What Are the Differences Between Workers Compensation and a Personal Injury Claim for a Construction Accident?

worker's compensation claim in Philadelphia

The construction site is a dangerous, constantly moving environment where the presence of crews, heavy equipment, and machinery creates significant hazards. Safety rules exist to prevent construction accidents in Pennsylvania, but they still occur with alarming frequency. The causes vary considerably, and they can be traced to the acts of many different parties and teams on the work site. Based upon the circumstances, you could have multiple legal remedies if you were hurt on the job. Therefore, it is crucial to know the differences between workers’ compensation and a personal injury claim for a construction accident.

On the one hand, you could qualify for workers’ comp on account of being injured in an incident at work. Pennsylvania has a system that offers benefits for those who are hurt, and many employees will qualify. However, there is another option through a personal injury case. You could file a claim for a construction accident, occupational disease, or other job-related harm under these laws.

Workplace accidents are complex in the sense that it can be difficult to determine whether to pursue a workers’ compensation claim or a personal injury case. You benefit greatly from working with a Philadelphia construction accidents attorney who will advise you and assist with the legal process. It is also useful to review some information about the differences with these remedies.

How Construction Accidents Happen

Statistics from the Occupational Safety and Health Administration (OSHA) shed some light on the frequency of construction accidents and how they affect workers and their families:

  • Construction accidents comprise nearly one-half of all fatal incidents at work, along with employees in the transportation industry.
  • A total of 976 construction-related deaths occurred in 2020, out of a total of 4,764.
  • The most common injuries in construction include falls from a height, falls on a same level, electrocution, and being struck by an object. 

In addition, OSHA reports on the Top 10 citations issued to employers for violations of safety standards. For instance:

  • The Number 1 reason companies received citations is because they did not comply with rules on fall protection, including personal protective equipment (PPE) like harnesses and tethers.
  • Unsafe ladders and scaffolding platforms were also cause for OSHA to issue citations for violations of construction standards. Employers who fail to provide railings, PPE, and other equipment put workers at risk.
  • Failure to provide proper fall protection training and problems with eye and face protection were also in the Top 10 reasons for OSHA to issue citations.

Workers Compensation for Pennsylvania Construction Accidents

Filing a workers’ comp claim is an option for most employees under regulations established by the Pennsylvania Department of Labor and Industry - Workers’ Compensation (PA WC). To qualify, you must be a true employee as opposed to an independent contractor. Those working in seasonal, temporary, or part-time employment are eligible. In addition, you must be working within the scope of your employment or engaged in work-related tasks when the construction accident occurred.

The workers’ compensation system in Pennsylvania is considered no-fault because you do not need to prove that your employer was negligent in causing the accident. Companies are required to carry workers’ comp insurance, which means you file a claim to gain access to your benefits. In most cases, workers’ compensation is your sole, exclusive remedy for a construction accident.

The process might seem as simple as filling out forms, but keep in mind that insurers are for-profit businesses. They may deny your workers’ comp claim or offer payment that is less than what you deserve by law. In such a situation, you do have options to take your case to the next steps. You can file a lawsuit or pursue other avenues of appeal when the insurance company refuses to pay fairly. 

Construction Accidents Under Personal Injury Laws

Though incidents in the workplace must usually go through the process with PA WC, there are some exceptions to the rule that workers’ comp is your sole remedy. You may have the option to file a personal injury claim if your situation falls under one of these exceptions:

  1. Intentional Acts: If your employer acted with willful intent to cause your injuries, you could sue the company in a civil lawsuit. 
  2. Failure to Insure: As mentioned, employers are required to purchase workers’ compensation insurance when they employ 1 or more workers. When the company fails to comply with the statute, the laws allow you to pursue it through a personal injury case. 
  3. Third Party Negligence: There can be many different crews present on the construction site, and any of them may cause a workplace accident through negligence. A third party, unaffiliated with your employer, could be at fault for causing harm. In such a situation, you could seek damages under personal injury laws. 

