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The Third Party Claim Time Frame

 

In a third party claim if a workplace injury or occupational disease was caused by a defective product, a defective machine or someone who is not a co-worker, this "third party" will be asked to pay for the injured worker's medical treatment and other claim expenses. For example, the driver of the car that hit the worker (not an employee of the worker's company), the manufacturer of a defective product that injured the worker, a property owner who failed to properly maintain a safe workplace, a fall that was not the employer, employee, or co-worker's fault, another contractor on the job site whose negligence caused the worker's injury or the owner of an animal that bit a worker.

A third party claim can be against the person or company (other than the employer or co-employee) that caused an industrial injury. The attorney is paid reasonable fees and costs. The injured worker receives 25 percent of the net recovery. Any remaining balance is paid to the worker. The amount of this remaining balance, less the department's proportionate share of fees and costs, is subject to offset against any future benefit entitlement under the claim.

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If the worker is settling the case and is not represented, the insurance adjuster will pay the lien claim and pay the balance of the settlement directly to the worker. If the worker has an attorney, the insurance adjuster will pay the attorney the full amount of the settlement.

Worker's compensation benefits are the exclusive remedy of an employee for an industrial injury against the employer, any other employee of the same employer and the worker's compensation insurer. There are very limited exceptions, usually involving an action against a co-employee for an assault intended to cause bodily harm, or against a co-employee for negligent operation of a motor vehicle not owned or leased by the employer.

The term "third party claim" is frequently used to describe a tort claim by a worker against a person other than the employer or a co-employee. An injured employee, the employer or worker's compensation insurer may sue a third party who is responsible for the employee's injuries. The employee claims damages for injuries above and beyond worker's compensation benefits. Such damages include pain and suffering, mental anguish, and derivative claims for loss of society and companionship. The employer or worker's compensation insurer seeks reimbursement of amounts paid for such items as medical bills or disability. Each has an equal voice in the claim under the law.

The third party claim must be made within three years from the date of the accident, if you know who caused the accident. There will be two years to claim, if you don't know who the driver or owner of the vehicle that caused the accident was. For example, the car that caused the accident just drove away without you getting a name or registration number. If the lawyer leaves the claim too late, and you did not cause any delays, then you can sue (in other words, make a claim against) the lawyer for doing the job badly.



 

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