to do. and it can make things a little bit more difficult. If you change jobs and then in the middle of the case, you're still responsible. The insurance company is still responsible for paying for your medical treatment. But what if you have to get taken out of work before a surgery or for some sort of treatment? Your new employer may not worry about that. They may not honor your restrictions or the time that you have to take off from work because they didn't You didn't get hurt on their job. You didn't get hurt on their dime earful

about leaving your job after an injury in a workers compensation open watch. Open workers compensation contexts because it can absolutely cost your money they can thank you for joining us, and we'll see you next time.

Welcome to the catastrophic comeback podcast with American Injury Lawyer Clark speaks, helping you find hope, purpose and joy after a catastrophic injury.

Okay, now let's look at a catastrophic case. And then first of all, in terms of a catastrophic case, the way that I would describe a catastrophic case, is going to have permanent, lifelong life altering injuries that are going to make it so that a person is probably not going to be able to do the same thing, or the same sorts of things they were doing before, what I'm thinking of is, you know, paralysis, loss of limbs, you know, death, you know, and, and something really, really, really serious, that's going to impact a person's ability to, to provide for his or her family going forward. Let's, let's look at those cases. And how are those cases different?

Well, you know, in a catastrophic case, it's all hands on deck, right? It's not in the

very beginning, right, from the very beginning, intake investigation the whole day, getting out there seeing

the person and establishing that rapport with them. Because just like any other case, it's kind of like a marriage, you're gonna have a relationship with this person, for an extended period of time, you've got to like one another, and you've got to trust one another, right? So we could go out there and tell somebody that, you know, everything that we can do for them, everything we've done for people in the past. But if there's not that warm fuzzy, then it's not a relationship that's going to work. So getting out there. And being compassionate, and empathetic and explaining what we can do to help them out and what our limitations are. That's real important. I'm a big fan of face to face. And that's a catastrophic injury, it's even more important. Well,

so I remember getting called on a catastrophic case, a few years ago, and before our intake person was off the phone with a daughter of the person that called I had plane tickets to go to the spawn center and in Atlanta, to see them probably that probably the next day, if not that day. So I know, I know what you mean. So let's look at it from the so. So in terms of stage one, the first thing that would be different, I like your description, all hands on deck. And that's my observation, too. If we get a call about a cast, if anybody gets a call about a catastrophic case, that does this, and does this? Well, the first thing I think they would have to do is to go to work immediately to secure to secure evidence to develop a relationship to to find coverage to investigate. And it's just an if I didn't already say it secure evidence, and so that we can use that to develop the claim in the future. Is that where you see it?

Yeah, yeah. And in, in a catastrophic case, to our investigation into whether somebody else is responsible for this happening is even more important.

Now, let me ask you that just explain to me a little bit more about what you what you mean here, because I think this is really, really important than a catastrophic in all comp claims, and all workers compensation claims, but but especially in this constant this in this area. So can you describe a little bit more detail what you mean?

Yeah, you know, in workers comp fault is really not a consideration. But what if somebody else caused the accident to happen? Right? So say your, we can use the example of of the case that you are referring to somebody's on scaffolding or a ladder. And our person, our clients company, didn't assemble it and wasn't responsible for the maintenance, then you want to look to see who was because that just may be another avenue of recovery for our catastrophically injured client.

So just to elaborate, I think it's important for people to understand that there are some things that workers comp does that are beneficial, that that's not available in ordinary liability and third party liability context, for example. In a third party liability context of context, like if you're just injured by somebody else's negligence, do you do you get do they pay your medical bills? Do they pay your lost wages as you go?

In a regular personal you know, you're recovering everything at the end

at the very end right. So you do not have the benefit of weekly checks. And you do not have the belt built the availability of somebody paying your medical bills as you go Uh, and you do not have the the ability to, you know, to have your basic expenses and medical treatment covered. While you're getting better. Instead, you have this sort of situation where you have to, you have to survive until the very end of that process, which is very difficult for people. But the, what's you're talking about, which I think is so so important is that when you have a comp claim, any comp claim, but especially a catastrophic claim, you have to look to see if there's some other source of recovery beyond just workers comp. And the reason for that is, is worker's comp is generally an exclusive remedy. Can you explain what that means?

Well, you can't sue your employer for negligence in the state of North Carolina. So workers comp is all you've got?

Well, unless there's some, like we talked about Woodsen claims, and that's such a tiny, narrow window, it almost seems to never be open. Right? Not never,

but close very, very more and more every time somebody challenged every time. That's

a great point. So in general, what's in claim, whereas a Woodson claim may be may be possible. It seems like it's very unlikely and getting more unlikely with every court ruling, like you say, but so So if if, if ordinary if a person can't sue his employer in ordinary negligence, for negligent conduct in a workers compensation or in a work injury kind of situation, what other options might be available to that person?

Well, if somebody else is responsible for the accident, and the injuries, then we can file a civil claim against that company. And again, it's just another avenue for recovery for our client, whether they're catastrophically injured or just injured, just

the important thing is this analysis has to be done very, very carefully.

Is that right? And we try to do it as early on as possible.

