Third Party Claims Explained
A third party claim is an L&I claim together with a Personal Injury claim arising out of the same facts. When you have both a personal injury claim and an L&I claim, the personal injury claim is called a third party claim.
For example: a delivery driver is rear ended on the highway. He or she has two claims. He has an L&I claim because he is injured while on the job. He also has a third party claim because that same set of facts also resulted in an injury caused by someone who is not his employer or a co-employee.
There are two claims, both L&I and third party. Two is better than one, right? What could go wrong? Some third party claims can be worth a lot of money.
The downside of a third party claim is that L&I or the self insured employer has a lien on your third party recovery. This is also known as a workers comp lien on a personal injury settlement. That means because L&I or the Self Insurer has paid money on your L&I claim they will get some of that money back from you when you settle your third party claim. The exact amount they get from you is subject to the worksheet formula, and possible compromise. Sometimes the amount L&I or the self insured employer take is shockingly large. Sometimes the third party settlement will ruin the remaining L&I claim because it creates an offset and takes away L&I benefits. Understand how the offset formula applies to your L&I claim BEFORE you settle your third party claim.
Some personal injury attorneys are clueless about this interrelationship between L&I claims and Third Party claims. This could cost you a lot of money. These lawyers typically are personal injury lawyers who “aren’t handling your L&I claim.” While that is an OK relationship on its face, it is very bad if that attorney does not know that when the PI claim settles first, the PI claim can ruin the L&I claim. Insist your third party personal injury attorney explains to you in writing how the offset works and how much it will be, and how it affects your ongoing L&I claim benefits. Be sure your attorneys work to reduce the offset as part of the third party settlement. If they cannot reduce the offset or if they take no interest in what you’re saying, you have the wrong attorney. They could unintentionally or otherwise ruin your L&I claim. Don’t let your third party attorney do that. Be careful. Read this section again if you have any questions or concerns.
The third party election form is a formal notice given by you to L&I on the subject of whether or not you believe you have a third party claim. Even though L&I is asking, as a practical matter you don’t have any choice whether you have a third party claim. The facts decide that. For more information see Third Party Election Form
The third party election form also serves to designate who will be in charge of the third party claim, you or L&I.
Yes, that’s what we’re talking about. You can sue a third party even if you have an L&I claim. Your claim against them is a third party lawsuit. The third party is a person who is not your co-employee and not your employer.
WISHA and OSHA regulations are in place to protect workers. Employers are required to furnish a work environment free from injury causing hazards. Violations of the regulations are evidence of negligence and can be very helpful in third party lawsuits. Washington Industrial Safety and Health Act (WISHA) regulations can be found at WISHA. Occupational Safety and Health Act (OSHA) can be found at OSHA.
If you are on the job and any of these happen to you then you may have a third party workers compensation claim.
No. The general rule is you cannot sue your employer or coworker for a job injury because they are not a third party. Instead you can file an L&I claim.
There are three of exceptions to this rule:
Here is the information required to file a third party claim:
There are two things, both must be done to effectively handle a third party claim .
L&I Third Party Recovery Worksheet
To figure out the value of a third party claim use the interactive online worksheet formula. To figure the value you must know the following:
• Gross Recovery
• Benefits Paid
• Attorney Fees
Fill in the numbers and the interactive worksheet formula will work itself out. If your numbers aren’t set yet you can only make estimates. You can also call or e-mail us and we’ll help with the calculation for you, based on the above figures you supply to us.
Early on in your case you won’t know these numbers, so case value will be a guess.
Third party corporations are usually represented by a virtual army of corporate and insurance lawyers. If you hope to do well then consult with your own third party lawyer. The consultation is free, and then you can make your best decision about DIY or hire a lawyer. The lawyer will look at your case from every angle and give you his expert opinion about your best course of action.
Still got questions? We have answers.We know L&I and Third Party Law. See: L&I Attorney – Washington Workers Compensation
Telephone – Call for information or a free strategy session – 206-343-1988