Work Accident Claims

When do I make a works accident injury claim?

When you have a works accident injury, you will usually have gone to hospital where the doctors and nursing staff will have provided your initial treatment and care needs.  This may have involved one or more operations.  After then, when you are recovering the hospital may involve other health professionals, such as occupational therapist and physiotherapist, to help with your rehabilitation and hopefully your discharge.  The exact nature of this help will depend on your injuries and individual circumstances.

As lawyers who specialise in work accident injury claims, many patients will contact us very soon after their injury to ask for our help.  The main advantage of us being involved at this early stage, is that we may be able to arrange more rehabilitation to facilitate your discharge because your health is the top priority.  It is commonly accepted that early rehabilitation intervention improves your chances of reaching your maximal recovery sooner.

How can we help with your rehabilitation?

To help us work alongside your medical team in serious injury cases, we will instruct a case manager in suitable cases.  A case manager is an independent healthcare professional, often a registered nurse, occupational therapist, or physiotherapist, who works for you outside of the legal claim process.  They will see you, often in your home environment, to prepare an immediate needs assessment report. They have access to your medical records and so are best placed to identify any additional care or support needs that you may require, as well as any aids or adaptations that you need.

The case manager is often instructed jointly with the insurance company of the employer.  However, sometimes this is not always possible, in which case we may be able to instruct the case manager unilaterally, in suitable cases.

Depending on the severity of your injuries, their impact on your life, and how you recover, the case manager may be involved supporting, coordinating your rehabilitation needs for a long time.

Starting the claim

It should be possible after meeting with you to have a good idea of who may be to blame for your work injury, although in some cases more than one party may possibly be liable.

We will send a letter of claim to the employer or anyone else we consider is responsible for your accident.  If you do not know their insurer details, we may be able to find out who the insurer is from the ELTO database, which helps trace workplace insurers. 

The letter of claim sets out the basic circumstances of the incident, why we hold them responsible, brief details of your injuries and other losses such as lost income.  It also includes some personal details that the insurer will need to register your claim with the Department of Work and Pensions’ Compensation Recovery Unit (CRU).  The CRU recovers money from insurers who accept liability for an injury claim, to reimburse the cost to the NHS of any ambulance you needed, staying in an NHS hospital and, also, any state benefits you may have needed due to your injuries.  We will also nominate details of the case managers we propose are suitable to prepare your immediate needs assessment, if appropriate.

It is usual for the insurer to acknowledge your letter of claim within 21 days, and to confirm their decision on whether they accept responsibility for your catastrophic injury within the next 3 months.  Although sometimes liability may not always be resolved in that time if say, the accident circumstances are unclear or are contested, or the insurer wants to see a HSE accident investigation report before confirming their stance.

Evidence needed to make a claim

When we first see you, we will need to know that details of the incident that caused your work injury.  As well as taking details of what you remember happened, we will also want to know if there are any photos or CCTV of the incident, and whether you have the details of any witnesses.  Objects involved in the incident may also provide important evidence and should be kept.  Depending on how you suffered your injury, there may be other bodies investigating the incident for regulatory or criminal investigation purposes.  For example, there may be inquiries by the Health and Safety Executive (HSE) or the Local Authority, depending on which body oversees your workplace safety.  These reports can contain important evidence which may support establishing what happened and who should take legal responsibility.

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations

Depending on the severity of the work accident injury, your employer may have to report your accident to the Health and Safety Executive (HSE).  The HSE is a government agency which is responsible for workplace safety.  The requirement to report to the HSE is contained in the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013, and a so-called RIDDOR reports must be made by your employer when:

• anyone dies following a work-related accident.

Or when a worker suffers one of the following injuries:

• fractures, other than to fingers, thumbs and toes
• amputations
• any injury likely to lead to permanent loss of sight or reduction in sight
• any crush injury to the head or torso causing damage to the brain or internal organs
• serious burns (including scalding) which:
  • covers more than 10% of the body
  • causes significant damage to the eyes, respiratory system or other vital organs
• any scalping requiring hospital treatment
• any loss of consciousness caused by head injury or asphyxia
• any other injury arising from working in an enclosed space which:
  • leads to hypothermia or heat-induced illness
  • requires resuscitation or admittance to hospital for more than 24 hour

Other than this, accidents must also be reported if an employee is off work or unable to perform their usual work duties for more than seven consecutive days after the accident, including weekends. 

