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February 16, 2026
What Are the Most Common Reasons to Sue Workers’ Comp?
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Quick Answer
Workers’ compensation is supposed to protect employees after a workplace injury by providing medical care and wage replacement without the need to sue an employer. In reality, the system does not always work as intended. Many injured workers find themselves facing denied claims, delayed payments, or unfair treatment by workers’ compensation insurance companies.
In these situations, workers often ask an important question: Can I sue workers’ comp?
While workers’ compensation laws generally limit lawsuits against employers, there are circumstances where legal action may be appropriate. Understanding the most common reasons to sue workers’ comp can help injured workers recognize when their rights are being violated and when it may be time to speak with an experienced workers’ compensation attorney.
Key Takeaways
- Workers’ compensation usually prevents lawsuits against employers, but legal action may be possible when insurers or third parties act unfairly or violate the law.
- Bad faith claim handling, denied benefits, or delayed medical treatment are common reasons injured workers pursue legal action related to workers’ comp claims.
- Retaliation or third-party negligence can create separate legal claims, allowing injured workers to seek compensation beyond standard workers’ compensation benefits.
Can You Sue Workers’ Compensation?
In most cases, workers’ compensation is considered an exclusive remedy. This means employees typically cannot sue their employer directly for a work-related injury. However, this rule does not give insurance companies free rein to act unfairly or illegally.
There are several scenarios where suing for workers’ compensation, or taking legal action related to a workers’ comp claim, may be possible. Injured workers may be able to pursue legal action against a workers’ compensation insurance company, a third party, or even an employer in limited situations. These cases often arise when the workers’ comp system fails to provide the benefits the law requires.
Common Reasons to Sue Workers’ Comp
Below are some of the most common situations that lead injured workers to explore lawsuits or other legal remedies related to workers’ compensation.
Bad Faith by the Workers’ Compensation Insurance Company
One of the most common reasons for suing workers’ compensation involves bad faith conduct by the insurance company. Workers’ comp insurers are legally required to handle claims fairly and promptly. When they intentionally delay payments, deny valid claims without justification, or fail to authorize necessary medical treatment, they may be acting in bad faith.
Bad faith conduct can include ignoring medical evidence, misrepresenting policy terms, or using delay tactics to pressure injured workers into giving up their claims. In these situations, injured workers may have grounds to pursue legal action beyond the workers’ compensation claim itself.
Denial of a Valid Workers’ Compensation Claim
Workers’ compensation claims are sometimes denied even when injuries clearly occurred on the job. Insurance companies may argue that the injury is not work-related, claim it resulted from a pre-existing condition, or allege that the worker failed to report the injury properly.
When a valid claim is denied without legitimate reasons, injured workers may need legal intervention. While this often begins with an appeal or petition within the workers’ comp system, repeated or unreasonable denials can sometimes lead to lawsuits against the insurer.
Delayed or Withheld Benefits
Workers’ compensation benefits are meant to provide timely support while an employee recovers. When wage loss checks or medical payments are consistently delayed or withheld, injured workers may experience serious financial hardship.
Unjustified delays can be a sign of improper claims handling. If an insurance company repeatedly fails to issue payments on time or ignores approved benefits, legal action may be warranted to enforce compliance and protect the worker’s rights.
Failure to Cover Medical Treatment
Another common reason for suing for workers’ compensation arises when an insurer refuses to pay for necessary medical care. This may include denying surgery, physical therapy, diagnostic testing, or specialist referrals recommended by a treating physician.
When an insurance company places profits over patient care, injured workers may be left without treatment that is essential to their recovery. In some cases, this conduct may support legal claims beyond the standard workers’ comp process.
Retaliation by an Employer
Although workers generally cannot sue their employer for a workplace injury, they are protected from retaliation for filing a workers’ compensation claim. Retaliation may include termination, demotion, reduced hours, harassment, or other adverse employment actions.
If an employer punishes an employee for seeking workers’ compensation benefits, the worker may have grounds for a separate legal claim against the employer. Retaliation claims are among the most serious reasons injured workers pursue lawsuits related to workers’ comp.
Third-Party Liability Claims
In some workplace accidents, someone other than the employer or a co-worker is responsible for the injury. These situations may involve defective equipment, negligent subcontractors, careless drivers, or unsafe property conditions.
When a third party causes a work-related injury, injured workers may be able to file a personal injury lawsuit in addition to receiving workers’ compensation benefits. These third-party claims can provide compensation for losses not covered by workers’ comp, such as pain and suffering.
Serious Injury or Gross Negligence
In limited circumstances, lawsuits may arise when an employer’s conduct goes beyond ordinary negligence. This can include intentional harm, extreme safety violations, or fraudulent behavior designed to avoid providing workers’ compensation coverage. While these cases are less common, they represent another reason injured workers may explore legal action outside the traditional workers’ compensation system.
What Compensation Is Available if You Sue Workers’ Comp?
The compensation available depends on the type of legal action pursued. Workers’ compensation benefits typically cover medical expenses and a portion of lost wages. However, lawsuits against insurers or third parties may allow injured workers to seek additional damages.
This may include compensation for emotional distress, financial losses caused by bad faith conduct, and, in some cases, punitive damages. Third-party lawsuits may also allow recovery for pain and suffering, which is not available under workers’ compensation.
When Should You Speak with a Workers’ Compensation Attorney?
If your workers’ compensation claim has been denied, delayed, or mishandled, it is important to seek legal guidance as soon as possible. An experienced workers’ compensation attorney can review your case, explain your options, and determine whether legal action may be appropriate.
Many injured workers are unsure whether their situation qualifies as one of the valid reasons to sue workers’ comp. A knowledgeable attorney can help clarify your rights and protect you from unfair treatment.
How Pond Lehocky Can Help Injured Workers
Pond Lehocky has extensive experience representing injured workers and holding insurance companies accountable. Our firm understands the tactics workers’ compensation insurers use and knows how to fight for the benefits and protections injured workers deserve.
If you believe your workers’ compensation claim has been unfairly denied, delayed, or mishandled, Pond Lehocky is here to help. We offer consultations to review your case, explain your options, and guide you toward the best path forward.
Get Help With Your Workers’ Compensation Claim Today
If you are dealing with a denied claim, unpaid benefits, or retaliation after a workplace injury, you do not have to face the workers’ comp system alone. Understanding the most common reasons to sue workers’ comp is the first step toward protecting your rights.
Contact Pond Lehocky today to learn how we can help you pursue the benefits and justice you deserve.
