How Do I Claim Medical Damages After a Construction Accident?

The construction industry is one of the most hazardous sectors in the United States, accounting for over 1,000 fatal injuries and 74,520 nonfatal injuries among private construction workers in 2020 alone. 

If you’ve suffered a construction accident, you can claim medical damages through workers' compensation or personal injury claim, depending on the circumstances of your accident.

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Workers' Compensation vs. Personal Injury Claims

Most construction workers are covered under workers' compensation, which provides medical benefits and wage replacement for job-related injuries, regardless of who is at fault. To start a claim, you need to do the following:

  1. Report the injury to your employer immediately or within 30 days, 
  2. Fill out the necessary paperwork, and 
  3. Provide medical records that detail your injuries.

On the other hand, if a third party—such as a subcontractor or equipment manufacturer—is at fault, you may be able to pursue a third party claim. It does however, require proving that another party's negligence caused your injuries.

Key Differences

AspectWorkers' CompensationThird-Party Claims
Fault RequirementNo-fault systemMust prove negligence of a third party
Compensation ScopeLimited to specific benefitsPotential for broader compensation
Right to SueGenerally cannot sue the employer directlyCan sue third parties responsible
TimelineOften quicker resolutionMay take longer to resolve

When You Can Pursue Both Options

In some situations, you can receive workers' comp and still file a third-party lawsuit if someone other than your employer contributed to the accident. 

For example, if faulty equipment caused your injury, you could sue the manufacturer. In such cases, you can maximize your compensation since workers' compensation alone may not be enough to cover all your damages, especially those related to pain and suffering.

Benefits and Limitations of Each Route

Workers' compensation is generally easier to obtain but provides less comprehensive compensation. Third-party claims are potentially more lucrative but can be more challenging to win. An skilled personal injury attorney can help determine which route is most beneficial for your case and guide you through the decision-making process.

Deadlines and Statutes of Limitations

Timeliness is paramount. Workers' compensation claims usually needs to be reported immediately, and the deadline for personal injury claims in New York has a 3-year window starting from the date of the accident. Missing these deadlines can bar you from receiving any compensation.

What Evidence Do You Need to Support Your Claim?

Strong, comprehensive evidence is the foundation of a successful medical damage claim. Gather:

EvidenceDescription
Medical RecordsEmergency room reports, hospital records, physician notes, test results, prescription records
Accident ReportsOfficial incident reports, OSHA investigation reports, police reports, if law enforcement was involved
Witness StatementsWritten or recorded accounts from coworkers
Photographic and Video EvidenceImages of the accident scene and injuries, any available surveillance or security camera footage
Employment and Wage InformationPay stubs or W-2 forms, employment records
Expert TestimonyMedical experts, occupational experts, safety experts
Personal DocumentationPain and recovery journal, accident-related expense records
Communication RecordsEmails, letters, or other correspondence with your employer about the accident

Challenges may arise, such as insurers questioning the severity of your injuries. An experienced construction accident attorney can help counter these tactics and ensure you receive what you're owed. They can help you strengthen your claim and rebut insurance company arguments.

What to Do If Your Claim Is Denied

Facing a denied workers' compensation claim or a rejected personal injury settlement offer can be disheartening, but it's not the end of the road. Here's what you should do:

Understand the Reason for Denial

Carefully review the denial letter or settlement rejection. Common reasons for denial include:

  • Missed deadlines for reporting or filing
  • Disputes over whether the injury is work-related
  • Insufficient medical evidence
  • Pre-existing conditions

Gather Additional Evidence

If your claim was denied due to lack of evidence, work on obtaining:

  • More detailed medical reports
  • Expert medical opinions
  • Additional witness statements
  • Any missing accident reports or documentation

File an Appeal

  • For workers' compensation claims, file an appeal with the New York State Workers' Compensation Board within 30 days of the denial.
  • For third-party claims, discuss with your attorney the possibility of filing a lawsuit or continuing negotiations.

Attend the Hearing

If your workers' compensation appeal goes to a hearing:

  • Prepare thoroughly with your attorney
  • Bring all relevant medical records and other evidence
  • Be ready to testify about your accident and injuries

Explore All Options

If your workers' compensation claim is ultimately denied, you may still have other options, such as:

  • Filing a personal injury lawsuit (if a third party was involved)
  • Applying for Social Security Disability benefits
  • In some cases, mediation can be an effective way to resolve disputes without a formal hearing or trial.
  • Exploring other state or federal assistance programs

Seek Legal Representation

If you haven't already, this is the time to consult with an experienced attorney. They can review your case, advise you on the best course of action, and represent you through the appeals process.

Remember: a denial is not necessarily final. Many claims are initially denied but later approved on appeal. The key is to act quickly, gather strong evidence, and present a compelling case for why you deserve compensation.

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What Medical Damages Can You Claim?

Construction accidents can lead to various medical expenses, all of which may be compensable. Here are the categories of medical damages you may be entitled to claim:

Immediate Medical CareThese include emergency room visits, hospitalization, surgeries, follow-up visits, prescription medications, and physical therapy.

Any costs directly related to treating your injury should be documented and submitted as part of your claim.
Long-Term Medical Care and Rehabilitation CostsDepending on the severity of your injury, you may need ongoing care, such as rehabilitation services, assistive devices, or in-home care.

These expenses are also compensable and should be accounted for when filing your claim.
Mental Health TreatmentIf the accident has led to anxiety, depression, or PTSD, mental health treatment costs may also be included in your medical damages claim.

Psychological injuries are common after serious accidents, and compensation should reflect the full scope of harm caused.
Future Medical NeedsInjuries often require future medical treatment, including additional surgeries or long-term physical therapy.

Your claim should account for these expected costs, and having a medical expert estimate future expenses can support this aspect of your claim.

It's important to note that long-term or permanent injuries may require ongoing care, and these future medical needs must be carefully considered when claiming damages. An experienced personal injury attorney can help you accurately calculate and claim these future expenses.

Speak to A Construction Accident Lawyer Today

If you feel overwhelmed or unsure about your next steps, we at the Porter Law Group are here to help. The extensive experience of our attorneys in construction accident cases can guide you through the claims process and ensure that you receive the compensation you deserve.  

Reach out to us today for a free case evaluation by calling 833-PORTER9 (toll-free) or emailing info@porterlawteam.com.

Whether you are dealing with workers' compensation, a personal injury lawsuit, or an appeal, we have the expertise to represent your best interests. You don't pay anything unless we win your case.

Last Updated on 
January 21, 2025
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