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Workers' Compensation
in Eastern PA

Are there situations where I would owe back my workers’ compensation benefits?

In the unfortunate event of a work related injury, the first step in everyone’s mind should be to claim worker’s compensation benefits. Though filing claims and dealing with legal matters right after an injury is no one’s idea of fun, it is vital that you follow the correct procedures and pathways to ensure that you will be properly compensated both for your medical expenses and any lost wages that you might incur due to an inability to continue work in a normal capacity.

Though the law is there to protect workers and help them get appropriate compensation, it also requires active participation from the employee’s part. First of all, you should immediately contact an experienced workers’ compensation lawyer who can provide you with all the necessary information. The initial consultation will instantly let you know whether you can actually file a claim or not so that you do not have to waste any time researching this complex area of the law on your own. A professional will be able to look at your specific case and help you make an informed decision about the future, especially if you provide them with adequate information.

When you contact a workers’ compensation attorney, the most important thing of all is to be honest about everything that occurred. Providing accurate and detailed information is the only way to ensure that your claim is viable and help with you in receiving compensation due to an injury that happened while you were working. The attorney you will discuss your case with will detail exactly what you need to provide as far as documents and personal information are concerned which is another reason why a professional should be your first stop.

If you have another lawsuit that arises out of your work injury, such as a motor vehicle accident, where your vehicle was struck by another, there is something that you need to know regarding your receipt of workers’ compensation benefits, and receipt of an award or settlement in that other lawsuit (usually referred to as a third party lawsuit). Let’s say that your workers’ compensation claim was accepted, and you have been receiving ongoing wage loss and medical benefits, and you have another lawyer representing you in the third party lawsuit, and you get a settlement of award, can you keep the total of both? The short answer is no.

Are you required to pay back all of the wage loss benefits that you received to the workers’ compensation carrier, if you get money on the third party lawsuit? No, but the workers’ compensation carrier has what is known as a subrogation lien against the insurance company who is paying out the money on the third party claim. So how it works is when you receive the third party settlement or award, a Third Party Settlement Statement must be prepared by the lawyers to calculate how much money will have to be paid back to the workers’ compensation carrier. If the workers’ compensation carrier paid out, let’s say, $100,000.00 in wage loss benefits over the course of your claim, and you received an award or settlement of $300,000.00 on the third party claim, then the workers’ compensation carrier is entitled to get it’s money back according to the calculation on the Third Party Settlement Statement.

So while you will not have to pay the money back out of your pocket, the amount that you receive from the third party lawsuit will be reduced.

Always advise both your workers’ compensation lawyer and your third party lawyer of all updates, so that they can properly advise you as your cases progress.