FAQs

Workers' compensation is a type of insurance that provides wage replacement and medical benefits to employees who are injured in the course of employment. It serves as a safety net to ensure workers receive proper medical care and financial support while recovering from work-related injuries or illnesses.

Most states require employers to carry workers' compensation insurance to cover employees in case they get hurt on the job. (The only state that makes that insurance coverage completely optional is Texas.) This insurance policy ensures eligible workers don't have to pay medical bills for work-related injuries out of their own pocket. And if your injury forces you to stop working for long enough, you may also qualify for partial lost-wage payments. Lost-wage benefits typically don't begin until after you miss 3-7 workdays due to your injury, depending on where you live.

These benefits aren't automatic, and you don't have to sue your employer to get them. However, you must report your injury and seek medical care in a timely manner to qualify for workman's comp. Failing to take any steps required by your state's laws may make it impossible for you to get workers' comp.

No matter what state you work in, every employer's insurer has certain standard requirements for approving workers' comp benefits. These are:

You were clocked in and at your workplace at the time of your accident

The injury resulted from doing your usual job duties during scheduled work hours

You reported your injury to your employer in the time your state requires you to do so

You sought medical treatment for your injury from an approved healthcare provider

Your injury isn't self-inflicted, the result of a criminal act or refusing to follow standard OSHA safety protocols (i.e., intentionally removing earplugs, goggles, a hard hat, etc.)

Employer negligence played a role in your accident (for example, not cleaning up the wet floor you slipped and fell on)

In general, if you have medical bills and lost wages because of your injury, you likely qualify for workman's comp.

If your injury doesn't force you to stop working for several days, then it only covers your medical bills. Every state has a different waiting period, but it's usually 3-7 days off work before you'll get lost-wage payments. And while each state has its own formula to calculate those payments, it won't replace your usual paycheck. In most cases, workman's comp pays anywhere from 2/3 to ¾ of your weekly job income while you cannot work.

Here are just a few examples of injuries that seem work-related, but absolutely aren't:

1. You slip and fall on the sidewalk while walking into your job site but aren't clocked in.
2. You're visiting your workplace but not actually working when you get hurt.
3. You choke on a snack in the break room that you brought from home to eat.
4. A coworker rear-ends you while leaving the parking lot at your job.
5. A brick falls and knocks you unconscious because you took your hard hat off on a construction site.
6. You accidentally cut yourself with a steak knife during a company holiday dinner party.
7. You break your leg while roller skating at a company team-building outing.
8. A coworker brings in food for everyone working late during the holiday season and it gives you food poisoning.
9. Once a month, you're allowed to bring pets to work. A coworker's dog bites you and you need stitches.
10. A truck crashes into you while driving your company car back to the lot for the day.
11. You get into a car accident while driving a passenger around for your Uber/Lyft job. Since you're a contractor, not an employee, the rideshare company owes you nothing.
12. You and a coworker are joking around and play-fighting when you fall and break an arm.

It's always best to apply for workers' compensation within one year of your accident date. Otherwise, you may not qualify for any benefits. Here's why: 18 states have a one-year statute of limitations (that's the deadline to file your claim according to local law). In another 25 states, you have 2 years to apply for benefits. But all these deadlines won't matter if you don't report your injury as soon as possible to your employer. In some states, you have as little as 7 days from your accident to notify your employer. In others, it's closer to 30 days. So, your state's filing deadline won't matter if you don't report your injury right away!

Approved claims may qualify for up to 3 different types of workers' comp benefits. These are:

1. Medical expenses from your work injury. This covers things like doctor's visits, prescriptions, physical therapy, equipment required to treat your injury, etc.
2. Partial replacement of lost wages while you need time off work to recover. Workers' comp won't cover your whole paycheck while you're out of work due to your injury. However, it will pay about 2/3 of your usual wages, on average, after your state's required waiting period ends. (In most states, this means you must miss 3-7 days of work before you can start receiving these payments. However, those first few days off are always unpaid until you're out for 3 weeks or longer.)
3. Death benefits. Fatal work accidents are a worst-case scenario that nobody likes to think about. But if it happens to you, workers' comp will provide money to your survivors to cover your funeral and burial expenses. In most states, this compensation amount falls somewhere in the $5,000-$10,000 range.

