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What Is Subrogation in Workers’ Compensation?

What Is Workers’ Compensation Subrogation?

Subrogation in a workers’ compensation case occurs when another party can secure a portion of your workers’ compensation benefits. Usually, it comes about in a workers’ compensation case when a third party’s negligence results in your workplace injury.

In that case, you would file a personal injury lawsuit against them and a workers’ compensation claim with your employer.

What Benefits Can I Recover I You File a Workers’ Compensation Claim?

According to the California Department of Industrial Relations (DIR), when you suffer injury in the workplace, you can seek workers’ compensation benefits, which may include:

  • Medical expenses related to your workplace injury
  • Lost current and future income due to your workplace injury
  • Temporary or permanent disability payments if you cannot work because of your work-related injury
  • Vocational training and rehabilitation, if your work-related injury permanently prevents you from returning to your prior position or career

Most employers must carry workers’ compensation insurance to ensure that injured employees receive appropriate care and financial support. A workers’ compensation claim can cost the insurance company and your employer, so they will often fight to reduce or deny claims altogether. If a third-party lawsuit is involved, they may try to recover your benefits through a subrogation claim.


Why Would the Workers’ Compensation Insurance Carrier File a Claim of Subrogation?

When your injury stems from a third party’s negligent actions, you could pursue a personal injury lawsuit against the responsible party. If your employer’s workers’ comp carrier believes the other party is fully responsible for your injuries, they may try to recoup the monetary value of your workers’ comp benefits from your personal injury settlement.

In essence, your workers’ comp carrier believes that if your employer is not liable for your injuries, they should not have to pay for them. A successful subrogation claim can reduce your settlement value. This is where a lawyer can step in to protect your right to compensation.


Can I Request a Waiver of Subrogation for a Workers’ Compensation Claim?

To avoid a subrogation claim, your attorney may request a waiver of subrogation on your workers’ compensation claim from the insurance carrier. Unless they believe they can gain something, the insurance carrier may not agree to waive their right to subrogation.

However, you could use a waiver of subrogation request to negotiate a lump sum settlement with the workers’ compensation carrier and close the claim.


How Will a Subrogation Claim Affect My Workers’ Compensation Settlement?

Your employer’s insurance company can file a subrogation claim if they can prove that you have received full compensation for your losses.

Even then, insurance companies may be limited to retrieving a portion of the economic losses and none of the non-economic losses. For example, they could take a portion of your settlement for medical bills and lost income to recoup their payments to you, but they could not take from the portion of the settlement allocated for pain and suffering.


Does Employer Liability Affect a Subrogation Claim for Workers’ Compensation?

Subrogation claims are rooted in liability. When your employer is not responsible for an injury, their workers’ compensation carrier will not want to pay for your associated costs. However, such situations are rarely cut-and-dry. Sometimes, both the third party and your employer share some level of responsibility for your workplace injury. The insurance company may use the subrogation claim to reduce or eliminate their liability, even if your employer shared fault for the incident. These cases can become extremely complicated when neither side is willing to claim fault. Unfortunately, it is you who gets caught in the middle and risks losing critical workers’ comp benefits or settlement money.


Do I Need an Attorney to Handle a Workers’ Comp Subrogation Claim?

While you do not need a workers’ compensation attorney to pursue a workers’ compensation claim, you could benefit from working with one. A workers’ compensation claim can be complicated even when the case is relatively simple. When you involve a third-party lawsuit and subrogation claims, the case becomes significantly more complex. An attorney can help you understand how a subrogation claim may affect your ongoing third-party lawsuit and workers’ compensation claim. They can also represent you in settlement negotiations and advise of your best legal options. You should not have to face attorneys and big-name insurance companies on your own. Take the time you need to recover from your injuries and let a workers’ compensation attorney help you secure the financial compensation and benefits you deserve.


Can I Use a Settlement to Avoid a Subrogation Claim?

Sometimes, your employer and workers’ compensation carrier work with you to pursue the responsible third party. In this situation, both you and your employer have a shared interest in establishing third-party liability. This shared interest could erode if your employer is partially responsible for your injuries.

If your employer shares fault with the third party and refuses to negotiate, your attorney may recommend settling with the third party separately. Any funds from such a settlement may be held in trust until you have established the level of fault. This way, you can keep the funds intact, including the amount you may have to pay to the employer or workers’ comp.Trying to settle around a subrogation claim can be complex. It could result in your losing workers’ comp benefits while the case is being heard or even tension between you and your employer. It can also lead to more difficult negotiations if your settlement talks have reached a halt.


Hire a Workers’ Compensation Attorney With KJT Law Group Today

Before you move forward with any type of settlement for a workers’ compensation claim involving subrogation, consult the legal team at KJT Law Group. We can represent you throughout all proceedings. Call us today at (818) 507-8525 for a free case review.

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