How to Defend Against a Workers Compensation Claim
Check the names of the defendants., Analyze the court's jurisdiction., Check the statute of limitations., Research your state's workers' compensation law., Analyze the allegations in the complaint.
Step-by-Step Guide
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Step 1: Check the names of the defendants.
If the employee has not correctly named the employer or the employer's insurance company in the lawsuit, you may be able to get the lawsuit dismissed.
However, keep in mind having a lawsuit dismissed in this way typically doesn't make it go away – the employee still has the option of filing another lawsuit in which you and your insurance company are correctly identified.
Another reason you can seek dismissal of a claim is if the complaint was improperly served.
Again, this sort of dismissal generally doesn't preclude the plaintiff from simply refiling the suit and serving it properly the second time around. -
Step 2: Analyze the court's jurisdiction.
The employee must file his or her claim in a court that has the power both to decide workers' compensation cases and to order you to comply with that decision.This means the court must have both subject matter and personal jurisdiction.
Subject matter jurisdiction relates to the type of case – here, a workers' compensation claim – while personal jurisdiction relates to you as the employer and where your business is located.
If the employee has filed his or her lawsuit in the wrong court, you may be able to get the lawsuit dismissed.
However, typically the employee still has the ability to refile the lawsuit in the correct court., Each state has a deadline for how long after the injury an employee has to file a workers' compensation claim.
In most states, this deadline is two or three years after the date of the employee's injury.After the statute of limitations has expired, the employee is no longer entitled to recover workers' compensation benefits for his or her injury.Depending on your state's law, the statute of limitations may begin to run from the date the first report of injury is filed, or from the date the employee receives his or her last medical payment from your workers' compensation insurer if the claim is initially accepted.
There are circumstances, such as a sudden increase in disability as a result of the injury, that may enable the plaintiff to avoid the statute of limitations and file a claim anyway.
For example, the employee may have been treated for the injury and returned to work believing she was back to 100 percent, only to suffer pain later on that her doctor attributes to that original injury. , Since each state's workers' compensation law has different requirements, you must have a basic understanding of the law that applies to the claim before you can defend against it.
Generally, employees bear the burden of proving their eligibility for workers' compensation benefits.
However, in certain situations the burden may flip to the employer to prove certain defenses or exceptions to coverage.
For example, if you're arguing that the employee is not entitled to workers' compensation benefits because he or she was engaging in willful misconduct, it's up to you to prove that the employee knew about a rule designed to protect employee health and safety, and that he or she intentionally broke that rule despite full understanding of the possible consequences.
Your state law also will include details about available defenses and what must be proven for the defense to apply.
Aside from being able to defend against workers' compensation claims, you should have a basic understanding of the legal requirements and procedures for workers' compensation in your state.
Many insurance carriers and workers' compensation attorneys provide detailed summaries of the law in your state that are written in layman's terms and relatively easy to understand. , After you understand the elements your state's workers' compensation law requires, check the complaint's allegations to ensure all requirements have been met.
Generally, there are three requirements for an employee to be eligible for workers' compensation benefits: you must have (or be required by law to have) workers' compensation insurance; the person must be your employee (not an independent contractor); and his or her injury must be work-related.Most defenses against workers' compensation claims hinge on the argument that the injury is not work-related. -
Step 3: Check the statute of limitations.
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Step 4: Research your state's workers' compensation law.
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Step 5: Analyze the allegations in the complaint.
Detailed Guide
If the employee has not correctly named the employer or the employer's insurance company in the lawsuit, you may be able to get the lawsuit dismissed.
However, keep in mind having a lawsuit dismissed in this way typically doesn't make it go away – the employee still has the option of filing another lawsuit in which you and your insurance company are correctly identified.
Another reason you can seek dismissal of a claim is if the complaint was improperly served.
Again, this sort of dismissal generally doesn't preclude the plaintiff from simply refiling the suit and serving it properly the second time around.
The employee must file his or her claim in a court that has the power both to decide workers' compensation cases and to order you to comply with that decision.This means the court must have both subject matter and personal jurisdiction.
Subject matter jurisdiction relates to the type of case – here, a workers' compensation claim – while personal jurisdiction relates to you as the employer and where your business is located.
If the employee has filed his or her lawsuit in the wrong court, you may be able to get the lawsuit dismissed.
However, typically the employee still has the ability to refile the lawsuit in the correct court., Each state has a deadline for how long after the injury an employee has to file a workers' compensation claim.
In most states, this deadline is two or three years after the date of the employee's injury.After the statute of limitations has expired, the employee is no longer entitled to recover workers' compensation benefits for his or her injury.Depending on your state's law, the statute of limitations may begin to run from the date the first report of injury is filed, or from the date the employee receives his or her last medical payment from your workers' compensation insurer if the claim is initially accepted.
There are circumstances, such as a sudden increase in disability as a result of the injury, that may enable the plaintiff to avoid the statute of limitations and file a claim anyway.
For example, the employee may have been treated for the injury and returned to work believing she was back to 100 percent, only to suffer pain later on that her doctor attributes to that original injury. , Since each state's workers' compensation law has different requirements, you must have a basic understanding of the law that applies to the claim before you can defend against it.
Generally, employees bear the burden of proving their eligibility for workers' compensation benefits.
However, in certain situations the burden may flip to the employer to prove certain defenses or exceptions to coverage.
For example, if you're arguing that the employee is not entitled to workers' compensation benefits because he or she was engaging in willful misconduct, it's up to you to prove that the employee knew about a rule designed to protect employee health and safety, and that he or she intentionally broke that rule despite full understanding of the possible consequences.
Your state law also will include details about available defenses and what must be proven for the defense to apply.
Aside from being able to defend against workers' compensation claims, you should have a basic understanding of the legal requirements and procedures for workers' compensation in your state.
Many insurance carriers and workers' compensation attorneys provide detailed summaries of the law in your state that are written in layman's terms and relatively easy to understand. , After you understand the elements your state's workers' compensation law requires, check the complaint's allegations to ensure all requirements have been met.
Generally, there are three requirements for an employee to be eligible for workers' compensation benefits: you must have (or be required by law to have) workers' compensation insurance; the person must be your employee (not an independent contractor); and his or her injury must be work-related.Most defenses against workers' compensation claims hinge on the argument that the injury is not work-related.
About the Author
Christopher Ortiz
Specializes in breaking down complex DIY projects topics into simple steps.
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