There isn't a list of injuries that automatically qualify for workers' compensation in every state. However, if you need to see a doctor to treat your injury, that's usually enough to qualify for workers' compensation. Here are some of the most common injuries on approved workers' comp claims in the past few years:

• Strains, sprains, or tears to muscles, ligaments, or tendons
• Muscle pain, and especially back pain from things like herniated discs, sciatica, spinal injuries, or bone spurs
• Broken bones
• Cuts, puncture wounds and lacerations
• Burns (either chemical or from an actual fire)
• Repetitive motion injuries (i.e., carpal tunnel, tendonitis, bursitis)
• Concussions
• Hearing or vision loss/damage

While each state's laws are different, most follow a similar process:

1. Seek medical treatment at the closest emergency facility right away if your injury is severe or life-threatening. Be sure to tell any healthcare provider who treats your injury that it's work-related.
2. Otherwise, report your injury to your supervisor immediately and ask where you should go for medical attention. (In some states, you'll need to see an employer-approved doctor to treat your injury. Otherwise, workers' comp insurance won't cover your medical bills.)
3. Your employer should then give you a form to fill out and sign. Then, they'll return that form to either their insurance provider or the proper state authority.
4. Your employer's insurer approves or denies your request for benefits. Typically, they'll send you a letter in the mail within 14-21 days after receiving your claim paperwork.
5. If approved, workers' comp automatically covers all medical bills related to your workplace injury. You may also get partial wage-replacement benefits paid once every two weeks after your state's required waiting period ends. In most states, if you need at least a week off to recover, then you should qualify for lost-wage payments.
6. If they deny your claim, you can take certain steps to appeal that decision. Insurers deny valid workman's comp claims more often than you might think. If this happens to you, ask a WCL workers' compensation attorney to review your case for free.

No. That's called "retaliation," and it's illegal in every U.S. state.

In most states, workers' compensation insurance coverage begins on your first day of work. However, state laws may exempt certain workers that don't count as "employees" from this type of insurance coverage.

Most state laws specifically say contractors cannot qualify for workers' compensation benefits. This also applies to "gig economy" workers, such as Uber or Lyft drivers and delivery services like Instacart. Some states, however, do pay workers' comp benefits to part-time, seasonal, or temporary employees. If you're not sure whether you have coverage, ask your company's HR department or your supervisor.

It depends. Typically, anyone legally employed in the U.S. may qualify for workers' compensation, regardless of their citizenship status. This includes:

• Green card holders
• H1-B visa workers
• Certain non-resident aliens (i.e., college students from other countries studying in the U.S. or Puerto Ricans, etc.)

Many states do allow insurers to pay workers' comp if you're undocumented and have an on-the-job injury accident. However, workman's comp may be hard to impossible to get for undocumented people working in the following states:

• Alaska
• Delaware
• Florida
• Georgia
• Indiana
• Maine
• Michigan
• Missouri
• Nebraska
• Rhode Island
• South Dakota
• Vermont
• Washington
• West Virginia
• Wyoming

Once your employer's insurer approves your claim, then your medical benefits start immediately. Medical benefits pay for things like your doctor's visits, prescriptions, physical therapy, etc. Those payments go directly to your healthcare provider(s), so you won't see them.

If you miss enough work due to your injury, your wage-loss benefits begin after your state's required waiting period ends. In most states, you need to miss 3-7 work shifts before you can qualify for lost-wage benefits. Most states won't pay for those required "waiting period" days until you're out of work for 3 weeks or longer.

It's extremely hard to impossible in most states to get workers' comp for mental health-related conditions. Some states, however, do accept workman's comp claims from first responders who develop PTSD on the job, including:

• California
• Connecticut
• Idaho
• Louisiana
• Nevada
• New Hampshire
• New Mexico
• Oregon
• Texas

Employees who regularly deal with traumatic events as part of their job duties may qualify for workers' compensation in Colorado. In other words, Colorado's rule applies to any worker in that state applying for workman's comp, not just first responders.

