8 Reasons To Sue Workers’ Comp

If you’ve ever found yourself injured on the job, you probably know how frustrating and confusing the workers’ compensation process can be. 

It’s supposed to be a straightforward process, but it doesn’t always go that way. 

Sometimes claims get denied for no good reason. Sometimes payments don’t show up. And sometimes, it feels like your employer or the insurance company is working against you.

So what can you do when things start going sideways? 

In some situations, you might actually have grounds to sue workers comp.

In this post, we’ll go over 8 common reasons people sue workers’ comp for.

#1 Your Claim Was Wrongfully Denied

You get injured at work, you file your claim, and then – nothing. You wait, and wait, and then get a letter saying your claim has been denied.

It’s frustrating. And confusing.

The denial might be over something minor, like missing paperwork. But sometimes, it’s because the insurance company or your employer just doesn’t want to pay.

If your claim was wrongfully denied and appeal fails, you can sue the workers’ comp insurer.

You’ll probably need to hire a workers comp attorney for this because you’re going to need strong evidence to prove everything.

Also Read: Can You Sue A Sibling For Emotional Distress?

#2 You Didn’t Receive The Full Benefits You’re Owed

Another reason to sue workers comp is if you didn’t receive the full benefits you’re entitled to. 

Workers’ comp is supposed to cover things like medical expenses, lost wages, and even some long-term disability payments, depending on your injury. 

But sometimes, the insurance company will try to shortchange you. Maybe they offer you less than what you need, or cut your medical treatment short even though you’re still in pain. 

If that is the case, taking legal action can help make sure you get what you’re owed. 

An attorney can help you figure out exactly what benefits you’re entitled to, and make sure the insurer doesn’t get away with paying you less than you deserve.

#3 Your Employer Retaliated Against You

You file a workers’ comp claim, and suddenly things at work change. Maybe you get demoted. Maybe you get strange looks or snide comments. Or maybe you get fired.

That’s retaliation, and it’s 100% illegal.

You have every right to file a claim if you’ve been hurt on the job. And your boss or manager isn’t allowed to punish you for it. If they do, you might have a whole separate case on your hands. 

Suing for retaliation is different from a regular comp claim, and it can open the door to more damages like lost wages, emotional distress, and more.

#4 Bad Faith Insurance Practices

Insurance companies are supposed to process claims fairly. But in some cases, they don’t. 

They delay payments. They ignore doctor recommendations. They stop responding altogether.

That’s called acting in bad faith.

You’re already dealing with pain and stress from the injury and getting the runaround from an insurance company just makes it worse. 

If you feel like the insurance company is messing with you, it might be time to consider legal action. A lawyer can help hold them accountable and make sure they do what’s right.

Also Read: Can You Sue Workers Comp For Taking Too Long?

#5 Gross Negligence Or Intentional Harm By Your Employer

Workers’ comp laws usually protect employers from being sued, even when accidents happen. 

But there’s a big exception: when the employer does something so reckless (or intentionally harmful) that it goes beyond an accident.

This means things like:

• Removing safety equipment on purpose
  
• Forcing you to work in clearly unsafe conditions
  
• Physically harming you or threatening violence

In those rare but serious cases, you might be able to sue your employer directly, outside of the workers’ comp system for personal injury. 

And that can lead to bigger compensation for pain and suffering, emotional trauma, and more.

#6 A Third Party Caused Your Injury

Not every work injury is your employer’s fault. Sometimes someone else causes it like a contractor, a delivery driver, or an equipment manufacturer

In those cases, you can still file your workers’ comp claim and go after the third party. 

This is called a third-party claim, and it’s actually a separate lawsuit.

Let’s say you were working on a construction site, and a subcontractor’s crane operator messed up and dropped something that injured you. You’d file workers’ comp with your employer, but you could also sue the subcontractor’s company for damages. 

Same goes for defective tools or machinery that cause harm.

These cases can lead to more compensation, especially for things like pain, suffering, or long-term impact.

Also Read: Can You File Workers’ Comp And Personal Injury?

#7 Fraud Or Misconduct

Fraud and misconduct can happen on both ends of the workers’ comp process. 

Maybe your employer is trying to lie about the nature of your injury, or perhaps the insurance company is trying to cover up something. 

Some employers even try to dodge workers’ comp altogether by misclassifying employees. You might be listed as an “independent contractor” when you’re actually doing the work of a full-time employee. 

Fraud could look like:

• Your employer providing false statements about how the injury occurred
  
• The insurance company trying to understate the severity of your injury
  
• A company doctor downplaying your condition to save the insurer money

If fraud is involved, the consequences for the wrongdoers can be serious, and you may be able to take legal action.

#8 Employer Doesn’t Have  Workers’ Comp

In most states, employers are legally required to carry workers’ comp insurance. But not everyone follows the rules. 

If you get injured and find out your employer doesn’t have coverage, things get complicated fast.

Good news is, you still have options.

You may be able to sue your employer directly. Not only could you recover medical expenses and lost wages, but your employer might face penalties for failing to provide coverage.

Some states even have special funds that help injured workers in cases like this.

Bottom Line

So, there you have it: eight reasons you might want to sue workers’ comp. 

The workers’ comp system isn’t perfect, but it’s there to help you. If things go sideways, you can (and should) stand up for your rights.

Just make sure to consult with an attorney to figure out the best course of action.

In the end, you deserve the help and support you need when you’re hurt at work. Don’t let anyone, whether it’s your employer or the insurance company, take advantage of you. 

Stay informed, stay persistent, and make sure you’re getting the full benefits you’re owed.