Employer’s disclosure

Very often, we will not have all the relevant evidence on which to make a full assessment of liability for your injury.  This is because the employer holds all the relevant records, such as risk assessments, maintenance records, training records, inspection logs etc.  When the employer responds to the letter of claim, if it denies full responsibility or argues that you should share some of the responsibility for the accident, then they should disclose all relevant documents. They should not cherry-pick the disclosed documents. 

If the employer does not disclose any documents, or if on reviewing what they have sent it is clear to us that not all relevant documents have been provided, then we will ask for these.  If they refuse or delay, we will apply to the court for an order requiring their disclosure.  At this stage, we should be able to give you a more accurate assessment of the prospects of your claim.

Rehabilitation Code 2015 and Serious Injury Guide

The court’s pre-action protocol makes it clear that parties should cooperate in line with Rehabilitation Code 2015, in facilitating early rehabilitation.  However, there are weaknesses in the Rehabilitation Code, so we are also voluntary signatories of the Serious Injury Guide along with other specialist serious injury lawyers and many insurers.  This demonstrates our commitment to your rehabilitation and means that when the insurer or lawyer who represents the other party is also a signatory to the Serious Injury Guide, we can use it to your benefit.  In many serious injury cases we can arrange early rehabilitation, even if an insurer is still reserving its position on whether to accept liability for the injury.

In our team we also have a client support manager, who is a registered social worker.  She supports clients and their families, particularly in the early stages of a serious injury claim when an insurer may not yet be engaged.  The issues they support with are various, but they may especially be needed when a client is ready to be discharged from hospital, but their home is unsuited because of their injuries.  In these cases, the client support manager will liaise with the relevant local authority who have a statutory duty in the circumstances to provide support.

Medical evidence to support a works accident injury claim

In any work accident injury claim, the burden of proof rests with the claimant.  This means that even if an employer accepts responsibility for the injury, then the claimant must still prove the extent of the injuries caused due to the incident and their prognosis.  In addition, they must prove what other losses have reasonably been caused either in the incident, such as car repairs, or caused by the injury, such as loss of earnings or care.

This means that expert evidence is key in supporting the claim.  We work with leading expert witnesses across a range of medical disciplines to establish the full impact of the injuries.  This includes not only assessing the current situation, but also looking ahead and considering the chances of, for example, a deterioration in symptoms due to arthritis in a joint brought on by the accident, which may impact someone’s work capacity or care needs.  Another example may be someone with a brain injury who, as a result, may be at an increased risk of developing epilepsy.  For some people, if it occurred, it would prevent them from driving, or working at height or with machinery.  This clearly would have a significant impact on the value of a claim.  In fact, in such a case, we would advise the client that their interests would be best protected by settling their claim on a provisional basis.  This means that they could a agree a settlement on the assumption that the epilepsy will not occur but retaining the ability to claim further compensation for the full extent of their epilepsy injury and associated losses if the epilepsy did develop in the expected time frame.

Interim payments

Interim payments are another way in which we are able to support people with an injury.  A works accident injury can have a significant impact on someone’s ability to work.  This may only be for an initial period whilst they are receiving treatment and rehabilitation however, some people may never be able to return to their work or may have to take up different work.  It is also a fact that people with a disability are more likely to have time out of work and to have longer periods of unemployment compared to people without a disability. 

It is therefore unsurprising that many people with a serious injury will have financial needs.  When an insurer is engaged, we are often able to secure significant, early interim payments for clients.  In some instances, an insurer does not cooperate, so we advise clients on their option of applying to the court for an order.

Negotiate a settlement

When we have all the evidence needed to support a work accident injury claim, we will enter into negotiations with the insurer.  This could be by an exchange of settlement offers however, on more significant injury cases this may be done in a face-to-face meeting with the other party’s lawyers.  In these cases we will also involve a specialist injury barrister to assist in these meetings and, if a settlement is not agreed, the same barrister will help prepare and present your case at trial.