• I want to consult about a traffic accident in the Yaizu, Makinohara, Yoshida, Omaezaki, and Fujieda area
• I want to know the benefits of receiving leave compensation from workers' compensation insurance after a traffic accident
• I received leave compensation from workers' compensation insurance. Can I also claim lost wages from the at-fault party?

Are you troubled by issues like these in Yaizu, Makinohara, Omaezaki, Fujieda, Shimada, Yoshida Town, or surrounding areas?
Yaizu Sogo Law Office offers a free initial legal consultation regarding traffic accident concerns. There is no obligation to retain our services after the initial consultation. We are also available on weekday evenings and Saturdays. Please feel free to contact us by phone or email.

Introduction

When workers' compensation insurance is available for a traffic accident, there are many benefits.

In particular, if you are forced to take extended leave from work, you can receive a payment unique to workers' compensation insurance (Special Leave Allowance) in addition to the lost wages you can claim from the at-fault party.

Depending on whether or not you use workers' compensation insurance, the total amount you ultimately receive may increase.

The details are explained below.

Details of Leave Compensation under Workers' Compensation Insurance

(1) Leave Compensation Benefits

When workers' compensation insurance is available for a traffic accident, if you miss more than 3 days of work (*1), you can receive (i) Leave Compensation Benefits from workers' compensation insurance.

Leave Compensation Benefits are paid at only 60% of the Basic Daily Benefit Amount.

The Basic Daily Benefit Amount is, roughly speaking, your daily wage.

In other words, "Daily Wage x 60% x (Number of Days Absent - 3 days)" is the Leave Compensation Benefits you will receive.

Note that Leave Compensation Benefits are treated as "part of lost wages," so the important point is that the amount you can claim from the at-fault party is reduced accordingly.

(*) The first 3 days from the start of leave are a waiting period under workers' compensation insurance, and no Leave Compensation Benefits are paid for those 3 days.

(2) Special Leave Allowance

Under workers' compensation insurance, in addition to (i) Leave Compensation Benefits, (ii) Special Leave Allowance is also provided.

(ii) Special Leave Allowance is paid as part of the Social Rehabilitation Promotion Programs (welfare benefits) and differs slightly in nature from Leave Compensation Benefits themselves.

The Special Leave Allowance is paid at 20% of the Basic Daily Benefit Amount (daily wage).

Roughly speaking, "Daily Wage x 20% x (Number of Days Absent - 3 days)" is the Special Leave Allowance you will receive.

The Special Leave Allowance is a "welfare benefit" and differs in nature from compensation, so it is not deducted from claims against the at-fault party.

As explained in detail below, this means that using workers' compensation insurance provides the significant advantage of "increasing the total amount you receive."

(3) Summary

Adding (i) Leave Compensation Benefits and (ii) Special Leave Allowance together, the total benefit amounts to "Daily Wage x 80% x (Number of Days Absent - 3 days)."

Since workers' compensation benefits alone cover 80% of lost wages, this provides significant support for those experiencing reduced income.

The Advantage That the Special Leave Allowance Is Not Deducted from Compensation

(i) Leave Compensation Benefits under workers' compensation insurance share the same nature as lost wages in traffic accident compensation (i.e., compensation for losses due to absence from work). Therefore, to the extent you receive benefits under (i), you cannot separately claim lost wages from the at-fault party.

In contrast, (ii) Special Leave Allowance, as explained earlier, is not compensation for losses due to absence from work but rather has the nature of a welfare benefit. Therefore, to the extent you receive benefits under (ii), you can still claim lost wages from the at-fault party.

In other words, if you receive (i) Leave Compensation Benefits (60% of lost wages) and (ii) Special Leave Allowance (20% of lost wages) from workers' compensation insurance, even though you have already received 80% of your lost wages from workers' compensation, you are not limited to claiming only the remaining 20% from the at-fault party. Instead, only the amount under (i) is deducted, and you can claim 40% from the at-fault party.

The table below illustrates this more clearly. As a rough example, if the lost wages from your traffic accident (the amount claimable from the at-fault party) were 1,000,000 yen, the following differences arise depending on whether or not you used workers' compensation insurance.

	With Workers' Comp Insurance	Without Workers' Comp Insurance
(i) Your Lost Wages	1,000,000 yen	1,000,000 yen
(ii) Leave Compensation Benefits	600,000 yen	-
(iii) Special Leave Allowance	200,000 yen	-
(iv) Amount Received from Workers' Comp Insurance	800,000 yen (ii + iii)	-
Amount Deducted from (i) Due to Workers' Comp Insurance	600,000 yen (only (ii) Leave Compensation Benefits deducted)	-
Amount Claimable from the At-Fault Party	400,000 yen (i - ii)	1,000,000 yen
(vii) Total Amount You Can Receive	1,200,000 yen (i + iii)	1,000,000 yen

As shown above, using workers' compensation insurance provides the advantage of receiving additional money equal to the Special Leave Allowance. Therefore, if your leave period is expected to be lengthy, it is advisable to use workers' compensation insurance.

When the Victim Is Also at Fault for the Accident

If the victim is also at fault for the traffic accident, the compensation received is the damage amount minus the victim's share of fault.

Furthermore, if the victim's fault is significant, the (i) Leave Compensation Benefits from workers' compensation insurance may exceed the lost wages claimable from the at-fault party.

In such cases, you might think that the excess would be deducted from your total compensation including consolation money, but rest assured that it will not be deducted from other categories of damages.

For example, let us consider a case where you were involved in a traffic accident and the fault ratio was 70% for you and 30% for the other party.

In this case, suppose you incurred 1,000,000 yen in consolation money and 1,000,000 yen in lost wages, and you received 600,000 yen in (i) Leave Compensation Benefits from workers' compensation insurance.

In the above case, the lost wages you can claim from the other party would be 300,000 yen (30% of 1,000,000 yen, corresponding to the other party's share of fault). Since you have already received 600,000 yen in (i) Leave Compensation Benefits, there is a difference of -300,000 yen, meaning you have received more than what you can claim.

You might then think that the 300,000 yen excess would be deducted from the consolation money you can claim from the other party, but in reality, this amount is not deducted.

Workers' compensation benefits have the nature of leave compensation and are entirely different in nature from consolation money, so they cannot be deducted from consolation money.

Even when the fault ratio is significant, the fact that the Special Leave Allowance is "not deducted from consolation money" is a major advantage for the victim.

The relationship between workers' compensation insurance and traffic accident compensation is complex, and settling without proper understanding carries the risk of financial loss. We strongly recommend consulting an expert.

In Closing

The above is an explanation of leave compensation under workers' compensation insurance.

In particular, the fact that the "Special Leave Allowance is not deducted" is highly advantageous for the victim.

Whether you should use workers' compensation insurance depends on the circumstances of your accident. If workers' compensation insurance is available for your traffic accident, there are many financial benefits, so please check whether it applies to your situation and consult an attorney if you have any questions.

Frequently Asked Questions

The Initial Legal Consultation for Traffic Accidents at Yaizu Sogo Law Office Is Free of Charge

Yaizu Sogo Law Office provides a free initial legal consultation regarding traffic accidents.

We handle all traffic accident-related legal matters, regardless of severity or whether they involve property damage or personal injury. If you are feeling stressed by dealings with insurance companies, or if you want to know whether the amount offered by your insurance company is fair, please do not hesitate to consult with us.

Yaizu Sogo Law Office is available not only during regular weekday hours but also on weekday evenings and Saturdays. Please contact us by phone or email to schedule a legal consultation.

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