Ohio workers who suffer injuries, incur medical expenses and are confronted with lost wages from injuries that did not occur on the job should be aware of subrogation and how it affects workers’ compensation benefits. With subrogation, the Ohio Bureau of Workers’ Compensation will collect benefits for injured workers if their injuries were caused by a third party. Often, for the worker to receive subrogation, there must be a settlement or a judgment against the party deemed at fault.
Under state law, the BWC, employers who self-insure, and employers who contract for medical services to be paid directly have the right to subrogation. With subrogation, the employer who self-insures can collect the costs for the workers’ compensation claim from who or what caused the injury. Expenses that can be recovered include: medical expenses, rehabilitation costs, future compensation, and death benefits. A frequent reason for subrogation is if the worker was in a car accident that was caused by another driver. There are other circumstances where it can be used, including premises liability, product liability, medical malpractice, a construction site accident that was caused by a third party, or an animal attack.
The case will be reviewed by the BWC and will then be referred to the subrogation unit. Other entities, such as the managed care organization, a representative of the employer, a lawyer, and an insurer can make the referral. Once the BWC receives the referral, the case will be reviewed by an account examiner or a lawyer who works in the subrogation unit. If the third-party claim is settled, the BWC will be notified. The subrogation departed subsequently negotiates a settlement of the BWC lien with the worker, the representative, or the insurer. Other issues can arise, such as how much of the lien can be collected by the BWC. The settlement amount must often be shared among the parties and can reduce the total. There might be a limit to the insurance policy amount and this, too, can lower the offer.
Subrogation is an important part of workers’ compensation, as it comes about when workers are injured in an accident away from work. Workers who are hurt when not on the job, need medical help and are unable to work should understand subrogation. A lawyer experienced in all areas of workers’ compensation can help with subrogation and how it can affect a case.
Source: bwc.ohio.gov, “Subrogation,” accessed on March 19, 2018