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Determining "Dependency" for Workers' Compensation Death Benefits

The issue of "dependency," with respect to the receipt of workers' compensation death benefits, is generally determined either as of the date of the worker's death or the date of the accident that caused his death. Those individuals who are, therefore, "dependents" on the requisite date will be eligible to receive death benefits in an amount commensurate with the measure of dependency on the worker, i.e. total or partial dependency.

Proper Party to a Third Party Action

When an employer or its carrier (collectively "employer") pays workers' compensation for an employee's injury arising out of his employment but through the fault of a third party, the employer may step into the shoes of the employee as his "subrogee." When the action against the third party is completely subrogated to the employer, the only essential plaintiff to the action is the employer. This means, only the party who has been substituted for the employee is required to maintain the action against the third party and recover damages. The employee does not have to be a part of the action for it to remain viable.

Casual Employment

Many states apply an exemption to the workers' compensation system for "casual" employment, although the majority also requires that the employment not be within the employer's regular course of business. As to the majority's additional requirement, it is important to note that no matter how brief or irregular the employee's work may be, if it falls within the employer's regular course of business he will be covered by workers' compensation. In some states, the casual employee exemption has been specifically denied.

Notice of Injury

Generally, workers' compensation statutes contain a limitations period in which the injured employee must give notice of his injury. Under most circumstances, the notice is provided to the employer. The notice period itself is relatively small. Some statutes mandate that it be given as soon as possible while others provide for a fixed timeframe such as, for example, within a designated number of weeks or months following the injury. The required notice allows the employer to immediately provide the employee with medical care and allows for a more accurate and comprehensive investigation into the accident causing the employee's injury. If the employee does not give the mandated notice, his claim for benefits will be denied.

Subrogation

Subrogation is a tool used by employers or their workers' compensation insurance carriers to seek reimbursement from a third party for the amounts paid to an injured worker. The employer's position is that the third party who caused the employee's injury should rightfully bear the burden of compensating the injured worker. In various forms, each state provides for subrogation. Some states have instituted no limits on an employer's right to seek reimbursement, others allow both the employer and the employee to maintain actions against the third party, and still others give either the employer or the employee priority in filing an action against the third party.