Injured at Work? How Workers’ Compensation Works
This guide is general information, not legal advice. Laws differ from state to state and change over time. For advice about your situation, talk to a licensed lawyer in your state.
If you are hurt on the job or develop an illness because of your work, workers’ compensation insurance is designed to pay your medical care and replace part of your lost income. Each state runs its own system, but the basic rules are similar across the country.
A no-fault system
Workers’ compensation is “no-fault.” You usually do not have to prove that your employer did anything wrong, and benefits are generally available even if you made a mistake that contributed to the injury. In exchange, workers’ compensation is usually your only remedy against your employer, which means you generally cannot sue your employer for the injury. There are limited exceptions in some states, such as intentional harm.
Who is covered
Most employees are covered from their first day of work. Common exceptions, which vary by state, include independent contractors, some agricultural and domestic workers, and employees of very small businesses. Being labeled an “independent contractor” does not always mean you are one. If your employer controls how and when you work, you may still be an employee.
What to do after a work injury
- Get medical care. In an emergency, go to the nearest emergency room. Some states let your employer or its insurer choose the treating doctor, at least at first.
- Report the injury in writing, right away. States set deadlines for notifying your employer, sometimes as short as a few days or 30 days. Late notice can put your claim at risk.
- File the claim. Your employer usually reports the injury to its insurer, but in many states you must also file a claim form with the state workers’ compensation agency within a set time.
- Keep records. Save medical records, work restrictions from your doctor, pay stubs, and copies of everything you send or receive.
- Follow your treatment plan. Missing appointments or ignoring restrictions can be used to reduce or stop benefits.
What benefits are available
- Medical benefits: treatment, prescriptions, therapy and related travel, usually with no copay.
- Temporary disability: partial wage replacement while you cannot work, often about two thirds of your average weekly wage, up to a state maximum.
- Permanent disability: payments if you have a lasting impairment.
- Vocational rehabilitation: in some states, help with retraining if you cannot return to your old job.
- Death benefits: support for dependents if a worker dies from a job injury or illness.
If your claim is denied
Claims are denied for reasons such as late reporting, disputes over whether the injury happened at work, or a pre-existing condition. A denial is not the final word. Every state has an appeals process, usually starting with a hearing before a workers’ compensation judge. Appeal deadlines can be short, so act quickly.
Claims against someone other than your employer
If someone other than your employer caused your injury, such as another driver, a property owner or the maker of defective equipment, you may have a separate personal injury claim against them. Unlike workers’ compensation, these claims can include pain and suffering.
Retaliation is not allowed
Most states prohibit firing or punishing an employee for reporting an injury or filing a workers’ compensation claim.
When to talk to a lawyer
Many simple claims are paid without a lawyer. It is worth getting legal help if your claim is denied, your benefits are cut off, you are offered a settlement, you have a permanent injury, or a third party may be responsible. Workers’ compensation lawyers usually work on contingency, and in many states their fees are limited by law and must be approved by the workers’ compensation agency or judge.
Find a Personal Injury lawyer near you
Browse Personal Injury lawyers on NearLawyers, or choose your state to see lawyers grouped by city. You can also search by legal issue and location from the home page. Searching and contacting lawyers through NearLawyers is free.
