Atlanta Workers Compensation Law : Atlanta Workers' Compensation Lawyer & Attorney : Seth Bader Law Firm : Construction Accidents, Repetitive Motion Injuries, Disability : Atlanta, Marietta, Roswell, Georgia

If someone other than your employer or a co-worker caused your injuries, you may, in addition to having a valid workers' compensation claim, have a basis for filing a civil lawsuit against the party who caused your injuries.  If you prevail against this third party, however, your employer and its workers' compensation insurance company may be entitled to recover some or all of your damages or settlement proceeds as a means of recouping some of all of the workers' compensation benefits they already paid.  This concept is known as subrogation.

Employers are not entitled to subrogation simply because you obtain damages or settlement proceeds from a third party.  Indeed, an employer can recover on a subrogation lien only if they can prove that you have been "fully and completely compensated" for both your economic and non-economic damages.  The law does not prescribe a specific method for proving this, however, and it is difficult, if not impossible, to quantify non-economic damages such as "pain and suffering."  As a result, employers often are not able to recoup all of their losses through subrogation.

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(a)  Any party to a claim under this chapter, a group insurance company, or other health care provider who covers the costs of medical treatment for a person who subsequently files a claim under this chapter may give notice in writing to the board at any time during the pendency of the claim that such provider is or should be a party at interest as a result of payments made in the employee's behalf for medical treatment.

(b)  In cases where a group insurance company or other health care provider covers the costs of medical treatment for a person who subsequently files a claim and is entitled to benefits under this chapter, the board shall be authorized to order the employer or workers' compensation insurance carrier to repay the group insurance company or other health care provider the funds it has expended for the claimant's medical treatment, provided that such employer or its workers' compensation insurance carrier is liable under this chapter for such medical treatment and provided, further, that such other provider has become or should be a party at interest pursuant to the provisions of subsection (a) of this Code section.  The employer or its workers' compensation insurance carrier deemed liable for such medical treatment shall not be obligated to pay such sums directly to the employee unless, and only to the extent that, it is proven that the employee has paid for such medical treatment himself.

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