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Worker Fights to Re-Open Workers’ Compensation Claim

In a case from the Supreme Court of the State of Nevada, the claimant was working as construction driver for a paving company.  While he was at work one day, he was driving a truck, and another worker on the job site hit his truck with a backhoe.  When this occurred, he suffered severe injuries to various parts of his body, including his head, neck, knee, and back.

truckAfter this workplace accident, he filed a claim for workers’ compensation, and his employer accepted the claim.  After he had received workers’ compensation benefits and was treated for his injuries, his employer closed the claim and told him how reopen it should his condition get worse in the future, as they were required to do under the relevant state statute.In addition to filing a claim for workers’ compensation, claimant also filed a lawsuit against the driver of the backhoe. That claim was settled for $63,500.  However, as sometimes happens, a large portion of the claim was paid directly to the healthcare providers.

As our Boston workplace lawyers can explain, in most cases, workers’ compensation is an exclusive remedy. This means that if you are eligible to file for workers’ compensation benefits following a workplace injury, you are not able to file a civil personal injury lawsuit against your employer because of what is known as the single recovery rule.  However, if a negligent third party caused your accident, you may be able to collect workers’ compensation benefits in Boston and also file a civil lawsuit against that negligent third party.  However, to avoid a double recovery, you will be required to repay your employer for any workers’ compensation benefits you have already received to the extent necessary to avoid unjust enrichment.

In this case, the employee tried to go back to work after settling the lawsuit.  He was not able to work given his condition, and his doctors had told him not to work anyway.  Since he couldn’t work and wasn’t receiving any more workers’ compensation benefits, he applied to reopen his claim, but that request was denied.  At this point, he filed an appeal with the workers’ compensation commission.  The defendant said employee was not eligible to receive any more workers’ compensation benefits, because he had received money in a personal injury lawsuit, and that money was not entirely spent on medical costs.  In other words, he was able to keep some of the money that was given for pain and suffering.  His claim was denied at the hearing level, and he again appealed to the district court.

Initially, the district court denied his request for judicial review, but eventually the court held that he was not entitled to additional benefits because he had settled, and some of that money was not spent on medical providers.  It was said that he would have to exhaust that amount of money before opening his claim again. He appealed, and the court concluded that the relevant state workers’ compensation statute did not require to first exhaust those funds, and his employer was not entitled to reimbursement before opening a claim.

If you or someone you love has been injured a Boston work accident, call for a free and confidential appointment at 1-888-367-2900.

Additional Resources:

Poremba v. Southern Nevada Paving, January 26, 2017, Supreme Court of Nevada

More Blog Entries:

OSHA’s New Injury Reporting Rule and Employee Drug Testing, July 14, 2016, Boston Workers’ Compensation Lawyer Blog