Special Cases of Personal Injury

No Fault, Workers Comp and Government Suits

In most instances when you suffer an injury, the law allows you the opportunity to recover damages from the person who caused that injury through a lawsuit. For example, if you get into a car accident as a result of a negligent driver, the negligent driver can be sued. If your doctor is careless and you suffer harm as a result, your doctor can be brought to court for a medical malpractice claim. The body of law that governs financial liability for these injuries, and any others that occur as a result of negligence or intentional bad actions, is called personal injury law or "tort" law. However, there are a few special circumstances in which personal injury laws do not apply.

When Can't You Sue for an Injury?

There are two specific cases in which you may not sue for an injury, even though many people tend to assume that these situations are treated just like any other accident case. These two situations are:

1. When you suffer non-serious car accident injuries in a no fault state
2. When you suffer an injury at work

In either of these two situations, legislation has been passed that removes the claim from the tort system.

No Fault States and Car Accidents

The first situation in which you can't sue for personal injuries caused through negligence is a non-serious car accident in a no fault state. 12 states in the US have created an alternative system for recovering the financial costs of a car accident.

While the rules differ from state to state, in general, each of the 12 no fault states requires you to collect any and all car accident injury damages from your own insurer. These damages are paid by your insurer under a special kind of coverage called Personal Injury Protection, or PIP. All drivers in the state have to buy PIP, and it covers both th driver and people in their household.

While all drivers have PIP to provide coverage in the event of an accident, the damages that you can recover under your personal injury protection are more limited than damages that you can collect by making a personal injury claim in a fault state. Under the rules, you may only collect damages for:

• Actual lost wages (in some states, you can collect 100 percent but in others you receive only a percentage)
• The actual cost of the medical bills necessary to treat your car accident injuries

You are also limited by your policy limits and can collect payments only up to those limits.

While the limitations on damages are the major disadvantage of a no fault system, there are some benefits to no fault rules as well. The major benefit is that you are allowed to recover the above-listed costs, even if you are the one who causes the accident. In fact, this is one of the justifications that no fault states usually use for why this policy is a good one: everyone has his or her bills covered and there's no waiting for a long, drawn out claims process to get reimbursed.

There are no states that are "pure no fault," though. In all no fault states, there are exceptions to the rules that will allow you to collect additional damages for things like pain and suffering. The specifics of when you can collect these additional damages vary by state, but the basic rule is that you can collect the damages when the injuries are "serious." States define seriousness in one of two ways:

Quantitatively

If the cost of treating your injuries exceeds a certain dollar amount, you can make a claim for additional damages.

Qualitatively

If the nature and type of your injuries matches a written description of "serious" injuries (which usually encompasses permanent injuries or those that are disabling or disfiguring) then you can make a claim for additional damages.

If you live in one of these 12 no fault states, understanding these limits on your right to make a personal injury claim is essential. The 12 no fault states are:

1. Florida
2. Michigan
3. Minnesota
4. North Dakota
5. Massachusetts
6. New Jersey (Optional or choice no fault)
7. New York
8. Pennsylvania (Optional or choice no fault)
9. Hawaii
10. Kansas
11. Kentucky
12. Utah

Workers Compensation

Another situation in which you may not file a standard personal injury claim is when you are injured at work. In all states in the US, work related injuries have essentially been removed from the field of personal injury law through legislation called Workers Compensation.

Under workers compensation rules, employers have to buy insurance for all covered employees. When a worker is injured as a direct result of doing his or her job (which doesn't necessarily mean injured at the job site), then the worker can collect compensation through workers comp. The employee is not required to show any negligence on the part of the employer in order to collect compensation. Because of this, workers compensation is referred to as a "strict liability" system.

The worker, instead of having to prove negligence, must:

1. Notify his or her employer of the injury within a set time limit (limits vary by state)
2. Provide evidence that the injury would not have occurred but for the worker's required performance of a work related duty

Once a worker has had a claim approved by the workers compensation insurer, he or she will have medical bills paid. Additional benefits may also be available, as set by the laws of the state and the policies of the employer and insurer. For example, if a worker becomes partially or totally disabled, either temporarily or permanently, he or she will receive disability payments. If a worker passes away, the remaining family members may also collect benefits, including money to pay for funeral expenses.

Because the workers compensation system provides coverage even without fault, it essentially ensures that employers will have to pay for all work related injuries. This serves two important public policy purposes: it ensures people get the care that they need, and it ensures that employers will take extra precautions to make their workplace safe to avoid potential workers comp claims. Some argue that it isn't fair that workers have no recourse other than workers comp, and that the option for a lawsuit has been taken away.

Governmental Immunity and Torts

You should also be aware that there are limitations on your ability to sue the government in a personal injury action. For example:

Governmental immunity exists to protect the government and officials from possible civil liability that arises as a result of their work. For example, a police officer who arrests someone is usually protected from a false imprisonment suit by governmental immunity, even if it later turns out the arrest was unwarranted.

• Governmental immunity exists to limit government exposure to lawsuits based on things like slippery roads.
• The Federal Tort Claims Act (FTCA) imposes a number of protections, such as requiring individuals who have a claim against government workers to sue the government instead of the individual.
• Time limits and procedures for suing the government also differ from standard personal injury cases due to the special protections afforded.

It is important to understand these three examples of personal injuries where you cannot sue in the traditional manner, so you will be aware of how to proceed when injured. Because the field of personal injury law is so complex, you should consider hiring a lawyer if you find yourself in any of the above situations or dealing with any type of personal injury. Your lawyer can explain all your options under the laws where you live and help you to determine the best possible course of action.

Next Steps

4. Property Owners and Injury Liability
5. Defective Products and Dangerous Drugs
6. Car Accident Cases

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