What You Need to Know About Workers’ Comp and Subrogation

Posted January 19th, 2017 by .

Categories: Workers Compensation.

workers comp and subrogation anthony carboneYou were injured at work.  The workers’ compensation carrier paid your medical bills and reimbursed you for lost time.  You don’t see the point in contacting an attorney because you’re satisfied with the benefits you’ve received.  You get an unsolicited letter from a lawyer about your accident.  It says he is pursuing subrogation on behalf of the workers’ compensation insurance company.  Huh?  What does this mean exactly and what should you do?

This scenario may apply to your situation.  So, let’s first start with the definition of subrogation.  It’s a term commonly used in the insurance industry.  Workers’ compensation is no-fault insurance in the State of New Jersey.  There are very few exemptions to payment for benefits for work-related accidents.  However, if someone else was responsible for your accident, the workers’ compensation insurance company is entitled to a certain percentage of reimbursement.  We’ll explain the details.

Understanding How Subrogation Applies to Workers’ Comp

Let’s say you were hurt on a machine at work.  It is clear that there was a malfunction of the equipment through no fault of your employer.  Yet, you are concerned that if you pursue legal action, it could affect your employment status.  It’s a risk you’re hesitant to take.  You should know that New Jersey laws prohibit your employer from terminating you for filing or testifying about a workers’ compensation claim.  An experienced workers’ compensation attorney can best explain your rights.

You should also know what you might miss out on by not filing a formal workers’ compensation claim.  If your injuries are at all permanent, the insurance company may not necessarily voluntarily offer you a portion of permanent partial or total disability.  You can learn more about this benefit here.

To reiterate, you might be missing out on a permanent disability award of any type if you don’t seek legal counsel.  And, then there’s the fact that somebody else’s negligence may have caused the accident.  Pursuing a case against that individual or entity is known as a third party claim.

The workers’ compensation carrier looks for third party liability in every filed claim for benefits.  Why?  They can assert a lien for reimbursement of payments.   Although the law acknowledges that workers’ compensation benefits should be paid first, it recognizes the right of the insurance company to seek repayment.  The amount that is reimbursed makes allowances for attorneys’ fees and costs and is generally reduced by one-third.

If you do not seek counsel on your own to pursue a third party case, the insurance company may do it for you.  They will assign counsel to assert subrogation rights.  Keep in mind that this lawyer is working for the insurance carrier.

What does this mean?  The subrogation attorney is hired to seek repayment for the workers’ compensation insurance company.  Their goal is to obtain enough money to cover the payments made to you.  There really is no incentive to aggressively pursue further funds for your accident.

Bottom line.  It makes sense to seek out experienced counsel on your own behalf.  The insurance company will still be able to assert a lien regarding any third party claims.  However, it is advisable to choose a lawyer who considers you the client, rather than the insurance company.

Need Answers about Subrogation?

If you have been injured in a workers’ compensation accident, you may have questions about subrogation.  Or, third party claims in general.  The Law Offices of Anthony Carbone has significant experience handling both types of cases.  Have questions?  We can help you.  Give us a call to learn your legal rights

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