Have questions about workers’ compensation and how it can affect your legal rights? We put together this simple FAQ with answers to some of the most commonly asked questions by people hurt at work.
Note that workers’ compensation may not be the best way to recover money for injuries at work. If you were hurt by a faulty product or the actions of another individual, you could be eligible to file a third-party claim.
Jump to Your Question
- What Is Workers’ Comp?
- What Does Workers’ Comp Cover?
- What Doesn’t Workers’ Comp Cover?
- How Does Workers’ Comp Work?
- How Much Does Workers’ Comp Pay?
- Who Pays for Workers’ Compensation?
- Can I Sue If I Get Workers’ Comp?
Don’t see your question answered here? If you had an accident on the job, you can get a free case review from a work injury lawyer. Just click on the type of accident you suffered below:
What Is Workers’ Comp?
Workers’ compensation is a type of no-fault insurance that protects both employees and employers when an on-the-job injury occurs.
- Employees: Workers’ comp provides workers coverage for medical treatment of injuries suffered on the job, as well as partial payment of wages while the worker is out of work.
- Employers: Workers’ comp removes liability from employers for injuries suffered by their employees.
For a more in-depth answer, see What Is Workers’ Compensation?
What Does Workers’ Comp Cover?
In general, workers’ compensation benefits include:
- Coverage of medical costs for work-related injuries
- Payment for rehabilitation, including physical therapy, occupational counseling, and even training for a new job
- A portion of lost wages for disability (temporary or permanent) due to workplace injuries
- Funeral and burial expenses for injuries that cause death
Benefits can be paid out in a lump sum or over time as part of a structured settlement. For injuries that lead to death, the employee’s spouse or dependents receive cash benefits for lost wages.
For additional information about benefits and settlement options, see Workers’ Compensation Benefits and Settlements.
What Doesn’t Workers’ Comp Cover?
Workers’ compensation covers most workplace injuries, but it may not cover everything. Some things that are not covered by workers’ comp include:
- Avoidable self-inflicted injuries
- Accidents due to inebriation or impediment caused by illegal drug use
- Injuries that happen off company property during a work break
- Accidents during your commute to and from work
- Injuries during optional work-sponsored social functions, such as a company picnic or holiday party
- Altercations or fights with other coworkers for reasons unrelated to work
- Noneconomic damages, such as compensation for pain and suffering, or punitive damages
Every state has different workers’ compensation laws, so some of these things may be covered in some states, while some may not be covered in other states. If you are unsure whether your claims are covered, you should talk with a lawyer to understand what workers’ compensation covers in your location.
How Does Workers’ Comp Work?
Workers’ compensation works similar to other forms of insurance:
- Employers pay the insurance premium.
- When an employee gets hurt on the job, he or she files a workers’ compensation claim.
- The workers’ comp administrator reviews and either approves or denies the claim.
- If the claim is approved, the worker will receive workers’ comp benefits, including payment for medical costs and a portion of income lost while out of work.
- If the claim is denied, the employee can appeal or even file a lawsuit to try and get the claim approved.
Specific procedures may differ from state to state. Talk to your union rep, HR contact or a worker injury lawyer to understand the process where you live.
How Much Does Workers’ Comp Pay?
Workman’s comp pays for the medical costs of work-related injuries, plus a portion of income lost while out of work. The exact amount that workers’ comp pays will depend on several factors:
- The total amount of medical expenses for treating the injury
- How much the employee makes on a regular basis
- Whether the injury causes a temporary or permanent disability
- The costs of follow-up care, including rehab, therapy or retraining
If your workers’ compensation claim for some or all of these costs is denied, you may be able to appeal or even file a lawsuit to recover out-of-pocket expenditures.
Who Pays for Workers’ Compensation?
Workers’ comp is paid for by employers. No money is taken out of employees’ paychecks for workers’ compensation premiums – though, employers generally include the cost of workers’ comp in calculating an employee’s total compensation and benefits package.
Premium amounts vary widely based on location, industry, job classification, and claims history. Some carriers also provide discounts, such as for belonging to a particular industry association.
Note that not all employers are required to provide workers’ compensation insurance for their employees. For example, some states allow exceptions for sole proprietors, small businesses with only a few employees, or those who employ domestic workers.
Can I Sue If I Get Workers’ Comp?
Workers’ compensation insurance protects employers from lawsuits over injuries that happen at work. This means that, in most cases, you will not be able to file a lawsuit against your employer if you get hurt while on the job.
However, in certain circumstances, you may still be able to file a third-party claim if someone other than your employer was at least partially responsible for the injury.