No. The only way to get money for pain and suffering is to sue your employer. Workers' compensation laws exist in every U.S. state so injured workers can receive benefits without suing their employers. If you accept workers' compensation for a workplace injury, then you automatically waive your right to sue your employer. And the only state that doesn't require employers to carry workers' compensation insurance is Texas. So, if you work for an employer in Texas who doesn't carry workers' compensation insurance, you may file a lawsuit.

No. Workers' compensation doesn't count harassment as a work injury in any U.S. state. However, it's a great reason to consult an employment attorney for free about your case!

WCL can try to match you with a work injury lawyer who's available to help right away! To get started, fill out this free claim evaluation form to see if you may qualify. You can also call 1-800-614-0044 to speak with someone right away. If you do qualify for legal assistance, then a qualified local attorney will call you as soon as possible the next business day.

Some workplace injury accidents are serious enough to limit your ability to perform everyday life activities, not just your job. When something like this happens, doctors that work for your employer's insurance company will write up a detailed medical report. This report shows the extent of your permanent disability and how much your work-related injury contributed to it.

Then, that same doctor uses a specific formula to calculate a "percentage of disability" based on your:

• Current occupation
• Hourly pay rate or annual salary
• Age at the time of your workplace accident
• How much future earning capacity you lost specifically due to your disabling injury
• Whether anything other than your work injury played a role in your permanent disability

In at least 40 out of 50 states, doctors use one authoritative source to calculate workers' comp permanent disability awards. That source is the most current edition of the American Medical Association's Guide to the Evaluation of Permanent Impairment. Once the doctor completes the formula in evaluating your work injury, that percentage determines your permanent disability award. Since state guidelines set specific dollar amounts for these awards, where you work determines how much money you can receive.

Attorneys that specialize in work injury claims charge no money up front. They only ask for a percentage of your final settlement award as payment. If your case doesn't win, then you pay $0 in legal fees. And if you do win, then state laws limit how much of a percentage that your attorney can charge. This percentage ranges from 10% for less complicated cases to no more than 25% in any U.S. state. You can sign up for a free, no-obligation claim review with a local attorney before deciding to do anything else.

No employer can force an employee to take a drug test simply because they apply for workers' comp. Instead, your employer must strongly suspect drugs or alcohol are the reason why your work injury occurred. But if your employer already requires random drug and alcohol tests for all employees, it's not totally out of line. Federal rules require certain workers to pass random drug tests (i.e., pilots, school bus drivers, air traffic controllers, etc.). If your employer demands a drug test after your work injury accident, it may not be legal. Consulting an attorney for free who understands how your state's laws apply to your case is always a smart move!

No, there are plenty of times when you won't need a lawyer to get workers' compensation. But there are also times when you're much more likely to get the benefits you need with legal representation. Always consult a workers' comp lawyer if any of these apply to your case:

• Your boss fired you for refusing a drug or alcohol test after your accident.
• You have pre-existing health conditions that make it harder to prove your claim.
• The workers' comp doctor and your own physician disagree about your treatment.
• Another person is at least partially responsible for your injury (i.e., a coworker or customer assaults you at work).
• Your employer refuses to file required paperwork or their insurer denies your claim.
• The injury accident leaves you permanently unable to work full-time. It doesn't matter if you're partially or totally disabled, now is the time to lawyer up!
• You lose your job shortly after your accident and you believe it's because you applied for workers' comp benefits.
• The employer's insurer offers you too little money to cover all your medical expenses.

This rarely happens, so no, probably not. Lawyers settle most cases like these directly with insurers. Some states may require you to take the additional step of going through arbitration for appealed workers' comp cases.

Unfortunately, no. WCL has no workman's comp lawyers in our network that can review cases involving federal employees.

If your injury doesn't force you to miss at least 3 work shifts, you may only qualify for medical benefits. In cases like this, that means all payments from your approved workers' comp claim go directly to your healthcare provider(s).

