Workers' compensation is a state-mandated insurance program that provides benefits to employees who suffer job-related injuries and illnesses. Each state has its own laws and programs for workers' compensation. The federal government also has a separate workers' comp program, mostly for federal employees. For up-to-date information on workers' comp in your state, contact your state's workers' compensation office. (You can find links to the appropriate office in your state on the State Workers' Compensation Officials page of the U.S. Department of Labor's website.)
In general, an employee with a work-related illness or injury can get workers' compensation benefits regardless of who was at fault—the employee, the employer, a coworker, a customer, or some other third party. But there are some limits (discussed below).
No. As long as your injury is job-related, it's covered. For example, you will be covered if you are injured while traveling on business, doing a work-related errand, or even attending a required business-related social function. Learn more about what does and doesn't count as a work-related injury or illness.
Workers' compensation covers most work-related injuries—but not all. Generally, workers' comp doesn't cover injuries that happen because an employee is intoxicated or using illegal drugs. Coverage may also be denied in situations involving:
Your injury need not be caused by an accident—such as a fall from a ladder—to be covered by workers' compensation. Many employees receive compensation for injuries resulting from overuse or misuse over a long period of time, such as repetitive stress injuries or chronic back problems. You may also receive benefits for some illnesses and diseases that are the gradual result of work conditions, such as heart conditions, lung disease, and stress-related digestive problems.
Workers' comp does pay hospital and medical expenses that are necessary to diagnose and treat your injury. But it also provides disability payments while you are unable to work (typically, about two-thirds of your regular salary). Depending on the state and the injury, it may also pay for rehabilitation, retraining, and other benefits. See more on types of workers' comp benefits.
No. First of all, not all employers are required to have workers' compensation coverage. State laws vary, but an employer's responsibility to provide coverage usually depends on how many employees it has, what type of business it is, and what type of work the employees are doing. Second, every state excludes certain types of workers. Although these exclusions vary, they often include farm workers, domestic employees, and seasonal or casual workers. Learn more about eligibility requirements for workers' comp benefits.
States have different rules about who gets to choose the treating doctor in workers' comp cases. In some states, you have a right to see your own doctor. Other states require that you request this in writing before the injury occurs. More typically, however, an injured worker must—at least initially—go to a doctor or medical provider network that the employer designates.
Your treating doctor's report will have a big impact on the benefits you receive. (Learn more about the role of treating doctors in workers' comp cases.) Keep in mind that doctors who are paid by employers or insurance companies may have a conflict of interest. For instance, that business relationship may motivate some company doctors to minimize the seriousness of an injury or to identify it as a preexisting condition.
Depending on the rules in your state, you might be able to change treating doctors in your workers' comp case if you're unhappy with the one you were sent to or chose on your own.
Maybe. In some states and under some circumstances—including when your employer doesn't have workers' comp insurance or caused your injury intentionally or through gross recklessness—you may be able to sue outside of the workers' comp system for a full range of damages, including punitive damages, pain and suffering, and mental anguish.