And as early as possible, let me for investigative purposes and other purposes. So so so let's look at another example, let's say there is a person who's working at a plant, who is terribly injured. And that person is working for company A. And there are other companies work Company B and Company C, are working in that plant to if if a person is injured by company, a, his employer, and or another co worker, or, or, or a supervisor or something like that, and it's all that supervisors fault, and no one else's fault, then how does the exclusive remedy apply in that situation, that

is a workers compensation case and won't ever be anything else. Okay. An example where there might be a third party case is this guy who's in the factory, and he's working on complicated equipment. And the company that he works for, all they do is they run the equipment, but they have an outside firm come in, and do the maintenance and the repairs on the equipment. And maybe they didn't do something properly, or maybe they forgot to do something at all and the person gets injured, then that's a possible third party case against that other company,

or maybe they're operating a piece of equipment in a negligent way. And it causes in the person from Company B, or Company C is operating a piece of equipment in a negligent way, or secure or something and in the negative, negligent way doesn't secure it properly violates protocol. And then as a result, that guy employed for company A, whereas he can't sue his own employer, company A, he may be able to sue Company B or C. We've

had a lot of calls recently about people getting injured on forklifts, where their co workers are either messing around or not paying attention and forklifts collide. That's really just a worker's comp case. But say there were other companies working in the same area. And somebody from Company A is driving a forklift and runs into the person from Company B, then that person from Company B not only has a worker's comp case, but they may have a claim against the company a also

so so just so we're clear, you know, we're not giving legal advice to you or to anyone else we're trying to get illustrate to you how this works and how important it is to look at this to see if there is a third party liability claim because if they could be overlooked and if they're overlooked what happens then,

you know, the time to file a claim against that company could just run and then there's no claim to be made there. You never

know what you mean if you if you just never know that you had this claim. And you did we talked about some of the ways where workers compensation claims are good, you know, having a workers compensation case, you wouldn't ever want to be injured. But if you had to be injured, and you had workers comp and compensation insurance available to you, that could be good, right? They're gonna pay your weekly wage, your average weekly wage, they're gonna pay for your medical treatment going forward don't have to wait to the end. That's good. There are some ways where it's not as good as third party liability coverage. Give me some examples of what Where's not as good? Um, well, I, what I'm thinking of specifically is pain and suffering, for example.

Okay, so when workers compensation and City, North Carolina, pain and suffering is not taken into consideration at all, okay? You are, workers comp is going to pay for your wages, they're gonna pay for your medical treatment, and they're going to pay for a disability rating that your treating doctor is going to give you at the end of your treatment, but they don't have to consider pain and suffering, you know, they don't have to consider, hey, you know, I can't pick up my kids or I can't throw the ball around the yard with them anymore. I can't coach their basketball team anymore. There's no other way to say it. But the carriers don't care about any of that stuff. And they don't have to,

they're not legally required to do that. Even if they may personally be sympathetic or empathetic towards this. Right? They are legally not required to pay that that is not how those insurance contracts are drawn how they work. And that's not coverage that's provided. So So and and it's important to recognize that that I think that the reason for that right? The reason for that is something that you raised earlier, which is fault is not an issue and workers compensation. People don't seem to understand that people call us all the time about workers compensation, and they go, hey, I want you to know, I was doing what I was supposed to be doing. And this other guy was not doing what he was supposed or she was supposed to be doing. And it was their fault. And And do you find that that's a common misconception is people people tend to want to think that fault is somehow a component of Workers Compensation.

Yeah, they you know, the thing that people are most familiar with is a car wreck. Right? And the most important thing in a car wreck is who's at fault for it? So they take that knowledge and they say, Okay, well, was I at fault for my accident, or No, I wasn't at fault for my, for my accident. So I must have a worker's comp case. But the thing is, if you're a roofer, for example, and you lean your ladder up against the roof, and it's not on solid ground, and you're climbing up there, and your ladder falls over and you break your arm, you're probably covered.

Regardless of the fact that in a third party liability case, you would be looked at as being negligent on your entry within yourself, which would give entitle you to zero recover.

That's correct. Right.

So let me ask you this. With that in mind, what are some of the mistakes that you see people make in claims that are harmful to their cases,

um, there's, there's a couple of common ones, you know, if it's a smaller company, or kind of a mom and pop kind of thing, or the injured worker has, what they consider a friendly relationship with their employer. When they go and get medical treatment, they may not say, I got her to work, they'll say something else in their boss, their friend or boss a solid. That's right. And all they're doing is they're hurting themselves in the in the long run, because it's all about what's in your medical records. It's a paper trail. And if it starts off poorly, then it's usually going to continue to go on poorly. So that's something difficult to overcome, cannot be overcome. Absolutely, if, if an ambulance shows up and pick somebody up, we're going to know where they pick them up from, and we can get that report and show where it actually happened. But that's a I hate to use the word mistake, but it's just, it's something that people do, and not because they're trying to be deceptive. But like you said, they're trying to just do the right thing for these folks as they work for and, you know, people are afraid of losing their jobs.

Here's another one quitting their job. How's that harmful to people in this situation?

I don't know that in all the years that I've done this, that we've told somebody to quit a job. You know, when somebody comes to to us and says, Hey, listen, you know, these guys are just doing all this terrible stuff to me. I'm gonna quit my job and I'm gonna find something else. And you know what? It's not my family that is there taken care of. It's not my finances. You got to do what you got to do, but it is going to change the way we do things in the long run. But you got to do what you got to do. and it can make things a little bit more difficult. If you change jobs and then in the middle of the case, you're still responsible. The insurance company is still responsible for paying for your medical treatment. But what if you have to get taken out of work before a surgery or for some sort of treatment? Your new employer may not worry about that. They may not honor your restrictions or the time that you have to take off from work because they didn't You didn't get hurt on their job. You didn't get hurt on their dime earful

about leaving your job after an injury in a workers compensation open watch. Open workers compensation contexts because it can absolutely cost your money they can thank you for joining us, and we'll see you next time.