Worker's comp only pays lost-wage benefits to people who are out of work longer than their state's required waiting period. For most people, that doesn't start until after 3-7 days of missed work due to your injury accident. Once that state-required waiting period passes, then yes, you should get partial wage replacement payments. But if you need less than 3 days off to recover, then workers' comp only pays for your medical bills.

Every state has a different time limit for how long you can receive workers' compensation. It also depends on the type of lost-wage benefits your employer's insurer pays you. For example: Temporary total disability (TTD) workers' comp payments max out at 104 weeks (2 years) in some states. Other states will give you TTD payments for up to 500 weeks (nearly 10 years).

Permanent partial disability (PPD) benefits may last longer, or your state may force you to apply for federal disability benefits. Since these laws change constantly, we suggest checking with your HR department, supervisor, or your state's workers' compensation division.

There are many reasons why someone might not qualify for legal help. Here are some examples:

1. Your state's statute of limitations already expired. That means legally, it's not possible for anyone to help you with your workers' comp claim.
2. Another lawyer already accepted or rejected your case. Why does this matter? First, if another lawyer's already helping you, you signed some paperwork to hire that attorney. So even if you fire your lawyer, they still get a percentage of your settlement. If no settlement happens, you'll pay fees out of your pocket. So, the second lawyer would have to split those fees with your first attorney. Second, if another lawyer already reviewed and rejected your case, then they don't believe you'll win in court. Since most attorneys work on contingency, they won't get paid unless your claim is successful. So, our attorneys wouldn't want to take on clients they don't think can win.
3. Your injury isn't work-related. You must be at your job site, clocked in, and performing your usual work duties when the injury occurs.
4. You didn't seek treatment, have any doctor's bills, or miss any days at work due to your injury. Workman's comp pays for three things: Your medical expenses, lost wages from taking time off for your injury, and burials. If you didn't see a doctor, miss work, or pass away, you have no eligible expenses workers' comp can cover.
5. We have no workman's comp attorneys near where you live who are available to review your claim. Our national network of law firms doesn't include every lawyer who specializes in work injury claims. So, you could potentially have another local attorney review your case, even though WCL couldn't match you with one.

No. Insurance industry studies show even in states with the highest attorney fees, your payout will be much higher. If you pay your attorney the national average of 15%, you'll receive at least 3x more money after legal fees. Even if you pay the highest possible fee (25%), you'll still get 266% more money when you settle. In other words, you'll get less than $20k, on average, if you settle directly with insurance providers. Attorneys can always get you the max settlement amount allowed under your state's workers' compensation laws. In most cases, that's between 2.5-4x more money than insurers will offer you if you don't have a lawyer.

Maybe. If you go back to light-duty work or with job restrictions while receiving workers' compensation, then yes. Here's another scenario where workers' comp becomes taxable income: You start receiving disability benefits from the Social Security Administration. If you receive either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) payments and workers' comp, you will owe some taxes.

If you pass away and your survivors receive a workers' compensation settlement, they will not owe taxes on that income.

First, talk to your supervisor or your employer's human resources department. If you're getting workers' comp payments while on "light duty" work (or similar), quitting means all your income stops immediately. You may earn less now with your current job restrictions, but you'll lose that smaller paycheck. In addition, your workers' comp payments end as soon as you no longer work for that employer. So, see if you can negotiate something else with your employer before you take this drastic step. Here are some things you can try:

1. Ask about paid and unpaid options for additional time off to recover. This may include using your PTO, short-term disability (if that's part of your benefits package) or taking unpaid FMLA leave.
2. Schedule a follow-up appointment with your workers' comp doctor to reevaluate your injury. If your job makes your injury worse, that doctor may provide new evidence to your employer's insurance provider. This may be enough to get you additional workers' comp payments and more time off.
3. Ask your supervisor about reducing or temporarily stopping certain job tasks that worsen your injury. If you hurt your back and can't lift heavy objects, for example, can you stop lifting anything for a month? It can't hurt to bring it up!