Workers compensation provides medical care and wage replacement for employees injured on the job. This guide covers benefits, how to file claims, employer requirements, and what to do if your claim is denied.
Workers Comp Quick Facts 2025
- Coverage: Required in all states except Texas (for most employers)
- Benefits: Medical care, lost wages (typically 66% of pay), disability
- No-fault system: Benefits paid regardless of who caused injury
- Employer cost: Average $1.19 per $100 of payroll
- Filing deadline: 30 days to 2 years (varies by state)
Types of Workers Compensation Benefits
| Benefit Type | What It Covers | Duration |
|---|---|---|
| Medical Benefits | All treatment related to injury | Until recovered or permanent |
| Temporary Total Disability | Lost wages when can't work at all | Until return to work or MMI |
| Temporary Partial Disability | Wage difference if working reduced hours | Until full duty or MMI |
| Permanent Partial Disability | Compensation for lasting impairment | Lump sum or scheduled payments |
| Permanent Total Disability | Lifetime benefits if can't work | Lifetime (varies by state) |
| Death Benefits | Funeral costs + survivor benefits | Varies by state and dependents |
How to File a Workers Comp Claim
- Report injury immediately: Tell your supervisor right away
- Seek medical attention: Use employer-designated doctor if required
- Complete claim form: Fill out state-required paperwork
- Document everything: Keep copies of all medical records and correspondence
- Follow treatment: Attend all appointments, follow doctor's orders
- Track lost wages: Document all time missed from work
Common Workplace Injuries Covered
- Repetitive strain injuries: Carpal tunnel, tendinitis
- Back injuries: Lifting, falls, strain
- Slip and fall: Wet floors, uneven surfaces
- Vehicle accidents: Work-related driving
- Machinery accidents: Manufacturing injuries
- Occupational illness: Exposure to chemicals, asbestos
- Hearing loss: Prolonged noise exposure
Workers Comp for Employers
Employer Requirements
- Carry insurance: Required in 49 states (Texas optional)
- Post notices: Display workers comp information
- Report injuries: File required reports with state
- No retaliation: Can't fire employees for filing claims
- Provide forms: Give employees claim forms promptly
Average Workers Comp Insurance Costs
| Industry | Cost per $100 Payroll | Risk Level |
|---|---|---|
| Office/Clerical | $0.20 - $0.50 | Low |
| Retail | $0.50 - $1.50 | Low-Medium |
| Manufacturing | $1.50 - $3.00 | Medium |
| Construction | $3.00 - $10.00+ | High |
| Roofing | $10.00 - $30.00+ | Very High |
What If Your Claim Is Denied?
- Understand the reason: Review denial letter carefully
- Gather evidence: Medical records, witness statements
- File an appeal: Within state deadline (often 30-90 days)
- Consider an attorney: Workers comp lawyers work on contingency
- Attend hearings: Present your case to judge
When to Hire a Workers Comp Attorney
- Claim denied: Insurer refuses to pay benefits
- Serious injury: Permanent disability or surgery required
- Pre-existing condition: Employer claims injury isn't work-related
- Retaliation: Fired or demoted for filing claim
- Third-party liability: Someone other than employer at fault
- Settlement offered: Need help evaluating if it's fair
Workers Comp vs Personal Injury Lawsuit
| Factor | Workers Comp | Personal Injury |
|---|---|---|
| Fault Required | No | Yes |
| Pain & Suffering | No | Yes |
| Medical Bills | 100% covered | If you win |
| Lost Wages | ~66% of pay | 100% if you win |
| Timeline | Faster | Years potentially |
| Sue Employer | Generally no | N/A |
FAQ
Can I choose my own doctor?
It depends on your state. Some require using employer-designated providers; others allow free choice after initial treatment.
How much of my salary will I receive?
Typically 66% of your average weekly wage, up to a state maximum. This is usually tax-free.
Can I be fired for filing a claim?
No. Retaliating against employees for filing workers comp claims is illegal in all states.