Damages vs. Workers Comp Benefits

If the circumstances of your construction accident allow you to pursue either a workers’ comp claim or a personal injury case, there is an important detail. There are different amounts due to you if are successful through the legal system. For example, if your workers’ compensation claim is approved by the insurance company:

  • You can receive amounts for medical treatment, including care that is reasonable and necessary in the future.
  • You may qualify for wage replacement to recoup lost wages, if you missed work because of your construction accident injuries.
  • If you sustain disability, you might recover monetary benefits for total or partial disability, on a permanent or temporary basis.

You might notice that there is a key aspect missing from this list, which is damages for pain and suffering. Workers’ compensation does not cover these amounts, which are termed noneconomic damages.

When your situation warrants, it is better to file a personal injury lawsuit where you can recover noneconomic damages. Besides pain and suffering, you could recover amounts for emotional distress and other losses that impact your quality of life. 

Other Key Differences Between Workers Comp and Personal Injury

The damages versus benefits is an important distinction, but there are additional differences you should bear in mind with construction accidents.

  • You must show that you are an employee who was injured because of workplace conditions to qualify for workers’ comp benefits. For personal injury, you must prove that the construction accident happened as a direct result of the at-fault party’s negligence.
  • The statute of limitations for a Pennsylvania personal injury case is 2 years. If you do not file your lawsuit before the deadline, you lose your right to sue. The time limits for workers’ compensation cases are shorter. You must notify your employer of the construction accident within 21 days, and there are additional deadlines if you need to appeal a denial of your claim.
  • Death benefits are available under Pennsylvania’s workers’ comp laws, so survivors may recover a portion of the deceased workers’ wages. If the case qualifies as a personal injury claim, the legal action is a wrongful death lawsuit. You can recover monetary damages for the ways your loved one’s passing affects your life, financially and emotionally. 

Why Insurance Companies Deny Construction Accident Claims

There is a common element in personal injury and workers’ comp cases in that there is an insurance company involved with both types of claims. You will file a claim with your employer’s insurer for workers’ comp. For a personal injury case, you seek damages from the insurance company that provides liability coverage for the at-fault party. Insurers can present challenges because of their willingness to prioritize their own bottom line above your interests. To avoid paying, the insurance company may claim:

  • You were not injured while performing tasks within the scope of employment.
  • You are not a covered employee, but rather an independent contractor.
  • You did not meet proper legal deadlines under workers’ comp or personal injury laws.
  • The third party who caused your injuries was not negligent.

In addition, for a Pennsylvania personal injury case, you must be aware of the law on comparative negligence. If your own negligent acts contributed to your injuries, you could be barred from recovering monetary damages. The key is the percentage of fault attributed to you, so you cannot recover compensation if you were 50 percent or more liable. 

How a Construction Accident Attorney Helps with Claims

Due to the complications of construction accidents, seeking legal help from a professional is crucial. You need advice from the very beginning, since you must determine whether to pursue a workers’ compensation or personal injury claim. Once you and your lawyer decide on the best options for your situation, you can move forward with additional tasks, including:

  • Gathering and organizing all work documents and accident evidence;
  • Reviewing your medical records covering diagnosis, treatments, procedures, surgery, and other forms of care;
  • Preparing all forms as necessary to file a claim with the insurance company, along with all essential paperwork;
  • Assessing any reasons for denial by the insurer;
  • Engaging in settlement negotiations to resolve your workers’ comp or personal injury case by agreement;
  • Participating in mediation or other alternative dispute resolution;
  • Pursuing avenues of appeal for a workers’ comp denial; and,
  • Taking your case to court as necessary to ensure you receive fair payment.

Discuss Remedies with a Philadelphia Construction Accidents Lawyer 

It is helpful to review the differences between workers' compensation and a personal injury claim for a construction accident. However, you can also see that there are complications involved with either type of case. Retaining legal counsel is essential for the best possible outcome, so please contact Mattiacci Law, Inc., to learn about our services. We can schedule a free consultation with a Pennsylvania construction accidents lawyer who will discuss details and determine how to move forward.

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