What is workers compensation?
Workers compensation (workers comp) is a state-mandated insurance program that covers employees who are injured or become ill because of their job. In exchange for these guaranteed benefits, injured workers generally cannot sue their employer in court for negligence — this is called the "exclusive remedy" rule.
Workers comp covers:
- Medical treatment — all reasonable and necessary medical care related to your injury, including surgery, physical therapy, prescriptions, and future care
- Temporary disability — wage replacement (typically 60-70% of your pre-injury wages) while you cannot work
- Permanent disability — a lump sum or ongoing payments if your injury leaves you with lasting limitations
- Vocational rehabilitation — job retraining if you cannot return to your old job
- Death benefits — payments to dependents if a worker dies from a work-related injury or illness
Common workplace injuries that qualify
- Slip and fall injuries on job sites, in warehouses, or in offices
- Repetitive stress injuries (carpal tunnel, tendinitis) from repetitive job tasks
- Back and neck injuries from lifting, falls, or vehicle accidents on the job
- Construction accidents — falls from height, equipment injuries, scaffold collapses
- Burns, chemical exposure, and electrocution
- Occupational diseases — asbestosis, mesothelioma, hearing loss, respiratory conditions
- Car and truck accidents that happen while you are driving for work
- Mental health conditions (in some states) caused by work-related trauma
What benefits can you receive?
| Benefit Type | What It Covers | Typical Amount |
|---|---|---|
| Medical benefits | All treatment related to the injury | 100% of reasonable costs |
| Temporary total disability | Lost wages while completely unable to work | 60-70% of pre-injury wages |
| Temporary partial disability | Lost wages while working light duty at lower pay | Difference between old and new earnings |
| Permanent partial disability | Lasting impairment that limits (but does not eliminate) work ability | Based on impairment rating and state formula |
| Permanent total disability | Unable to work at all, permanently | Lifetime benefits in some states |
| Vocational rehab | Retraining for different work | State-funded programs |
| Death benefits | Surviving spouse and dependents | Percentage of deceased wages |
When should you hire a workers comp attorney?
Many straightforward claims — a cut finger, a minor sprain — do not require an attorney. But in the following situations, legal help significantly improves your outcome:
- Your claim is denied. Insurers deny a substantial portion of claims. An attorney knows how to appeal and what evidence to present.
- Your benefits are delayed or cut off. Insurers sometimes stop paying without warning. An attorney can challenge this quickly.
- Your injury is serious — surgery, permanent disability, long recovery.
- You disagree with the doctor's rating. The employer's doctor often minimizes your impairment. An attorney can challenge their assessment.
- Your employer is claiming the injury is not work-related.
- You have a pre-existing condition that the employer is using to limit your benefits.
- You want to settle and need to evaluate whether the lump sum offer is fair.
- There may be a third-party claim. If someone other than your employer caused your injury (a contractor, a driver, a product manufacturer), you may be able to sue them directly — and collect workers comp AND a civil settlement.
The difference between workers comp and a personal injury lawsuit
Workers comp is "no-fault" — you do not have to prove your employer was negligent. But the benefits are capped. A personal injury lawsuit can recover unlimited pain and suffering, but you must prove negligence. The two are not mutually exclusive in the right circumstances:
- If a third party (a vendor, contractor, driver, equipment manufacturer) caused your injury, you can file workers comp against your employer AND a personal injury lawsuit against the third party.
- If your employer was intentionally harmful or committed fraud, some states allow you to step outside the workers comp system entirely.
Important deadlines — do not miss these
Workers comp deadlines vary by state but failure to meet them can end your claim:
- Report the injury to your employer — typically within 30 days of the injury, though some states give you only 7 to 10 days for certain injury types
- File a formal claim — typically 1 to 3 years from the date of injury or discovery of illness
- Appeal a denial — deadlines for appealing a denied claim vary widely, some as short as 30 days
Report your injury in writing to your employer as soon as possible. Keep a copy. Verbal reports can be disputed later.
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Related Guides
Workers Comp Claim Denied? Here Is What to Do
Why claims get denied and how to fight back.
How Much Is a Workers Comp Case Worth?
Benefit formulas, impairment ratings, and lump sum settlements explained.
Can You Sue Your Employer for a Workplace Injury?
When workers comp is your only option — and when it is not.
Independent Medical Exams: What Workers Need to Know
How IMEs work and how to protect yourself from a biased report.
Third-Party Claims After a Workplace Injury
How to collect both workers comp AND a personal injury settlement.
Workers Compensation FAQ
Can my employer fire me for filing a workers comp claim?
Firing an employee for filing a workers comp claim is illegal retaliation in every state. If this happens to you, you may have both a workers comp claim and a wrongful termination lawsuit. Document everything and contact an employment attorney immediately.
What if my employer says the injury is my fault?
Workers comp is a no-fault system — your own negligence does not bar your claim in most cases. The main exceptions are: intentional self-injury, being under the influence of drugs or alcohol, and injuries that happened during horseplay or a fight you started. Most on-the-job injuries are covered regardless of fault.
How much do workers comp attorneys charge?
Workers comp attorneys typically charge a contingency fee of 10-20% of any settlement or award, which is often capped by state law. In many states, the attorney fee must be approved by the workers comp board. You pay nothing upfront.
What if my workers comp claim is denied?
A denial is not the end. You have the right to appeal. In most states, the process involves a hearing before a workers compensation judge. Having an attorney at this stage significantly improves your chances — studies show represented workers recover substantially more than unrepresented workers.
Can I choose my own doctor for workers comp treatment?
This varies by state. Some states allow you to choose any doctor. Others require you to treat with a doctor from the employer's or insurer's approved network, at least initially. An attorney can advise you on your state's rules and help you challenge restrictions that are limiting your care.
What is an independent medical examination (IME)?
An IME is an examination ordered by the employer's insurer — done by a doctor they choose — to evaluate your injury and limitations. These doctors often minimize impairment ratings to reduce the insurer's liability. You have the right to have your own doctor perform a counter-examination. An attorney can help you challenge an IME report.